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Izquierdo L, Imken FC, Larco P, Chauca J, Henriquez MA. Comparison of the Biometric Characteristics After Long-term Implantation of Iris-fixated Phakic Intraocular Lens in Explanted and Nonexplanted Groups of Eyes. Am J Ophthalmol 2024; 265:54-60. [PMID: 38395331 DOI: 10.1016/j.ajo.2024.02.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Revised: 02/08/2024] [Accepted: 02/10/2024] [Indexed: 02/25/2024]
Abstract
PURPOSE To evaluate and compare the biometric characteristics of the anterior chamber of a group of patients with significant endothelial cell loss (ECL) who required phakic intraocular lens (pIOL) explantation and a group of patients who did not fulfill the explantation criteria related to corneal decompensation. DESIGN Retrospective, consecutive, interventional case series. METHODS The study included all consecutive patients receiving a pIOL implantation at Oftalmosalud Instituto de Ojos, Lima, Peru, between 2001 and 2012. The explanted group (E group) consisted of eyes in which the pIOLs were explanted due to ECL, and the nonexplanted group (NE group) consisted of eyes randomly selected in which the pIOL was not explanted with a minimum follow-up time of 8 years. Slit-lamp biomicroscopy, visual acuity, refraction, endothelial cell count, and anterior segment optical coherence tomography were assessed at the preoperative evaluation for both groups and before explantation in the E group and 8 years post-implantation in the NE group. RESULTS pIOLs were implanted in 265 eyes. The annual percentage of ECL was 1.47% and 5.55% in the NE group and E group, respectively (P < .001). The mean minimum endothelial lens distance (ELD) was 1.44 ± 0.22 mm and 1.05 ± 0.23 mm in the NE group and E group, respectively (P < 0.001). The mean time for explantation was 12.58 ± 3.79 years for the E group. Annual ECL could accurately discriminate between the NE group and E group; a cutoff point of 3.5 (%/year) or 86.5 (cells/years) had a 100% sensitivity and specificity. A cutoff of 1.21 mm in the minimum ELD has a 91% sensitivity and 79% specificity to discriminate between the E group and NE group. CONCLUSIONS pIOL explantation due to ECL occurs in eyes with a significantly postoperative lower minimum ELD. Annual ECL and minimum ELC can effectively discriminate between the E and NE groups.
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Affiliation(s)
- Luis Izquierdo
- From the Research Department, Oftalmosalud Institute of Eyes, Lima, Perú (L.I., F.C.I. P.L., M.A.H.); Universidad Nacional Mayor de San Marcos, Lima, Perú (L.I.)
| | - Fiorella Casanova Imken
- From the Research Department, Oftalmosalud Institute of Eyes, Lima, Perú (L.I., F.C.I. P.L., M.A.H.)
| | - Pablo Larco
- From the Research Department, Oftalmosalud Institute of Eyes, Lima, Perú (L.I., F.C.I. P.L., M.A.H.)
| | - Jose Chauca
- Department of Statistics, Demography, Humanities and Social Sciences, Universidad Peruana Cayetano Heredia, Lima, Perú (J.C.)
| | - Maria A Henriquez
- From the Research Department, Oftalmosalud Institute of Eyes, Lima, Perú (L.I., F.C.I. P.L., M.A.H.); From the Research Department, Oftalmosalud Institute of Eyes, Lima, Perú (L.I., F.C.I. P.L., M.A.H.).
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Pors LJ, Haasjes C, van Vught L, Hoes NP, Luyten GPM, van Rijn GA, Vu THK, Rasch CRN, Horeweg N, Beenakker JWM. Correction Method for Optical Scaling of Fundoscopy Images: Development, Validation, and First Implementation. Invest Ophthalmol Vis Sci 2024; 65:43. [PMID: 38271188 PMCID: PMC10829800 DOI: 10.1167/iovs.65.1.43] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Accepted: 12/28/2023] [Indexed: 01/27/2024] Open
Abstract
Purpose Although fundus photography is extensively used in ophthalmology, refraction prevents accurate distance measurement on fundus images, as the resulting scaling differs between subjects due to varying ocular anatomy. We propose a PARaxial Optical fundus Scaling (PAROS) method to correct for this variation using commonly available clinical data. Methods The complete optics of the eye and fundus camera were modeled using ray transfer matrix formalism to obtain fundus image magnification. The subject's ocular geometry was personalized using biometry, spherical equivalent of refraction (RSE), keratometry, and/or corneal topography data. The PAROS method was validated using 41 different eye phantoms and subsequently evaluated in 44 healthy phakic subjects (of whom 11 had phakic intraocular lenses [pIOLs]), 29 pseudophakic subjects, and 21 patients with uveal melanoma. Results Validation of the PAROS method showed small differences between model and actual image magnification (maximum 3.3%). Relative to the average eye, large differences in fundus magnification were observed, ranging from 0.79 to 1.48. Magnification was strongly inversely related to RSE (R2 = 0.67). In phakic subjects, magnification was directly proportional to axial length (R2 = 0.34). The inverse relation was seen in pIOL (R2 = 0.79) and pseudophakic (R2 = 0.12) subjects. RSE was a strong contributor to magnification differences (1%-83%). As this effect is not considered in the commonly used Bennett-Littmann method, statistically significant differences up to 40% (mean absolute 9%) were observed compared to the PAROS method (P < 0.001). Conclusions The significant differences in fundus image scaling observed among subjects can be accurately accounted for with the PAROS method, enabling more accurate quantitative assessment of fundus photography.
