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Coc IR, Armstrong BK, Qadha K, Pennington N, John TLS, Kanwar O, Navon SE. Evaluation of ciliary body cysts in candidates for phakic lens implantation. Int Ophthalmol 2024; 44:402. [PMID: 39365361 PMCID: PMC11452535 DOI: 10.1007/s10792-024-03320-5] [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: 05/22/2024] [Accepted: 09/26/2024] [Indexed: 10/05/2024]
Abstract
PURPOSE Phakic lens implantation in the ciliary sulcus of the eye can be complicated by coincident ciliary body cysts (CBC). We developed an ultrasound imaging and mapping protocol for these cysts. METHODS This is a retrospective case series of all patients who underwent ICL workup at a single institution from April 2015 to October 2019. A standardized ultrasound biomicroscopy (UBM) imaging protocol was developed to screen for CBCs in either the ciliary body or sulcus. The locations and dimensions of all CBCs were graphically represented. RESULTS The prevalence of CBCs in 158 patients undergoing ICL workup was 34.8%. Among the 159 CBCs detected in 55 patients, 83 were in the sulcus (52%) and 76 were restricted to the ciliary body (48%). ICLs were implanted in 40 eyes with CBCs and 3 eyes with CBCs located within the sulcus horizontally required ICL repositioning due to ICL rotation or iris chafing. CONCLUSION CBCs were incidentally found in 34.8% of patients undergoing ICL workup. ICL implantation was complicated in 3 of the eyes with CBCs in the horizontal sulcus. Although CBCs are not an absolute contraindication for ICL surgery, we recommend preoperative UBM screening of the ciliary sulcus.
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Affiliation(s)
- Ivana Romac Coc
- Eye Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates.
- Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Cleveland, OH, USA.
| | | | - Khalid Qadha
- Eye Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates
| | - Natalya Pennington
- Eye Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates
| | - Terrence Lee St John
- Research Department, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates
| | - Oshin Kanwar
- Research Department, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates
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Wu H, Wang Z, Wang P, Meng Y, Wang Z, Xue Y, Jiang B, Pan S, Yan Z. Repeatability and Agreement of Central Vault for Implantable Collamer Lens Obtained by the Tomey OA-2000 Biometer and Spectralis OCT. J Ophthalmol 2024; 2024:3684626. [PMID: 38957378 PMCID: PMC11217569 DOI: 10.1155/2024/3684626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 04/04/2024] [Accepted: 06/15/2024] [Indexed: 07/04/2024] Open
Abstract
Objective To assess repeatability and agreement of central vault for implantable collamer lens (ICL) measured by the Tomey OA-2000 biometry and Spectralis optical coherence tomography (OCT). Methods In this prospective study, the central vault was measured by the Tomey OA-2000 biometer and Spectralis OCT in 84 eyes (43 patients) after ICL implantation at six month follow-up. Three consecutive scans were obtained by one experienced technician using Tomey OA-2000 and the Spectralis OCT in the same day. The coefficient of variation (CoV), intraclass correlation coefficient (ICC), within-subject standard deviation (Sw), and 2.77 Sw were calculated to assess the repeatability and reproducibility. The paired t-test and Bland-Altman plots were used to analyze the differences and agreements of central vault measured by two devices. Results Repeatability of the central vault measured by Tomey OA-2000 biometer and Spectralis OCT showed that the CoV was 2.71% and 1.66%, respectively. The ICC for both devices was 0.996 and 0.999, respectively. The paired t-test showed that central vault measured by Tomey OA-2000 biometer was -7.25 ± 23.57 microns lower than that measured by Spectralis OCT (P = 0.006). The mean difference between measurements for Tomey OA-2000 and ASM-OCT with 95% limits of agreement (LoAs) was -38.94 to 53.44 μm. Conclusion Both Tomey OA-2000 biometer and Spectralis OCT displayed good repeatability for the measurement of central vault of ICL. Good reliability and agreement were observed between Tomey OA-2000 biometer and Spectralis OCT. Both instruments are useful but not replaced each other for central vault measurements.
