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Wan T, Chen H, Wu S, Jin H. Analysis of surgically induced astigmatism of the anterior, posterior, and total cornea after implantable collamer lens implantation: a comparative study between temporal and superior clear corneal incisions. BMC Ophthalmol 2024; 24:252. [PMID: 38867207 PMCID: PMC11170833 DOI: 10.1186/s12886-024-03501-x] [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: 05/03/2023] [Accepted: 05/27/2024] [Indexed: 06/14/2024] Open
Abstract
BACKGROUND To comparatively analyze the surgically induced astigmatism (SIA) of the anterior, posterior, and total corneas of eyes undertaking implantable collamer lens (ICL) implantation with temporal or superior corneal incisions. METHODS One hundred and nine eyes of 109 patients who received ICL implantation were recruited: 40 eyes had temporal incisions and 69 eyes had superior incisions. Total corneal refractive power (TCRP); simulated keratometry of the anterior (Sim-KAnt) and posterior (Sim-KPost) corneal curvature; and astigmatism of the anterior (CAAnt), posterior (CAPost), and total (CATCRP) cornea were recorded through a Pentacam preoperatively and 3 months postoperatively. The SIA of the anterior, posterior, and total cornea were also compared between the two groups. RESULTS There were no significant intergroup differences for TCRP, Sim-KAnt, Sim-KPost, CAAnt, CAPost, or CATCRP, preoperatively. However, values of CAAnt, CAPost, and CATCRP with temporal incision were significantly higher than those parameters with superior incision postoperatively. All of the SIA of the anterior, posterior, and total cornea were significantly lower for temporal incision than those with a superior incision (p < 0.001, p = 0.006 and p = 0.001 respectively). Meanwhile, the superior incisions created against-the-rule (ATR) astigmatism, and temporal incisions always induce with-the-rule (WTR) astigmatism in total cornea. CONCLUSIONS A superior incision may be suitable for correcting WTR astigmatism, while a temporal incision for correcting ATR astigmatism when using a non-toric ICL. Meanwhile, temporal incision could be a better choice with little preoperative astigmatism or that preoperative astigmatism would be corrected with toric ICLs. TRIAL REGISTRATION Registration number: ChiCTR2100051739. Prospectively registered: 01 October 2021.
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Affiliation(s)
- Ting Wan
- Eye Center, Second Affiliated Hospital, School of Medicine, Zhejiang University, 88 Jiefang Road, Hangzhou, 310009, China
| | - Huaicheng Chen
- Department of Ophthalmology, The Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, Zhejiang, China
| | - Shirou Wu
- Eye Center, Second Affiliated Hospital, School of Medicine, Zhejiang University, 88 Jiefang Road, Hangzhou, 310009, China
| | - Hongying Jin
- Eye Center, Second Affiliated Hospital, School of Medicine, Zhejiang University, 88 Jiefang Road, Hangzhou, 310009, China.
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Qian T, Du J, Ren R, Zhou H, Li H, Zhang Z, Xu X. Vault-Correlated Efficacy and Safety of Implantable Collamer Lens V4c Implantation for Myopia in Patients with Shallow Anterior Chamber Depth. Ophthalmic Res 2023; 66:445-456. [PMID: 36596292 DOI: 10.1159/000528616] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Accepted: 11/27/2022] [Indexed: 01/04/2023]
Abstract
INTRODUCTION The aim of the study was to evaluate efficacy and safety outcomes after implantation of the Visian Implantable Collamer Lens (ICL V4c) in myopia patients with shallow anterior chamber depth (ACD). METHODS This retrospective study followed 163 eyes of 94 patients for at least 24 months. Uncorrected distance visual acuity (UDVA), corrected distance visual acuity, intraocular pressure (IOP), manifest refraction, vault, endothelial cell density (ECD), anterior chamber angle (ACA), anterior chamber volume, and the distance from the corneal endothelium to the central ICL (C-ICL) were measured during follow-ups. Spearman's correlation and logistic regression were used to identify variables correlated with changes in ECD and potential risk factors for ineffective outcomes, respectively. RESULTS All surgeries were performed safely. High IOP of 9 eyes and anterior capsular opacity of 5 eyes were observed. The last follow-up ACA had a significant difference between the high and normal IOP groups (p = 0.0003). The mean ECD and vault were 2,855.76 ± 270.82 cells/mm2 and 388.01 ± 135.28 μm at the last follow-up, respectively. The vault and C-ICL were significantly associated with ΔECD (all p < 0.05). Furthermore, the vault was most responsible for the ECD loss. Twenty-two eyes had unsatisfactory postoperative UDVA, and the low vault at the last follow-up was a significant risk factor for this ineffective outcome (p < 0.001, OR = 14.739). CONCLUSIONS ICL V4c implantation in patients with shallow ACD achieved stable visual outcomes. The vault is related to postoperative visual acuity and ECD loss, which needs to be paid attention during follow-up.
