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Alfonso JF, Fernández-Vega-Cueto L, Lisa C, Alfonso-Bartolozzi B, Palacios A, Madrid-Costa D. Clinical and Aberrometric Outcomes of a New Implantable Collamer Lens for Myopia and Presbyopia Correction in Phakic Patients. J Refract Surg 2023; 39:589-596. [PMID: 37675906 DOI: 10.3928/1081597x-20230726-02] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/08/2023]
Abstract
PURPOSE To assess the clinical and aberrometric outcomes of a new Implantable Collamer Lens (EVO Viva ICL; STAAR Surgical) to correct moderate to high myopia and presbyopia. METHODS The study included 80 eyes of 40 patients who had bilateral EVO Viva ICL implantation. Uncorrected (UDVA) and corrected (CDVA) distance visual acuities, refraction, presbyopic add power, binocular through-focus visual acuity, total ocular spherical aberration (SA), coma aberration, and root mean square of ocular higher order aberrations (RMS HOAs) (i-Trace Aberrometer; Tracey Technologies) for a 4.5-mm pupil size were evaluated. RESULTS The mean binocular postoperative UDVA and CDVA were 0.09 ± 0.19 and 0.02 ± 0.03 logMAR, respectively. The postoperative spherical equivalent was -0.61 ± 0.54 diopters (D). The presbyopic add power reduced from +1.31 ± 0.74 D preoperatively to +0.44 ± 0.58 D after surgery (P < .0001). The mean visual acuity was 0.1 logMAR or better (20/25 or better) across the vergence range from +0.50 to -1.50 D, better than 0.2 logMAR (20/32 or better) up to the vergence of -2.00 D, and remained better than 0.3 logMAR (20/40 or better) up to the vergence of -2.50 D. The total ocular aberrations induced by EVO Viva ICL were -0.34 ± 0.09 µm of SA, 0.24 ± 0.18 µm of coma, and 0.26 ± 0.12 µm of RMS HOAs. CONCLUSIONS The outcomes support that the new ICL might be a good alternative for myopia and presbyopia correction in patients aged between 45 and 55 years. Further studies are needed to evaluate the threshold lens misalignment from which the patient´s visual quality would be affected. [J Refract Surg. 2023;39(9):589-596.].
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Martínez-Plaza E, López-de la Rosa A, López-Miguel A, Holgueras A, Maldonado MJ. EVO/EVO+ Visian Implantable Collamer Lenses for the correction of myopia and myopia with astigmatism. Expert Rev Med Devices 2023; 20:75-83. [PMID: 36708714 DOI: 10.1080/17434440.2023.2174429] [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: 01/30/2023]
Abstract
INTRODUCTION Intraocular lens implantation in phakic eyes for the correction of refractive error is currently a widespread procedure. The EVO and EVO+ Visian Implantable Collamer Lenses (ICL) are two of the most prevalent lenses implanted. They incorporate a central orifice to avoid the need for iridotomy. The main difference between both ICL is the higher optical diameter zone provided by the EVO+, allowing a better quality of vision at night. This review aims to provide an overview of the current ICL models available for correcting myopia and myopic astigmatism. AREAS COVERED During the last decade, more than 100 scientific papers analyzing the performance of EVO and EVO+ lenses have been published. This review describes the objective visual performance achieved with the implantation of central hole ICL lenses and the subjective perception of the patients implanted with these lenses. In addition, the safety and the potential complications associated with undergoing an EVO and EVO+ ICL implantation have been addressed. EXPERT OPINION Refractive surgeons and candidates to undergo ICL implantation should be aware of the excellent safety and visual outcomes provided by the implantation of central hole ICL lenses. However, future research could address minor issues currently not resolved.
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Affiliation(s)
- Elena Martínez-Plaza
- Instituto de Oftalmobiología Aplicada (IOBA), Universidad de Valladolid, Valladolid, Spain
| | | | - Alberto López-Miguel
- Instituto de Oftalmobiología Aplicada (IOBA), Universidad de Valladolid, Valladolid, Spain
| | - Alfredo Holgueras
- Instituto de Oftalmobiología Aplicada (IOBA), Universidad de Valladolid, Valladolid, Spain
| | - Miguel J Maldonado
- Instituto de Oftalmobiología Aplicada (IOBA), Universidad de Valladolid, Valladolid, Spain
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ICL Postimplantation Decentration and Tilt in Myopic Patients with Primary Iridociliary Cysts. J Ophthalmol 2023; 2023:3475468. [PMID: 36700115 PMCID: PMC9870672 DOI: 10.1155/2023/3475468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 10/09/2022] [Accepted: 10/25/2022] [Indexed: 01/18/2023] Open
Abstract
Purpose To observe the decentration and tilt of implantable collamer lens (ICL) as well as possible visual effects postimplantation in primary iridociliary cysts. Methods The present investigation was a retrospective cohort study. All 48 patients (91 eyes) who underwent ICL surgery at the Center of Refraction Surgery of Tianjin Medical University Eye Hospital between July 2018 and May 2020 were split into two groups based on the absence or presence of primary iridociliary cysts established by ultrasonic biological microscopy (UBM) examination. Intraocular pressure (IOP), corrected distance visual acuity (CDVA), uncorrected distance visual acuity (UDVA), anterior chamber angle (ACA), anterior chamber volume (ACV), and anterior chamber depth (ACD) were recorded preoperatively and postoperatively at 1, 6, and 12 months. Additionally, we performed an analysis of the ICL vault, decentration, and tilt using a rotating Scheimpflug Oculus Pentacam camera system at 1, 6, and 12 months after surgery. Results No serious complications were observed. Significant postoperative improvement (P < 0.05) of UDVA was established in the two studied groups; however, we did not observe statistically significant intergroup differences (P > 0.05) throughout the entire research period. In each group, the preoperative ACA, ACV, and ACD were statistically significantly reduced (P < 0.05), but no such decrease was established between their postoperative values (P > 0.05). We observed no statistical differences between both groups with regard to their values of IOP, ACA, ACV, ACD, ICL vault, ICL decentration, and tilt at 1, 6, and 12 months after surgery. Similarly, no statistically significant within-group correlation (P > 0.05) of the decentration of ICL and the tilt and the CDVA values was established. Conclusion No postimplantation effect of ICL with a central hole on vision was established in myopia patients with primary iridociliary cysts, within certain limits of ICL decentration and tilt values.