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Affiliation(s)
- Hao Wu
- Department of OphthalmologyBengbu First People's Hospital, 229 Tushan Road, Bengbu 233000, China
- Department of OphthalmologyThe Third Hospital of Hebei Medical University, 139 Ziqiang Road, Shijiazhuang 050000, China
| | - Zuocheng Wang
- School of ManagementShijiazhuang Tiedao University, Shijiazhuang 050043, China
| | - Pengfei Wang
- Department of OphthalmologyThe Third Hospital of Hebei Medical University, 139 Ziqiang Road, Shijiazhuang 050000, China
| | - Yifei Meng
- Department of OphthalmologyThe Third Hospital of Hebei Medical University, 139 Ziqiang Road, Shijiazhuang 050000, China
| | - Zengying Wang
- Department of OphthalmologyThe Third Hospital of Hebei Medical University, 139 Ziqiang Road, Shijiazhuang 050000, China
| | - Yuhong Xue
- Department of OphthalmologyThe Third Hospital of Hebei Medical University, 139 Ziqiang Road, Shijiazhuang 050000, China
| | - Bohua Jiang
- Department of OphthalmologyThe Third Hospital of Hebei Medical University, 139 Ziqiang Road, Shijiazhuang 050000, China
| | - Shuaixi Pan
- Department of OphthalmologyThe Third Hospital of Hebei Medical University, 139 Ziqiang Road, Shijiazhuang 050000, China
| | - Zhipeng Yan
- Department of OphthalmologyThe Third Hospital of Hebei Medical University, 139 Ziqiang Road, Shijiazhuang 050000, China
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Alfonso-Bartolozzi B, Fernández-Vega-Cueto L, Lisa C, Palacios A, Madrid-Costa D, Alfonso JF. Ten-year follow-up of posterior chamber phakic intraocular lens with central port design in patients with low and normal vault. J Cataract Refract Surg 2024; 50:441-447. [PMID: 38085219 DOI: 10.1097/j.jcrs.0000000000001379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 12/05/2023] [Indexed: 04/24/2024]
Abstract
PURPOSE To assess the clinical outcomes and postoperative complications of the implantable collamer lens (ICL) with a central port throughout 10 years of follow-up in patients with low and normal vault. SETTING Fernández-Vega Ophthalmological Institute, Oviedo, Spain. DESIGN Retrospective and comparative case series. METHODS This study included eyes that underwent a V4c ICL implantation with 10 years of follow-up. The eyes were divided into 2 groups according to the vault at 1 year postoperatively: vault <250 μm and between 250 μm and 800 μm. Uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), intraocular pressure (IOP), endothelial cell density (ECD), vault, complications, and secondary surgeries were analyzed. RESULTS 37 and 90 eyes were enrolled in the low and normal-vault groups, respectively. No differences in UDVA, CDVA, and refraction were found between the groups over 10 years of follow-up. No cases developed ICL-induced anterior subcapsular opacity over the follow-up period. 2 (5.4%) and 8 (8.9%) eyes in the low and normal-vault groups, respectively, required ICL exchange. 1 (2.8%) and 2 (2.2%) eyes in the low and normal-vault groups, respectively, required excimer laser to correct residual refractive error. The IOP remained stable throughout the 10-year follow-up. The loss in ECD from that preoperatively to 10 years postoperatively was 3.8% and 4.5% in the low and normal-vault groups, respectively ( P = .4). No pigment dispersion glaucoma or other vision-threatening complications were reported. CONCLUSIONS This study shows good long-term outcomes of the V4c ICL, supporting that the central hole provides safety to the procedure and prevents the potential risk associated with low vault.
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Affiliation(s)
- Belén Alfonso-Bartolozzi
- From the Fernández-Vega Ophthalmological Institute, Oviedo, Spain (Alfonso-Bartolozzi, Fernández-Vega-Cueto, Lisa, Palacios, Alfonso); Clinical and Experimental Eye Reseach Group, Faculty of Optics and Optometry, Universidad Complutense de Madrid, Madrid, Spain (Madrid-Costa)
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Reinstein DZ, MacGregor C, Archer TJ, Gupta R, Potter JG. A review of posterior chamber phakic intraocular lenses. Curr Opin Ophthalmol 2024; 35:138-146. [PMID: 38059758 DOI: 10.1097/icu.0000000000001018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/08/2023]
Abstract
PURPOSE OF REVIEW Posterior chamber phakic intraocular lenses (pIOLs) are increasing in popularity as a viable alternative to laser refractive surgery. The purpose of this review is to evaluate the recent updates to pIOLs and to assess the advancements and safety of the procedure. RECENT FINDINGS Accurate lens sizing is the key determinant to suitable vault prediction, advancements to sizing formulae including the use of very high frequency (VHF) digital ultrasound and the application of artificial intelligence and machine learning has led to improved vault prediction and safety. The introduction of the central aquaport has been shown to reduce the formation of cataract and is now adopted in most myopic pIOLs. Recently published studies have demonstrated that pIOLs have an excellent safety profile with no increased risk of retinal detachment or endothelial cell loss. Advancements have led to the introduction of extended depth of focus pIOLs for the correction of presbyopia, further research is required to evaluate the efficacy of new lens designs. SUMMARY pIOL surgery is experiencing traction with improved lens design and increased lenses choices such as larger optical zone and presbyopic options. Accuracy of implantable collamer lens sizing is paramount to the safety and clinical outcomes, greater predictability is likely to encourage more posterior chamber pIOL users due to fewer sizing related complications.
