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Wan Q, He P, Wei R, Ma K, Yin H, Tang J, Deng YP. Long-term observation of V4c implantable collamer lenses implantation for moderate to extreme high myopia correction: five years follow-up. Eye (Lond) 2024; 38:1933-1940. [PMID: 38519715 PMCID: PMC11226664 DOI: 10.1038/s41433-024-03046-9] [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: 06/13/2023] [Revised: 03/06/2024] [Accepted: 03/18/2024] [Indexed: 03/25/2024] Open
Abstract
BACKGROUND This study aims to assess the long term effectiveness, safety, predictability and stability of V4c implantable collamer lenses (ICL) for correction of moderate to extreme high myopia. METHODS We reviewed 125 eyes from 64 patients who implanted V4c ICL at the Refractive Surgery Center of West China Hospital in Chengdu, China, between May 2015 and January 2017. The median spherical equivalent was -11.50 D (interquartile range [IQR]: -13.00 to -9.00 D). We followed up with the patients over five years and evaluated several parameters, including uncorrected visual acuity (UDVA), corrected visual acuity (CDVA), axial length, refractive error, endothelial cell density (ECD), intraocular pressure (IOP), white-to-white distance (WTW), and vault. We performed a correlation analysis to explore the potential impacts on vault following implantation. RESULTS The median safety index (postoperative CDVA/preoperative CDVA) during the last follow-up was 1.00 (interquartile range [IQR]: 1.00-1.20), and the efficacy indices (postoperative UDVA/preoperative CDVA) were 1.20 (IQR: 1.00-1.25), 1.20 (IQR: 1.00-1.33), and 0.8 (IQR: 0.65-1.00) at postoperative 1 week, 1 month, and 5 years, respectively. At the five-year mark, 16% of the eyes were within ±0.50 D of expected correction, and 73% were within ±2.00 D. No significant difference in ECD was observed between pre-operative and post-operative measurements. Compared to baseline, we observed a significant increase in IOP at the one-week follow-up, which decreased significantly at the one-month visit. Furthermore, we identified ICL size and spherical equivalent (SE) as independent variables in a multiple linear regression model that accurately predicted the five-year vault after surgery. CONCLUSION In conclusion, V4c ICL implantation is an effective and safe treatment for moderate to extreme high myopia with good predictability and stability over the long-term.
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Affiliation(s)
- Qi Wan
- Department of Ophthalmology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Peiyuan He
- Department of Ophthalmology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
- Department of Health Management & Institute of Health Management, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, Sichuan, China
| | - Ran Wei
- Department of Ophthalmology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Ke Ma
- Department of Ophthalmology, West China Hospital of Sichuan University, Chengdu, Sichuan, China.
| | - Hongbo Yin
- Department of Ophthalmology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Jing Tang
- Department of Ophthalmology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Ying-Ping Deng
- Department of Ophthalmology, West China Hospital of Sichuan University, Chengdu, Sichuan, China.
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Amer I, Ziada HA, Elgazzar AF, Abdella WS, Abdelgbar AA, Goda I, Amer RS, Abdel-Rahman Osman HO, Mohamed SA, Mansour MN, Alsadawy Hassan M, El Gabbar AGA, Hamed MA. Safety and efficacy of implantable phakic contact lens versus implantable collamer lens in myopia correction. MEDICAL HYPOTHESIS, DISCOVERY & INNOVATION OPHTHALMOLOGY JOURNAL 2024; 12:160-167. [PMID: 38601054 PMCID: PMC11002466 DOI: 10.51329/mehdiophthal1482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 01/28/2024] [Indexed: 04/12/2024]
Abstract
Background Phakic intraocular lenses (pIOLs) have proven to be excellent substitutes for excimer laser keratorefractive surgery in certain situations. We aimed to assess the efficacy and safety of two pIOLs, the implantable collamer lens (ICL V4c) versus the implantable phakic contact lens (IPCL V2), for myopic correction. Methods In this prospective randomized clinical trial, we allocated eligible eyes with myopia > - 6 diopters into IPCL or ICL implantation groups, each including 100 eyes of 100 individuals. Preoperative and postoperative assessments at 3, 6, and 12 months included measurements of the spherical equivalent (SE), uncorrected distance visual acuity (UCDVA), best-corrected distance visual acuity (BCDVA), intraocular pressure (IOP), maximum keratometry (K1), minimum keratometry (K2), mean keratometry (Kmean), anterior chamber depth (ACD), anterior chamber angle (ACA), and endothelial cell density (ECD). Results The groups had comparable demographic characteristics and baseline visual and anatomical values (all P > 0.05). The UCDVA, BCDVA, and SE of the two groups were comparable at baseline and at all postoperative follow-up examinations (all P > 0.05). Both groups experienced significant improvements in UCDVA, BCDVA, and SE at three months postoperatively (all P = 0.001), and measurements remained stable for up to 12 months. Keratometry readings were comparable between the groups over the follow-up period and remained unchanged at all visits (all P > 0.05). The ACA in the ICL group was significantly decreased at three months postoperatively (P = 0.001) and then widened significantly at 6 and 12 months (both P = 0.001). In the IPCL group, the postoperative ACA was significantly decreased at three months (P = 0.001) and was comparable to that in the ICL group (P > 0.01). However, at the 6- and 12-month postoperative visits, the ACA was significantly narrower in the IPCL group than in the ICL group (both P = 0.001). The ACD in both groups was decreased at three months postoperatively (both P = 0.001) and remained stable until the end of the study. The ECD remained comparable between the groups at all postoperative visits (all P > 0.05). We did not observe a significant ECD reduction in either group at any postoperative follow-up visit (all P > 0.05). We encountered no serious complications in either group. Conclusions ICL and IPCL had comparable safety and efficacy outcomes in terms of anterior chamber morphometrics, visual and refractive results, and corneal parameters. Further multicenter randomized clinical trials with longer follow-up periods, larger sample sizes, and measurement of additional anterior chamber and corneal morphometrics, vault, and other vision parameters are needed to verify these findings.
