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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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Liu S, Liu J, Lin F, Yu L, Cheng C, Wang T, Zhou X. Efficacy Comparison Between Steep-Meridian Incision and Non-Steep-Meridian Incision in Implantable Collamer Lens Surgery with Low-to-Moderate Astigmatism. Ophthalmol Ther 2023; 12:1711-1722. [PMID: 37016057 PMCID: PMC10164207 DOI: 10.1007/s40123-023-00704-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 03/16/2023] [Indexed: 04/06/2023] Open
Abstract
INTRODUCTION To compare the visual outcomes of astigmatism correction with implantable collamer lens (ICL) surgery with low-to-moderate astigmatism through a steep-meridian corneal relaxing incision (SM-CRI) and non-steep-meridian corneal relaxing incision (NSM-CRI). METHODS Seventy eyes of 70 patients with myopia and myopic astigmatism who underwent ICL V4c implantation were classified into two groups: SM-CRI and NSM-CRI. Refractive outcomes and vector analysis were evaluated preoperatively and 6 months postoperatively. RESULTS At the postoperative 6 month visit, all participants in both groups achieved an uncorrected distance visual acuity (UDVA) of 20/20 or better. The difference vector (DV) showed that the residual astigmatism in the SM-CRI group was much smaller than that in the NSM-CRI group (P = 0.021), and the correction index (CI) was 0.84 ± 0.30 and 0.67 ± 0.35 for the SM-CRI and NSM-CRI groups, respectively, with a significant statistical difference (P = 0.013). Approximately 71% of eyes in the SM-CRI group had an angle of error (AE) within ± 15°, whereas 55% of eyes in the NSM-CRI group were within that range. The absolute mean AE was 10.13 ± 14.57° in the SM-CRI group, compared with 23.88 ± 28.22° in the NSM-CRI group (P = 0.038). CONCLUSION SM-CRI can alleviate corneal astigmatism and decrease the cylindrical diopter of the ICL, thus improving postoperative visual quality compared with NSM-CRI.
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Affiliation(s)
- Shengtao Liu
- Key Lab of Myopia, Ministry of Health, Department of Ophthalmology, EYE & ENT Hospital of Fudan University, Shanghai, China
| | - Jingying Liu
- Jiangxi Research Institute of Ophthalmology and Visual Sciences, Department of Affiliated Eye Hospital, Nanchang University, Nanchang, China
| | - Feng Lin
- Key Lab of Myopia, Ministry of Health, Department of Ophthalmology, EYE & ENT Hospital of Fudan University, Shanghai, China
| | - Lanhui Yu
- Jiangxi Research Institute of Ophthalmology and Visual Sciences, Department of Affiliated Eye Hospital, Nanchang University, Nanchang, China
| | - Chiwen Cheng
- Jiangxi Research Institute of Ophthalmology and Visual Sciences, Department of Affiliated Eye Hospital, Nanchang University, Nanchang, China
| | - Ti Wang
- Key Lab of Myopia, Ministry of Health, Department of Ophthalmology, EYE & ENT Hospital of Fudan University, Shanghai, China.
| | - Xingtao Zhou
- Key Lab of Myopia, Ministry of Health, Department of Ophthalmology, EYE & ENT Hospital of Fudan University, Shanghai, China.
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Wan H, Tao Y, Duan J, Wang L, Tang L. Association between the site of clear corneal Phakic intraocular lens implantation incisions and the inflow of ocular surface fluid into the anterior chamber. Front Med (Lausanne) 2023; 10:1063003. [PMID: 36936228 PMCID: PMC10019354 DOI: 10.3389/fmed.2023.1063003] [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: 10/06/2022] [Accepted: 02/06/2023] [Indexed: 02/28/2023] Open
Abstract
Background Posterior chamber phakic intraocular implantable collamer lens (ICL) implantation is an effective surgical option for the management of myopia. Over the past few years, the number of ICL surgeries has significantly increased. Postoperative inflammation and endophthalmitis are among the most serious complications after successful ICL surgery. Sometimes, when the blepharospasm is removed at the end of surgery, a small amount of the ocular surface fluid will flow into the anterior chamber, which can lead to an increased risk of infection and inflammation. However, little attention has been paid to this phenomenon. Purpose We conducted a retrospective study to compare the incidence of extraocular fluid inflow into the eye through the clear corneal incision (CCI) at two different positions (superior and temporal sides). Methods A total of 116 patients with myopia underwent superior CCI ICL implantation (n = 58) or temporal CCI ICL implantation (n = 58) at our hospital from October to December 2021. The incidence of conjunctival sac fluid entering the anterior chamber after eyelid fixative was removed was compared in both groups. Results Both groups were well matched in all parameters. Ocular surface fluid inflow into the anterior chamber was significantly higher in the superior CCI group (25/58, 47.1%) than in the temporal CCI group (1/58, 1.7%) (p < 0.05). Conclusion In the patients with ICL implantation, the temporal CCI was better than the superior CCI in avoiding the ocular surface fluid inflow into the anterior chamber, and the potential risk of infection and inflammation was lower.
