1
|
Alfonso-Bartolozzi B, Fernández-Vega-Cueto L, Lisa C, Palacios A, Madrid-Costa D, Alfonso JF. Ten-year follow-up of posterior chamber phakic intraocular lens with central port design in patients with low and normal vault. J Cataract Refract Surg 2024; 50:441-447. [PMID: 38085219 DOI: 10.1097/j.jcrs.0000000000001379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 12/05/2023] [Indexed: 04/24/2024]
Abstract
PURPOSE To assess the clinical outcomes and postoperative complications of the implantable collamer lens (ICL) with a central port throughout 10 years of follow-up in patients with low and normal vault. SETTING Fernández-Vega Ophthalmological Institute, Oviedo, Spain. DESIGN Retrospective and comparative case series. METHODS This study included eyes that underwent a V4c ICL implantation with 10 years of follow-up. The eyes were divided into 2 groups according to the vault at 1 year postoperatively: vault <250 μm and between 250 μm and 800 μm. Uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), intraocular pressure (IOP), endothelial cell density (ECD), vault, complications, and secondary surgeries were analyzed. RESULTS 37 and 90 eyes were enrolled in the low and normal-vault groups, respectively. No differences in UDVA, CDVA, and refraction were found between the groups over 10 years of follow-up. No cases developed ICL-induced anterior subcapsular opacity over the follow-up period. 2 (5.4%) and 8 (8.9%) eyes in the low and normal-vault groups, respectively, required ICL exchange. 1 (2.8%) and 2 (2.2%) eyes in the low and normal-vault groups, respectively, required excimer laser to correct residual refractive error. The IOP remained stable throughout the 10-year follow-up. The loss in ECD from that preoperatively to 10 years postoperatively was 3.8% and 4.5% in the low and normal-vault groups, respectively ( P = .4). No pigment dispersion glaucoma or other vision-threatening complications were reported. CONCLUSIONS This study shows good long-term outcomes of the V4c ICL, supporting that the central hole provides safety to the procedure and prevents the potential risk associated with low vault.
Collapse
Affiliation(s)
- Belén Alfonso-Bartolozzi
- From the Fernández-Vega Ophthalmological Institute, Oviedo, Spain (Alfonso-Bartolozzi, Fernández-Vega-Cueto, Lisa, Palacios, Alfonso); Clinical and Experimental Eye Reseach Group, Faculty of Optics and Optometry, Universidad Complutense de Madrid, Madrid, Spain (Madrid-Costa)
| | | | | | | | | | | |
Collapse
|
2
|
Yoon HY, Byun YS, Kim HS, Chung SH. Causes and outcomes of implantable collamer lens explantation in patients with corneal endothelial cell loss. J Cataract Refract Surg 2024; 50:453-459. [PMID: 38270485 DOI: 10.1097/j.jcrs.0000000000001406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 01/13/2024] [Indexed: 01/26/2024]
Abstract
PURPOSE To investigate the correlated factors of corneal endothelial cell density (ECD) loss and ECD change in implantable collamer lens (ICL) explantation patients. SETTING Seoul St. Mary's Hospital, Seoul, South Korea. DESIGN Retrospective analysis. METHODS The study cohort consisted of 93 eyes from 50 patients who underwent ICL explantation. Correlation analysis was performed to assess the ocular parameters associated with ECD loss, while percentage of ECD change (ΔECD%) was monitored up to 6 months postoperatively. Receiver operating characteristic (ROC) curve was used to set cutoff values of ocular parameters to prevent ECD loss after explantation. RESULTS In multiple regression analysis, high vaulting, high vaulting/anterior chamber depth (ACD), low anterior chamber angle (ACA), and high iris pigmentations are the significant factors of ECD loss. At postoperative 6 months, 14 eyes (15.1%) had decrease (10.5% loss), 47 eyes (51.0%) were stationary, and 32 eyes (34.4%) had increase (12.7% gain) of ECD. The ROC curve analysis showed that vaulting had the highest area under the curve (AUC = 0.822), followed by vaulting/ACD (AUC = 0.821), ECD (AUC = 0.753), and ACA (AUC = 0.723) (all P < .01). Preoperative ECD showed a sensitivity of 77.6% and specificity of 86.7% in preventing ECD loss after explantation, with a cutoff value of 1722 cells/mm 2 , as determined by ROC curve analysis. CONCLUSIONS Our study demonstrated that high vaulting is a significant factor in ECD loss among ICL-inserted patients. To prevent continuous ECD loss in ICL patients, close monitoring of ECD and making appropriate decisions regarding explantation may be necessary.
Collapse
Affiliation(s)
- Hye Yeon Yoon
- From the Department of Ophthalmology and Visual Science, Seoul St. Mary's Hospital, College of Medicine, Catholic University of Korea, Seoul, South Korea
| | | | | | | |
Collapse
|
3
|
Tello A, Galvis V. Determination of progressive endothelial cell loss after posterior chamber phakic intraocular lens implantation. Int Ophthalmol 2024; 44:195. [PMID: 38658386 DOI: 10.1007/s10792-024-03124-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2023] [Accepted: 04/11/2024] [Indexed: 04/26/2024]
Abstract
Comments about endothelial cell loss after posterior chamber phakic intraocular lens are provided, with a particular emphasis on the importance of determining progressive postoperative cell density reduction, excluding that related to surgical trauma.
Collapse
Affiliation(s)
- Alejandro Tello
- Centro Oftalmológico Virgilio Galvis, Centro Medico Carlos Ardila Lulle, Floor 3, Module 7. Urbanización El Bosque, Floridablanca, Santander, Colombia.
- Ophthalmology Department, Fundación Oftalmológica de Santander FOSCAL, Floridablanca, Colombia.
- Ophthalmology Department, Universidad Autónoma de Bucaramanga (UNAB), Bucaramanga, Colombia.
- Surgery Department, Universidad Industrial de Santander (UIS), Bucaramanga, Colombia.
| | - Virgilio Galvis
- Centro Oftalmológico Virgilio Galvis, Centro Medico Carlos Ardila Lulle, Floor 3, Module 7. Urbanización El Bosque, Floridablanca, Santander, Colombia
- Ophthalmology Department, Fundación Oftalmológica de Santander FOSCAL, Floridablanca, Colombia
- Ophthalmology Department, Universidad Autónoma de Bucaramanga (UNAB), Bucaramanga, Colombia
| |
Collapse
|
4
|
Kisiel FB, Gurumurthy GJ. Endothelial cell loss post-implantable collamer lens V4c: meta-analysis. J Cataract Refract Surg 2024; 50:420-423. [PMID: 38194352 DOI: 10.1097/j.jcrs.0000000000001389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 12/03/2023] [Indexed: 01/10/2024]
Abstract
Endothelial cell density (ECD) loss is a noted effect of implantable collamer lens (ICL) V4c surgery. Current literature provides a wide range of values for ECD loss postsurgery, which may not be helpful in advising patients and clinicians. A meta-analysis exploring ECD loss in ICL V4c for myopia correction was undertaken. 18 studies were included in this meta-analysis with 2 subgroup analyses to account for the variability in follow-up lengths. The average ECD loss 3 months, 12 months, and 21.25 (mean) months postsurgery were 1.32% ± 1.28% ( P < .001, 95% CI, -75.158 to -1.19), 1.75% ± 2.17% ( P < .001, 95% CI, -134.09 to 14.52), and 3.84% ± 1.78% ( P < .001, 95% CI, -156.04 to -54.26), respectively. ECD loss is most pronounced 3 months postsurgery, suggesting that acute surgical trauma was the primary contributor rather than long-term lens implantation. Overall, ICL V4c is for myopia correction exhibits similar ECD loss as seen in other ICL models, thereby affirming its safety.
Collapse
Affiliation(s)
- Filip Blazej Kisiel
- From the Department of Chemical Engineering, University of Manchester, Manchester, United Kingdom (Kisiel); Department of Medicine, University of Manchester, Manchester, United Kingdom (Gurumurthy)
| | | |
Collapse
|
5
|
Zhang GM, Zhao LJ, Xie HT, Wu MF. Anterior Segment Biometry During Accommodation After Posterior Chamber Phakic Implantable Collamer Lens Implantation. J Refract Surg 2024; 40:e164-e172. [PMID: 38466765 DOI: 10.3928/1081597x-20240212-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/13/2024]
Abstract
PURPOSE To evaluate the dynamic changes in anterior segment parameters during accommodation following Implantable Collamer Lens (ICL) implantation with swept-source optical coherence tomography (SS-OCT). METHODS Under the accommodation of 0.00 diopters (D), 3.00 D, and maximum amplitude, SS-OCT was used to examine the anterior segment parameters, including ICL vault, ICL depth (the distance between the corneal endothelium and the posterior surface of ICL), crystalline lens thickness, anterior chamber depth, and various parameters of the anterior chamber angle, comprising angle opening distance, angle recess area, trabecular iris space area, and trabecular iris angle. RESULTS During accommodation, the ICL vault showed a significant decrease from baseline (536 ± 278 μm) to 3.00 D (522 ± 281 μm), followed by an increase from 3.00 D to maximum amplitude (548 ± 306 μm) (analysis of variance [ANOVA], P < .001). Four eyes (2.61%) exhibited a decrease in ICL vault to less than 100 μm (47 ± 32 μm) at maximum accommodation. The ICL depth decreased significantly as accommodation increased (ANOVA, P < .001). Crystalline lens thickness increased, whereas anterior chamber depth decreased during accommodation (ANOVA, P < .001). The anterior chamber angle widened during 3.00 D of accommodation but narrowed at maximum accommodation, leading to significant changes in the angle opening distance, angle recess area, trabecular iris space area, and trabecular iris angle during accommodation (ANOVA, P < .001 for all). CONCLUSIONS The anterior segment, including ICL vault and anterior chamber angle, undergo significant dynamic changes during accommodation. These accommodative changes may require careful monitoring for the surgery design of ICL implantation. [J Refract Surg. 2024;40(3):e164-e172.].
Collapse
|
6
|
Chen X, Lin IC, Miao H, Cheng M, Li B, Jiang Y, Lei Y, Wang X, Zhou X. Effects of Decentration of Implantable Collamer Lens V4c on Visual Quality With the OPD-Scan III Aberrometer. Am J Ophthalmol 2024; 259:88-95. [PMID: 37952651 DOI: 10.1016/j.ajo.2023.11.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 11/04/2023] [Accepted: 11/05/2023] [Indexed: 11/14/2023]
Abstract
PURPOSE This study aimed to analyze the relationship between visual quality and implantable collamer lenses (ICL) decentration. DESIGN Prospective treatment evaluation clinical study METHODS: This prospective study included 119 eyes with ICL implantation. Refractive parameters and ocular aberrations were examined pre- and postoperatively. ICL decentration and higher-order aberrations (HOAs) were evaluated using the OPD-Scan III aberrometer. RESULTS At the 1-month follow-up, the mean values for decentration were 0.38 ± 0.19 mm (0.02-0.78). Regarding the position of decentration in right and left eyes, 22.8% and 17.7% were located in the superior nasal section, 0% and 6.5% in the inferior nasal section, 50.9% and 53.2% in the superior temporal section, and 26.3% and 22.6% in the inferior temporal section, respectively. The root mean square values of whole-eye total HOAs, coma, and trefoil had significantly increased. Decentration had a significant negative correlation with variation in the pre- and postoperative trefoils of the whole eye. CONCLUSIONS ICL decentration had a slightly negative correlation with trefoil and slightly affected visual quality.