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Affiliation(s)
- Dan Z Reinstein
- Reinstein Vision
- London Vision Clinic, EuroEyes Group, London, UK
- Columbia University Medical Center, New York, USA
- Sorbonne Université, Paris, France
- Biomedical Science Research Institute, Ulster University, Coleraine, UK
| | | | - Timothy J Archer
- Reinstein Vision
- London Vision Clinic, EuroEyes Group, London, UK
| | - Ruchi Gupta
- Reinstein Vision
- London Vision Clinic, EuroEyes Group, London, UK
| | - Joseph G Potter
- Reinstein Vision
- London Vision Clinic, EuroEyes Group, London, UK
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Chang W, Niu L, Zhou X, Wang X, Yu Z, Qian Y. Risk factors associated with haptic malposition in eyes implanted with implantable collamer lenses. J Cataract Refract Surg 2024; 50:276-282. [PMID: 38031330 PMCID: PMC10878456 DOI: 10.1097/j.jcrs.0000000000001368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 11/09/2023] [Accepted: 11/11/2023] [Indexed: 12/01/2023]
Abstract
PURPOSE To examine the risk factors for haptic malposition in eyes with implantable collamer lens (ICL). SETTING Eye and ENT Hospital, Fudan University, Shanghai, China. DESIGN Prospective nonrandomized observational study. METHODS This study included 134 (77.9%) of 172 initially enrolled patients who underwent ICL implantation and completed a 1-year follow-up. The extent of haptics present in the ciliary sulcus (ICS) was measured. Patients were categorized based on ICS count (0 to 4). The position of the haptics was quantified as the distance between the iris root and the terminal tip of ICL haptics (iris root to haptic tip, IRH). The related factors to the ICS count and its correlation with the central vault were analyzed. RESULTS ICS distribution was 0 ICS in 19 eyes (14.2%), 1 in 22 eyes (16.4%), 2 in 32 eyes (23.9%), 3 in 29 eyes (21.6%), and 4 in 32 eyes (23.9%). Parameters like maximum ciliary body thickness (CBTmax, P = .008), iris-ciliary process distance (ICPD, P < .001), and ciliary process length ( P = .034) varied significantly across ICS groups. A multiple linear regression analysis revealed that the iris-ciliary angle ( P = .006), CBTmax ( P = .007), the distance between the sulcus-to-sulcus plane and the anterior crystalline lens surface (STSL, P = .035), and ICL size ( P = .015) were significantly associated with IRH. Spherical equivalents ( P = .042), STSL ( P = .001), and ICS count ( P = .020) significantly correlated with the central vault. CONCLUSIONS Shortened ciliary process is a primary risk for haptic malposition. The ICS count significantly relates to the central vault.
