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Moshirfar M, Moin KA, Pandya S, Karimian F, Zaugg B, Khan S, Kim G, Zhu D, Mifflin M, Mohamed M, Murri M. Severe intraocular pressure rise after implantable collamer lens implantation. J Cataract Refract Surg 2024; 50:985-989. [PMID: 39183446 PMCID: PMC11338031 DOI: 10.1097/j.jcrs.0000000000001534] [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: 08/27/2024]
Abstract
A 22-year-old woman with a history of high myopia (-8.00 -3.75 × 011, right eye; -6.75 -3.75 × 174, left eye) presented to our clinic for implantable collamer lens (ICL) evaluation. Medical history was noncontributory. The patient's father had a history of glaucoma. Slitlamp and dilated fundus examination were unremarkable with a cup-to-disc ratio of 0.5 in both eyes and a myopic fundus. Intraocular pressures (IOPs) were 20 mm Hg in the right eye and 19 mm Hg in the left eye. Galilei G4 (Ziemer USA, Inc.) measured a white-to-white (WTW) distance of 12.98 mm in the right eye and 13.05 mm in the left eye and central corneal thickness of 512 μm in the right eye and 504 μm in the left eye. Ultrasound biomicroscopy (UBM) (Sonomed Escalon) displayed a sulcus-to-sulcus distance of 12.76 mm in the right eye and 12.75 mm in the left eye and an anterior chamber depth (ACD) of 3.57 mm in the right eye and 3.79 mm in the left eye (Figure 1JOURNAL/jcrs/04.03/02158034-202409000-00014/figure1/v/2024-08-19T175148Z/r/image-tiff). Prednisolone acetate 0.1% ophthalmic suspension eye drops and ofloxacin 0.3% ophthalmic solution eye drops 4 times daily were prescribed prophylactically 2 days preoperatively. A -12.5 and -12 D EVO+ Visian toric ICL -13.2 mm (STAAR Surgical Co.) was implanted along the 180-degree meridian in the right eye and left eye, respectively. Immediate postoperative IOPs were 23 mm Hg in both eyes. The patient was instructed to continue ofloxacin drops for 1 week and taper prednisolone acetate drops over 1 month. On postoperative day (POD) 1, uncorrected distance visual acuity (UDVA) was 20/20 in the right eye and 20/25 in the left eye. The patient's IOP was 24 mm Hg in the right eye and 26 mm Hg in the left eye. Anterior chambers (ACs) were unremarkable with minimal edema at the clear temporal corneal incision sites. Anterior segment optical coherence tomography (AS-OCT) vault measurements were 766 μm in the right eye and 697 μm in the left eye. Subsequently, the prednisolone dosage was reduced to 3 times a day, and brimonidine eye drops 3 times a day in both eyes were added to the regimen. On POD 5, the patient returned to the clinic reporting sudden-onset blurred vision with severe retro-orbital pain in the left eye upon awakening. Her UDVA was 20/25 in the right eye and 2/40 in the left eye. IOP was 30 mm Hg in both eyes. The ACs were deep, and there was minimal corneal edema in both eyes. Vaults were 674 μm in the right eye and 623 μm in the left eye (Figure 2JOURNAL/jcrs/04.03/02158034-202409000-00014/figure2/v/2024-08-19T175148Z/r/image-tiff). The patient was instructed to reduce prednisolone to 2 times a day, discontinue brimonidine, and start brimonidine/timolol (Combigan) 2 times a day and latanoprost at bedtime in both eyes. At the routine 1-week postoperative appointment, the patient's IOP was 30 mm Hg in the right eye and 29 mm Hg in the left eye. The patient was instructed to reduce prednisolone to once a day, continue brimonidine/timolol 2 times a day and latanoprost at bedtime, and start acetazolamide (Diamox) 250 mg 2 times a day. The patient was told to return to the office in a few days for an IOP check. What are the differential diagnoses concerning this case? What is the most likely mechanism underlying this patient's elevated IOP? What additional diagnostic workup would aid you in making the correct diagnosis?
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Zhu J, Li FF, Jiang SY, Cheng D, Yu GS, Zhu XY, Bao FJ, Wu SQ, Dai Q, Ye YF. Predictability comparison of sizing parameters for postoperative vault after implantable Collamer lens implantation. Graefes Arch Clin Exp Ophthalmol 2024; 262:2329-2336. [PMID: 38376562 DOI: 10.1007/s00417-024-06408-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 01/26/2024] [Accepted: 02/06/2024] [Indexed: 02/21/2024] Open
Abstract
PURPOSE This study aims to assess the accuracy of three parameters (white-to-white distance [WTW], angle-to-angle [ATA], and sulcus-to-sulcus [STS]) in predicting postoperative vault and to formulate an optimized predictive model. METHODS In this retrospective study, a cohort of 465 patients (comprising 769 eyes) who underwent the implantation of the V4c implantable Collamer lens with a central port (ICL) for myopia correction was examined. Least absolute shrinkage and selection operator (LASSO) regression and classification models were used to predict postoperative vault. The influences of WTW, ATA, and STS on predicting the postoperative vault and ICL size were analyzed and compared. RESULTS The dataset was randomly divided into training (80%) and test (20%) sets, with no significant differences observed between them. The screened variables included only seven variables which conferred the largest signal in the model, namely, lens thickness (LT, estimated coefficients for logistic least absolute shrinkage of -0.20), STS (-0.04), size (0.08), flat K (-0.006), anterior chamber depth (0.15), spherical error (-0.006), and cylindrical error (-0.0008). The optimal prediction model depended on STS (R2=0.419, RMSE=0.139), whereas the least effective prediction model relied on WTW (R2=0.395, RMSE=0.142). In the classified prediction models of the vault, classification prediction of the vault based on STS exhibited superior accuracy compared to ATA or WTW. CONCLUSIONS This study compared the capabilities of WTW, ATA, and STS in predicting postoperative vault, demonstrating that STS exhibits a stronger correlation than the other two parameters.
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Affiliation(s)
- Jun Zhu
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China
| | - Fen-Fen Li
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China
| | | | - Dan Cheng
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China
| | - Guan-Shun Yu
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China
| | - Xue-Ying Zhu
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China
| | - Fang-Jun Bao
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China
| | - Shuang-Qing Wu
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China
| | - Qi Dai
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China
| | - Yu-Feng Ye
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China.
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Vanathi M. Lens sizing calculation in phakic lens implantation - What is the best applicable measurement? Indian J Ophthalmol 2024; 72:923-924. [PMID: 38905456 PMCID: PMC11329818 DOI: 10.4103/ijo.ijo_1402_24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/23/2024] Open
Affiliation(s)
- M Vanathi
- Cornea and Ocular Surface, Cataract and Refractive Services, Dr. R P Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India E-mail:
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Assaf JF, Yazbeck H, Reinstein DZ, Archer TJ, Arbelaez J, Bteich Y, Arbelaez MC, Abou Mrad A, Awwad ST. Enhancing the Automated Detection of Implantable Collamer Lens Vault Using Generative Adversarial Networks and Synthetic Data on Optical Coherence Tomography. J Refract Surg 2024; 40:e199-e207. [PMID: 38593258 DOI: 10.3928/1081597x-20240214-01] [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: 04/11/2024]
Abstract
PURPOSE To investigate the efficacy of incorporating Generative Adversarial Network (GAN) and synthetic images in enhancing the performance of a convolutional neural network (CNN) for automated estimation of Implantable Collamer Lens (ICL) vault using anterior segment optical coherence tomography (AS-OCT). METHODS This study was a retrospective evaluation using synthetic data and real patient images in a deep learning framework. Synthetic ICL AS-OCT scans were generated using GANs and a secondary image editing algorithm, creating approximately 100,000 synthetic images. These were used alongside real patient scans to train a CNN for estimating ICL vault distance. The model's performance was evaluated using statistical metrics such as mean absolute percentage error (MAPE), mean absolute error (MAE), root mean squared error (RMSE), and coefficient of determination (R2) for the estimation of ICL vault distance. RESULTS The study analyzed 4,557 AS-OCT B-scans from 138 eyes of 103 patients for training. An independent, retrospectively collected dataset of 2,454 AS-OCT images from 88 eyes of 56 patients, used prospectively for evaluation, served as the test set. When trained solely on real images, the CNN achieved a MAPE of 15.31%, MAE of 44.68 µm, and RMSE of 63.3 µm. However, with the inclusion of GAN-generated and algorithmically edited synthetic images, the performance significantly improved, achieving a MAPE of 8.09%, MAE of 24.83 µm, and RMSE of 32.26 µm. The R2 value was +0.98, indicating a strong positive correlation between actual and predicted ICL vault distances (P < .01). No statistically significant difference was observed between measured and predicted vault values (P = .58). CONCLUSIONS The integration of GAN-generated and edited synthetic images substantially enhanced ICL vault estimation, demonstrating the efficacy of GANs and synthetic data in enhancing OCT image analysis accuracy. This model not only shows potential for assisting postoperative ICL evaluations, but also for improving OCT automation when data paucity is an issue. [J Refract Surg. 2024;40(4):e199-e207.].
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Zhou Z, Zhao X, Jiao X, Xue W, Yang J, Wang W, Bai Y. The Distribution of Crystalline Lens Rise in High Myopia Population and Its Influence on Vault After Implanting Intraocular Collamer Lens. Ophthalmol Ther 2024; 13:969-977. [PMID: 38319552 PMCID: PMC10912385 DOI: 10.1007/s40123-024-00891-5] [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: 11/14/2023] [Accepted: 01/17/2024] [Indexed: 02/07/2024] Open
Abstract
INTRODUCTION As a result of the insufficient ocular anatomical parameters used to customize implantable collamer lens (ICL), many patients still cannot achieve a suitable vault after ICL implantation surgery. This study analyzed the characteristics of a new anatomical parameter crystalline lens rise (CLR) in a population with high myopia and explored the influence of CLR on the vault after ICL implantation. METHODS Patients (298 eyes) with high myopia who underwent ICL implantation were enrolled to study CLR characteristics. Postoperatively, patients (159 eyes) were divided into five groups according to the value of CLR (A, CLR ≤ - 150; B, - 150 < CLR ≤ 0; C, 0 < CLR < 150; D, 150 ≤ CLR < 300; E, CLR ≥ 300 μm), and to investigate the correlation between CLR and vault. RESULTS In the 298 eyes, the CLR had a normal distribution (P = 0.35) and the mean CLR was 67.93 ± 150.66 μm. Ninety-nine eyes (33.22%) had a CLR ≤ 0 μm, of which 20 eyes (6.71%) had a CLR ≤ - 150 μm; 199 eyes (66.78%) had a CLR > 0 μm, of which 20 eyes (6.71%) had a CLR ≥ 300 μm. In 159 eyes, the CLR was negatively correlated with the vault at 1 day (R = - 0.497, P < 0.001), 3 months (R = - 0.505, P < 0.001), and 6 months (R = - 0.505, P < 0.001) postoperatively. At 6 months, the vault of group A was statistically significantly different compared to groups B-E (all P < 0.05), and that of group E was statistically significantly different compared to groups A-D (all P < 0.001). The remaining groups did not show statistically significant differences (all P > 0.05). CONCLUSION The CLR had a normal distribution in the high myopia population, and 13.42% of the CLR values were extreme (CLR ≤ - 150 μm or CLR ≥ 300 μm). A larger ICL diameter than that recommended by the manufacturer should be considered when the CLR is ≥ 300 μm and a smaller ICL diameter should be considered when the CLR is ≤ - 150 μm.
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Affiliation(s)
- Ziyu Zhou
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450000, China
| | - Xiaoyu Zhao
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450000, China
| | - Xiaohang Jiao
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450000, China
| | - Wenxin Xue
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450000, China
| | - Jing Yang
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450000, China
| | - Weiqun Wang
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450000, China
| | - Yanhui Bai
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450000, China.