Collapse
Affiliation(s)
- Xun Chen
- From the Fudan University Eye Ear Nose and Throat Hospital (X.C., I.-C.L., H.M., M.C., B.L., Y.J., Y.L., X.W., X.Z.), Shanghai, China; National Health Commission Key Lab of Myopia (Fudan University) (X.C., I.-C.L., H.M., M.C., B.L., Y.J., Y.L., X.W., X.Z.), Shanghai, China; Shanghai Research Center of Ophthalmology and Optometry (X.C., I.-C.L., H.M., M.C., B.L., Y.J., Y.L., X.W., X.Z.), Shanghai, China; Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care (20DZ2255000) (X.C., I.-C.L., H.M., M.C., B.L., Y.J., Y.L., X.W., X.Z.), Shanghai, China
| | - I-Chun Lin
- From the Fudan University Eye Ear Nose and Throat Hospital (X.C., I.-C.L., H.M., M.C., B.L., Y.J., Y.L., X.W., X.Z.), Shanghai, China; National Health Commission Key Lab of Myopia (Fudan University) (X.C., I.-C.L., H.M., M.C., B.L., Y.J., Y.L., X.W., X.Z.), Shanghai, China; Shanghai Research Center of Ophthalmology and Optometry (X.C., I.-C.L., H.M., M.C., B.L., Y.J., Y.L., X.W., X.Z.), Shanghai, China; Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care (20DZ2255000) (X.C., I.-C.L., H.M., M.C., B.L., Y.J., Y.L., X.W., X.Z.), Shanghai, China
| | - Huamao Miao
- From the Fudan University Eye Ear Nose and Throat Hospital (X.C., I.-C.L., H.M., M.C., B.L., Y.J., Y.L., X.W., X.Z.), Shanghai, China; National Health Commission Key Lab of Myopia (Fudan University) (X.C., I.-C.L., H.M., M.C., B.L., Y.J., Y.L., X.W., X.Z.), Shanghai, China; Shanghai Research Center of Ophthalmology and Optometry (X.C., I.-C.L., H.M., M.C., B.L., Y.J., Y.L., X.W., X.Z.), Shanghai, China; Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care (20DZ2255000) (X.C., I.-C.L., H.M., M.C., B.L., Y.J., Y.L., X.W., X.Z.), Shanghai, China
| | - Mingrui Cheng
- From the Fudan University Eye Ear Nose and Throat Hospital (X.C., I.-C.L., H.M., M.C., B.L., Y.J., Y.L., X.W., X.Z.), Shanghai, China; National Health Commission Key Lab of Myopia (Fudan University) (X.C., I.-C.L., H.M., M.C., B.L., Y.J., Y.L., X.W., X.Z.), Shanghai, China; Shanghai Research Center of Ophthalmology and Optometry (X.C., I.-C.L., H.M., M.C., B.L., Y.J., Y.L., X.W., X.Z.), Shanghai, China; Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care (20DZ2255000) (X.C., I.-C.L., H.M., M.C., B.L., Y.J., Y.L., X.W., X.Z.), Shanghai, China
| | - Boliang Li
- From the Fudan University Eye Ear Nose and Throat Hospital (X.C., I.-C.L., H.M., M.C., B.L., Y.J., Y.L., X.W., X.Z.), Shanghai, China; National Health Commission Key Lab of Myopia (Fudan University) (X.C., I.-C.L., H.M., M.C., B.L., Y.J., Y.L., X.W., X.Z.), Shanghai, China; Shanghai Research Center of Ophthalmology and Optometry (X.C., I.-C.L., H.M., M.C., B.L., Y.J., Y.L., X.W., X.Z.), Shanghai, China; Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care (20DZ2255000) (X.C., I.-C.L., H.M., M.C., B.L., Y.J., Y.L., X.W., X.Z.), Shanghai, China
| | - Yinjie Jiang
- From the Fudan University Eye Ear Nose and Throat Hospital (X.C., I.-C.L., H.M., M.C., B.L., Y.J., Y.L., X.W., X.Z.), Shanghai, China; National Health Commission Key Lab of Myopia (Fudan University) (X.C., I.-C.L., H.M., M.C., B.L., Y.J., Y.L., X.W., X.Z.), Shanghai, China; Shanghai Research Center of Ophthalmology and Optometry (X.C., I.-C.L., H.M., M.C., B.L., Y.J., Y.L., X.W., X.Z.), Shanghai, China; Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care (20DZ2255000) (X.C., I.-C.L., H.M., M.C., B.L., Y.J., Y.L., X.W., X.Z.), Shanghai, China
| | - Yadi Lei
- From the Fudan University Eye Ear Nose and Throat Hospital (X.C., I.-C.L., H.M., M.C., B.L., Y.J., Y.L., X.W., X.Z.), Shanghai, China; National Health Commission Key Lab of Myopia (Fudan University) (X.C., I.-C.L., H.M., M.C., B.L., Y.J., Y.L., X.W., X.Z.), Shanghai, China; Shanghai Research Center of Ophthalmology and Optometry (X.C., I.-C.L., H.M., M.C., B.L., Y.J., Y.L., X.W., X.Z.), Shanghai, China; Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care (20DZ2255000) (X.C., I.-C.L., H.M., M.C., B.L., Y.J., Y.L., X.W., X.Z.), Shanghai, China
| | - Xiaoying Wang
- From the Fudan University Eye Ear Nose and Throat Hospital (X.C., I.-C.L., H.M., M.C., B.L., Y.J., Y.L., X.W., X.Z.), Shanghai, China; National Health Commission Key Lab of Myopia (Fudan University) (X.C., I.-C.L., H.M., M.C., B.L., Y.J., Y.L., X.W., X.Z.), Shanghai, China; Shanghai Research Center of Ophthalmology and Optometry (X.C., I.-C.L., H.M., M.C., B.L., Y.J., Y.L., X.W., X.Z.), Shanghai, China; Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care (20DZ2255000) (X.C., I.-C.L., H.M., M.C., B.L., Y.J., Y.L., X.W., X.Z.), Shanghai, China.
| | - Xingtao Zhou
- From the Fudan University Eye Ear Nose and Throat Hospital (X.C., I.-C.L., H.M., M.C., B.L., Y.J., Y.L., X.W., X.Z.), Shanghai, China; National Health Commission Key Lab of Myopia (Fudan University) (X.C., I.-C.L., H.M., M.C., B.L., Y.J., Y.L., X.W., X.Z.), Shanghai, China; Shanghai Research Center of Ophthalmology and Optometry (X.C., I.-C.L., H.M., M.C., B.L., Y.J., Y.L., X.W., X.Z.), Shanghai, China; Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care (20DZ2255000) (X.C., I.-C.L., H.M., M.C., B.L., Y.J., Y.L., X.W., X.Z.), Shanghai, China
| |
Collapse
|
7
|
Naujokaitis T, Auffarth GU, Łabuz G, Khoramnia R. Endothelial Cell Loss in Patients with Phakic Intraocular Lenses. Klin Monbl Augenheilkd 2024. [PMID: 38242162 DOI: 10.1055/a-2209-5251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2024]
Abstract
Although the safety of phakic intraocular lenses (pIOLs) has been continuously improved over 70-years of development, high endothelial cell losses can occur even with current pIOL models. Numerous studies have demonstrated that the distance of a pIOL to the corneal endothelium plays a crucial role in the extent of endothelial cell loss. For this reason alone, higher endothelial cell loss tends to be observed with anterior chamber lenses than with posterior chamber lenses. Adequate preoperative anterior chamber depth is essential, at least for iris-fixed pIOLs, in order to ensure a safe distance from the endothelium. However, the anterior chamber becomes shallower with age and therefore it may be useful to consider patient age in the safety criteria. Although endothelial cell loss is generally low with current pIOL models, regular monitoring of the endothelial cell density remains essential due to large interindividual differences in patients with pIOLs. If the endothelial cell loss is greater than expected and the follow-up visits confirm the trend, the pIOL should be explanted without delay. The endothelial reserve should be considered on an individual basis by taking into account patient age, physiological endothelial cell loss, and loss due to further surgery. With careful indication and long-term patient care, pIOLs remain a safe treatment option.
Collapse
Affiliation(s)
- Tadas Naujokaitis
- International Vision Correction Research Centre (IVCRC) und David J Apple International Laboratory for Ocular Pathology, Universitäts-Augenklinik Heidelberg, Deutschland
| | - Gerd U Auffarth
- International Vision Correction Research Centre (IVCRC) und David J Apple International Laboratory for Ocular Pathology, Universitäts-Augenklinik Heidelberg, Deutschland
| | - Grzegorz Łabuz
- International Vision Correction Research Centre (IVCRC) und David J Apple International Laboratory for Ocular Pathology, Universitäts-Augenklinik Heidelberg, Deutschland
| | - Ramin Khoramnia
- International Vision Correction Research Centre (IVCRC) und David J Apple International Laboratory for Ocular Pathology, Universitäts-Augenklinik Heidelberg, Deutschland
| |
Collapse
|
8
|
Du J, Zhou W, Zhao T, Qian T, Lu Y, Li H, Zhang Z, Lian J. Efficacy and Safety of Implantable Collamer Lens V4c Implantation in 1,834 Myopic Eyes for 1 Year of Follow-up. J Refract Surg 2023; 39:694-704. [PMID: 37824302 DOI: 10.3928/1081597x-20230908-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2023]
Abstract
PURPOSE To evaluate visual outcomes of patients with myopia after EVO Implantable Collamer Lens (ICL) (STAAR Surgical) implantation and predict risk factors of postoperative vault abnormalities. METHODS In this single-center, retrospective analysis, 1,834 eyes of 926 patients with myopia who underwent EVO ICL implantation were recruited between 2020 and 2021. Patients were followed up for 1 year, during which surgery outcomes were evaluated. In addition, 31 eyes with vault abnormalities who underwent secondary surgery were enrolled to form a generalized linear model, which aimed to predict risk factors contributing to vault abnormalities. RESULTS At the final follow-up visit, safety and efficacy indexes were 1.12 ± 0.17 and 1.10 ± 0.19, respectively, and there was no statistical significance between the low and high myopia groups. Furthermore, 79.18% of eyes achieved a residual spherical equivalent within ±0.50 diopters. Except for the temporary elevation of intraocular pressure at 1 week postoperatively, IOP and endothelial cell density remained stable during follow-up visits. The rate of postoperative adverse events was 21.97% and most adverse events were transient. Vault abnormalities accounted for the majority of complications (9.54%). Results of generalized linear model showed that age was a risk factor for postoperative vault abnormalities, and the anterior chamber depth served as a protective factor (P < .05). CONCLUSIONS Visual outcomes of EVO ICL implantation were satisfactory in safety and efficacy indexes in both the low and high myopia groups for 1 year of follow-up, with acceptable stability in postoperative spherical equivalent, intraocular pressure, and endothelial cell density. This study emphasized cautious ICL size selection for older patients and those with shallow anterior chamber depth. [J Refract Surg. 2023;39(10):694-704.].