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Affiliation(s)
- Weiteng Chang
- From the Department of Ophthalmology, Eye and ENT Hospital, Fudan University, Shanghai, China; NHC Key Laboratory of Myopia, Fudan University, Shanghai, China
| | - Lingling Niu
- From the Department of Ophthalmology, Eye and ENT Hospital, Fudan University, Shanghai, China; NHC Key Laboratory of Myopia, Fudan University, Shanghai, China
| | - Xingtao Zhou
- From the Department of Ophthalmology, Eye and ENT Hospital, Fudan University, Shanghai, China; NHC Key Laboratory of Myopia, Fudan University, Shanghai, China
| | - Xiaoying Wang
- From the Department of Ophthalmology, Eye and ENT Hospital, Fudan University, Shanghai, China; NHC Key Laboratory of Myopia, Fudan University, Shanghai, China
| | - Zhiqiang Yu
- From the Department of Ophthalmology, Eye and ENT Hospital, Fudan University, Shanghai, China; NHC Key Laboratory of Myopia, Fudan University, Shanghai, China
| | - Yishan Qian
- From the Department of Ophthalmology, Eye and ENT Hospital, Fudan University, Shanghai, China; NHC Key Laboratory of Myopia, Fudan University, Shanghai, China
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Ouchi M. Vault changes in eyes with a vertically implanted implantable collamer lens. Sci Rep 2024; 14:3484. [PMID: 38346992 PMCID: PMC10861517 DOI: 10.1038/s41598-024-52913-8] [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: 07/19/2023] [Accepted: 01/25/2024] [Indexed: 02/15/2024] Open
Abstract
Sulcus-to-sulcus vertical diameter is longer than the horizontal. However, the effect of vertical positioning of the implantable collamer lens (ICL) on the vault compared to preoperative prediction is unclear. This prospective consecutive case series aimed to examine postoperative and preoperative predicted vaults during vertical ICL fixation. This study assessed 180 right eyes in 180 patients with myopic astigmatism. For the 90 eyes in 90 patients who underwent horizontal fixation (horizontal group) and 90 eyes in 90 patients who underwent vertical fixation (vertical group), biometrics by three-dimensional tomography of the anterior segment optical coherence tomography (A-OCT) was performed before surgery and 2 h, 1 day, 1 week, 1 month and 3 months after surgery. The anterior chamber depth did not change over time in both groups, and there was no significant difference from preoperative values. The postoperative vault values were significantly lower in the vertical group than in horizontal group over time. The difference between vault measurements and preoperative predictions at all postoperative time points was significantly greater in the vertical group than in horizontal group. Vertical fixation of the ICL reduced the vault by > 100 μm compared with horizontal fixation, which was different from the A-OCT preoperative predicted value.
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Affiliation(s)
- Masayuki Ouchi
- Masayuki Ouchi Eye Clinic, 9-1 Nishikujo Ohkuni-cho, Minami-ku, Kyoto, 601-8449, Japan.
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Gong D, Deng S, Dang K, Yan Z, Wang J. Causes and management strategies for elevated intraocular pressure after implantable collamer lens implantation. Front Med (Lausanne) 2024; 11:1351272. [PMID: 38384405 PMCID: PMC10879591 DOI: 10.3389/fmed.2024.1351272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 01/25/2024] [Indexed: 02/23/2024] Open
Abstract
With the widespread application of Implantable Collamer Lens (ICL) implantation surgery in the field of myopia correction, a comprehensive understanding of its potential complications, especially those related to intraocular pressure (IOP), becomes crucial. This article systematically reviews various complications that may lead to IOP elevation after ICL surgery. Firstly, common complications after ICL surgery, including residual viscoelastic, steroid response, and excessive vault of the ICL, are detailed, emphasizing their potential impact on intraocular pressure. Regarding residual viscoelastic, we delve into its direct relationship with postoperative elevated IOP and possible preventive measures. For steroid response, we stress the importance of timely adjustment of steroid therapy and monitoring intraocular pressure. Additionally, excessive vault of the ICL is considered a significant potential issue, and we elaborate on its mechanism and possible management methods. In further discussion, we focus on relatively rare complications such as Toxic Anterior Segment Syndrome (TASS), Urrets-Zavalia Syndrome (UZS), Pigment Dispersion Syndrome (PDS), and malignant glaucoma. For these relatively rare complications, this review thoroughly explores their potential mechanisms, emphasizes the importance of prevention, and provides guidance for early diagnosis and treatment. This is a comprehensible review that aims to offer eye care professionals a comprehensive understanding and effective management guidance for complications of elevated IOP after ICL surgery, ultimately providing optimal care for patients' visual health.