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Affiliation(s)
- Tianwei Qian
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, China
- National Clinical Research Center for Eye Diseases, Shanghai, China
- Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai, China
- Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, China
- Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Disease, Shanghai, China
| | - Jingxiao Du
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, China
- National Clinical Research Center for Eye Diseases, Shanghai, China
- Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai, China
- Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, China
- Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Disease, Shanghai, China
| | - Ruixia Ren
- Shanghai Xinshijie Zhongxing Eye Hospital, Shanghai, China
| | - Hao Zhou
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, China
- National Clinical Research Center for Eye Diseases, Shanghai, China
- Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai, China
- Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, China
- Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Disease, Shanghai, China
| | - Haiyan Li
- Shanghai Xinshijie Zhongxing Eye Hospital, Shanghai, China
| | - Zhihua Zhang
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, China
- National Clinical Research Center for Eye Diseases, Shanghai, China
- Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai, China
- Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, China
- Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Disease, Shanghai, China
| | - Xun Xu
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, China
- National Clinical Research Center for Eye Diseases, Shanghai, China
- Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai, China
- Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, China
- Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Disease, Shanghai, China
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Feldhaus L, Mayer WJ, Dirisamer M, Kassumeh S, Shajari M, Priglinger SG, Luft N. Comparison of Visual and Refractive Outcome between Two Methods of Corneal Marking for Toric Implantable Collamer Lenses (TICL) in Phakic Eyes. Curr Eye Res 2022; 48:357-364. [PMID: 36524538 DOI: 10.1080/02713683.2022.2159981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
PURPOSE To compare the efficacy of digital-assisted reference marking for toric implantable collamer lenses (Callisto Eye System) with manual marking technique using a slit lamp markeur. METHODS This study included patients that underwent implantation of a toric implantable collamer lens (EVO Visian toric ICL, Staar Surgical). Patients were included if they had a myopia above -3 diopters (D) and regular corneal astigmatism of 0.75 diopters or higher. Between both groups a 1:2 matching regarding similar preoperative level of myopia and astigmatism was performed. Visual and refractive outcomes were evaluated. Vector analysis was performed to evaluate total astigmatic changes. RESULTS This study comprised 57 eyes of 57 patients with 19 eyes in the digital group and 38 eyes in the manual marking group. Postoperatively there were no statistically significant differences between both groups in UDVA (p = 0.467), spherical equivalent (SE) (p = 0.864), sphere (p = 0.761) and cylinder (p = 0.878). Vector analysis showed a slightly more accurate postoperative refractive astigmatism in the manual group (0.26 D at 107° ± 0.50 D) compared to the digital marking group (0.31 D at 107° ± 0.45 D), nevertheless with no statistically significant differences between both groups. CONCLUSIONS A digital tracking approach for toric ICL alignment was an efficient and safe method for toric marking with similar results regarding visual and refractive outcomes compared to a conventional corneal marking method. Nevertheless, image-guided surgery helped to streamline the workflow in refractive ICL surgery.
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Affiliation(s)
- Lukas Feldhaus
- Department of Ophthalmology, University Hospital, LMU Munich, Munich, Germany
| | - Wolfgang J Mayer
- Department of Ophthalmology, University Hospital, LMU Munich, Munich, Germany
| | - Martin Dirisamer
- Department of Ophthalmology, University Hospital, LMU Munich, Munich, Germany
| | - Stefan Kassumeh
- Department of Ophthalmology, University Hospital, LMU Munich, Munich, Germany
| | - Mehdi Shajari
- Department of Ophthalmology, University Hospital, LMU Munich, Munich, Germany
| | | | - Nikolaus Luft
- Department of Ophthalmology, University Hospital, LMU Munich, Munich, Germany
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Cao K, Zhang J, Wang J, Yusufu M, Jin S, Chen S, Wang N, Jin ZB, Wan XH. Implantable collamer lens versus small incision lenticule extraction for high myopia correction: A systematic review and meta-analysis. BMC Ophthalmol 2021; 21:450. [PMID: 34961514 PMCID: PMC8711178 DOI: 10.1186/s12886-021-02206-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 12/06/2021] [Indexed: 11/10/2022] Open
Abstract
Purpose To compare the efficacy, safety, predictability and visual quality between implantable collamer lens (ICL) implantation and small incision lenticule extraction (SMILE) for high myopia correction in adults. Methods A systematic review and meta-analysis was conducted. A comprehensive literature search was done based on databases including PubMed, Science Direct, Embase, and the Cochrane Central Register of Controlled Trials. The efficacy index, safety index, changes in Snellen lines of corrected distance visual acuity (CDVA), predictability (difference between post-operative and attempted spherical equivalent error, SER), incidence of halos, and change in higher-order aberrations (HOAs) were compared. Mean difference (MD) and 95% confidence interval (CI) was used to estimate continuous outcomes, risk ratio (RR) and 95%CI was used to estimate categorical outcomes. Results Five observational studies involving 555 eyes were included in this review. Studies’ sample sizes (eyes) ranged from 76 to 197. Subjects’ refraction ranged from -6 diopter (D) to -12D. Study duration of most researches were 6 months or 12 months. Compared to SMILE, ICL implantation showed better efficacy index (MD=0.09, 95%CI:0.01 to 0.16) and better safety index (MD=0.08, 95%CI: 0.00 to 0.16). Compared with SMILE, more ICL-treated eyes gained one or more Snellen lines of CDVA (RR=1.54, 95%CI:1.28 to 1.86), more gained two or more lines (RR=2.09, 95%CI:1.40 to 3.13), less lost one or more lines (RR=0.17, 95%CI:0.05 to 0.63). There was no difference in predictability between two treatments, RRs of predictability of within ±0.5D and ±1D were 1.13 (95%CI: 0.94 to 1.36) and 1.00 (95%CI: 0.98 to 1.02). Compared with SMILE, ICL implantation came with a higher risk of halos [RR=1.79, 95%CI: 1.48 to 2.16] and less increase in total HOAs (MD=-0.23, 95%CI: -0.42 to -0.03). Conclusion Compared with SMILE, ICL implantation showed a higher risk of halos, but equal performance on SER control, and better performance on efficacy index, safety index, CDVA improvement and HOAs control. Overall, ICL implantation might be a better choice for high myopia correction in adults.