Collapse
|
9
|
Choi H, Ryu IH, Lee IS, Kim JK, Yoo TK. Comparison of implantation of posterior chamber phakic IOL implantation and laser vision correction in terms of corneal endothelial cells: 3-year observational paired-eye study. J Cataract Refract Surg 2023; 49:936-941. [PMID: 37379027 DOI: 10.1097/j.jcrs.0000000000001246] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 06/20/2023] [Indexed: 06/29/2023]
Abstract
PURPOSE To compare the postoperative endothelial cell counts of EVO-implantable collamer lenses (ICLs) with a central hole (V4c and V5) and laser vision correction surgery (laser in situ keratomileusis or photorefractive keratectomy). SETTING B&VIIT Eye Center, Seoul, South Korea. DESIGN Retrospective observational and paired contralateral study. METHODS 62 eyes of 31 patients who underwent EVO-ICLs with a central hole implantation in one eye (phakic intraocular lens [pIOL] group) and laser vision correction in the contralateral eye (LVC group) to correct refractive errors were retrospectively reviewed. Central endothelial cell density (ECD), percentage of hexagonal cells (HEX), coefficient of variation (CoV) in cell size, and adverse events were evaluated for at least 3 years. The endothelial cells were observed using a noncontact specular microscope. RESULTS All surgeries were performed, without complications during the follow-up period. The mean ECD loss values compared with the preoperative measurements were 6.65% and 4.95% during the 3 years after pIOL and LVC, respectively. There was no significant difference in ECD loss compared with the preoperative values (paired t test, P = .188) between the 2 groups. No significant loss in ECD was observed at any timepoint. The pIOL group showed higher HEX ( P = .018) and lower CoV ( P = .006) values than the LVC group at the last visit. CONCLUSIONS According to the authors' experience, the EVO-ICL with a central hole implantation was a safe and stable vision correction method. Moreover, it did not induce statistically significant changes in ECD at 3 years postoperatively compared with LVC. However, further long-term follow-up studies are required to confirm these results.
Collapse
Affiliation(s)
- Hannuy Choi
- From the Department of Refractive Surgery, B&VIIT Eye Center, Seoul, South Korea (Choi, Ryu, Lee, Kim, Yoo); Research and Development Department, VISUWORKS, Seoul, South Korea (Ryu, Yoo)
| | | | | | | | | |
Collapse
|
10
|
Luo W, Aruma A, Li M, Wang J, Xie J, Xiao X, Shen Y, Niu L, Wang X, Zhou X. Four-year visual outcomes and optical quality of SMILE and implantable collamer lens V4c (EVO-ICL) implantation for high myopia: a retrospective study. BMC Ophthalmol 2023; 23:341. [PMID: 37525155 PMCID: PMC10392000 DOI: 10.1186/s12886-023-03050-9] [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: 05/15/2022] [Accepted: 06/18/2023] [Indexed: 08/02/2023] Open
Abstract
BACKGROUND To compare the 4-year visual outcomes of implantable collamer lens V4c (EVO-ICL) implantation and small incision lenticule extraction (SMILE) for high myopia and astigmatism. METHODS This retrospective case study included 64 eyes of 40 patients. These patients with preoperative manifest refraction spherical equivalent (SE) between - 6.00 and - 10.00 diopters (D) were screened from the database of SMILE and EVO-ICL implantation procedures in 2015. The ICL group [32 eyes of 19 patients (mean age, 29.6 ± 6.3 years); mean SE, -8.71 ± 1.06 D] and SMILE group [32 eyes of 21 patients (mean age, 27.7 ± 5.6 years); mean SE, -8.35 ± 0.65D] were compared. All patients were then prospectively examined at a four-year follow-up for routine postoperative examinations, higher-order ocular aberrations, retinal image quality and a questionnaire. RESULTS The safety indexes were 1.15 ± 0.14 and 1.22 ± 0.21 (P = 0.36) for the SMILE and ICL groups, respectively. No eyes lost two or more lines of CDVA in either group. The efficacy indexes were 0.97 ± 0.16 and 0.96 ± 0.19 (P = 0.87), respectively. Twenty-three eyes (72%) in ICL and 26 eyes (81%) in SMILE groups were within ± 0.5 D of the attempted SE (P < 0.01). ICL-treated eyes had significantly less spherical aberration and coma (P < 0.01 and < 0.05, respectively) postoperatively. Halos were the prevalent visual disturbance in both groups. CONCLUSION SMILE and EVO-ICL implantation provided safe and effective correction of high myopia. SMILE showed slightly better long-term predictability. Mild postoperative visual disturbances were observed after ICL and SMILE at 4-year follow-up.
Collapse
Affiliation(s)
- Wuqiang Luo
- Visual Science and Optometry Center, the People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, 530021, Guangxi Zhuang Autonomous Region, China
| | - Aruma Aruma
- Department of Ophthalmology, NHC Key Laboratory of Myopia, Shanghai Research Center of Ophthalmology and Optometry, Eye and ENT Hospital of Fudan University, 200433, Shanghai, China
| | - Meiyan Li
- Department of Ophthalmology, NHC Key Laboratory of Myopia, Shanghai Research Center of Ophthalmology and Optometry, Eye and ENT Hospital of Fudan University, 200433, Shanghai, China
| | - Jing Wang
- Aier Eye Hospital Group, Aier Eye Hospital of Wuhan University, 430063, Wuhan, Hubei Province, China
| | - Jing Xie
- Department of Ophthalmology, Shenzhen Key Laboratory of ENT, Institute of ENT Shenzhen, Longgang ENT hospital, 518172, Shenzhen, China
| | - Xin Xiao
- Visual Science and Optometry Center, the People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, 530021, Guangxi Zhuang Autonomous Region, China
| | - Yang Shen
- Department of Ophthalmology, NHC Key Laboratory of Myopia, Shanghai Research Center of Ophthalmology and Optometry, Eye and ENT Hospital of Fudan University, 200433, Shanghai, China
| | - Lingling Niu
- Department of Ophthalmology, NHC Key Laboratory of Myopia, Shanghai Research Center of Ophthalmology and Optometry, Eye and ENT Hospital of Fudan University, 200433, Shanghai, China
| | - Xiaoying Wang
- Department of Ophthalmology, NHC Key Laboratory of Myopia, Shanghai Research Center of Ophthalmology and Optometry, Eye and ENT Hospital of Fudan University, 200433, Shanghai, China
| | - Xingtao Zhou
- Department of Ophthalmology, NHC Key Laboratory of Myopia, Shanghai Research Center of Ophthalmology and Optometry, Eye and ENT Hospital of Fudan University, 200433, Shanghai, China.
- Department of Ophthalmology and Optometry, Myopia Key Laboratory of the Health Ministry, Eye and ENT Hospital of Fudan University, No.83 Fenyang Road, 200031, Shanghai, People's Republic of China.
| |
Collapse
|
11
|
Naujokaitis T, Auffarth GU, Łabuz G, Kessler LJ, Khoramnia R. Diagnostic Techniques to Increase the Safety of Phakic Intraocular Lenses. Diagnostics (Basel) 2023; 13:2503. [PMID: 37568866 PMCID: PMC10417808 DOI: 10.3390/diagnostics13152503] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 07/25/2023] [Accepted: 07/25/2023] [Indexed: 08/13/2023] Open
Abstract
Preoperative and postoperative diagnostics play an important role in ensuring the safety of patients with phakic intraocular lenses (pIOLs). The risk of endothelial cell loss can be addressed by regularly measuring the endothelial cell density using specular microscopy and considering the endothelial cell loss rate and the endothelial reserve in accordance with the patient's age when deciding whether to explant a pIOL. The anterior chamber morphometrics, including the anterior chamber depth and the distance between the pIOL and the endothelium, measured using Scheimpflug tomography and anterior segment optical coherence tomography (AS-OCT), can help to assess the risk of the endothelial cell loss. In patients undergoing posterior chamber pIOL implantation, accurate prediction of the vault and its postoperative measurements using AS-OCT or Scheimpflug tomography are important when assessing the risk of anterior subcapsular cataract and secondary glaucoma. Novel approaches based on ultrasound biomicroscopy and AS-OCT have been proposed to increase the vault prediction accuracy and to identify eyes in which prediction errors are more likely. Careful patient selection and regular postoperative follow-up visits can reduce the complication risk and enable early intervention if a complication occurs.
Collapse
Affiliation(s)
| | | | | | | | - Ramin Khoramnia
- Department of Ophthalmology, University of Heidelberg, 69120 Heidelberg, Germany
| |
Collapse
|
12
|
Chen X, Miao H, Cheng M, Lin IC, Li B, Jiang Y, Lei Y, Wang X, Zhou X. Effect of long-term rotation on astigmatism following EVO-toric intraocular collamer lens implantation. Front Med (Lausanne) 2023; 10:1194006. [PMID: 37521343 PMCID: PMC10375410 DOI: 10.3389/fmed.2023.1194006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Accepted: 07/03/2023] [Indexed: 08/01/2023] Open
Abstract
Objective To evaluate the effect of long-term rotation on astigmatism following Evolution-toric intraocular collamer lens (EVO-TICL) implantation. Methods Forty eyes of 22 patients were enrolled in this prospective study. Visual acuity, refractive parameters, and axial position of the EVO-TICL by OPD-Scan III aberrometer were measured preoperatively, 1 month and 3 years postoperatively. Results Last visit, the safety index was 1.32 ± 0.15 and the efficacy index was 1.01 ± 0.23. The best-fitting curve of the attempted versus achieved correction was y = 0.9751x + 0.001. The mean spherical equivalent (SE) decreased from -8.94 ± 2.72D preoperatively to 0.06 ± 0.24D and - 0.36 ± 0.46D 1 month and 3 years postoperatively, respectively. The mean target and surgical induced astigmatism were 1.55 ± 0.61D and 1.67 ± 0.94D 3 years postoperatively. The average expected axis of the TICL was-1.15 ± 9.07 (-21-19°). One month and 3 years postoperatively, the average actual axis was -0.70 ± 9.86 (-20-20°) and - 0.35 ± 11.72 (-25-30°), respectively. The absolute rotation of the TICL was 3.70 ± 4.42 (0-22°) and 6.00 ± 6.70 (0-32°) 1 month and 3 years postoperatively, respectively (p < 0.001). The expected astigmatism was -0.10 ± 0.12D, and the mean actual astigmatism was -0.21 ± 0.30D and - 0.44 ± 0.45D 1 month and 3 years postoperatively, respectively. The mean absolute rotation without postoperative astigmatism was 3.73 ± 2.69 (0-9°) and 1.67 ± 1.66 (0-5°) for low (<2D) and high (≥2D) astigmatic TICL, respectively (p < 0.05). Conclusion EVO-TICL implantation is safe and effective, with good predictability and stability. OPD-Scan is a fast device to detect the axial position of the TICL without mydriasis, and the axial position is relatively stable in the long term postoperatively. A slight rotation of low-astigmatic TICL may not cause postoperative astigmatism, whereas rotation of the high-astigmatic TICL may cause it.