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Wannapanich T, Kasetsuwan N, Reinprayoon U. Intraocular Implantable Collamer Lens with a Central Hole Implantation: Safety, Efficacy, and Patient Outcomes. Clin Ophthalmol 2023; 17:969-980. [PMID: 36998514 PMCID: PMC10046236 DOI: 10.2147/opth.s379856] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 03/15/2023] [Indexed: 04/01/2023] Open
Abstract
This review summarizes the available literature and provides updates on the efficacy, safety, and patient outcomes of phakic intraocular lens implantation using implantable collamer lens (ICL), with a focus on newer models with a central port (EVO/EVO+ Visian Implantable Collamer Lens, STAAR Surgical Inc.). All studies included in this review were identified from the PubMed database and were reviewed for relevancy of their topic. Data on hole-ICL implantation performed between October 2018 and October 2022 in 3399 eyes showed a weighted average efficacy index of 1.03 and a weighted average safety index of 1.19 within an average follow-up of 24.7 months. The incidence of complications such as elevated intraocular pressure, cataract, and corneal endothelial cell loss was low. Moreover, both quality of vision and quality of life improved after ICL implantation, confirming the benefits of this procedure. In conclusion, ICL implantation is a promising refractive surgery alternative to laser vision correction with excellent efficacy, safety, and patient outcomes.
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Affiliation(s)
- Trakanta Wannapanich
- Department of Ophthalmology, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok, Thailand
| | - Ngamjit Kasetsuwan
- Department of Ophthalmology, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok, Thailand
- Chula Refractive Surgery Center, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
- Excellence Center for Cornea and Limbal Stem Cell Transplantation, Department of Ophthalmology, King Chulalongkorn Memorial Hospital, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Correspondence: Ngamjit Kasetsuwan, Department of Ophthalmology, Faculty of Medicine, Chulalongkorn University, 1873 Rama 4 Road, Pathumwan, Bangkok, 10330, Thailand, Tel +6622564142, Email
| | - Usanee Reinprayoon
- Department of Ophthalmology, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok, Thailand
- Chula Refractive Surgery Center, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
- Excellence Center for Cornea and Limbal Stem Cell Transplantation, Department of Ophthalmology, King Chulalongkorn Memorial Hospital, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
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Zhang D, Yang M, Liu Z, Cai H, Chen X, Zhang C. The effect of implantable collamer Lens V4c on ocular biometric measurements and intraocular lens power calculation based on Pentacam-AXL and IOLMaster 500. BMC Ophthalmol 2022; 22:421. [PMCID: PMC9637308 DOI: 10.1186/s12886-022-02644-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Accepted: 10/25/2022] [Indexed: 11/08/2022] Open
Abstract
Background To investigate the possible effect of implantable collamer lens (ICL) V4c on ocular biometric measurements by a new biometer Pentacam-AXL and partial coherence interferometry (PCI)-based IOLMaster 500 and intraocular lens power calculation using fourth-generation formula. Methods We retrospectively enrolled patients who underwent ICL (EVO-V4c, STAAR Surgical Co. Nidau, Switzerland) implantation surgery from September 2020 to November 2021. The Pentacam-AXL and IOLMaster 500 biometers were used to measure axial length (AL), anterior chamber depth (ACD), keratometry (K), white to white (WTW), and central corneal thickness (CCT) values before and at least 2 months after ICL V4c implantation. The IOL power was calculated using the Barrett Universal II formula. Results The study included 45 eyes in 28 patients. There was a significant increase in ALs (average 0.03 ± 0.07 mm, p = 0.01) and a significant decrease of ACDs (average 0.19 ± 0.17 mm, p < 0.001) based on Pentacam-AXL. Similar changes in ALs and ACDs were also found in IOLMaster 500. In addition, the difference in WTWs in the two devices and that of CCTs in Pentacam-AXL were statistically significant. However, the preoperative and postoperative K1 and K2 were separately comparable using either device. The IOL power calculated by the Barrett Universal II formula did not change significantly either by the software built in Pentacam-AXL or by manually putting the parameters of the IOLMaster 500 into the formula manually (p = 0.058, p = 0.675, respectively). Conclusions Ocular parameters including ALs, ACDs, WTWs, and CCTs using a new Pentacam-AXL and standard PCI-based IOLMaster 500 changed significantly before and after the ICL V4c implantation, while IOL power prediction using the Barrett Universal II formula was little affected.