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Lin F, Liu F, Niu L, Yao P, Wang X, Zhou X, Zhao J. The rate of vault changes after ICL V4c implantation and its correlation with anterior segment parameters. Heliyon 2024; 10:e25823. [PMID: 38352750 PMCID: PMC10863321 DOI: 10.1016/j.heliyon.2024.e25823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 01/26/2024] [Accepted: 02/02/2024] [Indexed: 02/16/2024] Open
Abstract
Purpose To investigate the rate of vault changes after implantation of ICL V4c and the correlation with anterior segment parameters. Methods A total of 64 eyes were studied from the 37 myopic subjects recruited. CASIA2 was used to record the vault at 1 week, 1 month, 3 months and 6 months after the operation as well as the preoperative anterior segment parameters including pupil diameter, lens vault, anterior chamber depth, anterior chamber width, iris area (IA), iris thickness, angle opening distance, angle recess area, trabecular iris space area, and trabecular iris angle. The rates of vault change in different time intervals were compared and the correlations between the rates and anterior segment parameters were analyzed. P < 0.05 was considered statistically significant. Results The rate of vault decrease was -19.53 ± 111.28 μm/month between 1 week and 1 month, -19.90 ± 29.71 μm/month between 1 month and 3 months and -4.25 ± 18.10 μm/month between 3 months and 6 months; hence the rate was shown to slow down significantly from 3 months post-operation (P = 0.024). The average rate of vault changes showed a significant positive correlation with IA (R2 = 0.140, F = 4.980, P = 0.01). No significant correlation was found with other anterior segment parameters (all P > 0.05). Conclusion The rate of decreasing vault significantly slowed down from 3 months post-operation. A larger IA may imply a lower decreasing rate of vault change.
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Affiliation(s)
- Feng Lin
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, 200031, China
- NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, 200031, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, 200031, China
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care, Shanghai, 200031, China
| | - Fang Liu
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, 200031, China
- NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, 200031, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, 200031, China
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care, Shanghai, 200031, China
| | - Lingling Niu
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, 200031, China
- NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, 200031, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, 200031, China
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care, Shanghai, 200031, China
| | - Peijun Yao
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, 200031, China
- NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, 200031, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, 200031, China
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care, Shanghai, 200031, China
| | - Xiaoying Wang
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, 200031, China
- NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, 200031, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, 200031, China
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care, Shanghai, 200031, China
| | - Xingtao Zhou
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, 200031, China
- NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, 200031, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, 200031, China
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care, Shanghai, 200031, China
| | - Jing Zhao
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, 200031, China
- NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, 200031, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, 200031, China
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care, Shanghai, 200031, China
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Cao W, Zhang S, Liu Q, Zhou J, Yuan X. Changes of dysfunctional lens index before and after implantable collamer lens V4c implantation in patients with moderate-to-high myopia. Int Ophthalmol 2023; 43:4111-4120. [PMID: 37480477 PMCID: PMC10520214 DOI: 10.1007/s10792-023-02812-0] [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: 11/22/2022] [Accepted: 07/10/2023] [Indexed: 07/24/2023]
Abstract
BACKGROUND Dysfunctional lens index (DLI) changing is rarely reported after implantable collamer lens (ICL) implantation. In the current research, we hope to investigate the changes of DLI by ray-tracing aberrometry before and after implantation of the posterior chamber phakic implantable collamer lens with a central artificial hole for patients with moderate-to-high myopia. METHODS This retrospective, observational case series included 206 eyes of 104 patients with moderate-to-high myopia who underwent ICL V4c implantation. Data were collected on ocular indicators preoperatively and at 1 day, 1, 3, and 6 months postoperatively. The i-Trace Visual Functional Analyzer was used to assess the DLI measurement. RESULTS The overall values of safety index and efficacy index were both more than 1. Preoperatively, the mean spherical equivalent (SE) of included 206 eyes was - 10.77 ± 3.46 diopter (D). Then at 1-day postoperation, the mean SE was - 0.22 ± 0.55 D, and barely changed from 1 day to 6 months postoperatively. Although the endothelial parameters had no significant differences between preoperation and postoperation, the mean loss of endothelial cells was 0.74 ± 0.98% at 6 months. Regarding the vault, there was a significant difference between each time of follow-up (P < 0.001). The mean of the vault decreased 109.6 ± 13.5 µm from 1-day post-op to 6 months post-op. The DLI values were 3.70, 9.26, 10.00, and 9.68 at baseline, 1, 3, and 6 months, respectively (P < 0.001), but no significant differences were found between 1, 3, and 6 months postoperatively (P > 0.05). The preoperative lnDLI showed a significant positive linear correlation (r = 0.621, P < 0.001) with the preoperative spherical equivalent (SE). The lnDLI was negatively correlated with the axial length (r = - 0.462, P < 0.001), corneal thickness (r = - 0.207, P = 0.003), preoperative LogMAR UDVA (r = - 0.189, P = 0.006), and preoperative LogMAR CDVA (r = - 0.306, P < 0.001). CONCLUSIONS The postoperative refractive parameters were confirmed excellent in efficacy, predictability, and stability in half a year. The DLI was significantly improved after the ICL V4c implantation in patients with moderate-to-high myopia and showed good stability during the follow-up periods. The DLI deserves a more comprehensive understanding and application in clinical services.
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Affiliation(s)
- Weifang Cao
- Clinical College of Ophthalmology, Tianjin Medical University, Tianjin, 300070, China
- Tianjin Key Laboratory of Ophthalmology and Visual Science, Tianjin Eye Institute, Tianjin Eye Hospital, Tianjin, 300020, China
- Department of Cataract, Shanxi Eye Hospital, Taiyuan, 030002, Shanxi Province, China
| | - Suhua Zhang
- Department of Cataract, Shanxi Eye Hospital, Taiyuan, 030002, Shanxi Province, China
| | - Qian Liu
- Department of Cataract, Shanxi Eye Hospital, Taiyuan, 030002, Shanxi Province, China
| | - Jing Zhou
- Department of Cataract, Shanxi Eye Hospital, Taiyuan, 030002, Shanxi Province, China
| | - Xiaoyong Yuan
- Clinical College of Ophthalmology, Tianjin Medical University, Tianjin, 300070, China.
- Tianjin Key Laboratory of Ophthalmology and Visual Science, Tianjin Eye Institute, Tianjin Eye Hospital, Tianjin, 300020, China.
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Russo A, Filini O, Savini G, Festa G, Morescalchi F, Boldini A, Semeraro F. Predictability of the vault after implantable collamer lens implantation using OCT and artificial intelligence in White patient eyes. J Cataract Refract Surg 2023; 49:724-731. [PMID: 36913536 PMCID: PMC10284125 DOI: 10.1097/j.jcrs.0000000000001182] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 02/28/2023] [Accepted: 03/05/2023] [Indexed: 03/14/2023]
Abstract
PURPOSE To compare the predicted vault using machine learning with the achieved vault using the online manufacturer's nomogram in patients undergoing posterior chamber implantation with an implantable collamer lens (ICL). SETTING Centro Oculistico Bresciano, Brescia, Italy, and I.R.C.C.S.-Bietti Foundation, Rome, Italy. DESIGN Retrospective multicenter comparison study. METHODS 561 eyes from 300 consecutive patients who underwent ICL placement surgery were included in this study. All preoperative and postoperative measurements were obtained by anterior segment optical coherence tomography (AS-OCT; MS-39). The actual vault was quantitatively measured and compared with the predicted vault using machine learning of AS-OCT metrics. RESULTS A strong correlation between model predictions and achieved vaulting was detected by random forest regression (RF; R2 = 0.36), extra tree regression (ET; R2 = 0.50), and extreme gradient boosting regression ( R2 = 0.39). Conversely, a high residual difference was observed between achieved vaulting values and those predicted by the multilinear regression ( R2 = 0.33) and ridge regression ( R2 = 0.33). ET and RF regressions showed significantly lower mean absolute errors and higher percentages of eyes within ±250 μm of the intended ICL vault compared with the conventional nomogram (94%, 90%, and 72%, respectively; P < .001). ET classifiers achieved an accuracy (percentage of vault in the range of 250 to 750 μm) of up to 98%. CONCLUSIONS Machine learning of preoperative AS-OCT metrics achieved excellent predictability of ICL vault and size, which was significantly higher than the accuracy of the online manufacturer's nomogram, providing the surgeon with a valuable aid for predicting the ICL vault.
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Affiliation(s)
- Andrea Russo
- From the Centro Oculistico Bresciano, Brescia, Italy (Russo, Filini, Festa); Eye Clinic, Department of Neurological and Vision Sciences, University of Brescia, Italy (Russo, Morescalchi, Boldini, Semeraro); I.R.C.C.S.—G.B. Bietti Foundation, Rome, Italy (Savini)
| | - Ottavia Filini
- From the Centro Oculistico Bresciano, Brescia, Italy (Russo, Filini, Festa); Eye Clinic, Department of Neurological and Vision Sciences, University of Brescia, Italy (Russo, Morescalchi, Boldini, Semeraro); I.R.C.C.S.—G.B. Bietti Foundation, Rome, Italy (Savini)
| | - Giacomo Savini
- From the Centro Oculistico Bresciano, Brescia, Italy (Russo, Filini, Festa); Eye Clinic, Department of Neurological and Vision Sciences, University of Brescia, Italy (Russo, Morescalchi, Boldini, Semeraro); I.R.C.C.S.—G.B. Bietti Foundation, Rome, Italy (Savini)
| | - Giulia Festa
- From the Centro Oculistico Bresciano, Brescia, Italy (Russo, Filini, Festa); Eye Clinic, Department of Neurological and Vision Sciences, University of Brescia, Italy (Russo, Morescalchi, Boldini, Semeraro); I.R.C.C.S.—G.B. Bietti Foundation, Rome, Italy (Savini)
| | - Francesco Morescalchi
- From the Centro Oculistico Bresciano, Brescia, Italy (Russo, Filini, Festa); Eye Clinic, Department of Neurological and Vision Sciences, University of Brescia, Italy (Russo, Morescalchi, Boldini, Semeraro); I.R.C.C.S.—G.B. Bietti Foundation, Rome, Italy (Savini)
| | - Alessandro Boldini
- From the Centro Oculistico Bresciano, Brescia, Italy (Russo, Filini, Festa); Eye Clinic, Department of Neurological and Vision Sciences, University of Brescia, Italy (Russo, Morescalchi, Boldini, Semeraro); I.R.C.C.S.—G.B. Bietti Foundation, Rome, Italy (Savini)
| | - Francesco Semeraro
- From the Centro Oculistico Bresciano, Brescia, Italy (Russo, Filini, Festa); Eye Clinic, Department of Neurological and Vision Sciences, University of Brescia, Italy (Russo, Morescalchi, Boldini, Semeraro); I.R.C.C.S.—G.B. Bietti Foundation, Rome, Italy (Savini)
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Tan X, Liu W, Chang Y, Wu W, Yang L, Liu J. Analysis of Inter-Eye Vault Differences After Implantable Collamer Lens (V4c) Implantation. Int J Gen Med 2023; 16:2451-2459. [PMID: 37346811 PMCID: PMC10281286 DOI: 10.2147/ijgm.s384858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 06/12/2023] [Indexed: 06/23/2023] Open
Abstract
Purpose The safety and stability of implantable collamer lens (ICL) implantation are closely related to the vault. We aimed to assess clinical data from patients with similar anterior segment anatomy who received ICL of the same model placed in the same position and analyze common range and factors affecting the vault inter-eye difference. Patients and Methods A prospective study was performed, including 162 eyes of 81 patients with a bilateral ICL (V4c) implantation. Subjects were evaluated before the surgery and 1 day, 1 week, and 1 month postoperatively, and they were divided into 4 groups based on the ICL size. Bivariate correlation and multiple linear regression (stepwise) analyzed associations between vault inter-eye differences and horizontal sulcus-to-sulcus diameter, anterior chamber depth, lens thickness, ICL size, spherical equivalent, and vault. Results One month after surgery, mean vault inter-eye differences were 74.59 ± 55.59 µm. Nearly 70% of patients presented with vault inter-eye differences lower than 100 µm. The second eye vault variance of 69% was attributed to the first eye vault. Vault inter-eye differences were positively correlated with ICL spherical equivalent (regression equation: vault inter-eye differences (μm) = 139.415 + 6.295 × ICL spherical equivalent). Vaults after ICL implantation were similar in fellow eyes, with some considerable differences. The 95% confidence interval of the vault inter-eye difference was -34.4 ~ 183.6 μm. Conclusion In eyes with similar anterior segment anatomy, there is a 95% probability that the vault will vary from -34.4 μm to -183.6 μm when a similar ICL is implanted. These results can help surgeons to select an appropriate ICL size to achieve an ideal vault. The smaller the spherical equivalent, the larger the difference between the two vaults, which provides a reference for size in moderate myopia. ICL spherical equivalent affects and predicts vault inter-eye differences after ICL implantation.