Collapse
Affiliation(s)
- Xun Chen
- Fudan University Eye Ear Nose and Throat Hospital, Shanghai, China
- National Health Commission Key Lab of Myopia (Fudan University), Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care (20DZ2255000), Shanghai, China
| | - Huamao Miao
- Fudan University Eye Ear Nose and Throat Hospital, Shanghai, China
- National Health Commission Key Lab of Myopia (Fudan University), Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care (20DZ2255000), Shanghai, China
| | - Mingrui Cheng
- Fudan University Eye Ear Nose and Throat Hospital, Shanghai, China
- National Health Commission Key Lab of Myopia (Fudan University), Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care (20DZ2255000), Shanghai, China
| | - I-Chun Lin
- Fudan University Eye Ear Nose and Throat Hospital, Shanghai, China
- National Health Commission Key Lab of Myopia (Fudan University), Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care (20DZ2255000), Shanghai, China
| | - Boliang Li
- Fudan University Eye Ear Nose and Throat Hospital, Shanghai, China
- National Health Commission Key Lab of Myopia (Fudan University), Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care (20DZ2255000), Shanghai, China
| | - Yinjie Jiang
- Fudan University Eye Ear Nose and Throat Hospital, Shanghai, China
- National Health Commission Key Lab of Myopia (Fudan University), Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care (20DZ2255000), Shanghai, China
| | - Yadi Lei
- Fudan University Eye Ear Nose and Throat Hospital, Shanghai, China
- National Health Commission Key Lab of Myopia (Fudan University), Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care (20DZ2255000), Shanghai, China
| | - Xiaoying Wang
- Fudan University Eye Ear Nose and Throat Hospital, Shanghai, China
- National Health Commission Key Lab of Myopia (Fudan University), Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care (20DZ2255000), Shanghai, China
| | - Xingtao Zhou
- Fudan University Eye Ear Nose and Throat Hospital, Shanghai, China
- National Health Commission Key Lab of Myopia (Fudan University), Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care (20DZ2255000), Shanghai, China
| |
Collapse
|
13
|
Tang C, Sun T, Duan H, Liu Y, Qi H. Evaluation of the Performance of Two Nomograms and Four Vault Prediction Formulas for Implantable Collamer Lens Size Selection. J Refract Surg 2023; 39:456-461. [PMID: 37449504 DOI: 10.3928/1081597x-20230605-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/18/2023]
Abstract
PURPOSE To evaluate the performance of different nomograms and vault prediction formulas in predicting the optimal Implantable Collamer Lens (ICL; STAAR Surgical) size and vault. METHODS This retrospective study included 108 participants (214 eyes) who underwent ICL implantation. The efficacy of the manufacturer's nomogram, Parkhurst nomogram, NK formula, KS formula, Zhu formula, and ZZ formula was assessed by comparing the indicated ICL sizes to the postoperative vault measurements. Additionally, Bland-Altman plots and the Friedman test were used to assess the agreement and absolute error between the actual vault and predicted vault. RESULTS The proportions of the ideal ICL category recommended by the manufacturer's nomogram, Parkhurst nomogram, NK formula, KS formula, Zhu formula, and ZZ formula were 50.5%, 45.3%, 46.7%, 42.5%, 50.0%, and 28.5%, respectively. The mean differences between the actual vault and the predicted vault using the NK, KS, Zhu, and ZZ formulas were 144.1 ± 261.1, -19.3 ± 179.6, 70.8 ± 284.2, and 182.6 ± 361.5 μm, respectively. The predicted ICL vault tended to overestimate the actual ICL vault, particularly when choosing a larger ICL size. The KS formula shows the smallest deviation in prediction error and is least affected by variation in ICL size. CONCLUSIONS White-to-white distance from the Pentacam (Oculus Optikgeräte GmbH) coupled with the manufacturer's nomogram performed well for ICL size selection. Four vault prediction formulas tended to overestimate the actual ICL vault, particularly when selecting a larger ICL size. The KS formula appeared to have the least bias of the formulas. Simultaneously, vault prediction formulas need to be modified according to the ICL size. [J Refract Surg. 2023;39(7):456-461.].
Collapse
|
14
|
Li X, Wang M, Dong W, Cai J. Anterior segment structure changes caused by different luminance light after implantable collamer lens surgery. BMC Ophthalmol 2023; 23:281. [PMID: 37328783 DOI: 10.1186/s12886-023-03014-z] [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: 02/25/2023] [Accepted: 06/03/2023] [Indexed: 06/18/2023] Open
Abstract
BACKGROUNDS To investigate the changes of anterior eye segment with implantable collamer lens (ICL) under mesopic and photopic conditions. METHOD Forty-seven eyes of myopic patients who underwent ICL V4c implantation were included. Three months after surgery, the pupil diameter (PD), dynamic vault, ACD (distance from the posterior corneal surface to the anterior lens surface), ACD-ICL (distance from the posterior corneal surface to the anterior ICL surface), and anterior chamber angle parameters were measured using the anterior segment optical coherence tomography (AS-OCT, Carl Zeiss AG, Germany) under completely mesopic (0 lx) and photopic (5290 lx) lighting conditions. RESULTS Compared with mesopic conditions, a significant decreased vault was detected in photopic conditions (486.7 ± 186.1 μm versus 643.5 ± 191.2 μm, p < 0.001), while the ACD-ICL increased significantly (2.54 ± 0.24 mm versus 2.37 ± 0.23 mm, p < 0.001). The pupil was smaller in photopic condition (2.66 ± 0.23 mm versus 5.62 ± 0.55 mm, p < 0.001). ACD didn't change(3.32 ± 0.24 mm versus 3.31 ± 0.22 mm, p = 0.079). The change of the vault was positively related to the changes of the PD (r2 = 0.301, p = 0.04). There were no statistical difference between the change of vault and the change of ACD-ICL (158.0 ± 58.1 μm versus 165.9 ± 65.3 μm, p = 0.320). CONCLUSION When exposed to high intensity light after ICL surgery, the pupil constricted, vault decreased, ACA widened and ACD-ICL increased. All these changes were caused by the change of iris not the crystalline lens.
Collapse
Affiliation(s)
- Xia Li
- Department of Ophthalmology, Shanghai Aier Eye Hospital, Shanghai, China.
| | - Min Wang
- Department of Ophthalmology, Shanghai Aier Eye Hospital, Shanghai, China
| | - Weiwen Dong
- Department of Auxiliary Examination, Shanghai Aier Eye Hospital, Shanghai, China
| | - Jinfeng Cai
- Department of Ophthalmology, Shanghai Aier Eye Hospital, Shanghai, China.
| |
Collapse
|
15
|
Yang J, Zou Z, Wu M, He R, Nong Y, Li H, Zhou S. Development and validation of a new multivariable prediction model to estimate risk of abnormal vault. BMC Ophthalmol 2023; 23:203. [PMID: 37165326 PMCID: PMC10170721 DOI: 10.1186/s12886-023-02956-8] [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: 12/10/2022] [Accepted: 05/03/2023] [Indexed: 05/12/2023] Open
Abstract
PURPOSE To develop and validate a new multivariable prediction model to estimate risk of abnormal vault after EVO Implantable Collamer Lens (EVO-ICL) implantation using the preoperative parameters. METHODS This retrospective study comprised 282 eyes of 143patients who underwent EVO-ICL surgery between May 2021 and April 2022. We measured preoperative parameters before surgery and vaults in 1 week after the operation using swept-source optical coherence tomography (SS-OCT). Risk factors for abnormal vault were determined by univariate and multivariate logistic regression analyses, and a nomogram was developed to forecast the risk of abnormal vault after EVO-ICL implantation. We assessed the performance of nomogram in terms of discrimination and calibration, including concordance index (C-index), receiver operating characteristic curve (ROC), area under the ROC curve (AUC), and decision curve analysis (DCA). Bootstrap resampling was used as an internal verification method. RESULTS The logistic regression analysis revealed the independent risk factors for abnormal vault were white-to-white(WTW), anterior chamber angle(ACA), pupil size, and ICL-size, all of them were used to establish a nomogram based on multivariate logistic regression to predict the risk of abnormal vault. The C-indexes and AUC were 0.669 (95%CI, 0.605, 0.733). The calibration curves of the nomogram showed relatively small bias from the reference line, implicating an acceptable degree of confidence. The DCA indicates the potential clinical significance of the nomogram. CONCLUSIONS We developed a new multivariable prediction model to estimate risk of abnormal vault. The model shows good prediction effect and can provide assistance for clinical decision of ICL size.
Collapse
Affiliation(s)
- Jing Yang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, People's Republic of China.
| | - Zongyin Zou
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Minhui Wu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Runzhang He
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Yating Nong
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Hui Li
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Sheng Zhou
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, People's Republic of China.
| |
Collapse
|
16
|
Shen Y, Wang L, Jian W, Shang J, Wang X, Ju L, Li M, Zhao J, Chen X, Ge Z, Wang X, Zhou X. Big-data and artificial-intelligence-assisted vault prediction and EVO-ICL size selection for myopia correction. Br J Ophthalmol 2023; 107:201-206. [PMID: 34489338 PMCID: PMC9887372 DOI: 10.1136/bjophthalmol-2021-319618] [Citation(s) in RCA: 37] [Impact Index Per Article: 37.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Accepted: 08/23/2021] [Indexed: 02/03/2023]
Abstract
AIMS To predict the vault and the EVO-implantable collamer lens (ICL) size by artificial intelligence (AI) and big data analytics. METHODS Six thousand two hundred and ninety-seven eyes implanted with an ICL from 3536 patients were included. The vault values were measured by the anterior segment analyzer (Pentacam HR). Permutation importance and Impurity-based feature importance are used to investigate the importance between the vault and input parameters. Regression models and classification models are applied to predict the vault. The ICL size is set as the target of the prediction, and the vault and the other input features are set as the new inputs for the ICL size prediction. Data were collected from 2015 to 2020. Random Forest, Gradient Boosting and XGBoost were demonstrated satisfying accuracy and mean area under the curve (AUC) scores in vault predicting and ICL sizing. RESULTS In the prediction of the vault, the Random Forest has the best results in the regression model (R2=0.315), then follows the Gradient Boosting (R2=0.291) and XGBoost (R2=0.285). The maximum classification accuracy is 0.828 in Random Forest, and the mean AUC is 0.765. The Random Forest predicts the ICL size with an accuracy of 82.2% and the Gradient Boosting and XGBoost, which are also compatible with 81.5% and 81.8% accuracy, respectively. CONCLUSIONS Random Forest, Gradient Boosting and XGBoost models are applicable for vault predicting and ICL sizing. AI may assist ophthalmologists in improving ICL surgery safety, designing surgical strategies, and predicting clinical outcomes.