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Affiliation(s)
- Di Zhang
- grid.411642.40000 0004 0605 3760Department of Ophthalmology, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing, 100191 PR China ,grid.411642.40000 0004 0605 3760Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing, 100191 PR China
| | - Meng Yang
- Beijing Fenglian Jiayuelige Ophthalmic Clinic, 18 Chaoyangmenwai Street, Chaoyang District, Beijing, 100020 PR China
| | - Ziyuan Liu
- grid.411642.40000 0004 0605 3760Department of Ophthalmology, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing, 100191 PR China ,grid.411642.40000 0004 0605 3760Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing, 100191 PR China
| | - Hongyuan Cai
- grid.411642.40000 0004 0605 3760Department of Ophthalmology, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing, 100191 PR China ,grid.411642.40000 0004 0605 3760Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing, 100191 PR China
| | - Xiaoyong Chen
- grid.411642.40000 0004 0605 3760Department of Ophthalmology, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing, 100191 PR China ,grid.411642.40000 0004 0605 3760Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing, 100191 PR China
| | - Chun Zhang
- grid.411642.40000 0004 0605 3760Department of Ophthalmology, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing, 100191 PR China ,grid.411642.40000 0004 0605 3760Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing, 100191 PR China
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Niu L, Zhang Z, Miao H, Zhao J, Li M, He JC, Yao P, Zhou X. Effects of tilt and decentration of Visian Implantable Collamer Lens (ICL V4c) on visual quality: an observational study. BMC Ophthalmol 2022; 22:294. [PMID: 35790941 PMCID: PMC9254425 DOI: 10.1186/s12886-022-02499-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Accepted: 06/17/2022] [Indexed: 01/19/2023] Open
Abstract
Background The central hole of the Visian Implantable Collamer Lens (ICL V4c) provides a reference to observe its tilt or decentration. This study aimed to investigate the tilt and decentration effects of ICL V4c on visual quality after implantation. Methods A total of 135 eyes from 69 patients who underwent ICL V4c implantation were included in this study. Evaluation of uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), and aberrations were performed 6-months postoperatively. The anterior segment parameters were collected using CASIA2 anterior segment-optical coherence tomography, tilt and decentration of ICL V4c were analyzed using MATLAB software. All patients received questionnaires to investigate the visual quality postoperatively. Results The safety and effectiveness were 1.18 ± 0.17 and 1.11 ± 0.18, respectively. No significant changes were observed regarding higher-order and spherical aberrations after the operation; however, coma and trefoil significantly increased compared to preoperative values. The average total decentration and tilt was 0.21 ± 0.12 mm and 2.54 ± 1.00°, respectively. Horizontal, vertical, and total values of tilt and decentration were not significantly associated with postoperative CDVA, UDVA, and aberrations. The most common visual symptom was halo, and 97.04% of patients had a satisfaction score ≥ 8. The total or horizontal tilt was significantly positively correlated with the frequency, severity, and bothersome scores from the questionnaires. Conclusions ICL V4c implantation can obtain high visual quality and patient satisfaction. Although the degree of tilt and decentration after ICL V4c implantation was small, a positive effect on subjective visual quality was observed. Supplementary Information The online version contains supplementary material available at 10.1186/s12886-022-02499-4.
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Qin Q, Bao L, He Z, Chen F, Zhu D, Zhang S, Zhang W, Liu Y, Gao R, Xie Z. Pure ICL Implantation: A Novel Ophthalmic Viscosurgical Device-Free Method. J Ophthalmol 2021; 2021:7363267. [PMID: 34659826 PMCID: PMC8514915 DOI: 10.1155/2021/7363267] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 09/23/2021] [Indexed: 11/17/2022] Open
Abstract
PURPOSE To assess the clinical efficiency of a novel ophthalmic viscosurgical device-free (OVD-free) method for intraocular collamer lens (EVO-ICL) implantation in myopic eyes. METHODS In this study, 40 patients underwent ICL implantation for both eyes: one eye underwent traditional ICL implantation, and the other eye underwent OVD-free (pure) ICL implantation. Preoperative and postoperative UDVA, BCVA, equivalent spherical degree (SE), IOP, visual quality index, subjective visual quality scale, corneal endothelial cell density (ECD), operation time, and complications were compared between and within the traditional and pure ICL implantation groups. RESULTS Increased IOP >22 mmHg 2 h after surgery was noted in 8 eyes (20%) in the traditional group, but not in the pure group (0%, P < 0.001). Increased IOP relative to baseline was significantly higher at 2 h after surgery for the traditional group compared with the pure group (P < 0.001). UDVA, BCVA, and SE were significantly improved in the pure group compared with those in the traditional group 1 day (P < 0.001, P=0.003) after implantation, but not 1 week or 3 months after. Modulation transfer function cut-off frequency (MTF cut-off), Strehl ratio (SR), and OV20% were significantly better in the pure group than in the traditional group 1 day after implantation (P=0.013, P=0.009, and P=0.004). No significant difference in ECD changes within or between groups was observed (P > 0.05). The operation time for the pure group (2.897 ± 0.346 min) was significantly shorter than that for the traditional group (4.444 ± 0.656 min; P < 0.001). No complications were reported for either group during the observation period, except early IOP elevation in the traditional group. CONCLUSIONS The pure ICL implantation method was associated with faster visual acuity recovery, shorter operation time, and more stable intraocular pressure. Pure ICL represents a safe and convenient method for ICL implantation compared with the traditional method, completely eliminating OVD-related complications without causing additional complications.
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Affiliation(s)
- Qin Qin
- Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, Jiangsu, China
- Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing 210008, Jiangsu, China
- Nanjing Drum Tower Hospital Clinical College of Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing 210008, Jiangsu, China
| | - Lianyun Bao
- Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, Jiangsu, China
| | - Zifang He
- Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, Jiangsu, China
| | - Feifei Chen
- Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, Jiangsu, China
| | - Dandan Zhu
- Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, Jiangsu, China
| | - Si Zhang
- Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, Jiangsu, China
| | - Wenwen Zhang
- Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, Jiangsu, China
| | - Yajun Liu
- Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, Jiangsu, China
| | - Ruiying Gao
- Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, Jiangsu, China
| | - Zhenggao Xie
- Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, Jiangsu, China
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Montés-Micó R, Pastor-Pascual F, Artiaga-Elordi E, Ruiz-Mesa R, Tañá-Rivero P. In vivo optical quality of posterior-chamber phakic implantable collamer lenses with a central port. EYE AND VISION 2021; 8:30. [PMID: 34392836 PMCID: PMC8365931 DOI: 10.1186/s40662-021-00251-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Accepted: 07/15/2021] [Indexed: 11/10/2022]
Abstract
BACKGROUND The aim of this review is to summarize the optical quality results in patients following the implantation of the V4c implantable collamer lens with a central port (ICL, STAAR Surgical Inc.). MAIN TEXT A literature search in several databases was carried out to identify those publications, both prospective, retrospective and/or comparative with other refractive surgery procedures, reporting optical outcomes of patients who were implanted with the V4c ICL model. A total of 17 clinical studies published between 2012 and 2021 were included in this review. A detailed analysis of the available data was performed including number of eyes, follow-up and preoperative spherical equivalent. Specifically, the review focused on several optical parameters including higher-order aberrations (HOAs), modulation transfer function (MTF) cut-off frequency and Strehl ratio. This review encompassed a total of 817 eyes measured using different optical devices based on Hartmann-Shack, retinal image quality measurement and ray-tracing technologies at different follow-ups. CONCLUSIONS The outcomes found in this review lead us to conclude that the ICL V4c model provides good optical quality, by means of different metrics, when implanted.