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Affiliation(s)
- Huan Wan
- Department of Ophthalmology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
- Department of Ophthalmology, People's Hospital of Meishan, Meishan, Sichuan, China
| | - Yunhan Tao
- Department of Ophthalmology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Jianan Duan
- Department of Ophthalmology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Lin Wang
- Department of Ophthalmology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
- Lin Wang,
| | - Li Tang
- Department of Ophthalmology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
- *Correspondence: Li Tang,
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Zhang H, Gong R, Zhang X, Deng Y. Analysis of perioperative problems related to intraocular Implantable Collamer Lens (ICL) implantation. Int Ophthalmol 2022; 42:3625-3641. [PMID: 35731355 PMCID: PMC9587946 DOI: 10.1007/s10792-022-02355-w] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Accepted: 04/18/2022] [Indexed: 02/05/2023]
Abstract
PURPOSE To introduce a modified procedure of ICL implantation, to summarize the perioperative problems and their corresponding treatment after myopia correction with Implantable Collamer Lens (ICL), and to compare the difference of complications between the no-hole ICL and hole ICL. METHODS We searched all articles on ICL-related perioperative problems and their corresponding treatment in Scopus, Embase, PubMed and Web of Science databases for the last 22 years. RESULTS ICL implantation is safe, effective, stable and predictable in the correction of myopia, hyperopia and astigmatism, but can also cause a series of perioperative problems, including intraoperative and postoperative complications. CONCLUSION There are many kinds of complications related to ICL, but the common intraoperative and postoperative complications mainly include abnormality of arch height, abnormal position of ICL, loss of corneal endothelial cells and corneal decompensation, high intraocular pressure and secondary glaucoma, cataract and night vision symptoms. Compared with ICL without central pore, the incidence of complications such as loss of corneal endothelial cells and corneal decompensation, high intraocular pressure and secondary glaucoma and cataract was relatively lower in central hole ICL, while postoperative complications such as night vision symptoms were obvious.
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Affiliation(s)
- Hao Zhang
- Department of Ophthalmology, West China Hospital, Sichuan University, No.37, Guoxue Xiang, Chengdu, 610041 Sichuan China
| | - Rui Gong
- Department of Ophthalmology, West China Hospital, Sichuan University, No.37, Guoxue Xiang, Chengdu, 610041 Sichuan China
| | - Xiaolan Zhang
- Department of Ophthalmology, West China Hospital, Sichuan University, No.37, Guoxue Xiang, Chengdu, 610041 Sichuan China
| | - Yingping Deng
- Department of Ophthalmology, West China Hospital, Sichuan University, No.37, Guoxue Xiang, Chengdu, 610041 Sichuan China
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Monteiro T, Pinto C, Franqueira N, Faria-Correia F, Mendes J, Alfonso Sánchez J, Vaz F. Efficacy and Safety After Toric Posterior Chamber Implantable Collamer Lens and Toric Iris-Fixated Foldable Phakic Intraocular Lens for Myopic Astigmatism. J Refract Surg 2022; 38:339-347. [PMID: 35686710 DOI: 10.3928/1081597x-20220406-01] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
PURPOSE To compare visual, refractive, and safety outcomes of toric posterior chamber Implantable Collamer Lens (T-ICL) (STAAR Surgical) and toric iris-fixated foldable phakic intraocular lens (IOL) (T-Artiflex; Ophtec BV) implantation for the correction of myopic astigmatism. METHODS This retrospective cohort study included 312 eyes of 312 patients who had phakic IOL implantation for myopic astigmatism. Two groups were defined: 205 eyes that underwent T-ICL implantation and 107 eyes that underwent T-Artiflex implantation. Safety, efficacy, and predictability outcomes were evaluated preoperatively and at 12 months postoperatively. Refractive and corneal astigmatic vector analysis were performed using the Alpins method. RESULTS One year postoperatively, uncorrected distance visual acuity was 0.05 ± 0.18 (T-ICL) and 0.10 ± 0.16 (T-Artiflex) logMAR, with efficacy indexes of 1.16 ± 0.27 and 1.05 ± 0.31, respectively (P < .001). Safety indexes were 1.28 ± 0.30 and 1.21 ± 0.31, respectively (P = .04). Spherical equivalent was within ±0.50 diopters (D) of emmetropia in 165 (80.5%) and 88 (82.2%) eyes, respectively. Refractive astigmatic analysis showed an index of success of 0.28 ± 0.33 (T-ICL) and 0.31 ± 0.26 (T-Artiflex) (P = .07). Surgically induced corneal astigmatism was 0.48 ± 0.74 and 0.81 ± 0.61 D, respectively (P < .001). Mean endothelial loss was 1.11% and 2.05%, respectively (P = .42). Six (2.9%) eyes in the T-ICL group and 1 (0.9%) eye in the T-Artiflex group had phakic IOL repositioning due to significant misalignment. No vision-threatening complications occurred. CONCLUSIONS Both the T-ICL and T-Artiflex groups showed high visual and refractive efficacy with a good safety profile for the correction of myopic astigmatism. T-ICL implantation demonstrated significantly better efficacy and safety indexes after 12 months. Vector analysis showed similar refractive astigmatic correction in both groups, but T-Artiflex implantation revealed higher surgically induced corneal astigmatism. [J Refract Surg. 2022;38(6):339-347.].