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Affiliation(s)
- Kai Cao
- Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Beijing Key Laboratory of Ophthalmology and Visual Sciences, Capital Medical University, No17, Hougou ally, Dongcheng district, Beijing, 100005, China
| | - Jingshang Zhang
- Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Beijing Key Laboratory of Ophthalmology and Visual Sciences, Capital Medical University, No17, Hougou ally, Dongcheng district, Beijing, 100005, China
| | - Jinda Wang
- Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Beijing Key Laboratory of Ophthalmology and Visual Sciences, Capital Medical University, No17, Hougou ally, Dongcheng district, Beijing, 100005, China
| | - Mayinuer Yusufu
- Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Beijing Key Laboratory of Ophthalmology and Visual Sciences, Capital Medical University, No17, Hougou ally, Dongcheng district, Beijing, 100005, China
| | - Shanshan Jin
- Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Beijing Key Laboratory of Ophthalmology and Visual Sciences, Capital Medical University, No17, Hougou ally, Dongcheng district, Beijing, 100005, China
| | - Shuying Chen
- Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Beijing Key Laboratory of Ophthalmology and Visual Sciences, Capital Medical University, No17, Hougou ally, Dongcheng district, Beijing, 100005, China
| | - Ningli Wang
- Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Beijing Key Laboratory of Ophthalmology and Visual Sciences, Capital Medical University, No17, Hougou ally, Dongcheng district, Beijing, 100005, China
| | - Zi-Bing Jin
- Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Beijing Key Laboratory of Ophthalmology and Visual Sciences, Capital Medical University, No17, Hougou ally, Dongcheng district, Beijing, 100005, China
| | - Xiu Hua Wan
- Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Beijing Key Laboratory of Ophthalmology and Visual Sciences, Capital Medical University, No17, Hougou ally, Dongcheng district, Beijing, 100005, China.
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Kamiya K, Ando W, Takahashi M, Shoji N. Comparison of magnitude and summated vector mean of surgically induced astigmatism vector according to incision site after phakic intraocular lens implantation. EYE AND VISION 2021; 8:32. [PMID: 34470645 PMCID: PMC8411523 DOI: 10.1186/s40662-021-00257-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Accepted: 08/11/2021] [Indexed: 11/12/2022]
Abstract
Background To compare the arithmetic mean (M-SIA) and the summated vector mean of surgically induced astigmatism (SVM-SIA) according to the incision site after phakic intraocular lens (Visian implantable collamer lens (ICL), STAAR Surgical) implantation. Methods This study comprised 121 eyes of 121 consecutive patients undergoing ICL surgery through a 3.0-mm temporal or superior clear corneal incision. The magnitude and the axis of corneal astigmatism preoperatively and 3 months postoperatively were measured using an automated keratometer. The M-SIA and the SVM-SIA were determined according to the incision site. Results The magnitude of corneal astigmatism significantly increased from 1.23 ± 0.59 D preoperatively to 1.46 ± 0.72 D postoperatively in the temporal incision group (Wilcoxon signed-rank test, P < 0.001), but it significantly decreased from 1.09 ± 0.36 D preoperatively to 0.86 ± 0.41 D postoperatively in the superior incision group (P < 0.001). The M-SIA was 0.48 ± 0.30 D, and the SVM-SIA was 0.23 ± 0.52 D at a meridian of 82° in the temporal incision group. The M-SIA was 0.57 ± 0.30 D, and the SVM-SIA was 0.47 ± 0.45 D at a meridian of 1° in the superior incision group. Conclusions ICL implantation induces the M-SIA by approximately 0.5 D, but the SVM-SIA decreased to 50% and 80% of the M-SIA in magnitude through temporal and superior incisions, respectively. The direction of the SVM-SIA showed a tendency toward corneal flattening to the incisional site. It should be noted that the M-SIA is somewhat different from the SVM-SIA according to the incision site. Trial registration University Hospital Medical Information Network Clinical Trial Registry (000044269)
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Affiliation(s)
- Kazutaka Kamiya
- Visual Physiology, School of Allied Health Sciences, Kitasato University, 1-15-1 Kitasato, Minami, Sagamihara, Kanagawa, 252-0373, Japan.
| | - Wakako Ando
- Department of Ophthalmology, School of Medicine, Kitasato University, Sagamihara, Japan
| | - Masahide Takahashi
- Department of Ophthalmology, School of Medicine, Kitasato University, Sagamihara, Japan
| | - Nobuyuki Shoji
- Department of Ophthalmology, School of Medicine, Kitasato University, Sagamihara, Japan
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Kalra N, Asif MI, Bafna RK, Sharma N, Sinha R. Posterior Chamber Phakic Intraocular Lens Implantation for Refractive Correction in Corneal Ectatic Disorders: A Review. J Refract Surg 2021; 37:351-359. [PMID: 34044697 DOI: 10.3928/1081597x-20210115-03] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
PURPOSE To summarize the indications and outcomes of posterior chamber phakic intraocular lens (PIOL) implantation in corneal ectasias including keratoconus, pellucid marginal degeneration (PMD), post-refractive surgery, and post-keratoplasty ectasias. METHODS A review of the literature was conducted using the relevant keywords from various databases up to August 15, 2020. All pertinent studies were reviewed, and the relevant articles were studied in detail for efficacy, stability, predictability, and safety outcomes. In addition, visual quality, corneal biomechanical outcomes, complications, the role of posterior chamber PIOL in combination treatment, and comparison of posterior chamber PIOL with other PIOLs for ectasias were also evaluated. RESULTS A total of 30 relevant studies (13 prospective, 13 retrospective, 4 case reports) on the subject were studied and summarized. All studies showed a favorable refractive outcome. Quality of vision remained unaffected and no significant complications were reported in any of the studies. CONCLUSIONS Posterior chamber PIOLs represent a viable option in the treatment of mild to moderate and stable corneal ectasia in patients with contact lens intolerance who have low irregular astigmatism, a clear central cornea, and good preoperative corrected distance visual acuity. [J Refract Surg. 2021;37(5):351-359.].