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Affiliation(s)
- Robert Montés-Micó
- Optics and Optometry & Vision Sciences Department, University of Valencia, c/o Dr Moliner 50, 46100, Valencia, Spain. .,Oftalvist Clinic, Valencia, Spain.
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Martínez-Plaza E, López-Miguel A, Fernández I, Blázquez-Arauzo F, Maldonado MJ. Effect of central hole location in phakic intraocular lenses on visual function under progressive headlight glare sources. J Cataract Refract Surg 2020; 45:1591-1596. [PMID: 31706513 DOI: 10.1016/j.jcrs.2019.06.022] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2018] [Revised: 06/07/2019] [Accepted: 06/17/2019] [Indexed: 11/17/2022]
Abstract
PURPOSE To analyze the effect of the central hole location in the V4c implantable collamer lens (ICL) on the quality of vision, including progressive headlight glare simulation and quality of life. SETTING IOBA-Eye Institute, Valladolid, Spain. DESIGN Case series. METHODS The central hole location was determined by slitlamp and dual Scheimpflug imaging for 6 months or more postoperatively. The visual acuity, mesopic contrast sensitivity, halogen glare contrast sensitivity, xenon glare contrast sensitivity, photostress recovery time after glare, de Boer scale, and Quality of Life Impact of Refractive Correction (QIRC) questionnaire results were evaluated. Multiple regression models were used to analyze the effect of the central hole location on parameters using the pupil center and visual axis as references based on Cartesian and polar coordinates. RESULTS The safety index was 1.13 and the efficacy index, 1.12. Under all testing circumstances, central hole decentration did not affect the visual acuity or contrast sensitivity. With the visual axis as a reference, worse QIRC values were associated with greater upward central hole displacement (P = .03) and a lower polar angle value (P = .008); also, halogen glare discomfort was greater with a higher radius (P = .04). Using the pupil center as a reference, greater nasal central hole decentration was associated with longer xenon glare photostress recovery time (P = .002). CONCLUSIONS Implantation of the ICL with a central hole yielded excellent visual outcomes, even under increasing glare sources, regardless of the hole's location. However, hole decentration might affect patient-perceived quality of life, bothersome halogen glare, and longer xenon glare photostress recovery time. Such complaints after the early postoperative period might be managed with discrete ICL centration if the central hole is decentered upward or nasally.
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Affiliation(s)
- Elena Martínez-Plaza
- Instituto de Oftalmobiología Aplicada, Universidad de Valladolid, Valladolid, Spain
| | - Alberto López-Miguel
- Instituto de Oftalmobiología Aplicada, Universidad de Valladolid, Valladolid, Spain; Red Temática de Investigación Colaborativa en Oftalmología, Instituto de Salud Carlos III, Madrid, Spain.
| | - Itziar Fernández
- Instituto de Oftalmobiología Aplicada, Universidad de Valladolid, Valladolid, Spain; Networking Research Center on Bioengineering Biomaterials and Nanomedicine, Valladolid, Spain
| | | | - Miguel J Maldonado
- Instituto de Oftalmobiología Aplicada, Universidad de Valladolid, Valladolid, Spain; Red Temática de Investigación Colaborativa en Oftalmología, Instituto de Salud Carlos III, Madrid, Spain
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Vasavada V, Srivastava S, Vasavada SA, Sudhalkar A, Vasavada AR, Vasavada VA. Safety and Efficacy of a New Phakic Posterior Chamber IOL for Correction of Myopia: 3 Years of Follow-up. J Refract Surg 2019; 34:817-823. [PMID: 30540364 DOI: 10.3928/1081597x-20181105-01] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2018] [Accepted: 11/02/2018] [Indexed: 01/30/2023]
Abstract
PURPOSE To evaluate the outcomes of a new posterior chamber phakic intraocular lens (IPCL; Care Group, Baroda, India) to correct myopia. METHODS This prospective, observational case series included 30 eyes undergoing implantation of the IPCL for high myopia (> -8.00 diopters [D]). Uncorrected (UDVA) and corrected (CDVA) distance visual acuities, refraction, vault, endothelial cell loss, and adverse events were evaluated 3 years after implantation of the IPCL for high myopia. RESULTS The mean spherical equivalent decreased from -16.50 ± 5.62 D preoperatively to -0.89 ± 1.27 D at 3 years. The mean UDVA and CDVA were 0.38 ± 0.21 and 0.24 ± 0.09 logMAR. No eye lost any lines and 49% of eyes gained one line or more of CDVA. One eye (3.3%) developed anterior subcapsular cataract, but did not require cataract surgery at 3 years of follow-up. Two eyes (6.6%) developed a mild transient increase in intraocular pressure, which required topical medication only for 3 months. The percentage of endothelial cell loss at 3 years was 9.73% ± 6.72%. The IPCL vault tended to reduce with time, from a mean of 626.66 ± 188.98 μm at 1 month to 540.22 ± 210.76 μm at 3 years. No vision-threatening complications occurred. CONCLUSIONS Implantation of the new posterior chamber phakic IOL is an effective alternative to correct high myopia, showing good outcomes at 3 years. [J Refract Surg. 2018;34(12):817-823.].