Collapse
Affiliation(s)
- Yang Shen
- Department of Ophthalmology and Optometry, Fudan University Eye Ear Nose and Throat Hospital, Shanghai, China,NHC Key Laboratory of Myopia, Shanghai, China,Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Lin Wang
- Beijing Airdoc Technology Co., Ltd, Beijing, China,Monash University, Clayton, Victoria, Australia
| | - Weijun Jian
- Department of Ophthalmology and Optometry, Fudan University Eye Ear Nose and Throat Hospital, Shanghai, China,NHC Key Laboratory of Myopia, Shanghai, China,Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Jianmin Shang
- Department of Ophthalmology and Optometry, Fudan University Eye Ear Nose and Throat Hospital, Shanghai, China,NHC Key Laboratory of Myopia, Shanghai, China,Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Xin Wang
- Beijing Airdoc Technology Co., Ltd, Beijing, China
| | - Lie Ju
- Beijing Airdoc Technology Co., Ltd, Beijing, China,Monash University, Clayton, Victoria, Australia
| | - Meiyan Li
- Department of Ophthalmology and Optometry, Fudan University Eye Ear Nose and Throat Hospital, Shanghai, China,NHC Key Laboratory of Myopia, Shanghai, China,Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Jing Zhao
- Department of Ophthalmology and Optometry, Fudan University Eye Ear Nose and Throat Hospital, Shanghai, China,NHC Key Laboratory of Myopia, Shanghai, China,Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Xun Chen
- Department of Ophthalmology and Optometry, Fudan University Eye Ear Nose and Throat Hospital, Shanghai, China,NHC Key Laboratory of Myopia, Shanghai, China,Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Zongyuan Ge
- Beijing Airdoc Technology Co., Ltd, Beijing, China,Monash University, Clayton, Victoria, Australia
| | - Xiaoying Wang
- Department of Ophthalmology and Optometry, Fudan University Eye Ear Nose and Throat Hospital, Shanghai, China,NHC Key Laboratory of Myopia, Shanghai, China,Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Xingtao Zhou
- Department of Ophthalmology and Optometry, Fudan University Eye Ear Nose and Throat Hospital, Shanghai, China,NHC Key Laboratory of Myopia, Shanghai, China,Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| |
Collapse
|
17
|
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.
Collapse
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
| |
Collapse
|
18
|
Choi H, Kim T, Kim SJ, Sa BG, Ryu IH, Lee IS, Kim JK, Han E, Kim HK, Yoo TK. Predicting Postoperative Anterior Chamber Angle for Phakic Intraocular Lens Implantation Using Preoperative Anterior Segment Metrics. Transl Vis Sci Technol 2023; 12:10. [PMID: 36607625 PMCID: PMC9836008 DOI: 10.1167/tvst.12.1.10] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Purpose The anterior chamber angle (ACA) is a critical factor in posterior chamber phakic intraocular lens (EVO Implantable Collamer Lens [ICL]) implantation. Herein, we predicted postoperative ACAs to select the optimal ICL size to reduce narrow ACA-related complications. Methods Regression models were constructed using pre-operative anterior segment optical coherence tomography metrics to predict postoperative ACAs, including trabecular-iris angles (TIAs) and scleral-spur angles (SSAs) at 500 µm and 750 µm from the scleral spur (TIA500, TIA750, SSA500, and SSA750). Data from three expert surgeons were assigned to the development (N = 430 eyes) and internal validation (N = 108 eyes) datasets. Additionally, data from a novice surgeon (N = 42 eyes) were used for external validation. Results Postoperative ACAs were highly predictable using the machine-learning (ML) technique (extreme gradient boosting regression [XGBoost]), with mean absolute errors (MAEs) of 4.42 degrees, 3.77 degrees, 5.25 degrees, and 4.30 degrees for TIA500, TIA750, SSA500, and SSA750, respectively, in internal validation. External validation also showed MAEs of 3.93 degrees, 3.86 degrees, 5.02 degrees, and 4.74 degrees for TIA500, TIA750, SSA500, and SSA750, respectively. Linear regression using the pre-operative anterior chamber depth, anterior chamber width, crystalline lens rise, TIA, and ICL size also exhibited good performance, with no significant difference compared with XGBoost in the validation sets. Conclusions We developed linear regression and ML models to predict postoperative ACAs for ICL surgery anterior segment metrics. These will prevent surgeons from overlooking the risks associated with the narrowing of the ACA. Translational Relevance Using the proposed algorithms, surgeons can consider the postoperative ACAs to increase surgical accuracy and safety.
Collapse
Affiliation(s)
- Hannuy Choi
- Department of Refractive Surgery, B&VIIT Eye Center, Seoul, South Korea
| | - Taein Kim
- Research and Development Department, VISUWORKS, Seoul, South Korea
| | - Su Jeong Kim
- Research and Development Department, VISUWORKS, Seoul, South Korea
| | - Beom Gi Sa
- Research and Development Department, VISUWORKS, Seoul, South Korea
| | - Ik Hee Ryu
- Department of Refractive Surgery, B&VIIT Eye Center, Seoul, South Korea,Research and Development Department, VISUWORKS, Seoul, South Korea
| | - In Sik Lee
- Department of Refractive Surgery, B&VIIT Eye Center, Seoul, South Korea
| | - Jin Kuk Kim
- Department of Refractive Surgery, B&VIIT Eye Center, Seoul, South Korea
| | - Eoksoo Han
- Electronics and Telecommunications Research Institute (ETRI), Daejeon, South Korea
| | - Hong Kyu Kim
- Department of Ophthalmology, Dankook University Hospital, Dankook University College of Medicine, Cheonan, South Korea
| | - Tae Keun Yoo
- Department of Refractive Surgery, B&VIIT Eye Center, Seoul, South Korea,Research and Development Department, VISUWORKS, Seoul, South Korea
| |
Collapse
|
19
|
Qian T, Du J, Ren R, Zhou H, Li H, Zhang Z, Xu X. Vault-Correlated Efficacy and Safety of Implantable Collamer Lens V4c Implantation for Myopia in Patients with Shallow Anterior Chamber Depth. Ophthalmic Res 2023; 66:445-456. [PMID: 36596292 DOI: 10.1159/000528616] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Accepted: 11/27/2022] [Indexed: 01/04/2023]
Abstract
INTRODUCTION The aim of the study was to evaluate efficacy and safety outcomes after implantation of the Visian Implantable Collamer Lens (ICL V4c) in myopia patients with shallow anterior chamber depth (ACD). METHODS This retrospective study followed 163 eyes of 94 patients for at least 24 months. Uncorrected distance visual acuity (UDVA), corrected distance visual acuity, intraocular pressure (IOP), manifest refraction, vault, endothelial cell density (ECD), anterior chamber angle (ACA), anterior chamber volume, and the distance from the corneal endothelium to the central ICL (C-ICL) were measured during follow-ups. Spearman's correlation and logistic regression were used to identify variables correlated with changes in ECD and potential risk factors for ineffective outcomes, respectively. RESULTS All surgeries were performed safely. High IOP of 9 eyes and anterior capsular opacity of 5 eyes were observed. The last follow-up ACA had a significant difference between the high and normal IOP groups (p = 0.0003). The mean ECD and vault were 2,855.76 ± 270.82 cells/mm2 and 388.01 ± 135.28 μm at the last follow-up, respectively. The vault and C-ICL were significantly associated with ΔECD (all p < 0.05). Furthermore, the vault was most responsible for the ECD loss. Twenty-two eyes had unsatisfactory postoperative UDVA, and the low vault at the last follow-up was a significant risk factor for this ineffective outcome (p < 0.001, OR = 14.739). CONCLUSIONS ICL V4c implantation in patients with shallow ACD achieved stable visual outcomes. The vault is related to postoperative visual acuity and ECD loss, which needs to be paid attention during follow-up.
Collapse
Affiliation(s)
- Tianwei Qian
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, China
- National Clinical Research Center for Eye Diseases, Shanghai, China
- Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai, China
- Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, China
- Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Disease, Shanghai, China
| | - Jingxiao Du
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, China
- National Clinical Research Center for Eye Diseases, Shanghai, China
- Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai, China
- Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, China
- Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Disease, Shanghai, China
| | - Ruixia Ren
- Shanghai Xinshijie Zhongxing Eye Hospital, Shanghai, China
| | - Hao Zhou
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, China
- National Clinical Research Center for Eye Diseases, Shanghai, China
- Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai, China
- Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, China
- Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Disease, Shanghai, China
| | - Haiyan Li
- Shanghai Xinshijie Zhongxing Eye Hospital, Shanghai, China
| | - Zhihua Zhang
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, China
- National Clinical Research Center for Eye Diseases, Shanghai, China
- Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai, China
- Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, China
- Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Disease, Shanghai, China
| | - Xun Xu
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, China
- National Clinical Research Center for Eye Diseases, Shanghai, China
- Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai, China
- Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, China
- Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Disease, Shanghai, China
| |
Collapse
|
20
|
Di Y, Cui G, Li Y, Luo Y. A meta-analysis of visual outcomes and optical quality after small incision lenticule extraction versus implantable collamer lens for myopia. Eur J Ophthalmol 2023; 33:136-144. [PMID: 35469471 DOI: 10.1177/11206721221097249] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
OBJECTIVE To evaluate possible differences in visual outcome and optical quality when small incision lenticule extraction (SMILE) versus implantable collamer lens (ICL) is used to correct myopia. METHODS PubMed, EMBASE, and the Cochrane Central Register of Controlled Trials were searched up to August 2021 to identify relevant studies. The PRISMA guidelines were followed. Primary outcomes were postoperative efficacy, safety, and predictability at the end of follow-up. Secondary outcomes were changes in modulation transfer function cutoff frequency (MTF cut-off), objective scatter index (OSI) values, total higher-order aberrations (HOAs), spherical aberrations, and coma aberrations. RESULTS Seven studies with a total of 1296 eyes (SMILE: 731 eyes; TECXL: 565 eyes) were included. The ICL group had a better MTF cut-off (P = 0.007) and less change in the proportion of HOAs (P < 0.001), spherical aberrations (P = 0.009), and coma (P = 0.006) than the SMILE group. For the other outcomes, there were no statistically significant differences. CONCLUSIONS SMILE and ICL implantation are comparable in efficacy, safety, and predictability for correcting myopia. Larger studies with longer follow-up times are warranted to provide a better understanding of the benefits of SMILE and ICL implantation.
Collapse
Affiliation(s)
- Yu Di
- Department of Ophthalmology, 34732Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Ge Cui
- Department of Ophthalmology, 34732Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Ying Li
- Department of Ophthalmology, 34732Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Yan Luo
- Department of Ophthalmology, 34732Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| |
Collapse
|
21
|
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.