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Affiliation(s)
- Xin Tan
- Cataract Department, Shanxi Eye Hospital, Taiyuan, Shanxi Province, People’s Republic of China
| | - Wenjie Liu
- Cataract Department, Shanxi Eye Hospital, Taiyuan, Shanxi Province, People’s Republic of China
| | - Ying Chang
- Cataract Department, Shanxi Eye Hospital, Taiyuan, Shanxi Province, People’s Republic of China
| | - Wanmin Wu
- Cataract Department, Shanxi Eye Hospital, Taiyuan, Shanxi Province, People’s Republic of China
| | - Lichun Yang
- Cataract Department, Shanxi Eye Hospital, Taiyuan, Shanxi Province, People’s Republic of China
| | - Jiewei Liu
- Cataract Department, Shanxi Eye Hospital, Taiyuan, Shanxi Province, People’s Republic of China
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10
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Chen X, Ye Y, Yao H, Liu C, He A, Hou X, Zhao K, Cui Z, Li Y, Qiu J, Chen P, Yang Y, Zhuang J, Yu K. Predicting post-operative vault and optimal implantable collamer lens size using machine learning based on various ophthalmic device combinations. Biomed Eng Online 2023; 22:59. [PMID: 37322471 DOI: 10.1186/s12938-023-01123-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 05/31/2023] [Indexed: 06/17/2023] Open
Abstract
BACKGROUND Implantable Collamer Lens (ICL) surgery has been proven to be a safe, effective, and predictable method for correcting myopia and myopic astigmatism. However, predicting the vault and ideal ICL size remains technically challenging. Despite the growing use of artificial intelligence (AI) in ophthalmology, no AI studies have provided available choices of different instruments and combinations for further vault and size predictions. This study aimed to fill this gap and predict post-operative vault and appropriate ICL size utilizing the comparison of numerous AI algorithms, stacking ensemble learning, and data from various ophthalmic devices and combinations. RESULTS This retrospective and cross-sectional study included 1941 eyes of 1941 patients from Zhongshan Ophthalmic Center. For both vault prediction and ICL size selection, the combination containing Pentacam, Sirius, and UBM demonstrated the best results in test sets [R2 = 0.499 (95% CI 0.470-0.528), mean absolute error = 130.655 (95% CI 128.949-132.111), accuracy = 0.895 (95% CI 0.883-0.907), AUC = 0.928 (95% CI 0.916-0.941)]. Sulcus-to-sulcus (STS), a parameter from UBM, ranked among the top five significant contributors to both post-operative vault and optimal ICL size prediction, consistently outperforming white-to-white (WTW). Moreover, dual-device combinations or single-device parameters could also effectively predict vault and ideal ICL size, and excellent ICL selection prediction was achievable using only UBM parameters. CONCLUSIONS Strategies based on multiple machine learning algorithms for different ophthalmic devices and combinations are applicable for vault predicting and ICL sizing, potentially improving the safety of the ICL implantation. Moreover, our findings emphasize the crucial role of UBM in the perioperative period of ICL surgery, as it provides key STS measurements that outperformed WTW measurements in predicting post-operative vault and optimal ICL size, highlighting its potential to enhance ICL implantation safety and accuracy.
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Affiliation(s)
- Xi Chen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Sun Yat-Sen University, Guangzhou, People's Republic of China
| | - Yiming Ye
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Sun Yat-Sen University, Guangzhou, People's Republic of China
| | - Huan Yao
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Sun Yat-Sen University, Guangzhou, People's Republic of China
| | - Chang Liu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Sun Yat-Sen University, Guangzhou, People's Republic of China
| | - Anqi He
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Sun Yat-Sen University, Guangzhou, People's Republic of China
| | - Xiangtao Hou
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Sun Yat-Sen University, Guangzhou, People's Republic of China
| | - Keming Zhao
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Sun Yat-Sen University, Guangzhou, People's Republic of China
| | - Zedu Cui
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Sun Yat-Sen University, Guangzhou, People's Republic of China
| | - Yan Li
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Sun Yat-Sen University, Guangzhou, People's Republic of China
| | - Jin Qiu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Sun Yat-Sen University, Guangzhou, People's Republic of China
| | - Pei Chen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Sun Yat-Sen University, Guangzhou, People's Republic of China
| | - Ying Yang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Sun Yat-Sen University, Guangzhou, People's Republic of China
| | - Jing Zhuang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Sun Yat-Sen University, Guangzhou, People's Republic of China.
| | - Keming Yu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Sun Yat-Sen University, Guangzhou, People's Republic of China.
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11
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Li B, Chen X, Cheng M, Lei Y, Jiang Y, Xu Y, Wang X, Zhou X. Long-Term Vault Changes in Different Levels and Factors Affecting Vault Change After Implantation of Implantable Collamer Lens with a Central Hole. Ophthalmol Ther 2023; 12:251-261. [PMID: 36335511 PMCID: PMC9834492 DOI: 10.1007/s40123-022-00606-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 10/21/2022] [Indexed: 11/08/2022] Open
Abstract
INTRODUCTION This study evaluated vault changes in eyes implanted with an implantable Collamer lens (ICL) with a central hole (ICL V4c) for myopia and astigmatism correction as well as factors related to vault changes over time. METHODS This retrospective study enrolled 169 myopic eyes from 169 patients (137 women and 32 men) who underwent ICL V4c implantation to correct myopia and astigmatism. Vault values were measured quantitatively using a rotating Scheimpflug camera. Each patient underwent at least four postoperative follow-up visits at 1 month, 6 months, 1 year, and more than 2 years. We compared postoperative values between groups and identified factors affecting vault changes over time. RESULTS The mean vaults at 1 month (baseline), 6 months, 1 year, and the last follow-up time following ICL implantation were 540.83 ± 186.13, 520.00 ± 196.08, 503.79 ± 198.30, and 471.42 ± 211.35 μm, respectively. Eyes with baseline vaults of 250-750 and ≥ 750 μm exhibited a trend of vault decrease over time, and the differences were statistically significant (P < 0.05) at 6 months and 1 year postoperatively, respectively. The variables relevant to the value of vault decrease between baseline and last follow-up time were anterior chamber depth (ACD) and ICL power (adjusted R2 = 0.121, P < 0.001). CONCLUSIONS We found a trend of decreased mean objective vault values over time, which was more obvious in eyes with higher baseline vault values. The vault value of the ICL decreased more in eyes with shallower ACDs, higher ICL power, or both. Moreover, the decrease in vault values became statistically significant earlier in eyes with higher baseline vaults or shallower ACDs.
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Affiliation(s)
- Boliang Li
- grid.8547.e0000 0001 0125 2443Eye & Ear, Nose, and Throat Hospital, Fudan University, No. 19 BaoQing Road, XuHui District, Shanghai, 200031 China ,grid.8547.e0000 0001 0125 2443National Health Commission Key Lab of Myopia, Fudan University, Shanghai, China ,grid.411079.a0000 0004 1757 8722Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Xun Chen
- grid.8547.e0000 0001 0125 2443Eye & Ear, Nose, and Throat Hospital, Fudan University, No. 19 BaoQing Road, XuHui District, Shanghai, 200031 China ,grid.8547.e0000 0001 0125 2443National Health Commission Key Lab of Myopia, Fudan University, Shanghai, China ,grid.411079.a0000 0004 1757 8722Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Mingrui Cheng
- grid.8547.e0000 0001 0125 2443Eye & Ear, Nose, and Throat Hospital, Fudan University, No. 19 BaoQing Road, XuHui District, Shanghai, 200031 China ,grid.8547.e0000 0001 0125 2443National Health Commission Key Lab of Myopia, Fudan University, Shanghai, China ,grid.411079.a0000 0004 1757 8722Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Yadi Lei
- grid.8547.e0000 0001 0125 2443Eye & Ear, Nose, and Throat Hospital, Fudan University, No. 19 BaoQing Road, XuHui District, Shanghai, 200031 China ,grid.8547.e0000 0001 0125 2443National Health Commission Key Lab of Myopia, Fudan University, Shanghai, China ,grid.411079.a0000 0004 1757 8722Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Yinjie Jiang
- grid.8547.e0000 0001 0125 2443Eye & Ear, Nose, and Throat Hospital, Fudan University, No. 19 BaoQing Road, XuHui District, Shanghai, 200031 China ,grid.8547.e0000 0001 0125 2443National Health Commission Key Lab of Myopia, Fudan University, Shanghai, China ,grid.411079.a0000 0004 1757 8722Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Yilin Xu
- grid.8547.e0000 0001 0125 2443Eye & Ear, Nose, and Throat Hospital, Fudan University, No. 19 BaoQing Road, XuHui District, Shanghai, 200031 China ,grid.8547.e0000 0001 0125 2443National Health Commission Key Lab of Myopia, Fudan University, Shanghai, China ,grid.411079.a0000 0004 1757 8722Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Xiaoying Wang
- grid.8547.e0000 0001 0125 2443Eye & Ear, Nose, and Throat Hospital, Fudan University, No. 19 BaoQing Road, XuHui District, Shanghai, 200031 China ,grid.8547.e0000 0001 0125 2443National Health Commission Key Lab of Myopia, Fudan University, Shanghai, China ,grid.411079.a0000 0004 1757 8722Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Xingtao Zhou
- grid.8547.e0000 0001 0125 2443Eye & Ear, Nose, and Throat Hospital, Fudan University, No. 19 BaoQing Road, XuHui District, Shanghai, 200031 China ,grid.8547.e0000 0001 0125 2443National Health Commission Key Lab of Myopia, Fudan University, Shanghai, China ,grid.411079.a0000 0004 1757 8722Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
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Qian T, Du J, Ren R, Zhou H, Li H, Zhang Z, Xu X. Vault-Correlated Efficacy and Safety of Implantable Collamer Lens V4c Implantation for Myopia in Patients with Shallow Anterior Chamber Depth. Ophthalmic Res 2023; 66:445-456. [PMID: 36596292 DOI: 10.1159/000528616] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Accepted: 11/27/2022] [Indexed: 01/04/2023]
Abstract
INTRODUCTION The aim of the study was to evaluate efficacy and safety outcomes after implantation of the Visian Implantable Collamer Lens (ICL V4c) in myopia patients with shallow anterior chamber depth (ACD). METHODS This retrospective study followed 163 eyes of 94 patients for at least 24 months. Uncorrected distance visual acuity (UDVA), corrected distance visual acuity, intraocular pressure (IOP), manifest refraction, vault, endothelial cell density (ECD), anterior chamber angle (ACA), anterior chamber volume, and the distance from the corneal endothelium to the central ICL (C-ICL) were measured during follow-ups. Spearman's correlation and logistic regression were used to identify variables correlated with changes in ECD and potential risk factors for ineffective outcomes, respectively. RESULTS All surgeries were performed safely. High IOP of 9 eyes and anterior capsular opacity of 5 eyes were observed. The last follow-up ACA had a significant difference between the high and normal IOP groups (p = 0.0003). The mean ECD and vault were 2,855.76 ± 270.82 cells/mm2 and 388.01 ± 135.28 μm at the last follow-up, respectively. The vault and C-ICL were significantly associated with ΔECD (all p < 0.05). Furthermore, the vault was most responsible for the ECD loss. Twenty-two eyes had unsatisfactory postoperative UDVA, and the low vault at the last follow-up was a significant risk factor for this ineffective outcome (p < 0.001, OR = 14.739). CONCLUSIONS ICL V4c implantation in patients with shallow ACD achieved stable visual outcomes. The vault is related to postoperative visual acuity and ECD loss, which needs to be paid attention during follow-up.