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Kamiya K, Ando W, Hayakawa H, Gotoda S, Shoji N. Vertically Fixated Posterior Chamber Phakic Intraocular Lens Implantation Through a Superior Corneal Incision. Ophthalmol Ther 2022; 11:701-710. [PMID: 35119584 PMCID: PMC8927518 DOI: 10.1007/s40123-022-00470-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 01/21/2022] [Indexed: 11/27/2022] Open
Abstract
Introduction To assess the 1-year outcomes of vertically fixated posterior chamber phakic intraocular lens implantation through a superior corneal incision. Methods This pilot study comprised 78 eyes of 53 consecutive patients undergoing vertically fixated implantable collamer lens (ICL) implantation through a superior corneal incision to correct moderate to high myopia and myopic astigmatism. We prospectively determined the safety, efficacy, predictability, stability, and adverse events preoperatively, and at 1 week and 1, 3, and 12 months postoperatively. Results The mean follow-up period was 10.4 ± 5.4 months. Uncorrected and corrected visual acuity were −0.20 ± 0.10 and −0.25 ± 0.07 logMAR, respectively, at 1 year postoperatively. At 1 year postoperatively, 98% and 100% of eyes were within 0.5 and 1.0 D, respectively, of the targeted correction. A nonsignificant change in manifest refraction of −0.01 ± 0.08 D occurred from 1 week to 1 year. The manifest astigmatism decreased significantly, from 0.69 ± 0.73 D preoperatively to 0.21 ± 0.27 D at 1 year postoperatively (Mann–Whitney U test, p < 0.001). No vision-threatening complications occurred at any time in this series. Conclusions According to our experience, the vertically fixated ICL through a superior incision achieved good results, without significant complications. Considering that younger patients requiring ICL surgery tend to have with-the-rule astigmatism, this surgical technique may be a viable option for reducing astigmatism without using toric ICLs. Supplementary Information The online version contains supplementary material available at 10.1007/s40123-022-00470-6.
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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, Kanagawa, Japan
| | - Hideki Hayakawa
- Department of Ophthalmology, School of Medicine, Kitasato University, Kanagawa, Japan
| | - Satoshi Gotoda
- Department of Ophthalmology, School of Medicine, Kitasato University, Kanagawa, Japan
| | - Nobuyuki Shoji
- Department of Ophthalmology, School of Medicine, Kitasato University, Kanagawa, Japan
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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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Kamiya K, Iijima K, Ando W, Shoji N. Comparison of Mean and Centroid of Surgically Induced Astigmatism After Standard Cataract Surgery. Front Med (Lausanne) 2021; 8:670337. [PMID: 34150805 PMCID: PMC8212985 DOI: 10.3389/fmed.2021.670337] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Accepted: 05/12/2021] [Indexed: 11/13/2022] Open
Abstract
Purpose: To compare the arithmetic mean of surgically induced astigmatism (M-SIA) and the centroid of surgically induced astigmatism (C-SIA) after standard cataract surgery. Methods: We retrospectively examined 200 eyes of 100 consecutive patients undergoing bilateral cataract surgery through a 2.8 mm temporal clear corneal incision. We quantitatively measured the magnitude and axis of corneal astigmatism preoperatively and 3 months postoperatively using an automated keratometer (TONOREFF-II, Nidek). We assessed the M-SIA, the C-SIA, and the double angle plots for the display of the individual SIA distributions. Results: For bilateral data analysis, the magnitude of corneal astigmatism significantly increased from 0.66 ± 0.39 D preoperatively to 0.74 ± 0.46 D postoperatively (paired t-test, p = 0.012). The M-SIA was 0.50 ± 0.36 D. On the other hand, the C-SIA was 0.18 ± 0.60 D at an axis of 97°. For unilateral analysis, we obtained similar outcomes between the right and left eye groups. Conclusions: According to our experience, standard cataract surgery induces the M-SIA by approximately 0.5 D. The magnitude of the C-SIA largely decreased to approximately 40% of the M-SIA, and the direction of the C-SIA showed a tendency toward with-the-rule astigmatism. It should be noted that the M-SIA was considerably different from the C-SIA, especially when selecting the appropriate toric IOL model and power.