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Jabbour S, Bower KS. Three-Year Outcomes of Implantable Collamer Lens Followed by Excimer Laser Enhancement ("Bioptics") in the Treatment of High Myopic Astigmatism. Clin Ophthalmol 2021; 15:635-643. [PMID: 33623364 PMCID: PMC7896759 DOI: 10.2147/opth.s283888] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Accepted: 01/18/2021] [Indexed: 11/29/2022] Open
Abstract
Purpose Describe three-year outcomes of spherical implantable Collamer lens (ICL) followed by excimer laser enhancement (bioptics) in eyes with high myopic astigmatism. Patients and Methods Retrospective case series of thirty-four cases that underwent bioptics enhancement at the Johns Hopkins Wilmer Eye Institute. All eyes had a preoperative sphere of −6.00 D or more with a cylinder of at least 2.00 D. Uncorrected and corrected distance visual acuity (UDVA and CDVA), manifest spherical equivalent refraction (MSE), ICL vault measurements and central corneal thickness (CCT) were collected. Endothelial cell counts (ECC), root mean square (RMS) of higher order aberrations (HOAs), adverse events and subsequent surgeries were also assessed. Results All patients had a minimum follow-up of 3 years. Preoperative UDVA was 2.29 ± 0.46 logMAR and improved to 0.03 ± 0.23 logMAR at 3 years (p<0.05). MSE was −12.30 ± 4.05 preoperatively and changed to −0.21 ± 0.46 at 3 years (p<0.05). The efficacy and safety indices were 1.28 ± 0.32 and 1.47 ± 0.27 at 3 years post-enhancement. HOA did not significantly change throughout the follow-up (p<0.05). Endothelial cell loss at 12 months was calculated at 5.7%. Two eyes required ICL exchange due to vault-related issues. Conclusion Bioptics offered excellent long-term safe, predictable, and efficient outcomes for high myopic astigmatism and can be considered an option if toric ICL is not available. Results confirm that wavefront-guided photoablation remains an excellent option to manage residual refractive error after phakic IOL.
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Affiliation(s)
- Samir Jabbour
- The Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Kraig S Bower
- The Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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Moshirfar M, Thomson RJ, West Jnr WB, McCabe SE, Sant TM, Shmunes MH, Ronquillo YC, Hoopes PC. Visual Outcomes After Sequential Posterior Chamber Phakic IOL with Corneal Refractive Surgery (Bioptics) for the Treatment of Myopic Astigmatism. Clin Ophthalmol 2020; 14:4337-4346. [PMID: 33328722 PMCID: PMC7734069 DOI: 10.2147/opth.s285140] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2020] [Accepted: 11/06/2020] [Indexed: 11/23/2022] Open
Abstract
Purpose To report the outcomes of sequential posterior chamber phakic intraocular lens (PC-pIOL) with corneal refractive surgery in conventional (PC-pIOL prior to refractive surgery) and reverse (refractive surgery prior to PC-pIOL) bioptics for treating high myopic astigmatism. Setting Tertiary refractive center, Draper, Utah, USA. Design Retrospective case series. Methods Medical records of patients who underwent planned bioptics were reviewed. Surgery involved PC-pIOL placement using an implantable collamer lens (ICL) with preceding or subsequent LASIK or PRK. Pre- and postoperative manifest spherical equivalent (SEQ), visual acuity, and PC-pIOL vault were analyzed. Results Of the 51 eyes present at 12 months postoperatively, 49 eyes (96%) achieved target SEQ within ±1.00 D and an identical amount achieved refractive astigmatism ≤1.00 D. Post-bioptics eyes achieved a postoperative UDVA equal to or better than preoperative CDVA in 45 eyes (88%). Efficacy and safety indices were 1.08 ± 0.20 (41 eyes) and 1.13 ± 0.22 (44 eyes) for conventional bioptics and 0.99 ± 0.42 (7 eyes) and 1.15 ± 0.38 (7 eyes) for reverse bioptics eyes at 12 months. The maximum PC-pIOL vault of conventional bioptics eyes (27 eyes) within 6 months before and after LASIK/PRK was 385 ± 159 μm and 377 ± 135 μm, respectively (P = 0.71). Conclusion Bioptics for high myopic astigmatism was safe and effective. Reverse bioptics, although not as traditional, could provide similar results. Additionally, the PC-pIOL vault does not appear to be affected by LASIK/PRK.