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Affiliation(s)
- Tianwei Qian
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, China
- National Clinical Research Center for Eye Diseases, Shanghai, China
- Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai, China
- Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, China
- Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Disease, Shanghai, China
| | - Jingxiao Du
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, China
- National Clinical Research Center for Eye Diseases, Shanghai, China
- Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai, China
- Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, China
- Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Disease, Shanghai, China
| | - Ruixia Ren
- Shanghai Xinshijie Zhongxing Eye Hospital, Shanghai, China
| | - Hao Zhou
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, China
- National Clinical Research Center for Eye Diseases, Shanghai, China
- Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai, China
- Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, China
- Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Disease, Shanghai, China
| | - Haiyan Li
- Shanghai Xinshijie Zhongxing Eye Hospital, Shanghai, China
| | - Zhihua Zhang
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, China
- National Clinical Research Center for Eye Diseases, Shanghai, China
- Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai, China
- Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, China
- Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Disease, Shanghai, China
| | - Xun Xu
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, China
- National Clinical Research Center for Eye Diseases, Shanghai, China
- Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai, China
- Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, China
- Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Disease, Shanghai, China
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13
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Jiang Y, Luo Y, Li Y, Lu T. The long-term observation of the rotation of implantable collamer lens as the management of high postoperative vault. Front Med (Lausanne) 2023; 10:1104047. [PMID: 36910497 PMCID: PMC9995363 DOI: 10.3389/fmed.2023.1104047] [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: 11/21/2022] [Accepted: 02/02/2023] [Indexed: 02/25/2023] Open
Abstract
Purpose This study aimed to describe the effectiveness and stability of implantable collamer lens (ICL) rotation in reducing high postoperative vault. Setting This study was conducted in the Peking Union Medical College Hospital, Chinese Academy of Medical Sciences. Design This is a retrospective case series. Methods Twenty-two eyes from 22 patients who had ICL (V4c EVO) implantation with high postoperative vault (>=750 μm) were recruited for our study. All the lenses were rotated from a horizontal to an oblique position. The vault, SSA, AOD500, AOD750, TISA500, and TISA750 at 180° and 0° were measured pre-rotation, 1-week post-rotation, and in the at-least 1-year-follow-up. Results Twenty female patients and two male patients were recruited, with a mean age of 28.68 ± 6.08 years. The mean vault had declined significantly from 951.81 ± 154.26 μm pre-rotation to 772.27 ± 119.40 μm 1 week post-rotation (p < 0.001). The SSA, AOD500, AOD750, TISA500, and TISA750 at 180° and 0° pre-rotation and 1-week post-rotation were 30.40 ± 7.91° and 45.14 ± 6.75°, 32.37 ± 7.48° and 46.23 ± 6.39°, 303.27 ± 87.99 and 522.45 ± 122.16 μm, 323.81 ± 89.15 and 536.13 ± 121.66 μm, 387.95 ± 99.43 and 630.81 ± 133.59 μm, 435.68 ± 106.72 and 643.36 ± 132.82 μm, 0.109 ± 0.034 and 0.202 ± 0.053 mm2, 0.123 ± 0.034 and 0.212 ± 0.051 mm2, 0.194 ± 0.056 and 0.345 ± 0.083 mm2, and 0.216 ± 0.055 and 0.358 ± 0.079 mm2 (all p < 0.001). The mean vault value had changed from 747.50 ± 116.07 μm 1-week post-rotation to 586.87 ± 132.65 μm in the 1-year follow-up. However, the SSA, AOD500, AOD750, TISA500, and TISA750 at 180° and 0° had remained stable (p > 0.05). Conclusion Non-toric ICL rotation is a novel and effective technique in the treatment of high postoperative vault. Our results are more robust given the extended period of follow-up.
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Affiliation(s)
- Yang Jiang
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Yan Luo
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Ying Li
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Thomas Lu
- School of Medicine, University of New South Wales, Kensington, NSW, Australia
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Wannapanich T, Kasetsuwan N, Reinprayoon U. Intraocular Implantable Collamer Lens with a Central Hole Implantation: Safety, Efficacy, and Patient Outcomes. Clin Ophthalmol 2023; 17:969-980. [PMID: 36998514 PMCID: PMC10046236 DOI: 10.2147/opth.s379856] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 03/15/2023] [Indexed: 04/01/2023] Open
Abstract
This review summarizes the available literature and provides updates on the efficacy, safety, and patient outcomes of phakic intraocular lens implantation using implantable collamer lens (ICL), with a focus on newer models with a central port (EVO/EVO+ Visian Implantable Collamer Lens, STAAR Surgical Inc.). All studies included in this review were identified from the PubMed database and were reviewed for relevancy of their topic. Data on hole-ICL implantation performed between October 2018 and October 2022 in 3399 eyes showed a weighted average efficacy index of 1.03 and a weighted average safety index of 1.19 within an average follow-up of 24.7 months. The incidence of complications such as elevated intraocular pressure, cataract, and corneal endothelial cell loss was low. Moreover, both quality of vision and quality of life improved after ICL implantation, confirming the benefits of this procedure. In conclusion, ICL implantation is a promising refractive surgery alternative to laser vision correction with excellent efficacy, safety, and patient outcomes.
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Affiliation(s)
- Trakanta Wannapanich
- Department of Ophthalmology, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok, Thailand
| | - Ngamjit Kasetsuwan
- Department of Ophthalmology, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok, Thailand
- Chula Refractive Surgery Center, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
- Excellence Center for Cornea and Limbal Stem Cell Transplantation, Department of Ophthalmology, King Chulalongkorn Memorial Hospital, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Correspondence: Ngamjit Kasetsuwan, Department of Ophthalmology, Faculty of Medicine, Chulalongkorn University, 1873 Rama 4 Road, Pathumwan, Bangkok, 10330, Thailand, Tel +6622564142, Email
| | - Usanee Reinprayoon
- Department of Ophthalmology, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok, Thailand
- Chula Refractive Surgery Center, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
- Excellence Center for Cornea and Limbal Stem Cell Transplantation, Department of Ophthalmology, King Chulalongkorn Memorial Hospital, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
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15
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Zaldivar R, Zaldivar R, Adamek P, Quintero G, Cerviño A. Descriptive Analysis of Footplate Position After Myopic Implantable Collamer Lens Implantation Using a Very High-Frequency Ultrasound Robotic Scanner. Clin Ophthalmol 2022; 16:3993-4001. [PMID: 36504639 PMCID: PMC9733561 DOI: 10.2147/opth.s393223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 11/17/2022] [Indexed: 12/07/2022] Open
Abstract
Purpose To assess the position of the haptics of the implantable collamer lens (ICL) in myopic eyes using a high-frequency ultrasound robotic scanner. Methods This was a prospective, single-arm, observational study carried out at the Instituto Zaldivar SA (Mendoza, Argentina) in a sample of 52 eyes who have been submitted to successful ICL implantation prior to enrollment. Images of the eyes were obtained using a very-high frequency digital ultrasound robotic scanner (VHFDU) to establish the position of the ICL in the posterior chamber and its relation to the ciliary sulcus. New parameters for lens position analysis were also described. Results In 81% of cases (42 eyes), the ICL rests on the ciliary body (CB) in both temporal and nasal sides, being slightly lower than 6% (3 eyes) those that rest on the sulcus in both sides, with significant correlations between ICL position and vault values (p<0.05). Cases in which the ICL position was CB-CB yielded central vault values across the whole range determined within the sample, but most of the eyes where the ICL rests on both the sulcus in one side and the CB in the other yield greater central vault values. Correlation was significant between ICL position and retroposition distance on the temporal side (Spearman's rho -0.487, p<0.001). A significant but weaker correlation was also found between ICL position and retroiridian space (p<0.05). Conclusion ICL for myopia footplates tend to locate outside of the sulcus in a significant percentage of patients after successful implantation. VHFDU assessment in eyes implanted with an ICL to properly study the lens footplate position and posterior anatomical relations provides important additional information besides post-surgery vault.
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Affiliation(s)
| | | | | | | | - Alejandro Cerviño
- Department of Optics & Optometry & Vision Sciences, University of Valencia, Valencia, Spain,Correspondence: Alejandro Cerviño, Department of Optics & Optometry & Vision Science, University of Valencia, C / Dr. Moliner, 50. Burjassot, Valencia, 46100, Spain, Tel +34 963 544 852, Email
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16
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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: 18] [Impact Index Per Article: 9.0] [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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Ang RET, Reyes EKF, Ayuyao FAJ, Umali MIN, Cruz EM. Comparison of white-to-white measurements using four devices and their determination of ICL sizing. EYE AND VISION (LONDON, ENGLAND) 2022; 9:36. [PMID: 36182955 PMCID: PMC9526955 DOI: 10.1186/s40662-022-00308-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Accepted: 09/04/2022] [Indexed: 11/10/2022]
Abstract
BACKGROUND To compare the measurements obtained from the Orbscan II, IOLMaster 700, Pentacam AXL, and Castroviejo caliper and their effects on calculating the recommended implantable collamer lens (ICL) size and postoperative vault measurements. METHODS This is a retrospective cross-sectional study of patients who underwent ICL surgery by a single surgeon from March 1, 2018 to July 31, 2021. Records were reviewed for the anterior chamber depth (ACD) and white-to-white (WTW) measurements obtained from the Orbscan II, IOLMaster 700, Pentacam AXL, and Castroviejo caliper (WTW only). These were used to calculate the recommended ICL size. The actual ICL size implanted, and vault measurements obtained one month postoperatively were also collected. RESULTS One hundred seven eyes with a mean age of 27.9 ± 7.7 years were included in the study. Mean WTW measurements were significantly different between devices (P < 0.0001), with the IOLMaster 700 having the highest value (12.14 ± 0.04 mm) and the caliper having the lowest value (11.45 ± 0.04 mm). Mean ACD measurements were the lowest in Orbscan II (3.12 ± 0.25 mm) and the highest in Pentacam AXL (3.16 ± 0.24 mm). The Pentacam AXL produced an ICL size similar to the Orbscan in 69.2% of eyes. The IOLMaster yielded an ICL measurement one size larger than Orbscan-based calculations in 64.5% of eyes. Using the Orbscan WTW and ACD, the desired vault of 0.25 to 0.75 mm and 0.25 to 1.00 mm was achieved in 70% and 91% of eyes, respectively. Substituting caliper WTW to IOLMaster 700 or Pentacam AXL WTW increases the percentage of achieving the desired vault to 80%, similar to the Orbscan. CONCLUSIONS The Orbscan II, IOLMaster 700, and Pentacam AXL cannot be used interchangeably for calculating ICL sizing. Combining the WTW from caliper measurement with the ACD of the IOLMaster 700 or Pentacam AXL could improve ICL sizing and achieve a higher percentage of eyes with the desired vault.