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Affiliation(s)
- Ibrahim Amer
- Department of Ophthalmology, Faculty of Medicine, Al-Azhar University, Assiut, Egypt
| | - Hossameldin A Ziada
- Department of Ophthalmology, Faculty of Medicine, Al-Azhar University, Assiut, Egypt
| | - Akram Fekry Elgazzar
- Department of Ophthalmology, Faculty of Medicine, Al-Azhar University, Damietta, Egypt
| | - Walid Shaban Abdella
- Department of Ophthalmology, Faculty of Medicine, Al-Azhar University, Damietta, Egypt
| | | | - Islam Goda
- Department of Ophthalmology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
| | - Ramy Saleh Amer
- Department of Ophthalmology, Faculty of Medicine, Al-Azhar University, Damietta, Egypt
| | | | - Sanaa Ahmed Mohamed
- Department of Ophthalmology, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt
| | - Mona N Mansour
- Department of Ophthalmology, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt
| | | | | | - Mohamed Atito Hamed
- Department of Ophthalmology, Faculty of Medicine, Luxor University, Luxor, Egypt
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Cakir I, Sonmez O, Pehlivanoglu S, Cakir GY, Yildiz BK, Yildirim Y, Agca A. Long-term results of a new posterior chamber phakic intraocular lens in patients with high myopia: 5-year results. J Cataract Refract Surg 2023; 49:409-415. [PMID: 36888565 DOI: 10.1097/j.jcrs.0000000000001110] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 11/27/2022] [Indexed: 03/09/2023]
Abstract
PURPOSE To evaluate the long-term refractive outcomes of Eyecryl posterior chamber spherical phakic intraocular lens (pIOL) implantation in high myopia and endothelial cell density (ECD) change. SETTING Beyoglu Eye Training and Research Hospital, Istanbul, Turkey. DESIGN Retrospective. METHODS Eyes that were not suitable for corneal refractive surgery, had high myopia between -6.00 diopters (D) and -20.00 D, had Eyecryl posterior chamber spherical pIOL implantation, and had at least 5 years of follow-up were included. Preoperative ECD was ≥2300 cells/mm 2 and cylindrical value was ≤2.0 D in all cases. Preoperative and postoperative first, third, and fifth years of refraction, uncorrected and corrected distance visual acuity (UDVA/CDVA), and ECD were recorded. RESULTS 36 eyes of 18 patients were examined. The mean UDVA and CDVA in postoperative fifth years were 0.24 ± 0.19 logMAR and 0.12 ± 0.18 logMAR, respectively. The safety and efficacy indices were 1.52 ± 0.54 and 1.14 ± 0.38, respectively. At 5 years, the spherical equivalent was ±0.50 D in 75% of eyes and ±1.00 D in 92% of eyes. After 5 years, the mean cumulative ECD loss was 6.91% ( P = .07). The annual ECD loss was 1.57% in the first year, 0.26% between 1 year and 3 years, and 2.38% between 3 years and 5 years. Asymptomatic anterior capsule opacity developed in 1 eye 4 years after surgery. Rhegmatogenous retinal detachment developed in 1, and myopic choroidal neovascular membrane occurred in 1 eye. CONCLUSIONS Eyecryl posterior chamber spherical pIOL implantation is one of the effective and safe refractive surgical methods in correcting high myopia with predictable and stable refractive results over a 5-year period. Longer-term studies are needed for complications such as decreased ECD, retinal complications, and lens opacity.
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Affiliation(s)
- Ihsan Cakir
- From the Beyoglu Eye Training and Research Hospital, University of Health Sciences, Istanbul, Turkey (I. Cakir, Sonmez, Pehlivanoglu, G.Y. Cakir, Yildiz, Yildirim); Atakoy World Eye Hospital, Istanbul, Turkey (Agca)
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Amer AA, Ahmed Ghanem Abu El Wafa Ali E, Sayed Ahmed E, Ateto Hamed M, el Shazly Eata W, Amer I. Posterior-Chamber Phakic Implantable Collamer Lenses with and without a Central Hole: A Comparative Study. Clin Ophthalmol 2023; 17:887-895. [PMID: 36942086 PMCID: PMC10023812 DOI: 10.2147/opth.s405689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 03/13/2023] [Indexed: 03/18/2023] Open
Abstract
Purpose This study aimed to compare the short-term outcome of implanting the Visian implantable collamer lens V4 ICL versus the Visian V4c ICL in patients with moderate and high myopia. Patients and Methods This is a retrospective that was conducted on patients with moderate or high myopia who were scheduled for ICL implantation at our institution, Patients who underwent V4 ICL implantation with peripheral iridectomy were assigned to group A, and those who underwent V4c ICL implantation without peripheral iridectomy were assigned to group B. In group A, a preoperative peripheral iridectomy was performed. In group B, the patients received cycloplegic and dilating agents. The patients underwent a complete ocular examination preoperatively and during the follow-up visits that were conducted at 3, 6, and 12 months postoperatively. Results This study included 214 eyes from 107 patients; group A included 110 eyes, and group B included 104 eyes. Postoperatively, the UCVA and BCVA showed statistically significant improvement across the follow-up time points (p<0.001), with no significant difference between the two groups. No statistically significant difference was found between the two groups in the mean achieved correction or the residual refraction. Both groups showed a strong correlation between the target and the achieved correction, with R2 = 0.99 in the two groups. No significant difference was found between the two groups in the IOP across all time measures. However, the intraocular pressure showed a statistically significant postoperative increase in group A (p=0.004), and no significant change in group B (p=0.817). There was a downward slope in the vaults of both groups across time, with significant variation in the last follow-up measure compared to the 3-month measure in the two groups (p<0.001). No significant difference was found between the two groups across all time measures. Conclusion The current study adds new evidence concerning the feasibility, safety, and efficacy of ICL V4c implantation for the treatment of moderate and high myopia, with safer postoperative IOP.