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Affiliation(s)
- Majid Moshirfar
- Hoopes Vision Research Center, Hoopes Vision, Draper, UT, USA.,John A. Moran Eye Center, Department of Ophthalmology and Visual Sciences, University of Utah School of Medicine, Salt Lake City, UT, USA.,Utah Lions Eye Bank, Murray, UT, USA
| | - Robert J Thomson
- McGovern Medical School at the University of Texas Health Science Center at Houston, Houston, TX, USA
| | | | - Shannon E McCabe
- Hoopes Vision Research Center, Hoopes Vision, Draper, UT, USA.,Mission Hills Eye Center, Pleasant Hill, CA, USA
| | - Thomas M Sant
- University of Utah School of Medicine, Salt Lake City, UT, USA
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Moshirfar M, Somani AN, Motlagh MN, Vaidyanathan U, Sumsion JS, Barnes JR, Ronquillo YC. Comparison of FDA-Reported Visual and Refractive Outcomes of the Toric ICL Lens, SMILE, and Topography-Guided LASIK for the Correction of Myopia and Myopic Astigmatism. J Refract Surg 2020; 35:699-706. [PMID: 31710371 DOI: 10.3928/1081597x-20190930-01] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Accepted: 09/30/2019] [Indexed: 11/20/2022]
Abstract
PURPOSE To compare U.S. Food and Drug Administration (FDA)-reported visual and refractive outcomes following surgical correction of myopia and myopic astigmatism using the Visian Toric Implantable Collamer Lens (STAAR Surgical, Monrovia, CA) (Toric ICL), small incision lenticule extraction (SMILE), and topography-guided laser in situ keratomileusis (TG-LASIK). METHODS FDA summary of safety and effectiveness data (SSED) were analyzed for each of the three platforms. Primary outcomes measured were efficacy, safety, stability, and accuracy of refractive correction. Stratified mean refractive spherical equivalent (MRSE) data were assessed. RESULTS One hundred twenty-four Toric ICL patients (210 eyes), 357 SMILE patients (357 eyes), and 212 TG-LASIK patients (249 eyes) were included. SMILE eyes had a significant improvement in postoperative uncorrected distance visual acuity with respect to preoperative corrected distance visual acuity from 3 to 12 months (P < .001), whereas TG-LASIK had no further improvement from 3 to 12 months (P = .79). For preoperative MRSE greater than 10.00 diopters (D), there was a significant difference in the percentage of eyes achieving postoperative MSRE within ±0.50 D between Toric ICL (66%) and SMILE (100%) (P < .001). SMILE was consistently more accurate than Toric ICL for cylinder within ±0.25 D (P < .001), ±0.50 D (P < .001), and ±1.00 D (P = .0014). CONCLUSIONS All three platforms analyzed in this study had excellent efficacy, safety, stability, and accuracy. Stratified analysis revealed that SMILE may be comparable to Toric ICL for patients with high myopia or myopic astigmatism, and SMILE may have a longer visual recovery compared to TG-LASIK than previously indicated. [J Refract Surg. 2019;35(11):699-706.].
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Fernández-Vega-Cueto L, Lisa C, Esteve-Taboada JJ, Montés-Micó R, Alfonso JF. Implantable collamer lens with central hole: 3-year follow-up. Clin Ophthalmol 2018; 12:2015-2029. [PMID: 30349185 PMCID: PMC6188208 DOI: 10.2147/opth.s171576] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Purpose To evaluate the long-term predictability, stability, safety, and efficacy of the V4c Visian implantable collamer lens (ICL) with central hole to correct myopia. Patients and methods One hundred and eighty-four eyes of 92 patients were evaluated during 3 years after implantation of the V4c ICL. The refraction, uncorrected distance visual acuity, best-corrected distance visual acuity, IOP, endothelial cell count, vault, and adverse effects were evaluated every 12 months during the whole follow-up. Results The mean spherical equivalent dropped from -8.30±2.98 D preoperatively to −0.37±0.47 D at 36 months post-surgery, with 91.8% eyes being within ±1.00 D of emmetropia. With respect to the astigmatic components J0 and J45, 98.4% and 99.5% of eyes, respectively, were within ±0.50 D of the desired refraction. At 36 months, 78.8% of eyes had no change in the Snellen lines of best-corrected distance visual acuity, while 8.7% gained one line and 6.5% gained two or more lines; mean safety and efficacy indexes were 1.03 and 0.90, respectively. Mean endothelial cell count was 2,742±340 cells/mm2 before and 2,663±366 cells/mm2 at 36 months post-surgery. Mean IOP reduced from 13.7±1.9 mmHg preoperatively to 12.8±1.7 mmHg at 36 months post-surgery. Mean vault varied from 409±196 µm at 12 months to 349±165 µm at 36 months. Conclusion The visual and refractive outcomes were very good and highly stable throughout the follow-up period, indicating that this ICL model may be predictable, stable, safe, and effective to correct myopia in the long term.
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Affiliation(s)
| | - Carlos Lisa
- Department of Surgery, Fernández-Vega Ophthalmological Institute, Oviedo, Spain,
| | - José J Esteve-Taboada
- Department of Optics and Optometry and Visual Sciences, University of Valencia, Valencia, Spain
| | - Robert Montés-Micó
- Department of Optics and Optometry and Visual Sciences, University of Valencia, Valencia, Spain
| | - José F Alfonso
- Department of Surgery, Fernández-Vega Ophthalmological Institute, Oviedo, Spain, .,School of Medicine, University of Oviedo, Oviedo, Spain,
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Packer M. Meta-analysis and review: effectiveness, safety, and central port design of the intraocular collamer lens. Clin Ophthalmol 2016; 10:1059-77. [PMID: 27354760 PMCID: PMC4907705 DOI: 10.2147/opth.s111620] [Citation(s) in RCA: 176] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
The purpose of this review is to summarize relevant data from publications appearing in the peer-reviewed scientific literature over the past decade since US Food and Drug Administration approval of the implantable collamer lens (ICL), and, in particular, to review studies relating to sizing methodology, safety, and effectiveness, as well as more recent studies reporting clinical outcomes of the V4c Visian ICL with KS Aquaport, VICMO. A literature search was conducted using two databases, PubMed.gov and Science.gov, to identify all articles published after 2005 related to the Visian ICL (STAAR Surgical, Inc.). Articles were examined for their relevance to sizing methodology, clinical safety, and effectiveness, and the references cited in each article were also searched for additional relevant publications. The literature review revealed that all currently reported methods of determining the best-fit size of the ICL achieve similarly satisfactory results in terms of vault, the safe distance between the crystalline lens and the ICL. Specifically, meta-analysis demonstrated that sulcus-to-sulcus and white-to-white measurement-based sizing methods do not result in clinically meaningful nor statistically significant differences in vault (two-sample two-sided t-test using pooled mean and standard deviations; t (2,594)=1.33; P=0.18). The reported rates of complications related to vault are very low, except in two case series where additional risk factors such as higher levels of myopia and older age impacted the incidence of cataract. On the basis of preclinical studies and initial clinical reports, with up to 5 years of follow-up, the new VICMO central port design holds promise for further reduction of complications. Given its safety record and the significant improvement in vision and quality of life that the ICL makes possible, the benefits of ICL implantation outweigh the risks.