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Affiliation(s)
- Robert Edward T. Ang
- grid.476917.a0000 0004 9154 7342Asian Eye Institute, Phinma Plaza, Rockwell Center, 8Th Floor, 1200 Makati, Philippines ,Cardinal Santos Medical Center, 10 Wilson St., Greenhills, 1502 San Juan, Philippines
| | | | - Fernando Amado J. Ayuyao
- grid.476917.a0000 0004 9154 7342Asian Eye Institute, Phinma Plaza, Rockwell Center, 8Th Floor, 1200 Makati, Philippines
| | - Maria Isabel N. Umali
- grid.476917.a0000 0004 9154 7342Asian Eye Institute, Phinma Plaza, Rockwell Center, 8Th Floor, 1200 Makati, Philippines
| | - Emerson M. Cruz
- grid.476917.a0000 0004 9154 7342Asian Eye Institute, Phinma Plaza, Rockwell Center, 8Th Floor, 1200 Makati, Philippines
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Zhang J, Shao J, Zheng L, Zhao X, Chen S. Implantable collamer lens sizing based on measurement of the sulcus-to-sulcus distance in ultrasound biomicroscopy video clips and ZZ ICL formula. BMC Ophthalmol 2022; 22:363. [PMID: 36071422 PMCID: PMC9454160 DOI: 10.1186/s12886-022-02583-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 08/29/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To evaluate a new method of implantable collamer lens (ICL) sizing based on ultrasound biomicroscopy (UBM) video clips. METHODS This observational study included consecutive patients with myopia and myopic astigmatism scheduled for V4c toric ICL (TICL) implantation (STAAR) at Hangzhou MSK Eye Hospital (October 2020 to November 2020). Sulcus-to-sulcus (STS) distance, lens thickness (LT), and clinical refraction were measured preoperatively. The ZZ ICL formula (provides the predicted vault height and refraction based on TICL size, intraocular meridian, power, and eye parameters, including STS distance and LT) was used to select TICL size and predict vault height and residual refraction, which was also compared with the STAAR software recommended. Vault and residual refraction were measured at 3 months postoperatively. RESULTS The analysis included 168 eyes in 84 patients. Postoperative vault size was comparable to that predicted by the ZZ ICL formula (528 ± 193 vs. 545 ± 156 μm, P = 0.227). Vault prediction error (PE) by the ZZ ICL formula was within 100, 300, and 500 μm in 40.48%, 88.10%, and 100% of eyes, respectively. Spherical equivalent (SE) and absolute cylindrical refractive error were 0.36 ± 0.48 and 0.40 ± 0.31 D at 3 months postoperatively. The SE PE, absolute cylindrical PE, and percentages of eyes with an absolute cylindrical PE within ± 0.50 D and ± 1.00 D were lower for the ZZ ICL formula than for the STAAR software (P < 0.01). CONCLUSIONS Combining measurements obtained in UBM video clips with the ZZ ICL formula provides an effective method of sizing TICLs and predicting vault height and residual refractive error.
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Affiliation(s)
- Jun Zhang
- Department of Ophthalmology, Hangzhou MSK Eye Hospital & MSK Eye Hospital of Hangzhou Medical College, Hangzhou, China.
| | - Jie Shao
- Department of Ophthalmology, Hangzhou MSK Eye Hospital & MSK Eye Hospital of Hangzhou Medical College, Hangzhou, China
| | - Li Zheng
- Department of Ophthalmology, Hangzhou MSK Eye Hospital & MSK Eye Hospital of Hangzhou Medical College, Hangzhou, China
| | - Xia Zhao
- Department of Ophthalmology, Hangzhou MSK Eye Hospital & MSK Eye Hospital of Hangzhou Medical College, Hangzhou, China
| | - Shu Chen
- Department of Ophthalmology, Hangzhou MSK Eye Hospital & MSK Eye Hospital of Hangzhou Medical College, Hangzhou, China
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Yang Z, Meng L, Zhao X, Chen Y, Luo Y. Clinical Prediction of Inadequate Vault in Eyes With Thick Lens After Implantable Collamer Lens Implantation Using Iris Morphology. Front Med (Lausanne) 2022; 9:906433. [PMID: 35755051 PMCID: PMC9218336 DOI: 10.3389/fmed.2022.906433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 05/23/2022] [Indexed: 12/01/2022] Open
Abstract
Background Obtaining an ideal vault is crucial in the implantable collamer lens (ICL) surgery. Prediction of the vault value is difficult since it requires the integration of multiple factors. The purpose of this study was to investigate the association between the iris shape and vault value in eyes with thick lens. Methods The study was conducted in Peking Union Medical College Hospital. Patients who received ICL V4c between 2017 and 2021 were screened. Eyes with thick lens (>4.0 mm) and abnormal iris shape (concave or convex) were included. The preoperative biometric parameters and postoperative vault value were compared between eyes with concave shape group and convex shape group. The relationship between various factors and vault was assessed by spearman rank analysis and multiple linear regression analysis. Representative cases our strategies to deal with the abnormal vault were demonstrated. Results Twenty eight eyes of 14 patients with thick lens and concave or convex shape iris were eventually included, with 14 eyes of 7 patients in group 1 (concave shape iris) and the other 14 eyes of 7 patients in group 2 (convex shape iris). The mean vault of group 1 was (0.16 ± 0.07) mm, which was significantly lower than (0.88 ± 0.13) mm in group 2. Multiple linear regression analysis showed iris shape (P < 0.001) was only the explanatory variables associated with the postoperative vault. In group1, 4 eyes showed extremely large ACA, requiring a secondary surgical intervention. So all of them underwent ICL exchange for a larger ICL. In group2, the ICL was implanted in a vertical or oblique position to avoid or rescue an extremely large vault. Conclusion Concave shape iris had a higher risk of low vault and convex shape iris were more likely to demonstrate high vault in eyes with thick lens. Exchanging ICL for the larger size and adjusting ICL to the vertical or oblique orientation are good option to rescue the low or high vault, respectively.
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Affiliation(s)
- Zhikun Yang
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Lihui Meng
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.,Key Lab of Ocular Fundus Diseases, Chinese Academy of Medical Sciences, Beijing, China
| | - Xinyu Zhao
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.,Key Lab of Ocular Fundus Diseases, Chinese Academy of Medical Sciences, Beijing, China
| | - Youxin Chen
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.,Key Lab of Ocular Fundus Diseases, Chinese Academy of Medical Sciences, Beijing, China
| | - Yan Luo
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
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20
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Guan N, Zhang XN, Zhang WJ. Correlation between intraoperative and postoperative vaulting of the EVO implantable Collamer lens: a retrospective study of real-time observations of vaulting using the RESCAN 700 system. BMC Ophthalmol 2022; 22:2. [PMID: 34980022 PMCID: PMC8721482 DOI: 10.1186/s12886-021-02237-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Accepted: 12/22/2021] [Indexed: 12/19/2022] Open
Abstract
Background Implantable Collamer lens (ICL) vaulting is one of the most important parameters for the safety, aqueous humor circulation, and lens transparency after ICL implantation. This study aimed to investigate the factors associated with the actual vaulting after refractive EVO-ICL surgery. Methods This retrospective study included patients who underwent EVO-ICL surgery at a tertiary eye hospital between October and December 2019. A RESCAN 700 was used for the intraoperative and CIRRUS HD-OCT was used for postoperative observation of vaulting. Subjective and objective refractions, anterior ocular segment, corneal morphology, intraocular pressure (IOP), anterior chamber volume (ACV), crystalline lens rise (CLR), white-to-white distance (WTW), anterior chamber depth (ACD), axial length, corneal endothelial cell density (ECD), and fundoscopy were examined. A multivariable analysis was performed to determine the factors independently associated with 1-month postoperative vaulting. Results Fifty-one patients (102 eyes) were included. Compared with the eyes with normal vaulting, those with high vaulting had higher preoperative diopter values (P = 0.039), lower preoperative corrected visual acuity (P = 0.006), lower preoperative IOP (P = 0.029), higher preoperative ACD (P = 0.004), lower preoperative CLR (P = 0.046), higher ICL spherical equivalent (P = 0.030), higher intraoperative vaulting (P < 0.001), and lower IOP at 1 month (P = 0.045). The multivariable analysis showed that the only factor independently associated with high vaulting at 1 month after surgery was the intraoperative vaulting value (odds ratio = 1.005, 95% confidence interval: 1.002–1.007, P < 0.001). The intraoperative and 1-month postoperative vaulting values were positively correlated (R2 = 0.562). Conclusions The RESCAN700 system can be used to perform intraoperative optical coherence tomography to predict the vaulting value of ICL at 1 month.
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Affiliation(s)
- Nian Guan
- Department of Refractive, Wuhan Bright Eye Hospital, Wuhan, 430000, Hubei, China
| | - Xiao-Nong Zhang
- Department of Refractive, Hefei Bright Eye Hospital, Hefei, 230000, Anhui, China
| | - Wan-Jun Zhang
- Department of Refractive, Hefei Bright Eye Hospital, Hefei, 230000, Anhui, China.
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21
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Xu G, Wu G, Du Z, Zhu S, Guo Y, Yu H, Hu Y. Distribution of White-to-White Corneal Diameter and Anterior Chamber Depth in Chinese Myopic Patients. Front Med (Lausanne) 2021; 8:732719. [PMID: 34869427 PMCID: PMC8639187 DOI: 10.3389/fmed.2021.732719] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 10/22/2021] [Indexed: 11/13/2022] Open
Abstract
Purpose: To investigate the distribution of white-to-white (WTW) corneal diameter and anterior chamber depth (ACD) in Chinese myopia patients. Methods: This was a cross-sectional observational study conducted at five ophthalmic centers. Anterior segment biometry was performed in 7,893 eyes of the 7,893 myopic patients using Pentacam, and the WTW and ACD were recorded. The distribution patterns of WTW and ACD were evaluated and the correlation between WTW and ACD was analyzed statistically. Results: There were 4416 (55.95%) males and 3477 (44.05%) females. The age of the study population was 25.14 ± 5.41 years. Distribution of WTW was slightly positively skewed (Skewness = 0.0076, Kurtosis = 0.3944, KS P = 0.020) with a mean of 11.65 ± 0.38 mm and a 95% normal range of 10.91-12.39 mm. A significant difference in WTW was found among different myopia groups (P < 0.001). The ACD was normally distributed (Skewness = 0.899, Kurtosis = 0.027, KS P = 0.086). The mean ACD was 3.25 ± 0.26 mm and the 95% normal range of was 2.74-3.75 mm. A significant difference in ACD was also found among different myopia groups (P = 0.030). There was a significant correlation between WTW and ACD (r = 0.460, P < 0.001). Conclusions: In our study, 95% of the Chinese myopic patients had a WTW within 10.91-12.39 mm and an ACD within 2.74-3.75 mm. ACD and WTW were significantly different among different myopia, gender and age groups. WTW was positively correlated with ACD.
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Affiliation(s)
- Guihua Xu
- Department of Ophthalmology, Huizhou Municipal Central Hospital, Huizhou, China
| | - Guanrong Wu
- Department of Ophthalmology, Guangdong Eye Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Zijing Du
- Department of Ophthalmology, Guangdong Eye Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Shanqing Zhu
- Aier Institute of Refractive Surgery, Refractive Surgery Center, Guangzhou Aier Eye Hospital, Guangzhou, China
| | - Yunxiang Guo
- Aier Institute of Refractive Surgery, Refractive Surgery Center, Guangzhou Aier Eye Hospital, Guangzhou, China
| | - Honghua Yu
- Department of Ophthalmology, Guangdong Eye Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Yijun Hu
- Department of Ophthalmology, Guangdong Eye Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China.,Aier Institute of Refractive Surgery, Refractive Surgery Center, Guangzhou Aier Eye Hospital, Guangzhou, China.,Aier School of Ophthalmology, Central South University, Changsha, China
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22
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Zhao J, Zhao J, Yang W, Li M, Hao G, Chen Z, Wang X, Yao P, Zhou X. Consecutive contralateral comparison of toric and non-toric implantable collamer lenses V4c in vault after implantation for myopia and astigmatism. Acta Ophthalmol 2021; 99:e852-e859. [PMID: 33369209 DOI: 10.1111/aos.14720] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 11/18/2020] [Accepted: 11/21/2020] [Indexed: 11/30/2022]
Abstract
AIMS To compare the vault performance between implantable collamer lens (ICL) V4c and Toric ICL (TICL) V4c after implantation and to investigate the affecting factors. METHODS Sixty-eight eyes from 34 patients with myopia or myopia astigmatism who underwent implantation of TICL in one eye (group A) and identically sized ICL (group B) in the contralateral eye were included. Mean follow-up time were 7.58 ± 1.63 months (range: 6-10 months). Vault was compared between the two groups and correlations between vault and age, preoperative ocular biometric measurements were analysed. Generalized estimating equation (GEE) model of postoperative vault adjusting for within-patient intereye correlations was performed. RESULTS The safety indices were 1.27 and 1.35, and the efficacy indices were 1.20 and 1.24 for groups A and B, respectively. Vault of TICL was significantly higher than that of ICL (554.11 ± 219.36 μm vs 449.70 ± 172.47 μm, P < 0.001). The difference between ICL/TICL size and WTW (size-WTW) and STS (size-STS), anterior chamber depth and pupil diameter (PD) were positively correlated with vault. Patient age and clear lens rise measured by Pentacam were negatively correlated with vault. Results of GEE model showed preoperative PD, age, cylindrical power of TICL and size-WTW were influencing factors for postoperative vault. CONCLUSIONS Vault after TICL implantation is higher than that with ICL. PD, age, cylindrical power of TICL and size-WTW could affect postoperative vault.