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Affiliation(s)
- Di Gong
- Shenzhen Eye Hospital, Jinan University, Shenzhen Eye Institute, Shenzhen, Guangdong, China
| | - Simin Deng
- The 2nd Clinical Medical College (Shenzhen People's Hospital) of Jinan University, Shenzhen, China
| | - Kuanrong Dang
- Shenzhen Eye Hospital, Jinan University, Shenzhen Eye Institute, Shenzhen, Guangdong, China
| | - Zonghui Yan
- Shenzhen Eye Hospital, Jinan University, Shenzhen Eye Institute, Shenzhen, Guangdong, China
| | - Jiantao Wang
- Shenzhen Eye Hospital, Jinan University, Shenzhen Eye Institute, Shenzhen, Guangdong, China
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Naujokaitis T, Auffarth GU, Łabuz G, Kessler LJ, Khoramnia R. Diagnostic Techniques to Increase the Safety of Phakic Intraocular Lenses. Diagnostics (Basel) 2023; 13:2503. [PMID: 37568866 PMCID: PMC10417808 DOI: 10.3390/diagnostics13152503] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 07/25/2023] [Accepted: 07/25/2023] [Indexed: 08/13/2023] Open
Abstract
Preoperative and postoperative diagnostics play an important role in ensuring the safety of patients with phakic intraocular lenses (pIOLs). The risk of endothelial cell loss can be addressed by regularly measuring the endothelial cell density using specular microscopy and considering the endothelial cell loss rate and the endothelial reserve in accordance with the patient's age when deciding whether to explant a pIOL. The anterior chamber morphometrics, including the anterior chamber depth and the distance between the pIOL and the endothelium, measured using Scheimpflug tomography and anterior segment optical coherence tomography (AS-OCT), can help to assess the risk of the endothelial cell loss. In patients undergoing posterior chamber pIOL implantation, accurate prediction of the vault and its postoperative measurements using AS-OCT or Scheimpflug tomography are important when assessing the risk of anterior subcapsular cataract and secondary glaucoma. Novel approaches based on ultrasound biomicroscopy and AS-OCT have been proposed to increase the vault prediction accuracy and to identify eyes in which prediction errors are more likely. Careful patient selection and regular postoperative follow-up visits can reduce the complication risk and enable early intervention if a complication occurs.
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Affiliation(s)
| | | | | | | | - Ramin Khoramnia
- Department of Ophthalmology, University of Heidelberg, 69120 Heidelberg, Germany
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Fan L, Chang Z, Xu Y, Yin X, Wang Z. The Non-uniform Distribution of Horizontal and Vertical Crystalline Lens Rise Using Optical Coherence Tomography. J Refract Surg 2023; 39:354-359. [PMID: 37162401 DOI: 10.3928/1081597x-20230207-02] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
PURPOSE To observe the crystalline lens rise (CLR) in horizontal and vertical orientations using anterior segment optical coherence tomography (AS-OCT). METHODS Non-invasive swept-source AS-OCT was used to measure the lens thickness, CLR, and angle-to-angle distance (ATA) in both the horizontal and vertical orientations. Anterior chamber depth (ACD) and horizontal white-to-white corneal diameter were obtained using the Pentacam HR (Oculus Optikgeräte GmbH). Axial length was obtained using the IOLMaster 700 (Carl Zeiss Meditec AG). The paired t test was used to analyze the difference in CLR between the two orientations. Pearson correlation analysis was performed to investigate the correlations between CLR and other ocular variables. RESULTS This prospective observational study comprised 99 eyes (99 patients) that underwent Visian Implantable Collamer Lens (STAAR Surgical) implantation for myopic correction. The mean CLR was 64.29 ± 168.04 and 208.09 ± 173.12 µm in the horizontal and vertical orientations, respectively. The vertical CLR (VCLR) was significantly greater than the horizontal CLR (HCLR) (P < .05). Both the HCLR and VCLR were positively correlated with lens thickness and negatively correlated with ACD (all P < .05). The difference in CLR (VCLR-HCLR) was positively correlated with the axial length and the difference in ATA between the two orientations (P < .05). CONCLUSIONS VCLR was greater than HCLR in most patients with myopia, especially in the longer eyes. This nonuniform distribution in CLR implied different placements of the iridocorneal angles in the horizontal and vertical orientations and should be considered for the selection of ICL size and placement position. [J Refract Surg. 2023;39(5):354-359.].