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Abstract
The purpose of this review is to summarize preclinical and clinical data from publications appearing in the peer-reviewed scientific literature relevant to the safety and effectiveness of the EVO Implantable Collamer Lens (ICL) posterior chamber phakic refractive lens with a central port (V4c Visian ICL with KS Aquaport, STAAR Surgical, Inc.). A literature search was conducted using PubMed.gov to identify all articles relating to the EVO ICL. Articles were examined for their relevance, and the references cited in each article were also searched for additional relevant publications. On the basis of a total of 67 preclinical studies and clinical reports, including effectiveness data on 1,905 eyes with average weighted follow-up of 12.5 months and safety data on 4,196 eyes with weighted average follow up of 14.0 months, the EVO ICL is safe and effective for the correction of a broad range of refractive errors. High levels of postoperative uncorrected visual acuity, refractive predictability, and stability demonstrate the effectiveness of the EVO ICL. Safety data suggest reduced rates of anterior subcapsular cataract and pupillary block compared with earlier models. Improved safety and proven effectiveness make EVO an attractive option for surgeons and patients.
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Affiliation(s)
- Mark Packer
- Mark Packer MD Consulting, Inc., Boulder, CO, USA,
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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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Miao H, Chen X, Tian M, Chen Y, Wang X, Zhou X. Refractive outcomes and optical quality after implantation of posterior chamber phakic implantable collamer lens with a central hole (ICL V4c). BMC Ophthalmol 2018; 18:141. [PMID: 29898694 PMCID: PMC6001218 DOI: 10.1186/s12886-018-0805-3] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2017] [Accepted: 05/30/2018] [Indexed: 02/03/2023] Open
Abstract
Background To investigate refractive outcomes and optical quality after implantation of posterior chamber phakic implantable collamer lens with a central hole (ICL V4c) to correct high myopia. Methods Sixty seven eyes of 38 patients who underwent ICL V4c implantation were enrolled. The mean preoperative spherical equivalent (SE) was − 12.44 ± 3.15 D (range: − 6.63 to − 20.50 D). The refractive outcomes and optical quality of the eyes at postoperative 1 and 3 months were evaluated and compared. Results At 3 months postoperatively, the mean safety and efficacy indexes were 1.33 ± 0.22 and 1.14 ± 0.23, respectively. The mean SE was − 0.32 ± 0.52 D; no patient lost 1 or more lines of corrected distance visual acuity (CDVA), 13% remained unchanged, 45% gained 1 line and 42% gained 2 or more lines. The mean modulation transfer function cutoff frequency (MTFcutoff), Strehl in two dimensions ratio, and objective scatter index (OSI) were 38.20 ± 9.96 cycles per degree, 0.21 ± 0.06, and 1.00 ± 0.73, respectively. No significant difference was found in any of the above parameters (P > 0.05) between 1 and 3 months. The postoperative intraocular pressure (IOP) did not change when compared with preoperative values (P > 0.05). Conclusions ICL V4c implantation is a safe, effective, and stable solution for high myopia. Patients will acquire high and stable postoperative optical quality. ICL V4c implantation has little influence on IOP.
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Affiliation(s)
- Huamao Miao
- Department of Ophthalmology, Eye and ENT Hospital of Fudan Universtity, NHC Key Laboratory of Myopia (Fudan Universtity), No.83 FenYang Road, Shanghai, 200031, People's Republic of China
| | - Xun Chen
- Department of Ophthalmology, Eye and ENT Hospital of Fudan Universtity, NHC Key Laboratory of Myopia (Fudan Universtity), No.83 FenYang Road, Shanghai, 200031, People's Republic of China
| | - Mi Tian
- Department of Ophthalmology, Eye and ENT Hospital of Fudan Universtity, NHC Key Laboratory of Myopia (Fudan Universtity), No.83 FenYang Road, Shanghai, 200031, People's Republic of China
| | - Yingjun Chen
- Department of Ophthalmology, Eye and ENT Hospital of Fudan Universtity, NHC Key Laboratory of Myopia (Fudan Universtity), No.83 FenYang Road, Shanghai, 200031, People's Republic of China
| | - Xiaoying Wang
- Department of Ophthalmology, Eye and ENT Hospital of Fudan Universtity, NHC Key Laboratory of Myopia (Fudan Universtity), No.83 FenYang Road, Shanghai, 200031, People's Republic of China.
| | - Xingtao Zhou
- Department of Ophthalmology, Eye and ENT Hospital of Fudan Universtity, NHC Key Laboratory of Myopia (Fudan Universtity), No.83 FenYang Road, Shanghai, 200031, People's Republic of China.
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Zhao J, Luo D, Sun Y, Niu L, Zhao F, Wang X, Wang H, Chen Q, Zhou X. Implanting a posterior chamber phakic intraocular lens in highly myopic eyes with peripheral primary iris and ciliary body cysts. Eur J Ophthalmol 2018; 29:171-177. [PMID: 29607656 DOI: 10.1177/1120672118766445] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE: To investigate the safety and efficacy of implanting a posterior chamber implantable collamer lens with a central hole in cases of high myopia with peripheral primary iris or ciliary body cysts. METHODS: A total of 37 eyes of 19 patients with primary iris or ciliary body cysts detected by ultrasonic biological microscope were included, with spherical powers of -10.26 ± 3.28 D and cylinder powers of -1.71 ± 1.18 D. Each patient received ultrasonic biological microscope and a routine examination before implantation of the implantable collamer lens. A routine postoperative follow-up was performed to observe changes in the iris or ciliary body cyst, ranging from 3 to 18 months. RESULTS: There were no complications. At the last follow-up, 56.8% (21/37) of eyes achieved the same corrected distance visual acuity as their preoperative measurements, 43.2% of eyes were enhanced by ≥1 line, and no patients' corrected distance visual acuity declined. The efficacy index and safety index were 0.95 and 1.11, respectively. After 18 months, 66.7% of the spherical equivalents were between ±0.5 D with 100% between ±1.0 D. The postoperative mean spherical equivalents at 1, 3, 6, 12, and 18 months were -0.45 ± 0.31 D, -0.39 ± 0.29 D, -0.36 ± 0.30 D, -0.39 ± 0.38 D, and -0.48 ± 0.23 D (p = 0.789). The vaults were 516 ± 140, 548 ± 124, 498 ± 133, 582 ± 161, and 557 ± 110 μm (p = 0.355). There were no changes in size (p > 0.05), number, or position of the iris or ciliary body cysts. CONCLUSION: Implantable collamer lens implantation is safe and effective for highly myopic patients with peripheral primary iris and ciliary body cysts. The cysts did not change after operation in this study.