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Affiliation(s)
- Jiao Zhao
- Department of Ophthalmology People’s Hospital of Leshan Leshan China
| | - 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
| | - Meiyan Li
- 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
| | - Gengsheng Hao
- Department of Ophthalmology People’s Hospital of Leshan Leshan China
| | - Zhuoyi Chen
- 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
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Kim BK, Chung YT. Long-term Clinical Outcomes of Implantable Collamer Lens. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2021. [DOI: 10.3341/jkos.2021.62.8.1043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Purpose: To evaluate the long-term clinical outcomes of implantable collamer lens (ICL) implantation in myopic patients.Methods: This retrospective study included 129 eyes of 68 patients who underwent ICL implantation for correction of myopia with a 10-year follow-up.Results: Ten years after ICL implantation, the mean uncorrected and corrected distance visual acuities (LogMAR) were 0.03 ± 0.13 and -0.07 ± 0.06, respectively. Ten years postoperatively, 52.7% and 84.5% of the eyes were within ± 0.5 and ± 1.0 diopters, respectively. The mean efficacy and safety indices were 0.91 ± 0.22 and 1.07 ± 0.19, respectively. There was no significant difference between mean preoperative (13.52 ± 2.88 mmHg) and postoperative (13.59 ± 3.55 mmHg) intraocular pressures. The endothelial cell density decreased from before surgery to 10 years after surgery (3,074 ± 365 cells/mm2, 2,812 ± 406 cells/mm2, respectively; mean decrease: 8.5 ± 10.8%; p = 0.011). Eight eyes (6.2%) developed cataract during follow-up, which was symptomatic in three eyes (2.3%) and treated with ICL explantation and phacoemulsification. Rhegmatogenous retinal detachment occurred in one eye (0.8%) and was treated with vitrectomy.Conclusions: ICL implantation for the correction of myopia had good efficacy and safety outcomes during long-term follow-up of 10 years. However, patients should be closely monitored for complications such as cataract formation, endothelial cell loss, and retinal detachment.
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Kim BK, Chung YT. Clinical results of Visian implantable collamer lens implantation according to various sizes and implantation angles. Eur J Ophthalmol 2021; 32:2041-2050. [PMID: 34369203 DOI: 10.1177/11206721211033468] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE To investigate the clinical outcomes of Visian implantable collamer lens (ICL) implantation according to lens size and implantation angle. SETTING Onnuri Smile Eye Clinic, Seoul, Republic of Korea. DESIGN Retrospective case series. METHODS This study included 566 eyes of 283 patients treated with ICL implantation. Patients were divided into three groups: horizontally implanted same-sized ICL (group A), horizontally implanted different sized-ICL (group B: large ICL and small ICL) and same sized-ICL implanted with a different implantation angle (group C: horizontal and vertical). RESULTS At 12-month follow-up, the mean vault was 0.78 ± 17, 0.48 ± 0.13, 0.71 ± 0.18 and 0.44 ± 0.16 mm when large and small sized ICL was used in group B (p < 0.001), and when ICL was horizontally and vertically implanted in group C (p = 0.021), respectively. And the mean SE was -0.11 ± 0.30, -0.34 ± 0.42, -0.3 ± 0.56 and -0.64 ± 0.66 dioptres (D), when the large and the small sized ICL was used group B (p = 0.039), and when the ICL was horizontally and vertically implanted in group C (p = 0.036), respectively. No significant difference in UDVA, IOP and ECD between both eyes in groups B and C was observed. No statistical difference was found in the vault between both eyes for groups B and C. CONCLUSIONS The vault was significantly higher and the SE was significantly more hyperopic when a larger-sized ICL was used or the ICL was horizontally implanted compared to when the ICL was vertically implanted.
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Affiliation(s)
- Bu Ki Kim
- Onuuri Smile Eye Clinic, Ara Tower B2F, Seoul, Republic of Korea
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25
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Use of neural networks to predict vault values after implantable collamer lens surgery. Graefes Arch Clin Exp Ophthalmol 2021; 259:3795-3803. [PMID: 34313826 PMCID: PMC8589809 DOI: 10.1007/s00417-021-05294-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 06/03/2021] [Accepted: 06/21/2021] [Indexed: 11/22/2022] Open
Abstract
Background Appropriate sizing of the implantable collamer lens (ICL) and accurate prediction of the vault are crucial prior to surgery. However, sometimes, the vault value is higher or lower than predicted, necessitating reoperation. The present study aimed to develop neural networks for improving predictions of vault values following ICL implantation based on preoperative biometric data. Methods This retrospective study included 137 eyes of 74 patients with ICLs. Linear regression and neural network analyses were used to examine the relationship between vault values at the 6-month follow-up and preoperative parameters (e.g., ICL characteristics and biometrics). Results Linear regression analysis revealed that vault values were correlated with five variables: ICL size, anterior chamber depth (ACD), angle-to-angle (ATA), white-to-white (WTW), and lens thickness (LT) (adjusted R2 = 0.411). Inclusion of more input variables was associated with better performance in the neural network analysis. The degree of fit when all 11 variables were included in the neural network model was close to 1 (R2 = 0.98). R2 values for the quaternary neural network model enrolling four input variables (ICL size, ATA, ACD, and LT) reached 0.90. Conclusions A neural network equation including the ICL size and biometric parameters of the anterior segment (ATA, ACD, and LT) can be used to predict the postoperative vault, aiding in the selection of an appropriate ICL size and reducing the need for reoperation after surgery.![]() Supplementary Information The online version contains supplementary material available at 10.1007/s00417-021-05294-x.
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Zaldívar R, Adamek P, Zaldívar R, Domínguez MS, Cerviño A. Intraoperative Versus Postoperative Vault Measurement After Implantable Collamer Lens Implantation in a Large Cohort of Patients. J Refract Surg 2021; 37:477-483. [PMID: 34236904 DOI: 10.3928/1081597x-20210405-03] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
PURPOSE To compare intraoperative and postoperative central vault measurement after implantable Collamer lens (ICL; STAAR Surgical) implantation using optical coherence tomography (OCT). METHODS A total of 574 eyes of 338 consecutive patients undergoing myopic ICL implantation were evaluated (mean age of 30.8 ± 5.7 years, 117 men and 221 women). Central ICL vault was measured both intraoperatively using the microscope-integrated iOCT (Optomedical Technologies GmbH) mounted on a standard surgical microscope (HS Hi-R NEO 900A; Haag-Streit Surgical GmbH), and postoperatively using the CASIA2 swept-source OCT (Tomey GmbH) at 4 and 24 hours. RESULTS Mean differences between intraoperative and postoperative vault values were 11.5 ± 29.0% of the mean value 4 hours postoperatively (P < .001) and 2.7 ± 33.5% of the mean value 24 hours postoperatively (P < .001). Correlation analysis shows significant agreement between vault values obtained intraoperatively and at the two postoperative times, 4 hours (Spearman Rho = 0.850, P < .001) and 24 hours (Spearman Rho = 0.745, P < .001). In 73% of cases, postoperative vault values 4 hours after the surgery could be predicted from intraoperative vault values, and so were 56% of vault values 1 day after surgery. Significant differences in vault were found at the different times, grouping cases by ICL size (Kruskal-Wallis, P = .028 for intraoperative vault, and P < .001 for both postoperative vault times), with smaller vault values for the smaller ICL size. CONCLUSIONS Intraoperative determination of ICL vault using iOCT is an effective method for predicting postoperative ICL vault and minimizing postoperative vault surprises that could require surgical retouching. [J Refract Surg. 2021;37(7):477-483.].
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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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28
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Zhu QJ, Chen WJ, Zhu WJ, Xiao HX, Zhu MH, Ma L, Yuan Y, Song E. Short-term changes in and preoperative factors affecting vaulting after posterior chamber phakic Implantable Collamer Lens implantation. BMC Ophthalmol 2021; 21:199. [PMID: 33957891 PMCID: PMC8101126 DOI: 10.1186/s12886-021-01963-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Accepted: 04/26/2021] [Indexed: 12/16/2022] Open
Abstract
Background To describe the very early vault changes in the first month after Implantable Collamer Lens (ICL) implantation and to evaluate the effect of preoperative biometric factors on vault. Methods Eighty-three eyes from eighty-three subjects with complete data who met follow-up requirements were recruited in this retrospective study between May 2019 and March 2020. We quantitatively assessed the postoperative vault at 2 h, 1 day, 1 week, and 1 month following implantation. Associations between the postoperative vault and age, ICL size, spherical equivalent (SE), axial length (AL), central corneal thickness (CCT), flat keratometry (K), steep K, mean K, anterior chamber depth (ACD), crystalline lens thickness (LT), white-to-white (WTW) diameter obtained by three devices, horizontal and vertical sulcus-to-sulcus (STS) diameter, bright and dark pupil sizes (BPS and DPS) and DPS-BPS were investigated using Spearman’s correlation analysis and stepwise multiple regression analysis. Results The mean vault values at 2 h, 1 day, 1 week, and 1 month after ICL implantation were 672.05 ± 30.72, 389.15 ± 28.33, 517.23 ± 30.76 and 530.12 ± 30.22 μm, respectively. Significant differences were found in the vault values at 2 h, 1 day and 1 week after the operation. The ICL size (β = 0.942; p < 0.001), followed by horizontal STS (β = -0.517; p < 0.001), crystalline LT (β = -0.376; p < 0.001) and vertical STS (β = -0.257; p = 0.017), significantly influenced the vault at 1 month after the operation. The multiple regression equation was expressed as follows: central vault (µm) = -1369.05 + 657.121 × ICL size- 287.408 × horizontal STS − 432.497 × crystalline LT − 137.33 × vertical STS (adjusted R2 = 0.643). Conclusions After ICL implantation, the vault decreased and then increased, but it did not return to the vault value 2 h after surgery. The ICL size, horizontal and vertical STS and crystalline LT are key factors for predicting postoperative vaulting. Supplementary Information The online version contains supplementary material available at 10.1186/s12886-021-01963-x.