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Moramarco A, di Geronimo N, Airaldi M, Gardini L, Semeraro F, Iannetta D, Romano V, Fontana L. Intraoperative OCT for Lamellar Corneal Surgery: A User Guide. J Clin Med 2023; 12:jcm12093048. [PMID: 37176489 PMCID: PMC10179477 DOI: 10.3390/jcm12093048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Revised: 04/07/2023] [Accepted: 04/18/2023] [Indexed: 05/15/2023] Open
Abstract
Intraoperative OCT is an innovative and promising technology which allows anterior and posterior segment ocular surgeons to obtain a near-histologic cross-sectional and tomographic image of the tissues. Intraoperative OCT has several applications in ocular surgery which are particularly interesting in the context of corneal transplantation. Indeed, iOCT images provide a direct and meticulous visualization of the anatomy, which could guide surgical decisions. In particular, during both big-bubble and manual DALK, the visualization of the relationship between the corneal layers and instruments allows the surgeon to obtain a more desirable depth of the trephination, thus achieving more type 1 bubbles, better regularity of the plane, and a reduced risk of DM perforation. During EK procedures, iOCT supplies information about proper descemetorhexis, graft orientation, and interface quality in order to optimize the postoperative adhesion and reduce the need for re-bubbling. Finally, mushroom PK, a challenging technique for many surgeons, can be aided through the use of iOCT since it guides the correct apposition of the lamellae and their centration. The technology of iOCT is still evolving: a larger field of view could allow for the visualization of all surgical fields, and automated tracking and iOCT autofocusing guarantee the continued centration of the image.
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Affiliation(s)
- Antonio Moramarco
- Ophthalmology Unit, Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum-University of Bologna, 40126 Bologna, Italy
- Ophthalmology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40126 Bologna, Italy
| | - Natalie di Geronimo
- Ophthalmology Unit, Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum-University of Bologna, 40126 Bologna, Italy
- Ophthalmology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40126 Bologna, Italy
| | - Matteo Airaldi
- Eye Unit, ASST Spedali Civili di Brescia, Piazzale Spedali Civili, 1, 25123 Brescia, Italy
- Eye Unit, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Viale Europa 15, 25123 Brescia, Italy
| | - Lorenzo Gardini
- Ophthalmology Unit, Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum-University of Bologna, 40126 Bologna, Italy
- Ophthalmology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40126 Bologna, Italy
| | - Francesco Semeraro
- Eye Unit, ASST Spedali Civili di Brescia, Piazzale Spedali Civili, 1, 25123 Brescia, Italy
- Eye Unit, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Viale Europa 15, 25123 Brescia, Italy
| | - Danilo Iannetta
- Ophthalmology Unit, Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum-University of Bologna, 40126 Bologna, Italy
- Ophthalmology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40126 Bologna, Italy
| | - Vito Romano
- Eye Unit, ASST Spedali Civili di Brescia, Piazzale Spedali Civili, 1, 25123 Brescia, Italy
- Eye Unit, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Viale Europa 15, 25123 Brescia, Italy
| | - Luigi Fontana
- Ophthalmology Unit, Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum-University of Bologna, 40126 Bologna, Italy
- Ophthalmology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40126 Bologna, Italy
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Jiang Y, Luo Y, Li Y, Lu T. The long-term observation of the rotation of implantable collamer lens as the management of high postoperative vault. Front Med (Lausanne) 2023; 10:1104047. [PMID: 36910497 PMCID: PMC9995363 DOI: 10.3389/fmed.2023.1104047] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 02/02/2023] [Indexed: 02/25/2023] Open
Abstract
Purpose This study aimed to describe the effectiveness and stability of implantable collamer lens (ICL) rotation in reducing high postoperative vault. Setting This study was conducted in the Peking Union Medical College Hospital, Chinese Academy of Medical Sciences. Design This is a retrospective case series. Methods Twenty-two eyes from 22 patients who had ICL (V4c EVO) implantation with high postoperative vault (>=750 μm) were recruited for our study. All the lenses were rotated from a horizontal to an oblique position. The vault, SSA, AOD500, AOD750, TISA500, and TISA750 at 180° and 0° were measured pre-rotation, 1-week post-rotation, and in the at-least 1-year-follow-up. Results Twenty female patients and two male patients were recruited, with a mean age of 28.68 ± 6.08 years. The mean vault had declined significantly from 951.81 ± 154.26 μm pre-rotation to 772.27 ± 119.40 μm 1 week post-rotation (p < 0.001). The SSA, AOD500, AOD750, TISA500, and TISA750 at 180° and 0° pre-rotation and 1-week post-rotation were 30.40 ± 7.91° and 45.14 ± 6.75°, 32.37 ± 7.48° and 46.23 ± 6.39°, 303.27 ± 87.99 and 522.45 ± 122.16 μm, 323.81 ± 89.15 and 536.13 ± 121.66 μm, 387.95 ± 99.43 and 630.81 ± 133.59 μm, 435.68 ± 106.72 and 643.36 ± 132.82 μm, 0.109 ± 0.034 and 0.202 ± 0.053 mm2, 0.123 ± 0.034 and 0.212 ± 0.051 mm2, 0.194 ± 0.056 and 0.345 ± 0.083 mm2, and 0.216 ± 0.055 and 0.358 ± 0.079 mm2 (all p < 0.001). The mean vault value had changed from 747.50 ± 116.07 μm 1-week post-rotation to 586.87 ± 132.65 μm in the 1-year follow-up. However, the SSA, AOD500, AOD750, TISA500, and TISA750 at 180° and 0° had remained stable (p > 0.05). Conclusion Non-toric ICL rotation is a novel and effective technique in the treatment of high postoperative vault. Our results are more robust given the extended period of follow-up.