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Affiliation(s)
- Ahmed Ali Amer
- Ophthalmology Department, Qena Faculty of Medicine, South Valley University, Qena, Egypt
- Correspondence: Ahmed Ali Amer, Tel +20 101 182 7000, Email
| | | | | | | | - Wael el Shazly Eata
- Ophthalmology Department, Qena Faculty of Medicine, South Valley University, Qena, Egypt
| | - Ibrahim Amer
- Ophthalmology Department, Al Azhar University, Assuit, Egypt
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Zhang H, Gong R, Zhang X, Deng Y. Analysis of perioperative problems related to intraocular Implantable Collamer Lens (ICL) implantation. Int Ophthalmol 2022; 42:3625-3641. [PMID: 35731355 PMCID: PMC9587946 DOI: 10.1007/s10792-022-02355-w] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Accepted: 04/18/2022] [Indexed: 02/05/2023]
Abstract
PURPOSE To introduce a modified procedure of ICL implantation, to summarize the perioperative problems and their corresponding treatment after myopia correction with Implantable Collamer Lens (ICL), and to compare the difference of complications between the no-hole ICL and hole ICL. METHODS We searched all articles on ICL-related perioperative problems and their corresponding treatment in Scopus, Embase, PubMed and Web of Science databases for the last 22 years. RESULTS ICL implantation is safe, effective, stable and predictable in the correction of myopia, hyperopia and astigmatism, but can also cause a series of perioperative problems, including intraoperative and postoperative complications. CONCLUSION There are many kinds of complications related to ICL, but the common intraoperative and postoperative complications mainly include abnormality of arch height, abnormal position of ICL, loss of corneal endothelial cells and corneal decompensation, high intraocular pressure and secondary glaucoma, cataract and night vision symptoms. Compared with ICL without central pore, the incidence of complications such as loss of corneal endothelial cells and corneal decompensation, high intraocular pressure and secondary glaucoma and cataract was relatively lower in central hole ICL, while postoperative complications such as night vision symptoms were obvious.
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Affiliation(s)
- Hao Zhang
- Department of Ophthalmology, West China Hospital, Sichuan University, No.37, Guoxue Xiang, Chengdu, 610041 Sichuan China
| | - Rui Gong
- Department of Ophthalmology, West China Hospital, Sichuan University, No.37, Guoxue Xiang, Chengdu, 610041 Sichuan China
| | - Xiaolan Zhang
- Department of Ophthalmology, West China Hospital, Sichuan University, No.37, Guoxue Xiang, Chengdu, 610041 Sichuan China
| | - Yingping Deng
- Department of Ophthalmology, West China Hospital, Sichuan University, No.37, Guoxue Xiang, Chengdu, 610041 Sichuan China
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Chen X, Chen F, Wang X, Xu Y, Cheng M, Han T, Wang X, Zhou X. Safety and anterior chamber structure of evolution implantable Collamer lens implantation with short white-to-white corneal diameters. Front Med (Lausanne) 2022; 9:928245. [PMID: 36059823 PMCID: PMC9428310 DOI: 10.3389/fmed.2022.928245] [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: 04/25/2022] [Accepted: 07/29/2022] [Indexed: 11/13/2022] Open
Abstract
Introduction To evaluate the safety and anterior chamber structure of implantation of the Evolution (EVO) implantable Collamer lens (EVO-ICL) in patients with short white-to-white (WTW) corneal diameters. Materials and methods The study population was divided into two groups: the experimental group (34 eyes of 34 patients) with WTW corneal diameters of ≤10.6 mm and the control group (59 eyes of 59 patients) with WTW corneal diameters of >10.6 mm. The outcome measures included uncorrected distance visual acuity, corrected distance visual acuity, refractive power, intraocular pressure (IOP), anterior chamber angle, depth, volume, and vault. Results The safety indices of the experimental and control groups were 1.17 ± 0.30 and 1.12 ± 0.14, respectively (P > 0.05); the effectiveness indices were 1.16 ± 0.31 and 1.07 ± 0.17, respectively (P > 0.05). The simulation curves of the expected and actual corrections in the experimental and control groups were y = 0.9876x – 0.0927 and y = 0.9799x + 0.0343, respectively. There were no significant differences between the IOPs and anterior chamber structures of the two groups (P > 0.05). The average vaults of the experimental and control groups were 395.76 ± 155.32 and 389.49 ± 135.01 μm, respectively (P > 0.05). Conclusion EVO-ICL implantation in patients with short WTW corneal diameters (≤ 10.6 mm) was determined to be a safe, effective, and predictable method for correcting myopia. The changes in the anterior chamber structure were still within normal limits after the surgery, the IOP remained stable, and the ideal vault was achieved after the surgery.