Collapse
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
| |
Collapse
|
22
|
Lin Q, Yang D, Zhou X. Early outcomes of anterior segment parameters after implantable collamer lens V4c implantation. BMC Ophthalmol 2022; 22:429. [PMID: 36357865 PMCID: PMC9650857 DOI: 10.1186/s12886-022-02656-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 10/28/2022] [Indexed: 11/12/2022] Open
Abstract
Background This study investigated the early outcomes of anterior segment parameters after implanting an implantable collamer lens with a central hole (ICL V4c) in patients with myopia and determined the earliest follow-up time for detecting potential complications. Methods Sixty-two patients were included, and the following parameters were measured at baseline (preoperative), 1 day, 1 week, and 1, 3, and 6 months after the operation: intraocular pressure (IOP), endothelial cell density (ECD), central anterior chamber depth (CACD), anterior chamber volume (ACV), nasal and temporal anterior chamber angle (n-ACA and t-ACA), horizontal corneal diameter (white-to-white, WTW), and axial length (AL). The vault was measured at each post-operative timepoint. Results The postoperative IOP and ECD at the 6 months were both statistically similar to the baseline. The post-operative CACD and ACV were significantly less at all timepoints compared with the baseline (P < 0.001) and stayed stable from 1 day and 1 month after the operation, respectively. Postoperative n-ACA and t-ACA decreased significantly at 1 day and 1 week compared with the baseline (P < 0.001), while tended to stabilization at 1, 3, and 6 months. The vault kept decreasing significantly at 1 day, 1 week, and 1 month, but stayed stable at 3 and 6 months. The postoperative n-ACA and t-ACA positively correlated with the baseline ACA, CACD, and ACV. Conclusions The anterior chamber parameters tended to stabilization early after the operation. Thus, it is essential to evaluate patients’ anterior segment status at earlier timepoints and prevent complications with prompt and non-invasive intervention.
Collapse
|
23
|
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.
Collapse
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
| |
Collapse
|
24
|
Alfonso-Bartolozzi B, Lisa C, Fernández-Vega-Cueto L, Baamonde B, Madrid-Costa D, Alfonso JF. Three-year follow-up of posterior chamber phakic intraocular lens with a central port design after deep anterior lamellar keratoplasty. EYE AND VISION 2022; 9:34. [PMID: 36068603 PMCID: PMC9450313 DOI: 10.1186/s40662-022-00306-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 08/17/2022] [Indexed: 11/10/2022]
Abstract
Abstract
Background
To evaluate clinical outcomes of the Visian implantable collamer lens (ICL) with a central port to correct myopia and astigmatism after deep anterior lamellar keratoplasty (DALK) for keratoconus throughout 3 years of follow-up.
Methods
This study included 20 eyes of 20 patients that underwent V4c ICL (13 eyes with a spherical ICL and 7 eyes with a toric ICL) implantation after DALK. Uncorrected (UDVA) and corrected (CDVA) distance visual acuities, refraction, intraocular pressure (IOP), endothelial cell density (ECD), and vault were analyzed.
Results
The mean UDVA improved from the preoperative 1.18 ± 0.33 logMAR to 0.25 ± 0.14 logMAR at 6 months after surgery (P < 0.0001) and remained unchanged throughout the whole follow-up (P = 0.4). All eyes gained lines of CDVA compared to preoperative values. At the last follow-up visit, all eyes achieved CDVA of 0.2 logMAR or better and 13 eyes (65%) 0.1 logMAR or better. At 6 months post-surgery, all eyes (100%) had a spherical equivalent within ± 1.50 D, and 19 (95%) within ± 1.00 D. The mean manifest spherical equivalent was stable over the postoperative follow-up (P = 0.25). No significant increase in IOP occurred in any case throughout the 3 years of follow-up. The loss in ECD from the preoperative baseline at the last follow-up visit was 2.27%.
Conclusions
The clinical outcomes suggest that the V4c ICL implantation for correction of myopia and regular astigmatism in post-DALK eyes was satisfactory in terms of effectiveness, safety, and stability during 3 years of follow-up.
Collapse
|
25
|
Han T, Chen X, Xu Y, Niu L, Wang X, Zhou X. Refractive outcomes of implantable collamer lens implantation in 1212 eyes with suboptimal corrected distance vision acuity. Curr Eye Res 2022; 47:1419-1423. [PMID: 35757851 DOI: 10.1080/02713683.2022.2094418] [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: 11/03/2022]
Abstract
Purpose: To analyze the factors related to corrected distance vision acuity (CDVA) after implantable collamer lens (ICL) implantation in patients with preoperative suboptimal CDVA.Methods: This retrospective study included patients with suboptimal preoperative CDVA (CDVA ≤20/25) who underwent ICL implantation (V4 or V4c). Preoperative and postoperative clinical evaluations included CDVA, uncorrected distance visual acuity (UDVA), and refraction.Results: A total of 1,212 eyes from 731 patients were identified. CDVA increased in 90.8% of the eyes after surgery. Among them, 57.5% of the eyes (697 eyes) gained more than one line. The preoperative LogMAR CDVA was 0.32 ± 0.23, which significantly improved to 0.13 ± 0.17 postoperatively (p < 0.001). There was no significant difference between ICL V4c and ICL V4 in the LogMAR UDVA, sphere, cylinder, SE, LogMAR CDVA, efficacy index, and safety index after surgery (p > 0.05). For eyes with full correction, the postoperative LogMAR CDVA =0.575 * preoperative LogMAR CDVA -0.061 (p < 0.001, R2 = 0.53). For eyes with partial correction, the postoperative LogMAR CDVA =0.536 * preoperative LogMAR CDVA - 0.007 * SE - 0.196 (P < 0.001, R2 = 0.55).Conclusion: ICL implantation can improve CDVA in eyes with suboptimal CDVA. This study provides the postoperative outcomes of eyes with different preoperative CDVA, which makes it convenient for surgeons to communicate with such patients before surgery.
Collapse
Affiliation(s)
- Tian Han
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia (Fudan University), Shanghai, China.,Research Center of Ophthalmology and Optometry Shanghai, Shanghai, China
| | - Xun Chen
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia (Fudan University), Shanghai, China.,Research Center of Ophthalmology and Optometry Shanghai, Shanghai, China
| | - Ye Xu
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia (Fudan University), Shanghai, China.,Research Center of Ophthalmology and Optometry Shanghai, Shanghai, China
| | - Lingling Niu
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia (Fudan University), Shanghai, China.,Research Center of Ophthalmology and Optometry Shanghai, Shanghai, China
| | - Xiaoying Wang
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia (Fudan University), Shanghai, China.,Research Center of Ophthalmology and Optometry Shanghai, Shanghai, China
| | - Xingtao Zhou
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia (Fudan University), Shanghai, China.,Research Center of Ophthalmology and Optometry Shanghai, Shanghai, China
| |
Collapse
|
26
|
Du Y, Jin C, Yin S, Wang G, Ma Q, Li Y, Chen B, Wang H, Qiu K, Zhang M. Comparison of Vault Measurements Using a Swept-Source OCT-Based Optical Biometer and Anterior Segment OCT. Front Med (Lausanne) 2022; 9:865719. [PMID: 35814765 PMCID: PMC9259877 DOI: 10.3389/fmed.2022.865719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Accepted: 05/26/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundTo newly describe the vault measurement by using a widely used swept-source OCT-based optical biometer (IOLMaster700) and accessd the accuracy of vault measurement.MethodsThis was a retrospective, cross-sectional study. All patients underwent implantable Collamer lens (ICL) implantation surgery without complications. IOLMaster700 and AS-OCT analyses were conducted for each eye on the same day in the same condition. Measurements of anterior chamber depth (ACD), corneal-ICL (C-ICL), and vault values were made and recorded. The repeatability of the IOL Master700 measurements was quantified based upon intraclass correlation coefficient (ICC) values. Correlations between IOL Master700 and AS-OCT measurements made with these different analytical approaches were assessed. The agreement of instruments was evaluated using Bland-Altman plots.ResultsThe IOLMaster700 instrument yielded highly reliable measurements of vault, C-ICL, and ACD (ICC = 0.996, 0.995, 0.995, respectively). Vault, C-ICL and ACD values as measured using the IOLMaster700, was slightly smaller than that measured via AS-OCT, but these differences were not significant (p = 0.652, p = 0.121 and p = 0.091, respectively). The vault, C-ICL, and ACD measurements by these two instruments were strongly correlated (r = 0.971, r = 0.944, and r = 0.963, respectively; all p < 0.001). The 95% limits of agreement for vault, C-ICL, and ACD measurements between the two devices were−0.08 to 0.08 mm,−0.14 to 0.11 mm, and−0.13 to 0.10 mm, respectively.ConclusionsThe IOLMasrer700 can measure implanted ICL vault with a high degree of accuracy and repeatability. Good correlations and agreement were observed between IOLMaster700 and AS-OCT in measuring vault, C-ICL, and ACD measurements.
Collapse
Affiliation(s)
- Yali Du
- Joint Shantou International Eye Center of Shantou University, The Chinese University of Hong Kong, Shantou, China
| | | | | | | | | | | | | | | | - Kunliang Qiu
- Joint Shantou International Eye Center of Shantou University, The Chinese University of Hong Kong, Shantou, China
| | - Mingzhi Zhang
- Joint Shantou International Eye Center of Shantou University, The Chinese University of Hong Kong, Shantou, China
| |
Collapse
|
27
|
Ye Y, Yang F, Ding L, Xia F, Niu L, Wang X, Zhao J, Zhou X. Comparison of Icare HOME and non-contact tonometer in intraocular pressure measurement in the early stage after ICL V4c implantation. Eur J Ophthalmol 2022; 32:3303-3311. [PMID: 35422146 DOI: 10.1177/11206721221093990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose To investigate the characteristics of intraocular pressure (IOP) measurements using the Icare HOME rebound tonometer (RBT) and non-contact tonometer (NCT) during the early stage after implantable collamer lens (ICL) V4c implantation, and to assess the agreement between the two methods. Methods This prospective case series study included 104 eyes of 53 patients (mean age 28.77 ± 5.34 years), who underwent ICL V4c implantation. IOP was measured preoperatively, and at 0.5, 1, 2, 4, and 24 h postoperatively by Icare HOME and NCT, respectively. Results All surgeries were uneventful. IOP measurements by Icare and NCT preoperatively were 14.03 ± 2.90 mmHg and 14.09 ± 2.87 mmHg, respectively.The corresponding values were 12.56 ± 8.09 mmHg and 14.12 ± 6.52 mmHg (P > 0.05) at postoperative 0.5 h, 19.21 ± 8.74 mmHg and 19.60 ± 7.66 mmHg at postoperative 1 h (P > 0.05), 21.21 ± 8.10 mmHg and 20.31 ± 6.93 mmHg at postoperative 2 h (P > 0.05), 16.11 ± 5.89 mmHg and 17.04 ± 4.84 mmHg at postoperative 4 h (P > 0.05), and 14.04 ± 3.88 mmHg and 14.78 ± 2.80 mmHg at postoperative 24 h, respectively (P > 0.05). There was good agreement based on intraclass correlation coefficients (ICCs) between NCT and Icare HOME (all ICCs > 0.6 at different time points [range, 0.6986–0.956]). The Bland-Altman plot showed a mean percentage of over 95.81% of the points falling within the limits of agreement. There was a significant difference in the low IOP measurements (<10 mmHg) between Icare HOME and NCT (7.28 ± 2.55 vs. 10.65 ± 2.48, P < 0.001). Conclusion Icare HOME can be used for IOP measurement after ICL V4c implantation and demonstrated good agreement with NCT, except in cases with low intraocular pressure (<10 mmHg).