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Affiliation(s)
- Yang Jiang
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Yan Luo
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Ying Li
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Thomas Lu
- School of Medicine, University of New South Wales, Kensington, NSW, Australia
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Zaldivar R, Zaldivar R, Adamek P, Quintero G, Cerviño A. Descriptive Analysis of Footplate Position After Myopic Implantable Collamer Lens Implantation Using a Very High-Frequency Ultrasound Robotic Scanner. Clin Ophthalmol 2022; 16:3993-4001. [PMID: 36504639 PMCID: PMC9733561 DOI: 10.2147/opth.s393223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 11/17/2022] [Indexed: 12/07/2022] Open
Abstract
Purpose To assess the position of the haptics of the implantable collamer lens (ICL) in myopic eyes using a high-frequency ultrasound robotic scanner. Methods This was a prospective, single-arm, observational study carried out at the Instituto Zaldivar SA (Mendoza, Argentina) in a sample of 52 eyes who have been submitted to successful ICL implantation prior to enrollment. Images of the eyes were obtained using a very-high frequency digital ultrasound robotic scanner (VHFDU) to establish the position of the ICL in the posterior chamber and its relation to the ciliary sulcus. New parameters for lens position analysis were also described. Results In 81% of cases (42 eyes), the ICL rests on the ciliary body (CB) in both temporal and nasal sides, being slightly lower than 6% (3 eyes) those that rest on the sulcus in both sides, with significant correlations between ICL position and vault values (p<0.05). Cases in which the ICL position was CB-CB yielded central vault values across the whole range determined within the sample, but most of the eyes where the ICL rests on both the sulcus in one side and the CB in the other yield greater central vault values. Correlation was significant between ICL position and retroposition distance on the temporal side (Spearman's rho -0.487, p<0.001). A significant but weaker correlation was also found between ICL position and retroiridian space (p<0.05). Conclusion ICL for myopia footplates tend to locate outside of the sulcus in a significant percentage of patients after successful implantation. VHFDU assessment in eyes implanted with an ICL to properly study the lens footplate position and posterior anatomical relations provides important additional information besides post-surgery vault.
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Affiliation(s)
| | | | | | | | - Alejandro Cerviño
- Department of Optics & Optometry & Vision Sciences, University of Valencia, Valencia, Spain,Correspondence: Alejandro Cerviño, Department of Optics & Optometry & Vision Science, University of Valencia, C / Dr. Moliner, 50. Burjassot, Valencia, 46100, Spain, Tel +34 963 544 852, Email
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Yang Z, Meng L, Zhao X, Chen Y, Luo Y. Clinical Prediction of Inadequate Vault in Eyes With Thick Lens After Implantable Collamer Lens Implantation Using Iris Morphology. Front Med (Lausanne) 2022; 9:906433. [PMID: 35755051 PMCID: PMC9218336 DOI: 10.3389/fmed.2022.906433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 05/23/2022] [Indexed: 12/01/2022] Open
Abstract
Background Obtaining an ideal vault is crucial in the implantable collamer lens (ICL) surgery. Prediction of the vault value is difficult since it requires the integration of multiple factors. The purpose of this study was to investigate the association between the iris shape and vault value in eyes with thick lens. Methods The study was conducted in Peking Union Medical College Hospital. Patients who received ICL V4c between 2017 and 2021 were screened. Eyes with thick lens (>4.0 mm) and abnormal iris shape (concave or convex) were included. The preoperative biometric parameters and postoperative vault value were compared between eyes with concave shape group and convex shape group. The relationship between various factors and vault was assessed by spearman rank analysis and multiple linear regression analysis. Representative cases our strategies to deal with the abnormal vault were demonstrated. Results Twenty eight eyes of 14 patients with thick lens and concave or convex shape iris were eventually included, with 14 eyes of 7 patients in group 1 (concave shape iris) and the other 14 eyes of 7 patients in group 2 (convex shape iris). The mean vault of group 1 was (0.16 ± 0.07) mm, which was significantly lower than (0.88 ± 0.13) mm in group 2. Multiple linear regression analysis showed iris shape (P < 0.001) was only the explanatory variables associated with the postoperative vault. In group1, 4 eyes showed extremely large ACA, requiring a secondary surgical intervention. So all of them underwent ICL exchange for a larger ICL. In group2, the ICL was implanted in a vertical or oblique position to avoid or rescue an extremely large vault. Conclusion Concave shape iris had a higher risk of low vault and convex shape iris were more likely to demonstrate high vault in eyes with thick lens. Exchanging ICL for the larger size and adjusting ICL to the vertical or oblique orientation are good option to rescue the low or high vault, respectively.