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Affiliation(s)
- Kazutaka Kamiya
- Visual Physiology, School of Allied Health Sciences, Kitasato University, Kanagawa, Japan
| | - Kei Iijima
- Department of Ophthalmology, School of Medicine, Kitasato University, Kanagawa, Japan
| | - Wakako Ando
- Department of Ophthalmology, School of Medicine, Kitasato University, Kanagawa, Japan
| | - Nobuyuki Shoji
- Department of Ophthalmology, School of Medicine, Kitasato University, Kanagawa, Japan
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Wan T, Yin H, Wu Z, Yang Y. Vector analysis of small incision lenticule extraction and toric implantable collamer lens implantation for astigmatism correction. Eur J Ophthalmol 2020; 31:994-1001. [PMID: 32468871 DOI: 10.1177/1120672120930607] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES To compare the efficacy of small incision lenticule extraction (SMILE) and toric implantable collamer lens (TICL) implantation for myopic astigmatism correction using vector analysis. METHODS In this retrospective study, 171 eyes of 171 patients with cylinder ⩾1.0 diopters (D) were recruited, with 97 eyes underwent SMILE and 74 eyes underwent TICL implantation. Preoperative and 3-months postoperative visual and refractive results were examined. The astigmatism correction, graded by the degree of preoperative cylinder was compared between two groups using vector analysis. RESULTS At 3-months postoperatively, the residual cylinder was -0.10 ± 0.21 D in the SMILE group and -0.30 ± 0.32 D in the TCL group (p < 0.05). Furthermore, 98% and 85% of eyes had the cylinder within ±0.5 D in the SMILE and TICL group, respectively. The vector analysis revealed similar target induced astigmatism vector in two groups. However, the difference vector, magnitude of error, angle of error, and index of success were significantly higher (0.30 ± 0.32 D, -0.19 ± 0.25, -2° ± 4.35°, and 0.16 ± 0.17 D, respectively) in the TICL group than the values in the SMILE group (0.10 ± 0.21 D, -0.05 ± 0.20, -0.03° ± 2.13°, and 0.05 ± 0.12, respectively), regardless of the degree of preoperative cylinder (all p < 0.05). For preoperative cylinder < 2.0 D, surgically induced astigmatism vector and correction index in the SMILE group were higher than those in the TICL group (p < 0.05). CONCLUSION Both SMILE and TICL implantation are effective techniques for myopic astigmatism correction. However, the accuracy of correction in the magnitude and axis of astigmatism with SMILE was better than that achieved with TICL implantation.
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Affiliation(s)
- Ting Wan
- Eye Center, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Houfa Yin
- Eye Center, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Zhiyi Wu
- Eye Center, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Yabo Yang
- Eye Center, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
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Ammar H, Anbar M, Abdellah MM. Comparison of Visian toric collamer lens and toric acrylic intraocular lens implantation for the treatment of myopia with astigmatism. Clin Ophthalmol 2017; 11:105-114. [PMID: 28096654 PMCID: PMC5207452 DOI: 10.2147/opth.s122442] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Purpose To compare the efficacy and outcome of phakic toric implantable collamer lens (TICL) and refractive clear lens extraction with AcrySof Toric intraocular lens (TIOL) implantation for the treatment of myopic astigmatism. Patients and methods This study assessed eyes with myopic astigmatism >−1 D and ≤−4 D with a spherical equivalent >10 D or <10 D if the patients were unsuitable for corneal refractive surgery. These eyes were divided into group A, in which Visian Toric ICL™ Phakic TICL was implanted, and group B, which involved clear lens extraction with implantation of an AcrySof IQ toric SN60T3-9™ IOL. The outcome and complications were evaluated. Results This study enrolled 63 eyes of 38 patients with a follow-up period of at least 6 months. The mean postoperative spherical equivalent was −0.19±0.31 D in group A and −0.21±0.28 D in group B (P=0.69). The mean postoperative cylinder value was −0.46±0.53 D in group A and −0.32±0.41 D in group B (P=0.35). Postoperative cylinder was <1 D in 76.47% and 79.31% of eyes in groups A and B, respectively. The mean endothelial cell count was reduced by 4.32% in group A and by 5.32% in group B (P=0.003). The mean postoperative intraocular pressure increased insignificantly in group A (P=0.22) and reduced significantly in group B (P=0.004). The complication rate was 11.76% in group A and 6.90% in group B. Conclusion Both procedures showed predictable results and good visual results. However, the loss of accommodation and risk of retinal complications in the TIOL group suggest that the use of TICL for myopic astigmatism is a better choice in younger patients.