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Affiliation(s)
- Qiu-Jian Zhu
- Department of Ophthalmology, Lixiang Eye Hospital of Soochow University, Jiangsu, 215021, Suzhou, China
| | - Wen-Jing Chen
- Department of Ophthalmology, Lixiang Eye Hospital of Soochow University, Jiangsu, 215021, Suzhou, China
| | - Wei-Jian Zhu
- Department of Ophthalmology, Lixiang Eye Hospital of Soochow University, Jiangsu, 215021, Suzhou, China
| | - Hai-Xiang Xiao
- Department of Ophthalmology, Lixiang Eye Hospital of Soochow University, Jiangsu, 215021, Suzhou, China
| | - Man-Hui Zhu
- Department of Ophthalmology, Lixiang Eye Hospital of Soochow University, Jiangsu, 215021, Suzhou, China
| | - Lie Ma
- Department of Ophthalmology, Lixiang Eye Hospital of Soochow University, Jiangsu, 215021, Suzhou, China
| | - You Yuan
- Department of Ophthalmology, Lixiang Eye Hospital of Soochow University, Jiangsu, 215021, Suzhou, China.
| | - E Song
- Department of Ophthalmology, Lixiang Eye Hospital of Soochow University, Jiangsu, 215021, Suzhou, China
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Montés‐Micó R, Ruiz‐Mesa R, Rodríguez‐Prats JL, Tañá‐Rivero P. Posterior-chamber phakic implantable collamer lenses with a central port: a review. Acta Ophthalmol 2021; 99:e288-e301. [PMID: 32841517 PMCID: PMC8246543 DOI: 10.1111/aos.14599] [Citation(s) in RCA: 60] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 07/26/2020] [Indexed: 02/06/2023]
Abstract
We aimed to summarize the outcomes reported following the implantation of the V4c implantable collamer lens with a central port (ICL, STAAR Surgical Inc) for myopia correction. A literature search in PubMed, Web of Science and Scopus was carried out to identify publications reporting clinical outcomes of patients who were implanted with the V4c ICL model and had a follow‐up period of at least 6 months. A total of 35 clinical studies published between 2012 and 2020 were included in the present review. A comprehensive analysis of the available data was performed, focusing on visual and refractive outcomes at different time‐points post‐surgery. In addition, adverse events and other parameters such as endothelial cell density, intraocular pressure and vault measurements—which were evaluated in some of the studies—were also compared. This review encompassed a total of 2904 eyes. The outcomes reported in this review lead us to conclude that ICL V4c implantation for myopia correction is a safe and efficient procedure, with stable visual and refractive outcomes and low adverse event rates. The patient’s anterior segment should be thoroughly characterized, and the ICL parameters should be carefully selected so as to achieve good outcomes and avoid complications.
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Affiliation(s)
- Robert Montés‐Micó
- Oftalvist Alicante Spain
- Optics and Optometry and Vision Sciences Department University of Valencia Valencia Spain
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Oleszko AA, Marek JJ, Muzyka‐woźniak MM. Horizontal and anterior chamber diameter for phakic intraocular lens sizing. Clin Exp Optom 2021; 104:62-68. [DOI: 10.1111/cxo.13101] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
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Clinical Effect and Rotational Stability of TICL in the Treatment of Myopic Astigmatism. J Ophthalmol 2021; 2020:3095302. [PMID: 33489326 PMCID: PMC7803223 DOI: 10.1155/2020/3095302] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2020] [Revised: 10/28/2020] [Accepted: 12/04/2020] [Indexed: 11/18/2022] Open
Abstract
Purpose To investigate the clinical outcomes and possible risk factors associated with rotational stability after the implantation of a V4c toric implantable Collamer lens (TICL) for the correction of moderate to high myopic astigmatism. Methods A total of 112 eyes of 66 patients with moderate to high myopic astigmatism underwent TICL implantation. All patients were followed up for more than 1 year. The uncorrected and best-corrected visual acuity (UCVA and BCVA), astigmatism and spherical equivalent, intraocular pressure, vault, endothelial cell morphometry, and rotation of the TICL axis were assessed at l day, 1 week, 1 month, 3 months, 6 months, and 12 months postoperatively. Postoperative rotation was defined as the angle between the intended axis and the achieved axis. Regression analysis was used to investigate the possible risk factors for TICL rotation postoperatively. Results The mean efficacy index and safety index 12 months postoperatively were 1.03 ± 0.09 and 1.05 ± 0.10, respectively. All patients had the same or better visual acuity than preoperatively. The mean astigmatism value decreased from -1.86 ± 0.79 D preoperatively to -0.37 ± 0.35 D. The mean absolute axis deviation of the TICL at the last follow-up was 2.75 ± 2.04° (range, 0°∼11°). The mean manifest refraction spherical equivalent (MRSE) changed from -9.04 ± 2.67 D preoperatively to -0.67 ± 0.51 D postoperatively. The logistic regression demonstrated that the absolute degree of TICL rotation had a significant association with the fixation angle of the TICL and the size of the lens (P=0.003, P=0.026, resp.). Conclusion The results of our study support that TICL implantation is safe, effective, and predictable in the treatment of moderate to high myopic astigmatism, with relatively good postoperative rotational stability.
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Cerpa Manito S, Sánchez Trancón A, Torrado Sierra O, Baptista AMG, Serra PM. <p>Inter-Eye Vault Differences of Implantable Collamer Lens Measured Using Anterior Segment Optical Coherence Tomography</p>. Clin Ophthalmol 2020; 14:3563-3573. [PMID: 33154615 PMCID: PMC7605967 DOI: 10.2147/opth.s258817] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Accepted: 08/12/2020] [Indexed: 12/29/2022] Open
Affiliation(s)
| | | | | | | | - Pedro Miguel Serra
- Ophthalmology Clinic Vista Sánchez Trancón, Badajoz, Spain
- Optics and Optometry Department, Instituto Superior de Educação e Ciências, Lisbon, Portugal
- Correspondence: Pedro Miguel Serra Email
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Oleszko A, Marek J, Muzyka-Wozniak M. Application of a Partial Least Squares Regression Algorithm for Posterior Chamber Phakic Intraocular Lens Sizing and Postoperative Vault Prediction. J Refract Surg 2020; 36:606-612. [PMID: 32901828 DOI: 10.3928/1081597x-20200630-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Accepted: 06/24/2020] [Indexed: 11/20/2022]
Abstract
PURPOSE To develop and validate a new algorithm for predicting the postoperative vault of the myopic EVO Visian Implantable Collamer Lens (ICL) V4c (STAAR Surgical AG). METHODS This study included 81 eyes of 43 patients who had undergone ICL implantation. Preoperative data obtained by swept-source optical coherence tomography, Scheimpflug camera, and anterior segment optical coherence tomography were applied to develop a new partial least squares (PLS) regression algorithm. ICL sizing was performed using the standard white-to-white method with the online calculation and ordering system. The postoperative vault was assessed based on anterior segment optical coherence tomography. The PLS approach was applied to create the calibration model for predicting the postoperative vault. The new PLS model was cross-validated using the leave-one-out method and compared to a recently published linear regression model. Agreement between the actual and predicted vault values for the two methods was assessed by the Bland-Altman method. RESULTS There was a statistically significant correlation (P < .001, r = 0.73) between the postoperative vault values and those predicted by the PLS algorithm. Validation of the PLS model yielded lower mean differences and limits of agreement (0 and 410 µm, respectively) than the linear regression method (400 and 750 µm, respectively). CONCLUSIONS The PLS algorithm increases the precision of ICL vault prediction. However, it shows a tendency to overestimate small vault values and underestimate high vaults. [J Refract Surg. 2020;36(9):606-612.].
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He X, Niu L, Miao H, Zhao F, Zhou X. Relative position of the central hole after EVO-ICL implantation for moderate to high myopia. BMC Ophthalmol 2020; 20:305. [PMID: 32723334 PMCID: PMC7385873 DOI: 10.1186/s12886-020-01569-9] [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: 07/04/2019] [Accepted: 07/14/2020] [Indexed: 11/25/2022] Open
Abstract
Background This study aimed to evaluate the relative position of the central hole (CH) of EVO Implantable Collamer Lens (EVO-ICL), the pupil center (CP), and the corneal center (CC) after implantation of EVO-ICLs for moderate to high myopia. Methods Eighty-nine eyes of forty-seven patients with moderate to high myopia were evaluated. The mean preoperative spherical equivalent (SE) was − 12.58 ± 4.13D. A routine postoperative follow-up was performed within 1 ~ 12 months. Positions of the CH of EVO-ICLs, the CP and the CC were recorded using a slit lamp anterior segment photography system, and their relative distances were calculated with the Visio image analysis software. Results All surgeries were performed safely, and no complications were observed in follow-ups 4.3 ± 4.82 months after surgery. At the last follow-up, the safety index (postoperative CDVA/preoperative CDVA) was 1.23 ± 0.48, and the efficacy index (postoperative UDVA/preoperative CDVA) was 1.08 ± 0.31. The CH in 85 eyes (95.51%) was superior to the CC, with 47.19% (42/89) on the temporal side and 48.31% (43/89) on the nasal side. The CH in 84 eyes (94.38%) was located on the temporal side of the CP, with 56.18% (50/89) superior and 38.2% (34/89) inferior to the CP. The CP of 85 eyes (95.51%) was superior on the nasal side of the CC. On the defined x-axis, the average distance from the CH to CC was significantly shorter than the average distance from the CP to CC (p < 0.001). Conclusions An imperfect match between the central hole of EVO-ICLs and the pupil center does not necessarily indicate ICL dislocation. Compared to the pupil center, the position of the central hole of EVO-ICL is closer to the corneal center.
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Affiliation(s)
- Xiaojian He
- Department of Ophthalmology, Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Lingling Niu
- 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
| | - Huamao Miao
- 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
| | - Feng 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.,Shuguang Hospital affiliated to Shanghai University of Traditional Chinese Medicine, 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.
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Choi JH, Lim DH, Nam SW, Yang CM, Chung ES, Chung TY. Ten-year clinical outcomes after implantation of a posterior chamber phakic intraocular lens for myopia. J Cataract Refract Surg 2019; 45:1555-1561. [DOI: 10.1016/j.jcrs.2019.06.015] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2019] [Revised: 06/08/2019] [Accepted: 06/17/2019] [Indexed: 11/25/2022]
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Gonzalez-Lopez F, Bilbao-Calabuig R, Mompean B, Luezas J, Ortega-Usobiaga J, Druchkiv V. Determining the Potential Role of Crystalline Lens Rise in Vaulting in Posterior Chamber Phakic Collamer Lens Surgery for Correction of Myopia. J Refract Surg 2019; 35:177-183. [PMID: 30855095 DOI: 10.3928/1081597x-20190204-01] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Accepted: 01/30/2019] [Indexed: 11/20/2022]
Abstract
PURPOSE To assess the effect of crystalline lens rise (CLR) on postoperative vault in eyes implanted with a phakic Visian Implantable Collamer Lens (ICL) (STAAR Surgical Company, Monrovia, CA) with a central port for myopic correction. METHODS Non-invasive Fourier-domain swept-source anterior segment optical coherence tomography was used for dynamic assessment of the study eyes under changing light conditions. Phakic intraocular lens (IOL) vault, anterior chamber depth (ACD), and CLR were recorded after surgery, and intra-eye differences were analyzed under scotopic and photopic ambient light conditions. Inter-group analysis and regression analysis were performed to investigate any potential correlation between these biometric variables. RESULTS This retrospective observational study comprised 111 eyes (65 patients) implanted with a myopic Visian ICL. The mean change in CLR from mydriasis to miosis was 59 ± 60 µm (P < .001). The sample was further divided into four groups according to the CLR value in miosis: CLR < 0, 0 to 200, 201 to 350, and > 350 µm. A significant difference in central vault values was observed between the < 0 and > 350 µm groups, the 0 to 200 and 201 to 350 µm groups, and the 0 to 200 and > 350 µm groups (P < .05). Eyes with a high vault value (> 750 µm in mydriasis) had lower CLR values (P < .001) and higher ACD values (P < .001) than eyes with a low vault value (< 100 µm in miosis). The linear correlation observed was negative between CLR and ACD, positive between postoperative vault and ACD, and negative between postoperative vault and CLR (P < .001). CONCLUSIONS CLR significantly affected anterior chamber depth and postoperative ICL vault. [J Refract Surg. 2019;35(3):177-183.].