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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
| | - Fang Chen
- The First People's Hospital of Zhaoqing, Zhaoqing, China
| | - Xuanqi 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
| | - Yilin Xu
- 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
| | - 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
| | - Tian Han
- 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
| | - 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
| | - 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
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Kulikova IL, Pozdeyeva NA, Terentieva AE, Sinitsyn MV. [Long-term clinical and functional outcomes of high myopia correction by femtosecond laser-assisted implantation of an intrastromal ring]. Vestn Oftalmol 2022; 138:74-80. [PMID: 36004594 DOI: 10.17116/oftalma202213804174] [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] [Indexed: 06/15/2023]
Abstract
OBJECTIVE To analyze remote clinical and functional outcomes of correcting high myopia in patients with thin cornea by the method of femtosecond laser-assisted implantation of intracorneal implant MyoRing. MATERIAL AND METHODS The study included 22 patients (22 eyes; the mean age of study patients was 30.2±5.37 years). Mean spherical equivalent (SE) of refraction was -11.52±1.96 D, cylindrical component (cyl) of refraction was -2.04±1.64 D, minimal pachymetry index in the center was 491.6±20 µm, corneal hysteresis (CH) amounted to 8.6±1.19 mm Hg. The average pupil diameter in mesopic conditions was 5.6±0.23 mm. All patients had a history of mild amblyopia. The follow-up period lasted 2 years. RESULTS Two years after the surgery uncorrected visual acuity was 0.6±1.22, corrected visual acuity 0.7±0.20. Mean spherical equivalent (SE) of refraction was 0.61±1.43 D, cylindrical component of refraction was -0.13±0.5 D. Predictability of SE within ±0.5 D was recorded in 84% of cases, ±1.0 - also in 84% of cases. Index of safety was 1.16, index of efficacy - 1.0. CH was 9.5±0.03 mm Hg. Mean pachymetry at the center did not change statistically significantly after the surgery in comparison to the initial data (p=1.00). CONCLUSION MyoRing implantation is an effective and safe method, which ensures correction of the spherical component of refraction, as well as correction of astigmatism, improvement of biomechanical properties of the cornea, and an increase in corneal hysteresis (p=0.01).
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Affiliation(s)
- I L Kulikova
- Cheboksary Branch of the S.N. Fedorov National Medical Research Center "MNTK "Eye Microsurgery", Cheboksary, Russia
| | - N A Pozdeyeva
- Cheboksary Branch of the S.N. Fedorov National Medical Research Center "MNTK "Eye Microsurgery", Cheboksary, Russia
| | - A E Terentieva
- Cheboksary Branch of the S.N. Fedorov National Medical Research Center "MNTK "Eye Microsurgery", Cheboksary, Russia
| | - M V Sinitsyn
- Cheboksary Branch of the S.N. Fedorov National Medical Research Center "MNTK "Eye Microsurgery", Cheboksary, Russia
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Chen X, Wang X, Xu Y, Cheng M, Han T, Wang X, Zhou X. Long-term Comparison of Vault and Complications of Implantable Collamer Lens with and without a Central Hole for High Myopia Correction: 5 Years. Curr Eye Res 2021; 47:540-546. [PMID: 34894946 DOI: 10.1080/02713683.2021.2012202] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
PURPOSE To investigate the long-term safety, efficacy, stability, vault, and complications of implantable collamer lens with (ICL V4c) and without (ICL V4) a central hole for correcting high myopia. METHODS 78 eyes (40 patients) underwent ICL V4c implantation and 78 eyes (48 patients) underwent ICL V4 implantation were enrolled. They were followed up for 5 years of the uncorrected and corrected distance visual acuity, spherical equivalent (SE), axial length, intraocular pressure, endothelial cell density and vault. RESUITS The safety indices of the ICL V4c and V4 groups at 5 years were 1.25 ± 0.40 and 1.31 ± 0.40, respectively (P = .353). The efficacy indices were 0.90 ± 0.29 and 1.00 ± 0.44, respectively (P = .098). The preoperative, 1 month and 5 year postoperative logMAR UDVAs were respectively 1.54 ± 0.48, 0.11 ± 0.17, and 0.20 ± 0.26 in the V4c group and 1.56 ± 0.44, 0.14 ± 0.19, and 0.22 ± 0.26 in the V4 group (P = .703, 0.329, 0.585). The logMAR CDVAs were resepectively 0.13 ± 0.18, 0.02 ± 0.11, and 0.05 ± 0.16 in the V4c group and 0.18 ± 0.22, 0.05 ± 0.14, and 0.09 ± 0.21 in the V4 group (P = .128, 0.169, 0.229). The SE were resepectively -15.10 ± 4.32 D, -0.71 ± 1.31 D and -1.65 ± 1.30 D in the V4c group and -15.44 ± 3.51 D, -0.61 ± 1.12 D and -1.40 ± 1.30 D in the V4 group (P = .585, 0.637, 0.296). The mean vault reduced by 97.31 ± 136.61 μm in the V4c group and by 99.74 ± 245.83 μm in the V4 group. Three eyes (3.85%) with mid-periphery anterior subcapsular opacification in the V4c group and two (2.56%) with cataract, one (1.28%) with central anterior subcapsular opacification in the V4 group were observed. The CDVA of 20/40 was obtained in the two cataract eyes after phacoemulcification and intraocular lens implantation. CONCLUSION Long-term ICL V4c and ICL V4 implantations are safe, effective, and stable for high myopia correction. ICL V4c can potentially reduce the risk of lens opacification and may be more tolerant to low vault than ICL V4.