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Affiliation(s)
- Mark Packer
- Mark Packer MD Consulting, Inc., Boulder, CO, USA
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Lee D, Lee SJ, Kyung H. Rotational Stability after Toric Implantable Collamer Lens Implantation. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2015. [DOI: 10.3341/jkos.2015.56.4.477] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
| | - Seung Jae Lee
- Department of Ophthalmology, National Medical Center, Seoul, Korea
| | - Haksu Kyung
- Department of Ophthalmology, National Medical Center, Seoul, Korea
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Price MO, Price FW. Evaluation of the toric implantable collamer lens for simultaneous treatment of myopia and astigmatism. Expert Rev Med Devices 2014; 12:25-39. [PMID: 25418502 DOI: 10.1586/17434440.2015.984685] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Myopic astigmatism is a prevalent condition that can be treated with spectacles, contact lenses, or laser refractive surgery. However, these treatment options have functional limitations at higher levels of refractive error. The toric implantable collamer lens is designed to treat a broad range of refractive error, generally up to -18 diopters with +1 to +6 diopters of astigmatism. Approval for a more limited treatment range of up to 15 diopters of myopia with +1 to +4 diopters of astigmatism is being sought in the US, where this device has not yet received marketing approval. Surgical correction of high-myopic astigmatism can be life-altering and allow people to participate in activities that were not previously feasible because of visual limitations. The toric implantable collamer lens is implanted behind the iris and in front of the natural crystalline lens. With earlier lens designs, it was necessary to create an iridectomy or iridotomy to prevent pupillary block. The newest toric implantable collamer lens model has a small central hole that is not visually noticeable. This eliminates the need to create a hole in the iris, thereby enhancing the safety of the procedure.
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Affiliation(s)
- Marianne O Price
- Cornea Research Foundation of America, 9002 N. Meridian St, Suite 212, Indianapolis, IN 46260, USA
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Kamiya K, Shimizu K, Igarashi A, Kobashi H. Factors influencing long-term regression after posterior chamber phakic intraocular lens implantation for moderate to high myopia. Am J Ophthalmol 2014; 158:179-184.e1. [PMID: 24699155 DOI: 10.1016/j.ajo.2014.03.010] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2013] [Revised: 03/18/2014] [Accepted: 03/20/2014] [Indexed: 11/19/2022]
Abstract
PURPOSE To evaluate the factors affecting the long-term regression after posterior chamber phakic intraocular lens (Visian ICL; STAAR Surgical) implantation for myopia. DESIGN Retrospective observational case series. METHODS We retrospectively examined 60 eyes of 35 consecutive patients (age, 38.4 ± 9.3 years [mean ± standard deviation]) with myopic refractive errors of -4.00 to -15.25 diopters (D) undergoing ICL implantation. We assessed the amount of myopic regression from 1 month to 6 years after surgery. Stepwise multiple regression analysis was used to assess the factors affecting the amount of myopic regression. RESULTS The mean myopic regression from 1 month to 6 years after surgery was -0.33 ± 0.71 D (0.75 to -3.00 D). Explanatory variables relevant to the myopic regression were, in order of influence, patient age (partial regression coefficient B = -0.042, P < .0001) and preoperative axial length (B = -0.186, P = .013) (adjusted R(2) = 0.300). No significant correlation was seen with other clinical factors such as sex, preoperative refraction, intraocular pressure, white-to-white distance, anterior chamber depth, central corneal thickness, or mean keratometric readings. CONCLUSIONS Although the great majority of the variance remains unexplained, eyes of older patients and eyes with longer axial length are more predisposed to show greater myopic regression after ICL implantation. These results indicate that not only patient age but also axial length may play some role in predicting the long-term refractive outcomes of this surgical procedure.
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Affiliation(s)
- Kazutaka Kamiya
- Department of Ophthalmology, University of Kitasato School of Medicine, Kanagawa, Japan.
| | - Kimiya Shimizu
- Department of Ophthalmology, University of Kitasato School of Medicine, Kanagawa, Japan
| | - Akihito Igarashi
- Department of Ophthalmology, University of Kitasato School of Medicine, Kanagawa, Japan
| | - Hidenaga Kobashi
- Department of Ophthalmology, University of Kitasato School of Medicine, Kanagawa, Japan
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Alfonso JF, Lisa C, Alfonso-Bartolozzi B, Pérez-Vives C, Montés-Micó R. Collagen copolymer toric phakic intraocular lens for myopic astigmatism: One-year follow-up. J Cataract Refract Surg 2014; 40:1155-62. [DOI: 10.1016/j.jcrs.2013.11.034] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2013] [Accepted: 11/11/2013] [Indexed: 10/25/2022]
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Shuber HS. Implantable Collamer Lens for Correction of Refractive Errors in Patients with Keratoconus following Collagen Cross-Linking: One Year Follow-up. ACTA ACUST UNITED AC 2014. [DOI: 10.5005/jp-journals-10025-1074] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
ABSTRACT
Objective
The purpose of this study is to assess the predictability, safety, efficacy and stability of correction of refractive errors in patients with keratoconus using Visian implantable collamer lens (ICL) following collagen cross-linking.
Materials and methods
This prospective, non-comparative study evaluated 20 eyes of 14 patients with keratoconus subjected to implantation of intraocular collamer lens at least 1 year following collagen cross-linking and stable refraction. Mean preoperative myopia was −8.43 ± 5.13 Diopters (D) (–3.5 to −20.0D and mean cylinder was −2.19 ± 1.28D (0.0 to −4.5D). The preoperative spherical equivalent (SE) was −9.52 ± 5.33D (–3.75 to −21.25D). During the 12 months follow-up, uncorrected visual acuity, best corrected visual acuity, refraction, intraocular pressure and vaulting are measured.