Collapse
Affiliation(s)
- Yuhao Ye
- Department of Ophthalmology and Optometry, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Fangwen Yang
- The second affiliated Hospital of Guizhou Medical University, Guizhou, China
| | - Lan Ding
- Department of Ophthalmology and Optometry, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Fei Xia
- Department of Ophthalmology and Optometry, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Lingling Niu
- Department of Ophthalmology and Optometry, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Xiaoying Wang
- Department of Ophthalmology and Optometry, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Jing Zhao
- Department of Ophthalmology and Optometry, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Xingtao Zhou
- Department of Ophthalmology and Optometry, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| |
Collapse
|
28
|
Long-term follow-up for monovision surgery by Implantable Collamer Lens V4c implantation for myopia correction in early presbyopia. Graefes Arch Clin Exp Ophthalmol 2022; 260:2763-2771. [PMID: 35129628 PMCID: PMC9325784 DOI: 10.1007/s00417-021-05545-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 12/13/2021] [Accepted: 12/27/2021] [Indexed: 11/15/2022] Open
Abstract
Purpose To investigate the long-term safety and efficacy of monovision surgery using implantable collamer lens V4c (ICL V4c) implantation in myopic patients with early presbyopia. Setting Eye and ENT Hospital of Fudan University, Shanghai, China. Design Prospective case series study. Methods This study included 64 eyes of 32 patients with early presbyopia, who underwent bilateral ICL V4c implantation for myopia correction. Parameters, including mean spherical equivalent (SE), uncorrected distance visual acuity, corrected distance visual acuity, intraocular pressure, endothelial cell density, presbyopic add power, visual acuity (logMAR) of dominant eyes (D-eye), nondominant (nD-eye) eyes, and both eyes (Bi) at 0.4 m, 0.8 m, and 5 m were recorded at the last follow-up. Results All surgeries were uneventful. At the last follow-up, the safety indices were 1.23 ± 0.18 (D-eyes) and 1.21 ± 0.18 (nD-eyes) (p > 0.05); the efficacy indices were 0.95 ± 0.27 (D-eyes) and 0.92 ± 0.28 (nD-eyes) (p < 0.05), the SE was -0.62 ± 0.47 D (D-eyes); and − 1.21 ± 0.78D (nD-eyes) (p < 0.05), presbyopic add power was 1.31 ± 0.58 D. The visual acuity (logMAR) of D-eyes, nD-eyes, and binocular (Bi) at 5.0 m were: 0.06 ± 0.15 (D-eye), 0.21 ± 0.18 (nD-eye), (p < 0.01), and 0.04 ± 0.13 (Bi); 0.8 m: 0.03 ± 0.18 (D-eye), 0.08 ± 0.16 (nD-eye), (p > 0.05), and − 0.02 ± 0.11 (Bi); 0.4 m: 0.08 ± 0.09 (D-eye), − 0.02 ± 0.08 (nD-eye), (p < 0.001), and − 0.03 ± 0.09 (Bi). Subjects were very satisfied or felt excellent with their visual acuity at near (81.25%) and far distances (87.50%), respectively (versus preoperative, p < 0.001). Conclusion Monovision surgery using ICL V4c implantation is safe and practicable for correction of myopes with presbyopia, with long-term efficacy at near and far distances and patient satisfaction. ![]()
Collapse
|
29
|
Safety of intraocular pressure measurement using air-puff tonometer following implantable Collamer lens implantation. J Cataract Refract Surg 2022; 48:900-905. [PMID: 35034070 DOI: 10.1097/j.jcrs.0000000000000886] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Accepted: 01/08/2022] [Indexed: 11/26/2022]
Abstract
PURPOSE To determine the safety of intraocular pressure (IOP) measurement using a non-contact tonometer in patients who have undergone implantable collamer lens (ICL) implantation. SETTING Eye Ear Nose and Throat Hospital. DESIGN Prospective study. METHODS Sixty-four eyes of 33 patients (aged 28.4±5.2 years) scheduled for ICL implantation were enrolled. The anterior segment parameters and vault were obtained using an anterior segment analyzer. A non-contact air-puff tonometer was employed before surgery, as well as 1 day and 1 week after surgery, to assess corneal biomechanical properties and intraocular pressure (IOP). Meanwhile, the Corvis ST was applied to evaluate the distance between the corneal endothelial layer and iris (E-Iris Dist), as well as the distance between the corneal endothelial layer and ICL (E-ICL Dist) when the cornea was deformed by the airflow. RESULTS The mean anterior chamber depth (ACD), anterior chamber volume (ACV), and anterior chamber angle (ACA) decreased significantly after surgery (all P-values < 0.001). The E-ICL Dists measured 1 day and 1 week postoperatively were similar (P=0.107). However, a contact between the corneal endothelium and ICL was detected in two eyes when the cornea was deformed to the highest concavity. The 1 day postoperative vault, ACV, ACA, and preoperative SSI contributed significantly (P=0.001, P=0.023, P=0.010, and P=0.019, respectively) to determine the distance. The mean E-iris Dists decreased significantly at 1 day and 1 week after operation (P<0.001). The 1-week postoperative vault and ACD contributed significantly (P=0.025 and P=0.039, respectively) to determine the E-Iris Dist value. CONCLUSIONS Excessively high vault, shallow ACD, narrow ACA, low ACV, and soft cornea are associated with a lower E-ICL distance, and thus may be risk factors for a contact between the corneal endothelium and ICL during IOP measurement. Although there is no proof that the contact may cause any risks to the endothelium, we recommend avoiding non-contact air-puff tonometry in eyes predicted by our model to be at risk of this occurring. Contact IOP measurements using goldmann applanation tonometers or dynamic contour tonometers may be alternate methods of IOP measurements in extreme cases.
Collapse
|
30
|
Chen X, Wang X, Xu Y, Cheng M, Han T, Niu L, Wang X, Zhou X. Five-year outcomes of EVO implantable collamer lens implantation for the correction of high myopia and super high myopia. EYE AND VISION 2021; 8:40. [PMID: 34753516 PMCID: PMC8576084 DOI: 10.1186/s40662-021-00264-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 10/20/2021] [Indexed: 11/20/2022]
Abstract
Background To evaluate the long-term safety, efficacy, predictability, and stability of implantable collamer lens with a central hole (EVO ICL) implantation for correcting high myopia (HM) and super high myopia (SHM). Methods This prospective study evaluated 83 eyes of 46 patients who were divided into groups based on their spherical equivalent refractive error (SE): HM group (− 12 D ≤ SE < − 6 D) and SHM group (SE < − 12 D). They were followed up for 5 years after ICL implantation; assessments of uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), manifest refractive error, axial length, intraocular pressure, corneal endothelial cell density, and vault were conducted, and a questionnaire was administered. ResuIts At 5 years postoperatively, the safety indices of the HM and SHM groups were 1.03 ± 0.10 and 1.32 ± 0.39, and the efficacy indices were 0.83 ± 0.25 and 0.86 ± 0.32, respectively. In the HM group, 60.47% and 79.07% of the eyes were within ± 0.50 D and ± 1.00 D of the attempted correction, while it was achieved for 22.50% and 47.50% of the eyes in the SHM group, respectively. The SE of the HM group decreased from − 9.72 ± 1.41 D preoperatively to 0.04 ± 0.39 D 1 month postoperatively and − 0.67 ± 0.57 D 5 years postoperatively, while in the SHM group, it decreased from − 15.78 ± 3.06 D preoperatively to − 0.69 ± 0.97 D 1 month postoperatively and − 1.74 ± 1.19 D 5 years postoperatively. Conclusion EVO ICL implantation is safe, effective, and predictable for correcting HM and SHM. CDVA improved more after surgery for SHM, but the growth of axial length still needs attention.
Collapse
Affiliation(s)
- Xun Chen
- Fudan University Eye Ear Nose and Throat Hospital, No. 19 BaoQing Road, XuHui District, Shanghai, 200031, China.,National Health Commission Key Lab of Myopia (Fudan University), Shanghai, China.,Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Xuanqi Wang
- Fudan University Eye Ear Nose and Throat Hospital, No. 19 BaoQing Road, XuHui District, Shanghai, 200031, China.,National Health Commission Key Lab of Myopia (Fudan University), Shanghai, China.,Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Yilin Xu
- Fudan University Eye Ear Nose and Throat Hospital, No. 19 BaoQing Road, XuHui District, Shanghai, 200031, China.,National Health Commission Key Lab of Myopia (Fudan University), Shanghai, China.,Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Mingrui Cheng
- Fudan University Eye Ear Nose and Throat Hospital, No. 19 BaoQing Road, XuHui District, Shanghai, 200031, China.,National Health Commission Key Lab of Myopia (Fudan University), Shanghai, China.,Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Tian Han
- Fudan University Eye Ear Nose and Throat Hospital, No. 19 BaoQing Road, XuHui District, Shanghai, 200031, China.,National Health Commission Key Lab of Myopia (Fudan University), Shanghai, China.,Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - LingLing Niu
- Fudan University Eye Ear Nose and Throat Hospital, No. 19 BaoQing Road, XuHui District, Shanghai, 200031, China.,National Health Commission Key Lab of Myopia (Fudan University), Shanghai, China.,Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Xiaoying Wang
- Fudan University Eye Ear Nose and Throat Hospital, No. 19 BaoQing Road, XuHui District, Shanghai, 200031, China. .,National Health Commission Key Lab of Myopia (Fudan University), Shanghai, China. .,Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China.
| | - Xingtao Zhou
- Fudan University Eye Ear Nose and Throat Hospital, No. 19 BaoQing Road, XuHui District, Shanghai, 200031, China. .,National Health Commission Key Lab of Myopia (Fudan University), Shanghai, China. .,Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China.
| |
Collapse
|
31
|
Long term efficacy and safety profiles following posterior chamber phakic intraocular lens implantation in eyes with ≥ 10-year follow-up. J Cataract Refract Surg 2021; 48:813-818. [PMID: 34670948 DOI: 10.1097/j.jcrs.0000000000000848] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 10/13/2021] [Indexed: 11/25/2022]
Abstract
PURPOSE Evaluate long-term efficacy, safety, predictability and stability of a posterior chamber phakic intraocular lens (Visian ICL) in eyes with ≥10-year follow-up. SETTING Instituto de Microcirugía Ocular, Barcelona, Spain. DESIGN Retrospective study. METHODS Eyes undergoing ICL implantation from 2008-2011 with ≥10-year follow-up were included. Variables analyzed were: preoperative, 1-month, 1-year, 5-years and last follow-up uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), manifest refraction, spherical equivalent (SE), endothelial cell count (ECC) and intraocular pressure (IOP). Descriptive statistics were performed and results reported following the Standard for Reporting Refractive Surgery Outcomes. RESULTS 45 eyes (26 patients) were analyzed, mean follow-up 11.35 ± 1.30 years. Mean preoperative SE was -10.06 ± 3.40D and mean preoperative cylinder -1.55 ± 1.45D. At last follow-up, efficacy and safety indices were 0.79 and 1.12, respectively. In total, 32 (71%) eyes achieved an UDVA of ≥20/40. 22 (49%) eyes gained ≥1 line of CDVA, and 2 (4%) eyes lost ≥2 lines of CDVA. At final follow-up, 19 (42%) and 29 (64%) eyes were within ±0.50D and ±1.00D of attempted SE correction, respectively. 31 (69%) eyes had ≤1.00D of postoperative astigmatism and 29 (74%) eyes were within ±15° from the intended correction axis. At the last visit, a statistically significant myopic progression of -0.75 ± 1.20D was observed (p=0.01). ECC loss at last follow-up was 9.85 ± 11.35%. IOP remained stable. There were no intraoperative complications. 3 eyes (7%) developed cataract after 10 years. CONCLUSIONS Long-term results demonstrate that ICL is effective, predictable, stable and safe.