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Affiliation(s)
- Xun Chen
- Ophthalmology, Fudan University Eye Ear Nose and Throat Hospital Shanghai, China.,National Health Commission Key Laboratory of Myopia, Fudan University, Shanghai, China.,Ophthalmology, Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Xuanqi Wang
- Ophthalmology, Fudan University Eye Ear Nose and Throat Hospital Shanghai, China.,National Health Commission Key Laboratory of Myopia, Fudan University, Shanghai, China.,Ophthalmology, Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Yilin Xu
- Ophthalmology, Fudan University Eye Ear Nose and Throat Hospital Shanghai, China.,National Health Commission Key Laboratory of Myopia, Fudan University, Shanghai, China.,Ophthalmology, Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Mingrui Cheng
- Ophthalmology, Fudan University Eye Ear Nose and Throat Hospital Shanghai, China.,National Health Commission Key Laboratory of Myopia, Fudan University, Shanghai, China.,Ophthalmology, Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Tian Han
- Ophthalmology, Fudan University Eye Ear Nose and Throat Hospital Shanghai, China.,National Health Commission Key Laboratory of Myopia, Fudan University, Shanghai, China.,Ophthalmology, Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Xiaoying Wang
- Ophthalmology, Fudan University Eye Ear Nose and Throat Hospital Shanghai, China.,National Health Commission Key Laboratory of Myopia, Fudan University, Shanghai, China.,Ophthalmology, Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Xingtao Zhou
- Ophthalmology, Fudan University Eye Ear Nose and Throat Hospital Shanghai, China.,National Health Commission Key Laboratory of Myopia, Fudan University, Shanghai, China.,Ophthalmology, Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
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Evaluation of Visual Outcome of 2 Phakic Posterior Chamber Implantable Lenses in High Myopia: A Comparative Study. Eye Contact Lens 2021; 48:38-44. [PMID: 34775453 DOI: 10.1097/icl.0000000000000854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/09/2021] [Indexed: 10/19/2022]
Abstract
PURPOSE To evaluate and compare the visual outcomes of two phakic intraocular lenses in high myopia. METHODS A prospective comparative study was undertaken on 50 eyes of 26 patients {age ≥21 years and divided into two groups (implantable collamer lens [ICL] V4c, n=25 eyes and refractive implantable lens [RIL], n=25 eyes)}. Patients were evaluated for uncorrected distance visual acuity (UCVA), best-corrected distance visual acuity, manifest refractive spherical equivalent (MRSE), contrast sensitivity, intraocular pressure, dilated fundus examination, trabecular-iris angle (TIA), anterior chamber depth, horizontal white-to-white diameter, wavefront aberrometry, and endothelial cell (EC) count. All patients were followed up until 6 months and additionally evaluated for anterior chamber inflammation, cataract, and lens vault. RESULTS The baseline parameters (UCVA, MRSE, and EC count) and postoperative improvement in UCVA, contrast sensitivity, MRSE, EC loss, safety index, and efficacy index were comparable between both the lenses. The improvement in aberrometric profile was significantly better in the ICL group. The mean postoperative vault was higher in RIL group (434.88±162.48 μm vs. 547.24±159.83 μm, P=0.0173); however, the vault was within normal range in both the groups. The decrease in mean TIA was significantly higher in RIL group (8.58 vs. 13.45 μm, P=0.0073). CONCLUSION Acrylic phakic lens can be considered as a suitable alternative to collamer lens for refractive correction of high myopia. The collamer lenses showed slight superiority in some qualitative visual parameters; however, collamer lenses do not present with subjective complaints in the patients.
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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.
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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.
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Initial clinical outcomes of two different phakic posterior chamber IOLs for the correction of myopia and myopic astigmatism. Graefes Arch Clin Exp Ophthalmol 2021; 260:1763-1772. [PMID: 34741659 DOI: 10.1007/s00417-021-05465-w] [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: 08/12/2021] [Revised: 10/04/2021] [Accepted: 10/15/2021] [Indexed: 10/19/2022] Open
Abstract
PURPOSE The purpose of this study is to document clinical outcomes of 2 posterior chamber phakic intraocular lenses with a central hole, the implantable contact lens (IPCL V2.0) and the Visian implantable collamer lens V4c (ICL), in myopic and myopic-astigmatic patients. METHODS Retrospective study comprising 111 IPCL (60 toric) and 106 ICL implantations (59 toric) with a follow-up of 3 months to 2 years. Primary outcome was uncorrected distance visual acuity (UDVA) improvement; secondary outcomes were changes in corrected distance visual acuity (CDVA), and complications. RESULTS At 3 months postoperatively, 76% of plano targeted eyes in the IPCL group and 83% of eyes in the ICL group had a UDVA of 20/20 or better. Ninety-six percent of IPCL implanted eyes and 94% of ICL implanted eyes had a postoperative UDVA within 1 line of preoperative CDVA. One eye lost one line of CDVA after IPCL implantation, and no lines were lost after ICL implantation; 33.7% of IPCL eyes and 40.6% of ICL eyes gained at least 1 line of CDVA. Cataract extraction (none because of anterior subcapsular opacification) was performed after 4 ICL implantations, none after IPCL implantation. Endothelial cell loss was mild with both pIOLs. Mean IOP was not clinically significantly affected at 3 months or thereafter. CONCLUSIONS We observed equally excellent (statistically not different) results with the IPCL and ICL for the correction of myopia and myopic astigmatism, at least up to 2 years post implantation. Longer follow-up is needed to determine the stability of these results especially with the IPCL.