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Affiliation(s)
- Jing Zhao
- 1 Key Laboratory of Myopia, Ministry of Health, Department of Ophthalmology, Eye and ENT Hospital, Fudan University, Shanghai, China
| | - Dongqiang Luo
- 2 Center of Ophthalmology and Optometric, People's Hospital of Hunan Province, Changsha, China
| | - Yong Sun
- 3 Department of Ophthalmology, The People's Hospital of Shajin in Baoan District, Shenzhen, China
| | - Lingling Niu
- 1 Key Laboratory of Myopia, Ministry of Health, Department of Ophthalmology, Eye and ENT Hospital, Fudan University, Shanghai, China
| | - Feng Zhao
- 1 Key Laboratory of Myopia, Ministry of Health, Department of Ophthalmology, Eye and ENT Hospital, Fudan University, Shanghai, China
| | - Xiaoying Wang
- 1 Key Laboratory of Myopia, Ministry of Health, Department of Ophthalmology, Eye and ENT Hospital, Fudan University, Shanghai, China
| | - Hua Wang
- 2 Center of Ophthalmology and Optometric, People's Hospital of Hunan Province, Changsha, China
| | - Qian Chen
- 1 Key Laboratory of Myopia, Ministry of Health, Department of Ophthalmology, Eye and ENT Hospital, Fudan University, Shanghai, China
| | - Xingtao Zhou
- 1 Key Laboratory of Myopia, Ministry of Health, Department of Ophthalmology, Eye and ENT Hospital, Fudan University, Shanghai, China
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Park MJ, Jeon HM, Lee KH, Han SY. Comparison of postoperative optical quality according to the degree of decentering of V4c implantable collamer lens. Int J Ophthalmol 2017; 10:619-623. [PMID: 28503437 DOI: 10.18240/ijo.2017.04.19] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2016] [Accepted: 11/08/2016] [Indexed: 11/23/2022] Open
Abstract
AIM To evaluate the clinical outcomes of V4c implantable collamer lens (Hole ICL) implantation with regard to the optical quality assessed according to different degrees of decentering. METHODS This included 49 eyes that received conventional ICL and 94 eyes that received Hole ICL. The eyes that received Hole ICL were divided into three groups according to the degree of decentering: group 1, central hole within 1 hole diameter (HD) from the pupil center; group 2, central hole within 1 HD to 2 HD; and group 3, central hole within 2 HD to 3 HD. Visual acuity (VA), intraocular pressure (IOP), and spherical equivalent (SE) values were assessed at 1wk, 1 and 3mo after surgery. The ocular modulation transfer function, Strehl ratio, objective scattering index, and higher order aberrations (HOAs) were measured for 4-mm pupils at 3mo after surgery. RESULTS There were no significant differences in VA, IOP, and SE among the conventional and Hole ICL groups. With regard to HOAs, values for coma and spherical aberrations showed no differences. The total HOA and trefoil values were significantly higher in group 2 than in group 1 (P=0.02, 0.03, respectively). There were no significant differences among groups with regard to other optical quality parameter at 3mo after surgery. CONCLUSION Our results suggest that Hole ICL implantation provides satisfactory visual quality that is equivalent to that provided by conventional ICL, regardless of the presence of central hole and degree of decentering.
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Affiliation(s)
- Min Ji Park
- Department of Cornea and Refractive Surgery, Sungmo Eye Hospital, Busan 48064, Korea
| | - Hye Min Jeon
- Department of Cornea and Refractive Surgery, Sungmo Eye Hospital, Busan 48064, Korea
| | - Kyoung Heon Lee
- Department of Cornea and Refractive Surgery, Sungmo Eye Hospital, Busan 48064, Korea
| | - Sang Youp Han
- Department of Cornea and Refractive Surgery, Sungmo Eye Hospital, Busan 48064, Korea
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Effects of V4c-ICL Implantation on Myopic Patients' Vision-Related Daily Activities. J Ophthalmol 2016; 2016:5717932. [PMID: 27965890 PMCID: PMC5124673 DOI: 10.1155/2016/5717932] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2016] [Revised: 08/13/2016] [Accepted: 09/27/2016] [Indexed: 11/17/2022] Open
Abstract
The new type implantable Collamer lens with a central hole (V4c-ICL) is widely used to treat myopia. However, halos occur in some patients after surgery. The aim is to evaluate the effect of V4c-ICL implantation on vision-related daily activities. This retrospective study included 42 patients. Uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), intraocular pressure (IOP), endothelial cell density (ECD), and vault were recorded and vision-related daily activities were evaluated at 3 months after operation. The average spherical equivalent was −0.12 ± 0.33 D at 3 months after operation. UCVA equal to or better than preoperative BCVA occurred in 98% of eyes. The average BCVA at 3 months after operation was −0.03 ± 0.07 LogMAR, which was significantly better than preoperative BCVA (0.08 ± 0.10 LogMAR) (P = 0.029). Apart from one patient (2.4%) who had difficulty reading computer screens, all patients had satisfactory or very satisfactory results. During the early postoperation, halos occurred in 23 patients (54.8%). However there were no significant differences in the scores of visual functions between patients with and without halos (P > 0.05). Patients were very satisfied with their vision-related daily activities at 3 months after operation. The central hole of V4c-ICL does not affect patients' vision-related daily activities.