Results
At 12 months postoperatively, 90% of eye had refractive cylinder of <1.0D with (p = 0.003) and 20 (100%) eyes was within ±0.75D of sphere at 1 year (r2 = 0.99) and (p = 0.0085). The mean postoperative BCVA in decimal was 0.498 ± 0.232, while the mean preoperative BCVA was 0.484 ± 0.285. The safety index at 12 months was 1.02. The mean postoperative UCVA in decimal was 0.498 ± 0.232 and the mean preoperative BCVA is 0.484 ± 0.29 and the efficacy index at 12 months was 1.01.
Conclusion
Implantation of Visian Intraocular collamer lens is predictable, safe and effective way to correct refractive error in patients with keratoconus following collagen cross-linking.
How to cite this article
Shuber HS. Implantable Collamer Lens for Correction of Refractive Errors in Patients with Keratoconus following Collagen Cross-Linking: One Year Follow-up. Int J Kerat Ect Cor Dis 2014;3(1):29-35.
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Comparison of optical quality and intraocular scattering after posterior chamber phakic intraocular lens with and without a central hole (Hole ICL and Conventional ICL) implantation using the double-pass instrument. PLoS One 2013; 8:e66846. [PMID: 23825575 PMCID: PMC3692553 DOI: 10.1371/journal.pone.0066846] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2013] [Accepted: 05/13/2013] [Indexed: 01/29/2023] Open
Abstract
Purpose To objectively compare the optical quality and the intraocular scattering after implantation of the posterior chamber phakic implantable collamer lens (Visian ICL™, STAAR Surgical) with and without a central artificial hole for moderate to high ametropia. Methods This retrospective study comprised 28 eyes of 28 consecutive patients undergoing Hole ICL implantation (mean age ± standard deviation, 30.3±5.8 years), and 24 age-matched eyes of 24 patients undergoing conventional ICL implantation (age, 30.4±6.1 years). We quantitatively assessed the postoperative values of MTF cutoff frequency, Strehl ratio, objective scattering index (OSI), and OQAS values (OVs), using an Optical Quality Analysis System™. We compared these postoperative variables between the two groups. Results The mean MTF cutoff frequency, Strehl ratio, OSI, OV100%, OV 20%, and OV9%, were 26.21±8.32 cycles/degree, 0.16±0.04, 1.16±0.57, 0.87±0.28, 0.80±0.35, and 0.80±0.33, respectively, 3 months after Hole ICL implantation. We found no significant differences in the MTF cutoff frequency (Mann Whitney U test, p = 0.59), the Strehl ratio (p = 0.82), the OSI (p = 0.63), or the OVs at contrasts of 100% (p = 0.58), 20% (p = 0.40), and 9% (p = 0.87), between the two groups. Conclusions Both Hole ICL and conventional ICL implantation provides an excellent optical performance including intraocular scattering. Newly developed Hole ICL implantation appears to be essentially equivalent in the optical quality variables to conventional ICL implantation, suggesting that the presence of the central artificial hole does not significantly affect the optical quality and the intraocular scattering after surgery.
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Three-year follow-up of posterior chamber toric phakic intraocular lens implantation for moderate to high myopic astigmatism. PLoS One 2013; 8:e56453. [PMID: 23409187 PMCID: PMC3568037 DOI: 10.1371/journal.pone.0056453] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2012] [Accepted: 01/08/2013] [Indexed: 02/05/2023] Open
Abstract
PURPOSE To assess the 3-year clinical outcomes of toric phakic intraocular lens (Visian ICL™; STAAR Surgical) implantation for moderate to high myopic astigmatism. METHODS This retrospective study evaluated fifty eyes of 28 patients who underwent toric ICL implantation for the correction of moderate to high myopic astigmatism and who regularly returned for postoperative examination. Before, and 1, 3, and 6 months after, and 1, 2, and 3 years after surgery, we assessed the safety, efficacy, predictability, stability, and adverse events of the surgery in eyes undergoing toric ICL implantation. RESULTS The logarithm of the minimal angle of resolution (LogMAR) uncorrected visual acuity and LogMAR best spectacle-corrected visual acuity were -0.10 (corresponding to Snellen equivalents 20/16) ± 0.16 and -0.20 (corresponding to 20/12.5) ± 0.07, 3 years postoperatively, respectively. The safety and efficacy indices were 1.16 ± 0.20 and 0.94 ± 0.28. At 3 year, 82% and 98% of the eyes were within 0.5 and 1.0 D, respectively, of the targeted correction. Manifest refraction changes of -0.15 ± 0.31 D occurred from 1 month to 3 year. No vision-threatening complications occurred during the observation period. CONCLUSIONS On the basis of the clinical results of this study, toric ICL implantation was good in all measures of safety, efficacy, predictability, and stability for the correction of moderate to high myopic astigmatism throughout a 3-year observation period.