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12
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Barros L, Sena N, Motta C, Criado G, Ambrósio R. Lentes intraoculares fácicas para miopia e astigmatismo: revisão prospectiva. REVISTA BRASILEIRA DE OFTALMOLOGIA 2021. [DOI: 10.37039/1982.8551.20210012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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13
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Balparda K, Vanegas-Ramírez CM, Herrera-Chalarca T, Silva-Quintero LA. Early results with the EyeCryl Phakic Toric intraocular lens implantation in keratoconus patients. Rom J Ophthalmol 2021; 65:163-170. [PMID: 34179582 PMCID: PMC8207862 DOI: 10.22336/rjo.2021.32] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Objective: Refractive management in keratoconus is challenging. Although some kinds of phakic intraocular lenses have been studied in keratoconus so far, no study evaluated the results of EyeCryl Phakic Toric intraocular lenses in this kind of patients. Materials and Methods: This is a retrospective chart review study, including all keratoconus patients implanted with an EyeCryl Phakic Toric intraocular lens in at least one of their eyes by an experienced cornea surgeon in Colombia. Follow-up to 6 months after surgery was also included. Results: A total of 20 eyes of 14 patients were included, with an average age of 29.3 ± 4.2 years. Spherical equivalent improved from a pre-surgical value of –10.31 D to +0.09 D at 6 months. 65% of the patients improved at least one line in the best-corrected distance visual acuity. At 6 months, 70% of the patients were within ± 0.50 D of spherical equivalent emmetropia. No complications occurred in any of the patients. Conclusion: EyeCryl Phakic intraocular lenses are an excellent option in keratoconus patients with high refractive error. Abbreviations: KC = Keratoconus, P-IOL = phakic intraocular lenses, ICL = Implantable Collamer Lens, WTW = White to White, SD = standard deviation, ANOVA = an analysis of variance, UDVA = monocular uncorrected distance visual acuity, CDVA = corrected distance visual acuity
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Affiliation(s)
- Kepa Balparda
- Department of Research and Surgery, Black Mammoth Surgical, Medellín, Colombia
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14
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Posterior chamber phakic intraocular lens for the correction of presbyopia in highly myopic patients. J Cataract Refract Surg 2021; 46:40-44. [PMID: 32050231 DOI: 10.1097/j.jcrs.0000000000000033] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To report the initial experience with a new presbyopic phakic intraocular lens (pIOL) in the correction of high myopia and presbyopia. SETTING Gemini Eye Clinic, Zlin, Czech Republic. DESIGN Prospective cohort study. METHODS Presbyopic eyes with moderate to high myopia were implanted with a presbyopic posterior chamber pIOL (IPCL). The visual acuities at near and distance, endothelial cell density, and ocular condition were examined 1 week, 3 months, 1 year and 2 years postoperatively. RESULTS The mean uncorrected distance visual acuity improved significantly from 1.25 logarithm of the minimum angle of resolution (logMAR) (1.15 to 1.35 95% confidence interval [CI]) to 0.11 logMAR (95% CI, 0.03 to 0.17) (P < .0001). No eye lost 1 or more lines of corrected distance visual acuity. The mean distance refraction improved significantly from -6.9 diopters (D) (range -8.6 to -5.3 D) preoperatively to -0.35 D (range -0.55 to -0.15 D, P < .0001) with less than -0.5 D residual refraction in 11 of 17 eyes. Fifteen of 17 eyes had improved uncorrected near visual acuity to J1 (Jaeger chart) at the 2-year follow-up. The near addition at the 2-year follow-up decreased from preoperatively +1.26 D (range 0.19 to 2.34 D) to +0.39 D (range 0.18 to 0.60 D). The mean endothelial cell density was reduced from 2552 cells/mm (range 2421 to 2682 cells/mm) to 2299 cells/mm (range 2108 to 2490 cells/mm) after 2 years. All patients were subjectively satisfied with the outcomes. CONCLUSIONS The new pIOL provided good visual outcomes in near and far distances in an initial case series of patients.
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15
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Jonker SMR, Berendschot TTJM, Saelens IEY, Bauer NJC, Nuijts RMMA. Phakic intraocular lenses: An overview. Indian J Ophthalmol 2020; 68:2779-2796. [PMID: 33229653 PMCID: PMC7856940 DOI: 10.4103/ijo.ijo_2995_20] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Phakic intraocular lenses (pIOLs) are a common solution for the surgical correction of high myopia and myopia in thin corneas. Global trends result in increasing rates of patients with high myopia which will result in increased rates of pIOL implantation. Three types of lenses can be distinguished: anterior chamber angle-supported, anterior chamber iris-fixated, and posterior chamber phakic IOLs. The efficacy of phakic intraocular lenses is generally very good, but pIOLs have undergone many changes over the years to improve the safety profile and decrease pIOL-related complications such as endothelial cell loss, corneal decompensation and cataract formation. This article describes the efficacy and safety profiles of the most recent pIOLs, as well as suggests gaps of knowledge that are deserve additional research to optimize the results of pIOLs.
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Affiliation(s)
- Soraya M R Jonker
- University Eye Clinic Maastricht, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Tos T J M Berendschot
- University Eye Clinic Maastricht, Maastricht University Medical Center, Maastricht, The Netherlands
| | | | - Noël J C Bauer
- University Eye Clinic Maastricht, Maastricht University Medical Center, Maastricht; Department of Ophthalmology, Zuyderland Medical Center, Heerlen, The Netherlands
| | - Rudy M M A Nuijts
- University Eye Clinic Maastricht, Maastricht University Medical Center, Maastricht; Department of Ophthalmology, Zuyderland Medical Center, Heerlen, The Netherlands
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Unilateral Toxic Anterior Segment Syndrome Resulting in Cataract and Urrets-Zavalia Syndrome after Sequential Uneventful Implantation of a Posterior Chamber Phakic Toric Intraocular Lens at Two Different Surgical Facilities: A Series of Unfortunate Events. Case Rep Ophthalmol Med 2020; 2020:1216578. [PMID: 33204556 PMCID: PMC7657676 DOI: 10.1155/2020/1216578] [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: 03/29/2020] [Revised: 09/14/2020] [Accepted: 09/30/2020] [Indexed: 11/17/2022] Open
Abstract
Background Phakic Intraocular Lens (P-IOL) implantation is a safe, easy, predictable intervention designed to manage moderate to high refractive errors. Complications are relatively uncommon and include mainly cataract and intraocular pressure spikes. Toxic Anterior Segment Syndrome (TASS) is a rather unusual sterile anterior segment inflammation after uneventful intraocular surgery, extremely rarely reported after P-IOL implantation. Urrets-Zavalia Syndrome (UZS) is also very rarely described after P-IOL. To date, to the best of the authors' knowledge, no article has ever described the simultaneous occurrence of TASS and UZS in a patient after P-IOL implantation. Objective In this article, the authors present the case of a female patient with moderate myopic astigmatism, who underwent sequential P-IOL implantation at two different facilities. The postoperative course of the first eye was uneventful, but she developed complications associated to the intervention in the second eye. Materials The article describes the case of a young patient who underwent a sequential Phakic Intraocular Lens (P-IOL) implantation at two different institutions. The postoperative course of the first eye (left eye) was uneventful; however, the second eye (right eye) initially developed Toxic Anterior Segment Syndrome (TASS). Although timely and correct management was instituted, upon resolution of TASS, the patient developed Urrets-Zavalia Syndrome, anterior subcapsular cataract, and significant endothelial damage in the same eye. Results The patient was followed closely and managed accordingly; corneal edema and anterior segment inflammation of the right eye eventually resolved. Nevertheless, an anterior subcapsular cataract and a fixed dilated pupil remained; with normal intraocular pressure (IOP). Specular microscopy confirmed an endothelial cell loss in the TASS eye (right eye). Pupil size showed no reaction to repeated doses of Pilocarpine 2%. A month after surgery, refraction on her right eye was +0.25 + 0.75 × 93, which resulted in a 20/50 vision. Conclusions TASS and UZS are both extremely rare complications after uneventful P-IOL implantation, with only a handful of cases having been reported of each of them. To date, this is the very first case where UZS ensued after and potentially as a consequence of TASS in a patient who had undergone P-IOL implantation. Although a direct causative element could not be pinpointed, the fact that the complication ensued after being operated in one surgical institution and not the other, could suggest some role of different sterilization and handling procedures, but no direct conclusion can be made on this case.