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Cao X, Wu W, Wang Y, Xie C, Tong J, Shen Y. Posterior chamber collagen copolymer phakic intraocular lens with a central hole for moderate-to-high myopia: First experience in China. Medicine (Baltimore) 2016; 95:e4641. [PMID: 27603356 PMCID: PMC5023878 DOI: 10.1097/md.0000000000004641] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
The purpose of this article is to evaluate the clinical outcomes of a posterior chamber phakic intraocular lens (pIOL) (Visian Implantable Collamer Lens V4c) for the correction of moderate to high myopia in Chinese eyes.The article is designed as a retrospective case series.This study included the first consecutive eyes that had implantation of a new pIOL design with a central hole, at our department by the same surgeon. The safety, efficacy, predictability, stability, and adverse events of the surgery were evaluated over 6 months.The study enrolled 63 eyes (32 patients). The mean spherical equivalent decreased from -12.81 ± 3.11 diopters (D) preoperatively to -0.05 ± 0.27 D 6 months postoperatively; 96.8% of eyes were within ±0.50 D of the target and 100% of eyes were within ±1.00 D. All eyes had a decimal uncorrected distance visual acuity of 0.5 (20/40) or better at every follow-up visit. The safety and efficacy indices were 1.42 ± 0.34 and 1.11 ± 0.19, respectively. Postoperatively, the intraocular pressure (IOP) remained stable over time. No significant rises in IOP (including pupillary block) and no secondary cataract were found. After 6 months, the mean vault was 505.2 ± 258.9 μm (range 120-990 μm), and the mean endothelial cell loss was 2.0%.Implantation of the pIOL was safe, effective, predictable, and stable in the correction of moderate-to-high myopia in Han Chinese patients, even without peripheral iridectomy.
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Affiliation(s)
- Xinfang Cao
- Department of Ophthalmology, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, P.R. China. Department of Orthopedics, Children's Hospital, College of Medicine, Zhejiang University, Hangzhou, P.R. China
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Eppig T, Spira C, Tsintarakis T, El-Husseiny M, Cayless A, Müller M, Seitz B, Langenbucher A. Ghost-image analysis in phakic intraocular lenses with central hole as a potential cause of dysphotopsia. J Cataract Refract Surg 2016; 41:2552-9. [PMID: 26703506 DOI: 10.1016/j.jcrs.2015.05.034] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2015] [Revised: 05/18/2015] [Accepted: 05/19/2015] [Indexed: 10/22/2022]
Abstract
PURPOSE To analyse the optical effect of an artificial hole in the optic centre of posterior chamber phakic intraocular lenses. SETTING Institute of Experimental Ophthalmology, Saarland University, Homburg/Saar, Germany. DESIGN Experimental simulation study. METHODS Four eye models with an ametropia of -4 D, -8 D, +4 D, and +8 D were created in the ray tracing software ASAP. Refractive correction of these models was implemented with a model of an Implantable Collamer Lens (ICL). Each eye was set up twice with 1 eye receiving a conventional ICL without a central hole and the second an ICL with a central hole. Ray bundles were traced for lateral visual field angles from 0 to 60 degrees in steps of 1 degree. Ray propagation and retinal illumination were then compared between the 2 ICL models. RESULTS All eye models showed ghost images originating from the anterior surface of the ICL. Eye models with the ICL with central hole showed additional light spots in the peripheral areas of the retina originating from reflections at the cylindrical wall of the central hole in the ICL. The average intensity of ghost images in the temporal retinal hemisphere was between 30 and 40 dB less than the maximum intensity of the primary image. CONCLUSION A central hole within a posterior chamber phakic intraocular lens may cause stray light and ghost images (positive dysphotopsia) although the on-axis visual quality of the eye with the ICL is mostly unaffected. FINANCIAL DISCLOSURE The authors have no financial interest in any of the material presented in this paper.
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Affiliation(s)
- Timo Eppig
- From the Institute of Experimental Ophthalmology (Eppig, Langenbucher), Saarland University, Homburg/Saar, Germany; Department of Ophthalmology (Spira, Tsintarakis, El-Husseiny, Müller, Seitz), Saarland University Medical Center, Homburg/Saar, Germany; Department of Physical Sciences (Cayless), Open University, Milton Keynes, Buckinghamshire, United Kingdom.
| | - Corinna Spira
- From the Institute of Experimental Ophthalmology (Eppig, Langenbucher), Saarland University, Homburg/Saar, Germany; Department of Ophthalmology (Spira, Tsintarakis, El-Husseiny, Müller, Seitz), Saarland University Medical Center, Homburg/Saar, Germany; Department of Physical Sciences (Cayless), Open University, Milton Keynes, Buckinghamshire, United Kingdom
| | - Themistoklis Tsintarakis
- From the Institute of Experimental Ophthalmology (Eppig, Langenbucher), Saarland University, Homburg/Saar, Germany; Department of Ophthalmology (Spira, Tsintarakis, El-Husseiny, Müller, Seitz), Saarland University Medical Center, Homburg/Saar, Germany; Department of Physical Sciences (Cayless), Open University, Milton Keynes, Buckinghamshire, United Kingdom
| | - Moatasem El-Husseiny
- From the Institute of Experimental Ophthalmology (Eppig, Langenbucher), Saarland University, Homburg/Saar, Germany; Department of Ophthalmology (Spira, Tsintarakis, El-Husseiny, Müller, Seitz), Saarland University Medical Center, Homburg/Saar, Germany; Department of Physical Sciences (Cayless), Open University, Milton Keynes, Buckinghamshire, United Kingdom
| | - Alan Cayless
- From the Institute of Experimental Ophthalmology (Eppig, Langenbucher), Saarland University, Homburg/Saar, Germany; Department of Ophthalmology (Spira, Tsintarakis, El-Husseiny, Müller, Seitz), Saarland University Medical Center, Homburg/Saar, Germany; Department of Physical Sciences (Cayless), Open University, Milton Keynes, Buckinghamshire, United Kingdom
| | - Marc Müller