Collapse
|
32
|
Miao HM, Zhao F, Niu LL, Zhao J, Wang XY, Zhou XT. One-step viscoelastic agent technique for ICL V4c implantation for myopia. Int J Ophthalmol 2021; 14:1359-1364. [PMID: 34540611 DOI: 10.18240/ijo.2021.09.10] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Accepted: 04/08/2021] [Indexed: 01/29/2023] Open
Abstract
AIM To investigate the safety and efficacy of using a one-step viscoelastic agent technique for posterior chamber phakic implantable collamer lens with a central hole (ICL V4c) implantation for myopia correction. METHODS The one-step viscoelastic agent technique for ICL V4c implantation was used in 100 eyes of 52 patients. Refractive outcomes, intraocular pressure (IOP), corneal endothelial cell, and corneal densitometry values were evaluated at 1d, 1wk, 1 and 3mo postoperatively. RESULTS All the surgeries were uneventful. No corrected distance visual acuity was lost after 3mo. IOP was 16.12±3.18 mm Hg before surgery, and 14.74±3.08 mm Hg at 1d and 14.50±2.56 mm Hg at 3mo after surgery (P<0.05). Corneal endothelial cell density was 2580±242 cell/mm2, the coefficient of variation in cell size was 42.11%±7.92%, and the percentage of hexagonal cells was 40.98%±9.46% before surgery. No significant difference was found when these outcomes were compared between the studied time points (P>0.05). The corneal densitometry values of the central 2 mm and 2 to 6 mm areas showed similar regularities. After surgery, the values significantly increased at 1d, then decreased to the preoperative values at 1wk, and then continued to decrease at 3mo (P<0.05). CONCLUSION The one-step viscoelastic agent technique for ICL V4c implantation is found to be safe and effective for myopia correction and causes little disturbance to the cornea.
Collapse
Affiliation(s)
- Hua-Mao Miao
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, NHC Key Laboratory of Myopia (Fudan University), Research Center of Ophthalmology and Optometry, Shanghai 200031, China.,Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care (20DZ2255000), Shanghai 200031, China
| | - Feng Zhao
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, NHC Key Laboratory of Myopia (Fudan University), Research Center of Ophthalmology and Optometry, Shanghai 200031, China.,Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 200021, China
| | - Ling-Ling Niu
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, NHC Key Laboratory of Myopia (Fudan University), Research Center of Ophthalmology and Optometry, Shanghai 200031, China.,Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care (20DZ2255000), Shanghai 200031, China
| | - Jing Zhao
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, NHC Key Laboratory of Myopia (Fudan University), Research Center of Ophthalmology and Optometry, Shanghai 200031, China.,Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care (20DZ2255000), Shanghai 200031, China
| | - Xiao-Ying Wang
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, NHC Key Laboratory of Myopia (Fudan University), Research Center of Ophthalmology and Optometry, Shanghai 200031, China.,Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care (20DZ2255000), Shanghai 200031, China
| | - Xing-Tao Zhou
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, NHC Key Laboratory of Myopia (Fudan University), Research Center of Ophthalmology and Optometry, Shanghai 200031, China.,Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care (20DZ2255000), Shanghai 200031, China
| |
Collapse
|
33
|
Ye Y, Zhao J, Niu L, Shi W, Wang X, Zhou X. Long-term evaluation of anterior lens density after implantable collamer lens V4c implantation in patients with myopia over 40 years old. Br J Ophthalmol 2021; 106:1508-1513. [PMID: 34183326 PMCID: PMC9606511 DOI: 10.1136/bjophthalmol-2021-319205] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 04/28/2021] [Indexed: 11/29/2022]
Abstract
Purpose To investigate the long-term safety and efficacy of implantable collamer lens (ICL) V4c implantation and changes in the anterior lens density (ALD) in patients with myopia ≥40 years of age. Methods This prospective study included 104 eyes of 52 patients >40 years of age before ICL V4c implantation. Spherical equivalent (SE), uncorrected distance visual acuity, corrected distance visual acuity (CDVA), intraocular pressure, endothelial cell density, anterior chamber depth, anterior chamber volume and anterior chamber angle preoperatively, at 1 and 3 months, and at 3 years postoperatively were recorded. Pentacam HR was used to analyse ALD changes at a depth of 0.5, 1.0 and 1.5 mm within a 3 mm diameter range around the pupil’s centre. Results The overall follow-up was uneventful at 42±7.1 months; the safety index at last follow-up was 1.26±0.35 and the efficacy index was 0.91±0.41. No eye lost the Snellen line of CDVA, 76% of the eyes had an increase in CDVA for ≥1 line and 62% had an SE within ±0.50 dioptre. The increase in ALD at 0.5, 1 and 1.5 mm was 16.52%±10.46%, 16.72%±9.85% and 17.28%±11.93%, respectively. Preoperative, 1-month and 3-month postoperative ALDs showed correlations with SE and age, and ALD at last follow-up was correlated only with age. There was no correlation between ALD and any other parameters. Conclusion ICL V4c shows long-term safety and efficacy in people ≥40 years of age. ALD increased in such patients, which may be related to age and SE.
Collapse
Affiliation(s)
- Yuhao Ye
- Department of Ophthalmology and Optometry, Fudan University Eye Ear Nose and Throat Hospital, Shanghai, China.,Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China.,Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Jing Zhao
- Department of Ophthalmology and Optometry, Fudan University Eye Ear Nose and Throat Hospital, Shanghai, China.,Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China.,Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Lingling Niu
- Department of Ophthalmology and Optometry, Fudan University Eye Ear Nose and Throat Hospital, Shanghai, China.,Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China.,Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Wanru Shi
- Department of Ophthalmology and Optometry, Fudan University Eye Ear Nose and Throat Hospital, Shanghai, China.,Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China.,Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Xiaoying Wang
- Department of Ophthalmology and Optometry, Fudan University Eye Ear Nose and Throat Hospital, Shanghai, China.,Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China.,Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Xingtao Zhou
- Department of Ophthalmology and Optometry, Fudan University Eye Ear Nose and Throat Hospital, Shanghai, China .,Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China.,Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| |
Collapse
|
34
|
Fernández-Vega-Cueto L, Alfonso-Bartolozzi B, Lisa C, Madrid-Costa D, Alfonso JF. Seven-year follow-up of posterior chamber phakic intraocular lens with central port design. EYE AND VISION 2021; 8:23. [PMID: 34112241 PMCID: PMC8194243 DOI: 10.1186/s40662-021-00247-1] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 05/22/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND To assess the clinical outcomes of the Visian Implantable Collamer Lens (ICL) with a central port throughout 7 years of follow-up. METHODS Eighty-four eyes of 52 patients were evaluated over a follow-up period of 7 years after V4c ICL implantation. Uncorrected (UDVA) and corrected (CDVA) distance visual acuities, refraction, intraocular pressure (IOP), endothelial cell density (ECD) and vault were analysed. RESULTS The mean postoperative UDVA (logMAR) was 0.04 ± 0.11, 0.13 ± 0.19 and 0.17 ± 0.23 at 1-, 5- and 7-years, respectively (P < 0.0001). The mean CDVA (logMAR) remains unchanged throughout a 7-year follow-up period (0.02 ± 0.08 and 0.02 ± 0.08, at 5- and 7-years, respectively, P = 0.2). At all follow-up visits, more than 95% of the eyes achieved a CDVA of 20/25 or better and more than 85% a CDVA of 20/20. At the end of the follow-up (7 years), no eye lost more lines of CDVA, 56 eyes (66.7%) and 28 eyes (33.3%) gained lines of CDVA. At 7-years, the spherical equivalent was - 0.62 ± 0.62 D. No significant increase in IOP (> 20 mmHg or an increase higher than 5 mmHg) occurred in any case throughout the 7-year of follow-up. The loss in ECD from the preoperative baseline at the last follow-up visit was 2.6%. No intraoperative or postoperative complications or adverse events occurred during the follow-up period. CONCLUSIONS The outcomes of this study show the long-term viability of the V4c ICL implantation as a surgical option for the correction of myopia.
Collapse
Affiliation(s)
| | | | - Carlos Lisa
- Fernández-Vega Ophthalmological Institute, Avda. Dres. Fernández-Vega 114, 33012, Oviedo, Spain
| | - David Madrid-Costa
- Optometry and Vision Department, Faculty of Optics and Optometry, University Complutense de Madrid, Madrid, Spain
| | - José F Alfonso
- Fernández-Vega Ophthalmological Institute, Avda. Dres. Fernández-Vega 114, 33012, Oviedo, Spain.
| |
Collapse
|
35
|
Zhao J, Yang W, Zhao J, Shen Y, Sun L, Han T, Wang X, Yao P, Zhou X. A four-year observation of corneal densitometry after implantable collamer lens V4c implantation. ANNALS OF TRANSLATIONAL MEDICINE 2021; 9:536. [PMID: 33987234 DOI: 10.21037/atm-20-6628] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background To observe the changes in corneal densitometry (CD) with a Pentacam after implantable collamer lens (ICL) V4c implantation in myopia patients, and to investigate potential influencing factors. Methods We reviewed 65 eyes of 33 patients (mean age, 29.08±5.54 years) with myopia or myopic astigmatism who underwent ICL V4c implantation. Clinic parameters and Pentacam images of corneal topography and CD were obtained pre- and postoperatively. Results After an average of 52±2.2 months follow-up, the efficacy and safety indexes assessed at the last follow-up were 1.03±0.18 and 1.21±0.21, respectively. Except in the central annular zone of 0-2 mm, the CD values increased significantly at postoperative day 1 and decreased significantly until postoperative 1 year (P<0.05). The increase in CD values at different annular zones at postoperative day 1 was ranked as: 0-2 mm <2-6 mm < 6-10 mm. No significant difference was observed in corneal density at 1 week, 1 month, and 1-year follow-up when compared with the preoperative value (P>0.05). The CD value at 4 years follow-up increased significantly and correlated positively with age and preoperative uncorrected distance visual acuity, and negatively with preoperative spherical equivalent and intraocular pressure (IOP) (P<0.05). Conclusions ICL V4c implantation demonstrated safety and efficacy for myopia correction. The CD value increased at 4 years postoperatively and correlated with age, preoperative spherical equivalent, uncorrected distance visual acuity, and IOP.
Collapse
Affiliation(s)
- Jing Zhao
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China.,Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Wen Yang
- Department of Ophthalmology, The Third People's Hospital of Chengdu, The Affiliated Hospital of Southwest Jiaotong University, Chengdu, China
| | - Jiao Zhao
- Department of Ophthalmology, People's Hospital of Leshan, Leshan, China
| | - Yang Shen
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China.,Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Ling Sun
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China.,Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Tian Han
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China.,Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Xiaoying Wang
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China.,Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Peijun Yao
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China.,Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Xingtao Zhou
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China.,Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| |
Collapse
|