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17
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Intraocular lens power calculation in a posterior chamber phakic intraocular lens implanted eye. Int Ophthalmol 2020; 40:2017-2022. [PMID: 32390101 DOI: 10.1007/s10792-020-01377-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Accepted: 04/10/2020] [Indexed: 10/24/2022]
Abstract
PURPOSE To evaluate the effect of Eyecryl posterior chamber phakic intraocular lens (pIOL) on axial length measurement and intraocular lens power calculation. METHODS Axial length (AL), keratometry (K), and IOL power calculations were compared at monthly preoperative and postoperative visits (preoperative vs 1-month). Preoperative IOL power (calculated using preoperative K and AL) was compared with a re-calculation where the pIOL was assumed to be in the posterior chamber (calculated using preoperative K value and postoperative AL). RESULTS Thirty-nine eyes of 39 patients were included. The mean preoperative AL and postoperative AL were 27.02 ± 1.50 and 27.17 ± 1.52 mm (p < 0.001), respectively. The mean preoperative and recalculated IOL powers to achieve emmetropia were 9.40 ± 3.35 and 8.98 ± 3.37 D (p < 0.001) with SRK-T formula, 8.82 ± 3.54 and 8.47 ± 3.60 (p = 0.02) with Holladay I formula, and 9.78 ± 3.43 and 9.44 ± 3.50 (p = 0.013) with Hoffer Q formula. CONCLUSION The presence of Eyecryl pIOL in the posterior chamber results in a small increase in the AL measurement, and this might result in a corresponding hypermetropic shift in the desired refraction.
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18
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Yaşa D, Köse B, Ağca A. Rotational Stability of a New Posterior Chamber Toric Phakic Intraocular Lens. J Ophthalmol 2020; 2020:1624632. [PMID: 32351717 PMCID: PMC7171658 DOI: 10.1155/2020/1624632] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2019] [Accepted: 03/12/2020] [Indexed: 11/17/2022] Open
Abstract
PURPOSE To evaluate the refractive results and rotational stability of Eyecryl toric phakic intraocular lens (pIOL). METHODS In this retrospective single-surgeon case series, manifest refraction, visual acuities, endothelial cell density (ECD), and pIOL rotation were evaluated over 6 months. RESULTS 43 eyes from 23 patients were included. At 6 months, the SE was within ±0.50 D of emmetropia in 30 (70%) eyes and within ±1.00 D of emmetropia in 39 (91%) eyes. The efficacy and safety indices were 1.25 ± 0.38 and 1.41 ± 0.34, respectively. Mean ECD was 2719 ± 296 cells/mm2 at the preoperative visit and 2779.42 ± 422 cells/mm2 at the 6-month visit (p > 0.05). The mean value of absolute axis orientation error was 4.95 ± 5.28°. Mean absolute change in axis orientation between visits was less than 3° for all visit intervals. Ninety percent or more of lenses were found to rotate 5° or less between all visit intervals. None of the patients experienced a vision-threatening complication, and no patient required secondary IOL repositioning. CONCLUSION The pIOL appears to effectively reduce subjective manifest astigmatism and provide good visual acuity. Its position was found to be stable throughout the follow-up.
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Affiliation(s)
- Dilek Yaşa
- Beyoğlu Eye Training and Research Hospital, Bereketzade Mah, No. 2, Beyoglu, Istanbul, Turkey
| | - Bülent Köse
- Aritmi Osmangazi Hospital, Ulu Mah, Ulubatlı Hasan Bulvarı, No. 48-62, Bursa, Turkey
| | - Alper Ağca
- Beyoğlu Eye Training and Research Hospital, Bereketzade Mah, No. 2, Beyoglu, Istanbul, Turkey
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Contralateral Posterior Chamber Phakic Intraocular Lens Implantation as Rehabilitation of Refractive Lens Exchange with a Monofocal Intraocular Lens in a Young, Nonpresbyopic, Bilateral Highly-Myopic Patient. Case Rep Ophthalmol Med 2019; 2019:8791071. [PMID: 31737391 PMCID: PMC6815972 DOI: 10.1155/2019/8791071] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Revised: 08/11/2019] [Accepted: 09/17/2019] [Indexed: 11/18/2022] Open
Abstract
Background Refractive errors are widespread in the human population; nowadays, numerous surgical options allow for efficient and safe correction them. One of the main elements to ensure success in this kind of intervention will depend on the careful patient and surgical approach selection. Excimer laser corneal surgery is considered by most for low to moderate ametropias. Another option, which has been suggested may be safer, is to cut a small corneal lenticule with femtosecond laser, and then extracting it through a small incision. Nevertheless, in some specific cases, such as patients with high refractive error or those with some corneal abnormality, laser corneal ablations are considered unsafe from either a biomechanical or refractive standpoint. In this kind of particular cases, Phakic Intraocular Lens (P-IOL) implantation constitutes attractive, highly predictable and safe option. Objective The authors want to show the case of a young high-myopic woman, already pseudophakic in one eye, where the P-IOL implantation in the fellow eye yielded excellent short-term visual results, and high patient's satisfaction, is presented. Materials The authors present the case of a 32-years-old, highly myopic female patient underwent a Refractive Lens Exchange (RLE) with a monofocal Intraocular Lens (IOL) implantation in her left eye elsewhere, and developed severe visual issues, especially regarding near-work. Symptoms resolved through the implantation of a posterior chamber P-IOL in the contralateral eye. Results The postoperative course was unremarkable, inflammation was mild, and visual recovery was quick. There was no need to perform any procedure on her left eye or to use any reading glasses, as unilateral effective near vision through her right eye was enough for all her daily tasks. Conclusions RLE in young pre-presbyopic highly myopic patients may not be an advisable alternative in most cases, because of the high risks of retinal complications observed. In addition, eliminating accommodation will cause significant limitations, and multifocal IOLs currently available are far from the quality of vision that a young human crystalline lens yields. On the other hand, implantation of a P-IOL is a good option if eye conditions are optimal, as it preserves natural accommodation. In this case an EyeCryl Phakic Toric® IOL showed excellent short-term refractive predictability and safety.