- From the Institute of Experimental Ophthalmology (Eppig, Langenbucher), Saarland University, Homburg/Saar, Germany; Department of Ophthalmology (Spira, Tsintarakis, El-Husseiny, Müller, Seitz), Saarland University Medical Center, Homburg/Saar, Germany; Department of Physical Sciences (Cayless), Open University, Milton Keynes, Buckinghamshire, United Kingdom
| | - Berthold Seitz
- From the Institute of Experimental Ophthalmology (Eppig, Langenbucher), Saarland University, Homburg/Saar, Germany; Department of Ophthalmology (Spira, Tsintarakis, El-Husseiny, Müller, Seitz), Saarland University Medical Center, Homburg/Saar, Germany; Department of Physical Sciences (Cayless), Open University, Milton Keynes, Buckinghamshire, United Kingdom
| | - Achim Langenbucher
- From the Institute of Experimental Ophthalmology (Eppig, Langenbucher), Saarland University, Homburg/Saar, Germany; Department of Ophthalmology (Spira, Tsintarakis, El-Husseiny, Müller, Seitz), Saarland University Medical Center, Homburg/Saar, Germany; Department of Physical Sciences (Cayless), Open University, Milton Keynes, Buckinghamshire, United Kingdom
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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: 177] [Impact Index Per Article: 22.1] [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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20
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Lisa C, Naveiras M, Alfonso-Bartolozzi B, Belda-Salmerón L, Montés-Micó R, Alfonso JF. Posterior chamber collagen copolymer phakic intraocular lens with a central hole to correct myopia: One-year follow-up. J Cataract Refract Surg 2016; 41:1153-9. [PMID: 26189376 DOI: 10.1016/j.jcrs.2014.10.030] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2014] [Revised: 09/16/2014] [Accepted: 10/19/2014] [Indexed: 02/06/2023]
Abstract
PURPOSE To assess the predictability, stability, efficacy, and safety of a newly developed posterior chamber phakic intraocular lens (pIOL) (model V4c Visian Implantable Collamer Lens) to correct moderate to high myopia. SETTING Fernández-Vega Ophthalmological Institute, Oviedo, Spain. DESIGN Prospective case series. METHODS This study evaluated eyes that had implantation of the new pIOL model with a central hole for myopia correction. Uncorrected (UDVA) and corrected (CDVA) distance visual acuities, refraction, intraocular pressure (IOP), endothelial cell density, pIOL vault, and adverse events were evaluated over 12 months. RESULTS The study comprised 147 eyes of 80 patients. Preoperatively, the mean spherical equivalent (SE) was -8.80 diopters (D) ± 2.60 (SD). At 12 months, the mean SE was -0.14 ± 0.26 D, with 93.9% of eyes within ±0.50 D of the target and 100% of eyes within ±1.00 D. The mean UDVA and CDVA were 0.028 ± 0.055 logMAR and 0.003 ± 0.013 logMAR, respectively. The efficacy and safety indices were 1.00 and 1.04, respectively. All eyes had unchanged CDVA or gained 1 or more lines during the follow-up. The IOP remained stable over time; no eye developed anterior subcapsular cataract. Twelve months postoperatively, the mean vault was 405.5 ± 184.7 μm (range 100 to 980 μm), and the mean endothelial cell loss was 1.7%. CONCLUSION The good refractive and visual acuity outcomes and the highly stable IOP values obtained over 12 months support the use of the new pIOL model with a central hole for the correction of moderate to high myopia. FINANCIAL DISCLOSURE No author has a financial or proprietary interest in any material or method mentioned.
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Affiliation(s)
- Carlos Lisa
- From Fernández-Vega Ophthalmological Institute (Lisa, Naveiras, Alfonso) and the Surgery Department (Alfonso), School of Medicine, University of Oviedo, Oviedo, the Department of Ophthalmology (Alfonso-Bartolozzi), Clínica Universidad de Navarra, Pamplona, and the Optics Department (Belda-Salmerón, Montés-Micó), Faculty of Physics, University of Valencia, Valencia, Spain
| | - Miguel Naveiras
- From Fernández-Vega Ophthalmological Institute (Lisa, Naveiras, Alfonso) and the Surgery Department (Alfonso), School of Medicine, University of Oviedo, Oviedo, the Department of Ophthalmology (Alfonso-Bartolozzi), Clínica Universidad de Navarra, Pamplona, and the Optics Department (Belda-Salmerón, Montés-Micó), Faculty of Physics, University of Valencia, Valencia, Spain
| | - Belén Alfonso-Bartolozzi
- From Fernández-Vega Ophthalmological Institute (Lisa, Naveiras, Alfonso) and the Surgery Department (Alfonso), School of Medicine, University of Oviedo, Oviedo, the Department of Ophthalmology (Alfonso-Bartolozzi), Clínica Universidad de Navarra, Pamplona, and the Optics Department (Belda-Salmerón, Montés-Micó), Faculty of Physics, University of Valencia, Valencia, Spain
| | - Lurdes Belda-Salmerón
- From Fernández-Vega Ophthalmological Institute (Lisa, Naveiras, Alfonso) and the Surgery Department (Alfonso), School of Medicine, University of Oviedo, Oviedo, the Department of Ophthalmology (Alfonso-Bartolozzi), Clínica Universidad de Navarra, Pamplona, and the Optics Department (Belda-Salmerón, Montés-Micó), Faculty of Physics, University of Valencia, Valencia, Spain
| | - Robert Montés-Micó
- From Fernández-Vega Ophthalmological Institute (Lisa, Naveiras, Alfonso) and the Surgery Department (Alfonso), School of Medicine, University of Oviedo, Oviedo, the Department of Ophthalmology (Alfonso-Bartolozzi), Clínica Universidad de Navarra, Pamplona, and the Optics Department (Belda-Salmerón, Montés-Micó), Faculty of Physics, University of Valencia, Valencia, Spain
| | - José F Alfonso
- From Fernández-Vega Ophthalmological Institute (Lisa, Naveiras, Alfonso) and the Surgery Department (Alfonso), School of Medicine, University of Oviedo, Oviedo, the Department of Ophthalmology (Alfonso-Bartolozzi), Clínica Universidad de Navarra, Pamplona, and the Optics Department (Belda-Salmerón, Montés-Micó), Faculty of Physics, University of Valencia, Valencia, Spain.
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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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