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Affiliation(s)
- Zhikun Yang
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Lihui Meng
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.,Key Lab of Ocular Fundus Diseases, Chinese Academy of Medical Sciences, Beijing, China
| | - Xinyu Zhao
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.,Key Lab of Ocular Fundus Diseases, Chinese Academy of Medical Sciences, Beijing, China
| | - Youxin Chen
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.,Key Lab of Ocular Fundus Diseases, Chinese Academy of Medical Sciences, Beijing, China
| | - Yan Luo
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
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Du Y, Jin C, Yin S, Wang G, Ma Q, Li Y, Chen B, Wang H, Qiu K, Zhang M. Comparison of Vault Measurements Using a Swept-Source OCT-Based Optical Biometer and Anterior Segment OCT. Front Med (Lausanne) 2022; 9:865719. [PMID: 35814765 PMCID: PMC9259877 DOI: 10.3389/fmed.2022.865719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Accepted: 05/26/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundTo newly describe the vault measurement by using a widely used swept-source OCT-based optical biometer (IOLMaster700) and accessd the accuracy of vault measurement.MethodsThis was a retrospective, cross-sectional study. All patients underwent implantable Collamer lens (ICL) implantation surgery without complications. IOLMaster700 and AS-OCT analyses were conducted for each eye on the same day in the same condition. Measurements of anterior chamber depth (ACD), corneal-ICL (C-ICL), and vault values were made and recorded. The repeatability of the IOL Master700 measurements was quantified based upon intraclass correlation coefficient (ICC) values. Correlations between IOL Master700 and AS-OCT measurements made with these different analytical approaches were assessed. The agreement of instruments was evaluated using Bland-Altman plots.ResultsThe IOLMaster700 instrument yielded highly reliable measurements of vault, C-ICL, and ACD (ICC = 0.996, 0.995, 0.995, respectively). Vault, C-ICL and ACD values as measured using the IOLMaster700, was slightly smaller than that measured via AS-OCT, but these differences were not significant (p = 0.652, p = 0.121 and p = 0.091, respectively). The vault, C-ICL, and ACD measurements by these two instruments were strongly correlated (r = 0.971, r = 0.944, and r = 0.963, respectively; all p < 0.001). The 95% limits of agreement for vault, C-ICL, and ACD measurements between the two devices were−0.08 to 0.08 mm,−0.14 to 0.11 mm, and−0.13 to 0.10 mm, respectively.ConclusionsThe IOLMasrer700 can measure implanted ICL vault with a high degree of accuracy and repeatability. Good correlations and agreement were observed between IOLMaster700 and AS-OCT in measuring vault, C-ICL, and ACD measurements.
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Affiliation(s)
- Yali Du
- Joint Shantou International Eye Center of Shantou University, The Chinese University of Hong Kong, Shantou, China
| | | | | | | | | | | | | | | | - Kunliang Qiu
- Joint Shantou International Eye Center of Shantou University, The Chinese University of Hong Kong, Shantou, China
| | - Mingzhi Zhang
- Joint Shantou International Eye Center of Shantou University, The Chinese University of Hong Kong, Shantou, China
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