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20
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Pandey SK, Sharma V. Commentary: Expanding indications of newer and economically viable phakic posterior chamber intraocular lens designs. Indian J Ophthalmol 2019; 67:1066-1067. [PMID: 31238412 PMCID: PMC6611326 DOI: 10.4103/ijo.ijo_173_19] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Affiliation(s)
- Suresh K Pandey
- SuVi Eye Institute and Lasik Laser Center, Kota, Rajasthan, India
| | - Vidushi Sharma
- SuVi Eye Institute and Lasik Laser Center, Kota, Rajasthan, India
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21
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Kim TI, Alió Del Barrio JL, Wilkins M, Cochener B, Ang M. Refractive surgery. Lancet 2019; 393:2085-2098. [PMID: 31106754 DOI: 10.1016/s0140-6736(18)33209-4] [Citation(s) in RCA: 164] [Impact Index Per Article: 32.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Revised: 11/29/2018] [Accepted: 12/11/2018] [Indexed: 01/19/2023]
Abstract
Refractive surgery has evolved beyond laser refractive techniques over the past decade. Laser refractive surgery procedures (such as laser in-situ keratomileusis), surface ablation techniques (such as laser epithelial keratomileusis), and photorefractive keratectomy have now been established as fairly safe procedures that produce excellent visual outcomes for patients with low-to-moderate amounts of ametropia. Additionally, a broader selection of options are now available to treat a wider range of refractive errors. Small incision lenticule extraction uses a femtosecond laser to shape a refractive lenticule, which is removed through a small wound. The potential advantages of this procedure include greater tectonic strength and less dry eye. In the future, intracorneal implants could be used to treat hyperopia or presbyopia. Phakic intraocular implants and refractive lens exchange might be useful options in carefully selected patients for correcting high degrees of ametropia. Thus, physicians are now able to provide patients with the appropriate refractive corrective option based on the individual's risk-benefit profile.
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Affiliation(s)
- Tae-Im Kim
- Department of Ophthalmology, The Institute of Vision Research, Yonsei University College of Medicine, Seoul, South Korea
| | - Jorge L Alió Del Barrio
- Cornea, Cataract and Refractive Surgery Unit, Research & Development Department VISSUM Innovation Alicante, Alicante, Spain; Division of Ophthalmology, School of Medicine, Universidad Miguel Hernández, Alicante, Spain
| | - Mark Wilkins
- Department of Ophthalmology, Moorfields Eye Hospital, London, UK
| | - Beatrice Cochener
- Department of Ophthalmology, University Hospital Morvan, Brest, France
| | - Marcus Ang
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore; Department of Ophthalmology and Visual Science, Duke-NUS Graduate Medical School, Singapore.
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Verisyse versus Veriflex Phakic Intraocular Lenses: Refractive Outcomes and Endothelial Cell Density 5 Years after Surgery. J Ophthalmol 2018; 2018:4210460. [PMID: 30363928 PMCID: PMC6186327 DOI: 10.1155/2018/4210460] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Revised: 08/11/2018] [Accepted: 08/26/2018] [Indexed: 11/25/2022] Open
Abstract
Purpose To compare refractive stability, central endothelial cell density (ECD), and complications between Verisyse (Abbott Medical Optics, Netherlands) and Veriflex (Abbott Medical Optics, Netherlands) phakic intraocular lenses (pIOL) over five years. Methods We retrospectively reviewed the medical records of patients who underwent Verisyse or Veriflex pIOL implantation for surgical correction of myopia. Patients with a 5-year follow-up period were included in the study. Uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), spherical equivalent of manifest refraction (SE), and ECD were compared between the groups preoperatively and 1, 3, and 5 years postoperatively. Results The study included 47 eyes in the Verisyse group and 50 eyes in the Veriflex group. There was no significant difference in mean SE, UDVA, CDVA, and ECD preoperatively or postoperatively. In both groups, there was a statistically significant myopic shift between 1-year and 5-year visits (−0.25 ± 0.30 D and −0.23 ± 0.48 D in the Verisyse and Veriflex groups, respectively). There was no significant difference between the groups in terms of efficacy and safety indexes at 5 years. ECD loss was highest during the first year (3.9% loss in the Verisyse group and 3.9% loss in the Veriflex group, p=0.670). At 5 years, the mean cumulative ECD losses in the Verisyse and Veriflex groups were 7.42% and 7.64%, respectively (p=0.709). Cataracts developed in 2.1% of the eyes in the Verisyse group and in 2.0% of those in the Veriflex group. No sight-threatening complications were observed. Conclusion Verisyse and Veriflex pIOLs are highly effective for treating high myopia up to 5 years after surgery. Longitudinal studies with longer follow-up periods are necessary to determine the endothelial safety profile.
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