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Affiliation(s)
- Hatem Ammar
- Department of Ophthalmology, Faculty of Medicine, Sohag University, Sohag, Egypt
| | - Mohamed Anbar
- Department of Ophthalmology, Faculty of Medicine, Sohag University, Sohag, Egypt
| | - Marwa M Abdellah
- Department of Ophthalmology, Faculty of Medicine, Sohag University, Sohag, Egypt
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Kim B, Mun S, Choi H, Chung Y. Short-term Clinical Outcomes of Implantable Collamer Lens Implantation with Simultaneous Full Thickness Astigmatic Keratotomy. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2017. [DOI: 10.3341/jkos.2017.58.8.916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Buki Kim
- Onnuri Smile Eye Clinic, Seoul, Korea
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Kwon HJ, Nam SM, Stulting RD, Lim CY, Seo KY. Comparison of surgically induced astigmatism following iris-claw PIOL insertion with scleral, limbal, or corneal incisions. J Refract Surg 2014; 30:330-5. [PMID: 24893358 DOI: 10.3928/1081597x-20140416-02] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2013] [Accepted: 12/05/2013] [Indexed: 11/20/2022]
Abstract
PURPOSE To compare surgically induced astigmatism (SIA) based on incision site and evaluate the clinical results and astigmatic stability of iris-claw phakic intraocular lens (Artisan lens; Ophtec BV, Groningen, Netherlands) implantation. METHODS Eighty-five eyes of 53 patients with myopia who underwent Artisan lens implantation with a 6.2-mm incision and follow-up of 6 months were retrospectively observed. SIA was assessed using keratometric astigmatism at 6 months postoperatively for the incision sites of the sclera, limbus, and cornea, and the efficacy, safety, predictability, and astigmatic stability were also calculated. RESULTS SIA obtained using Naeser's polar method (KP[90]SIA) was -0.48 ± 0.35 for scleral incisions, -0.99 ± 0.35 for limbal incisions, and -1.14 ± 0.54 for corneal incisions. Corresponding net astigmatism values, as calculated with KP(90)SIA and KP(135)SIA, were 0.70 ± 0.48 (177°), 1.04 ± 0.37 (175°), and 1.21 ± 0.57 (1°), respectively, with SIA increasing the nearer the incision was to the cornea center. Six months after surgery, the efficacy index was 1.03 and the safety index was 1.08. Ninety-eight percent of patients were within 1.50 diopters of attempted refraction. CONCLUSIONS The values of SIA after Artisan lens insertion showed significant differences among three incision locations, despite the absence of significant differences in preoperative steep corneal axis astigmatism values at the incision locations. It would be applicable for refractive surgery in the aspect of minimizing astigmatism 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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Kamiya K, Shimizu K, Aizawa D, Igarashi A, Komatsu M, Nakamura A. One-Year Follow-up of Posterior Chamber Toric Phakic Intraocular Lens Implantation for Moderate to High Myopic Astigmatism. Ophthalmology 2010; 117:2287-94. [DOI: 10.1016/j.ophtha.2010.03.054] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2009] [Revised: 02/07/2010] [Accepted: 03/24/2010] [Indexed: 10/19/2022] Open
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Kohnen T, Kook D, Morral M, Güell JL. Phakic intraocular lenses. J Cataract Refract Surg 2010; 36:2168-94. [DOI: 10.1016/j.jcrs.2010.10.007] [Citation(s) in RCA: 141] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2010] [Revised: 09/01/2010] [Accepted: 09/01/2010] [Indexed: 11/29/2022]
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Kamiya K. Current status of implantable collamer lens. EXPERT REVIEW OF OPHTHALMOLOGY 2010. [DOI: 10.1586/eop.09.69] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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