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Affiliation(s)
- Lennart J. Pors
- Department of Radiation Oncology, Leiden University Medical Center, Leiden, the Netherlands
- Department of Ophthalmology, Leiden University Medical Center, Leiden, the Netherlands
| | - Corné Haasjes
- Department of Radiation Oncology, Leiden University Medical Center, Leiden, the Netherlands
- Department of Ophthalmology, Leiden University Medical Center, Leiden, the Netherlands
- Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Luc van Vught
- Department of Ophthalmology, Leiden University Medical Center, Leiden, the Netherlands
- Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Noor P. Hoes
- Department of Ophthalmology, Leiden University Medical Center, Leiden, the Netherlands
| | | | - Gwyneth A. van Rijn
- Department of Ophthalmology, Amsterdam University Medical Center, Amsterdam, the Netherlands
- Department of Ophthalmology, Northwest Clinics, Alkmaar, the Netherlands
| | - T. H. Khanh Vu
- Department of Ophthalmology, Leiden University Medical Center, Leiden, the Netherlands
| | - Coen R. N. Rasch
- Department of Radiation Oncology, Leiden University Medical Center, Leiden, the Netherlands
| | - Nanda Horeweg
- Department of Radiation Oncology, Leiden University Medical Center, Leiden, the Netherlands
- Department of Ophthalmology, Leiden University Medical Center, Leiden, the Netherlands
| | - Jan-Willem M. Beenakker
- Department of Radiation Oncology, Leiden University Medical Center, Leiden, the Netherlands
- Department of Ophthalmology, Leiden University Medical Center, Leiden, the Netherlands
- Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands
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Royo M, Jiménez Á, Piñero DP. Long-term safety and efficacy of a foldable iris-fixated phakic intraocular lens for the correction of myopia. Int Ophthalmol 2023; 43:4491-4502. [PMID: 37589863 PMCID: PMC10724334 DOI: 10.1007/s10792-023-02850-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 08/03/2023] [Indexed: 08/18/2023]
Abstract
PURPOSE To analyze and report the long-term outcomes in terms of efficacy and safety of eyes implanted with the spherical version of a foldable iris-fixated phakic intraocular lens (pIOL) for the correction of myopia. METHODS Retrospective analysis of the results of 56 eyes of 32 patients (age, 19-45 years) who underwent implantation of the spherical model of the Artiflex pIOL (Ophtec B.V., Groningen, The Netherlands) for the correction of myopia. Visual, refractive, biometric, intraocular pressure (IOP) and corneal endothelial changes were evaluated during a long-term follow-up: 2, 7, 10 and 12 years for more than 50, 30, 20 and 10 eyes, respectively. RESULTS At 4 weeks postoperatively, a significant reduction of manifest sphere and spherical equivalent (SE), with a significant improvement of uncorrected distance visual acuity were found (all p < 0.001). No significant changes were found during the rest of follow-up in sphere (p ≥ 0.072). The percentage of eyes with SE within ± 1.00 D was over 83% during the whole follow-up. A non-significant trend to IOP increase was observed at 4 weeks postoperatively (p = 0.530), with a significant reduction at 1 year after (p = 0.039) and no significant changes during the rest of follow-up (p = 0.180). There was a significant reduction of anterior chamber depth at 4 weeks after surgery (p < 0.001), with no significant changes during the following 9 years of follow-up (p = 0.118). However, an additional significant decrease of this parameter was observed between 10 and 13 years after surgery (p = 0.027). Mean endothelial cell loss changed from 2.01 ± 4.49% at 4 weeks after surgery to 9.11 ± 2.24% at the end of the follow-up. No complications were reported during the follow-up. CONCLUSIONS Myopia correction with the Artiflex pIOL is an effective and safe procedure in the long term.
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Affiliation(s)
- Mariano Royo
- Department of Ophthalmology, San Rafael Hospital, Madrid, Spain
- Instituto Oftalmológico de Madrid, Madrid, Spain
| | - Ángel Jiménez
- Department of Ophthalmology, San Rafael Hospital, Madrid, Spain
- Instituto Oftalmológico de Madrid, Madrid, Spain
| | - David P Piñero
- Department of Optics, Pharmacology and Anatomy, University of Alicante, Crta San Vicente del Raspeig S/N 03016, San Vicente del Raspeig Alicante, Alicante, Spain.
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