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Sari ES, Pinero DP, Kubaloglu A, Evcili PS, Koytak A, Kutlutürk I, Ozerturk Y. Toric implantable collamer lens for moderate to high myopic astigmatism: 3-year follow-up. Graefes Arch Clin Exp Ophthalmol 2012; 251:1413-22. [PMID: 23052720 DOI: 10.1007/s00417-012-2172-8] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2012] [Revised: 08/23/2012] [Accepted: 09/27/2012] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND To evaluate the 3-year clinical outcomes after toric implantable collamer lens (ICL) implantation for the management of moderate to high myopic astigmatism. METHODS Thirty-four eyes of 20 patients who underwent toric ICL implantation were reviewed. All eyes completed 3-year follow-up. Uncorrected (UDVA) and corrected (CDVA) distance LogMAR visual acuities, refraction, endothelial cell density (ECD), and surgical complications were evaluated. Vectorial analysis of astigmatic correction was also done. RESULTS A significant improvement in UDVA, CDVA, manifest spherical and cylindrical refraction was observed at 1 week and remained stable after 3 years. Twenty-six eyes (76.5%) gained lines of CDVA, and two eyes (5.9%) showed a loss of 1 line of CDVA. The spherical equivalent (SE) was within ±0.50 D of emmetropia in 18 eyes (52.9%) and within ±1.00 D in 28 eyes (82.4%). Differences between target-induced astigmatism (TIA) and surgically-induced astigmatism (SIA) were statistically significant (p < 0.01), and a trend to undercorrection of the refractive astigmatism was present after 3 years. The magnitude of flattening effect (FE) was found to be significantly lower than the magnitude of TIA (p < 0.01). The magnitude of the torque vector was always positive, with a value below 0.50 D in all cases. No vision-threatening complications were observed during the follow-up. CONCLUSION Toric ICL implantation is an effective and safe surgical option that provides a relatively predictable and stable refractive correction of myopic astigmatism. Further improvements are needed to minimize the degree of undercorrection.
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Sheng XL, Rong WN, Jia Q, Liu YN, Zhuang WJ, Gu Q, Sun Y, Pan B, Zhu DJ. Outcomes and possible risk factors associated with axis alignment and rotational stability after implantation of the Toric implantable collamer lens for high myopic astigmatism. Int J Ophthalmol 2012; 5:459-65. [PMID: 22937505 DOI: 10.3980/j.issn.2222-3959.2012.04.10] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2012] [Accepted: 06/27/2012] [Indexed: 11/02/2022] Open
Abstract
AIM To assess the visual outcomes and possible risk factors associated with axis alignment and rotational stability after implantation of Toric implantable collamer lens (TICL) for the correction of high myopic astigmatism. METHODS In this prospective, nonrandomized clinical study, 54 consecutive eyes of 29 patients with high myopic astigmatism received TICL implantation. To evaluate postoperative axis deviation from the intended axis, a digital anterior segment photograph was taken. The ultrasound biomicroscopy(UBM) was used to observe footplate-position. RESULTS After mean follow-up of 8.6 months, mean manifest refractive cylinder (MRC) decreased 79.3% from (-1.88±1.49)D preoperatively to (0.39±0.61)D postoperatively. MRC within 1.00 D occurred in 68.5% (37/54) of eyes, whereas 48.1% (26/54) had MRC within 0.50 D. Mean manifest refraction spherical equivalent (MRSE) changed from (-12.08±4.22)D preoperatively to (-0.41±0.61)D postoperatively. Uncorrected binocular vision of 20/20 or better occurred in 72.2% (39/54) of patients compared with binocular best-corrected visual acuity (BCVA) of 20/20 or better in 44.4% (24/54) preoperatively. The mean difference between intended and achieved TICL axes was (6.96±8.37)°. Footplates of TICLs were in the ciliary sulcus in 22 eyes (46.3%), below the ciliary sulcus in 32 eyes (53.7%). The angle of TICL rotation had significant correlation with the footplates-position (t=2.127; P=0.045) and the postoperative TICL vaulting (r=-0.516; P=0.000). CONCLUSION The results of our study further support the safety, efficacy and predictability of TICL for the correct high myopic astigmatism. The footplate-position of TICL and vault value should be taken into consideration as two possible risks factors for TICL rotation.
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Affiliation(s)
- Xun-Lun Sheng
- Department of Ophthalmology, People's Hospital of Ningxia Hui Autonomous Region, Yinchuan 750001, Ningxia Hui Autonomous Region, China
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Factors affecting rotation of a posterior chamber collagen copolymer toric phakic intraocular lens. J Cataract Refract Surg 2012; 38:568-73. [PMID: 22342008 DOI: 10.1016/j.jcrs.2011.11.028] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2011] [Revised: 11/03/2011] [Accepted: 11/04/2011] [Indexed: 11/23/2022]
Abstract
PURPOSE To evaluate the correlation between postoperative rotation of the toric Implantable Collamer Lens phakic intraocular lens (pIOL) and associated factors. SETTING Nagoya Eye Clinic, Nagoya, Japan. DESIGN Case series. METHODS The toric pIOL axis was analyzed by calculating the ocular internal cylinder power and axis from the total refractive cylinder and corneal astigmatism using vector analysis (Jaffe and Clayman method). The correlation between the toric pIOL rotation over 6 months postoperatively and the associated factors (ie, age, preoperative manifest refractive sphere, preoperative manifest spherical equivalent, mean keratometric power, axial length, toric pIOL intraoperative fixation angle, postoperative toric pIOL vault [distance between toric pIOL and anterior surface of crystalline lens], toric pIOL spherical power) were evaluated. RESULTS The mean age of the 34 patients (58 eyes) was 35.7 years ± 6.5 (SD). The mean rotation 6 months postoperatively was 4.82 ± 6.98 degrees (range 0.0 to 47.2 degrees). The intraoperative toric pIOL fixation angle and postoperative toric pIOL rotation were significantly correlated (Spearman rank correlation: P=.0096 and R(2) = 0.1140; multiple logistic regression analysis: P=.009). In the 1 eye with significant rotation (47.2 degrees), the toric pIOL was exchanged for a larger toric pIOL. CONCLUSIONS A small toric pIOL rotation occurred during the 6-month follow-up. One cause of rotation could be the intraoperative fixation angle of the toric pIOL. A toric pIOL with a minimum intraoperative fixation angle should be used to prevent postoperative rotation.
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