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Gimbel HV, LeClair BM, Jabo B, Marzouk H. Incidence of implantable Collamer lens–induced cataract. Can J Ophthalmol 2018; 53:518-522. [DOI: 10.1016/j.jcjo.2017.11.018] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Revised: 11/17/2017] [Accepted: 11/21/2017] [Indexed: 10/17/2022]
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Analysis of pre-operative factors affecting range of optimal vaulting after implantation of 12.6-mm V4c implantable collamer lens in myopic eyes. BMC Ophthalmol 2018; 18:163. [PMID: 29980187 PMCID: PMC6035463 DOI: 10.1186/s12886-018-0835-x] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Accepted: 06/25/2018] [Indexed: 11/10/2022] Open
Abstract
Background To evaluate clinical factors affecting postoperative vaulting in eyes that had achieved optimal vaulting within the range of 250–750 μm following implantation of 12.6-mm V4c implantable collamer lenses (ICL). Methods A total of 236 eyes of 236 patients that had achieved optimal vaulting following implantation of a 12.6-mm V4c ICL were retrospectively analyzed. Associations between postoperative vaulting and age, preoperative anterior chamber depth (ACD), preoperative axial length (AL), preoperative white-to-white diameter, preoperative pupil size, preoperative sulcus-to-sulcus diameter, and preoperative manifest refraction spherical equivalent were investigated using simple regression, stepwise multiple regression, and multinomial logistic regression analyses. Results Mean central vaulting at the 6-month follow-up was 519.0 ± 112.8 μm. Variables relevant to postoperative vaulting were, in order of influence, preoperative ACD (β = 0.305, p < 0.001), preoperative pupil size (β = 0.218, p < 0.001), and preoperative AL (β = 0.171, p = 0.006). Low preoperative pupil size was associated with low optimal vaulting (250 to 450 μm), relative to that observed in the mid optimal vaulting group (451 to 550 μm) (odds ratio = 0.532, P = 0.021). Increasing preoperative ACD was associated with high optimal vaulting (551 and 750 μm), relative to that observed the mid optimal vaulting group (odds ratio = 6.340, P = 0.034). Conclusions Myopic eyes with greater preoperative ACD, larger pupil size, and longer AL are predisposed to higher postoperative vaulting following 12.6-mm V4c ICL implantation. Therefore, the extremes of these parameters should be considered when choosing V4c ICL size.
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Gonzalez-Lopez F, Mompean B, Bilbao-Calabuig R, Beltran J, Llovet F, Baviera J. Optimization of the lens sizing for the second eye based on the vault obtained in the first eye in bilateral myopic collamer phakic intraocular lens surgery. ACTA ACUST UNITED AC 2018; 93:368-374. [PMID: 29858153 DOI: 10.1016/j.oftal.2018.04.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2018] [Revised: 04/07/2018] [Accepted: 04/13/2018] [Indexed: 11/26/2022]
Abstract
PURPOSE To assess vault and the decision-making process involved in selecting the size of the lens for the fellow eye in a series of patients who received bilateral phakic collamer intraocular lens (pIOL) implants with central hole for correction of myopia. METHODS The study sample included all patients who underwent bilateral insertion of a different size pIOL from a pool of 269 patients who underwent sequential bilateral insertion of a pIOL from March 2012 to May 2015 in our institution. Procedures were separated in time to assess the value of the vault and select the pIOL size in second eyes. Vault was analysed objectively using optical coherence tomography. RESULTS The decision to change the size of the pIOL in the fellow eye was taken in 25 patients. A smaller pIOL was implanted in the second eye in 9 patients, whereas a lens that was 1 size larger was necessary in 16 patients. Implantation of a larger lens led to a mean increase in vault of 251 ± 180 microns; implantation of a smaller size lens led to a mean decrease in vault of 542 ± 187 microns. In 5 patients, the pIOL implanted in first eye was rotated vertically to reduce lens vault. No lenses had to be explanted. CONCLUSIONS Vault in fellow eyes can be improved in patients receiving bilateral myopic pIOL implants by modifying the pIOL size based on the vault value obtained in the first eyes.
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Affiliation(s)
- F Gonzalez-Lopez
- Clínica Baviera, Instituto Oftalmológico Europeo, Madrid, España.
| | - B Mompean
- Clínica Baviera, Instituto Oftalmológico Europeo, Madrid, España; Departamento de Oftalmología, Hospital Torrevieja, Alicante, España
| | | | - J Beltran
- Clínica Baviera, Instituto Oftalmológico Europeo, Madrid, España
| | - F Llovet
- Clínica Baviera, Instituto Oftalmológico Europeo, Madrid, España
| | - J Baviera
- Clínica Baviera, Instituto Oftalmológico Europeo, Madrid, España
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Zhang X, Chen X, Wang X, Yuan F, Zhou X. Analysis of intraocular positions of posterior implantable collamer lens by full-scale ultrasound biomicroscopy. BMC Ophthalmol 2018; 18:114. [PMID: 29743110 PMCID: PMC5944172 DOI: 10.1186/s12886-018-0783-5] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2017] [Accepted: 05/03/2018] [Indexed: 11/29/2022] Open
Abstract
Background To analyze the positions of intraocular posterior Implantable Collamer Lens (ICL) and its possible relationship with vault. Methods This cross-sectional study included 72 patients with high myopia (134 eyes) who were followed up after phakic intraocular lens implantation. The postoperative time ranged from 1 week to 7 years. We obtained the images of ICL by using Compact Touch STS UBM and observed the position of ICL in posterior chamber and ciliary sulcus. The horizontal lines vault was measured and recorded. Results There were various positions in the posterior chamber as observed by full-scale ultrasound biomicroscopy and the haptics were inserted at different positions. -Eight seven eyes (64.9%) that obtained ideal vault, 29 eyes (21.6%) had insufficient vaults and 18 eyes (13.4%) had excessive vault. The vault with various positions of haptics was in ideal range (250 μm–750 μm) almost in each group. Three eyes in this study with haptics on the top of ciliary sulcus obtained excessive vault (mean vault, 850.00 ± 70.71 μm) and one eye appeared one side haptics pushing forward the iris. Among five eyes (3.7%) with iridociliary body cysts, three eyes (60%) obtained ideal vault. One eye (0.7%) with ICL decentralization after implantation surgery had an ideal vault, but the patient had serious glare. Conclusions Though ICL in the posterior chamber had different positions and the haptics in most cases were not in the ciliary sulcus, the postoperative vault was almost in the ideal range.
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Affiliation(s)
- Xi Zhang
- Department of Ophthalmology, Zhongshan Hospital of Fudan University, Shanghai, People's Republic of China.,Department of Ophthalmology, Eye and ENT Hospital of Fudan University, Shanghai, People's Republic of China.,Department of Ophthalmology, Myopia Key Laboratory of the Health Ministry, Shanghai, People's Republic of China
| | - Xun Chen
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, Shanghai, People's Republic of China.,Department of Ophthalmology, Myopia Key Laboratory of the Health Ministry, Shanghai, People's Republic of China
| | - Xiaoying Wang
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, Shanghai, People's Republic of China. .,Department of Ophthalmology, Myopia Key Laboratory of the Health Ministry, Shanghai, People's Republic of China.
| | - Fei Yuan
- Department of Ophthalmology, Zhongshan Hospital of Fudan University, Shanghai, People's Republic of China
| | - Xingtao Zhou
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, Shanghai, People's Republic of China.,Department of Ophthalmology, Myopia Key Laboratory of the Health Ministry, Shanghai, People's Republic of China
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Implantable Collamer Lens Sizing Method Based on Swept-Source Anterior Segment Optical Coherence Tomography. Am J Ophthalmol 2018; 187:99-107. [PMID: 29294311 DOI: 10.1016/j.ajo.2017.12.015] [Citation(s) in RCA: 85] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2017] [Revised: 12/15/2017] [Accepted: 12/19/2017] [Indexed: 11/22/2022]
Abstract
PURPOSE To develop and evaluate the accuracy of a size-determination formula using anterior segment optical coherence tomography (AS-OCT) parameters. DESIGN Interventional case series. METHODS This study included 46 eyes of 23 patients with implantable collamer lens (ICL). Preoperatively, the anterior segment parameters were measured using high-frequency ultrasound biomicroscopy and AS-OCT. Three months postoperatively, the vaults were measured and the optimal ICL size was calculated using a previously published method. Stepwise multiple regression analysis was performed using the optimal ICL size as a dependent variable; the NK-formula was obtained. Thereafter, 35 eyes of 18 patients were implanted with ICL after the size was calculated using the NK-formula. Vaults measured at 3 months postoperatively were used to evaluate the accuracy of the NK-formula. RESULTS The distance between scleral spurs (ACW) and crystalline lens rise (CLR) were selected as significant parameters for the regression model (R2 = 0.68, P < .05). There were 25 (71%), 8 (23%), and 2 (6%) eyes in the moderate, high, and low vault categories, respectively. Using the STAAR nomogram for ICL sizing, 24 eyes (69%) were fitted in the moderate vault. The mean absolute error of the predicted vault was significantly lower with the NK-formula (0.190 ± 0.129 mm) than with the STAAR nomogram (0.331 ± 0.235 mm, P = .002, paired t test). CONCLUSION AS-OCT is useful for ICL size determination, because it calculates the anterior segment parameters using automatic analysis. The NK-formula shows higher accuracy for predicting vault than the STAAR nomogram.
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Mansoori T, Agraharam SG. Reverse Pupillary Block After Retinal Detachment Surgery in an Eye with Toric Implantable Collamer Lens. Int Ophthalmol 2018; 39:703-710. [PMID: 29478226 DOI: 10.1007/s10792-018-0848-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Accepted: 02/01/2018] [Indexed: 11/29/2022]
Abstract
PURPOSE To report an interesting phenomenon, after vitreoretinal surgery, in an eye with toric implantable collamer lens (ICL). METHODS A 20-year-old male presented with raised intraocular pressure (IOP) after the retinal detachment surgery in the left eye. He had toric ICL in both the eyes, and left eye showed shallow peripheral anterior chamber depth (ACD), narrow iridocorneal angle (ICA), increased ICL vault and pigments debris blocking central hole. After dilation, peripheral ACD deepened, ICL vault decreased and ICA increased, with posterior bowing of iris. RESULTS Patient was managed with topical steroids and antiglaucoma medications. A month later, after inflammation subsided, central hole of ICL became patent, peripheral ACD deepened, ICA increased and IOP was normal without medications, however, after dilation, posterior bowing of iris persisted. He was speculated to have unusual presentation of reverse pupillary block in the left eye after mydriasis. This phenomenon was not observed in the right eye. CONCLUSION Reverse pupillary block, after dilation is an unusual phenomenon, which was seen in a silicone-filled eye with toric ICL implant. In cases of inflammatory debris blocking Aquaport opening of ICL, conservative management with topical steroids and antiglaucoma medications can help reduce inflammation and IOP, alleviating need for any intervention, such as laser iridotomy.
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Affiliation(s)
- Tarannum Mansoori
- Sita Lakshmi Glaucoma Center, Anand Eye Institute, Habsiguda, Hyderabad, Telangana, 500007, India.
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Changes in Objective Vault and Effect on Vision Outcomes after Implantable Collamer Lens Implantation: 1-Year Follow-up. Eur J Ophthalmol 2018; 22:153-60. [PMID: 21607932 DOI: 10.5301/ejo.2011.8359] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/11/2011] [Indexed: 11/20/2022]
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Nam SW, Lim DH, Hyun J, Chung ES, Chung TY. Buffering zone of implantable Collamer lens sizing in V4c. BMC Ophthalmol 2017; 17:260. [PMID: 29273016 PMCID: PMC5741871 DOI: 10.1186/s12886-017-0663-4] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2017] [Accepted: 12/13/2017] [Indexed: 02/01/2023] Open
Abstract
Background The purpose of this study was to identify factors related to the unexpected vault in V4c implantable collamer lens (ICL; STAAR Surgical) implantation. Methods V4c ICLs were implanted in 43 eyes of 43 patients for the correction of myopia. The implanted V4c ICL sizes were determined individually with our previous V4 ICL sizing nomogram based on the sulcus-to-sulcus diameter (STS), and the V4 ICL sizes were then converted to V4c ICL sizes with a size-converting table. We defined the “normal-sizing group” as having a pre-converted ICL size larger than the STS, and the “under-sizing group” as having a pre-converted ICL size smaller than the STS. Refractive outcomes, safety and parameters related to postoperative vault were compared between the two groups. Results The value of “actual ICL size – STS” differed significantly between the normal-sizing and under-sizing groups (p < 0.001), but postoperative vault did not differ significantly (p = 0.442). The demographics, implanted ICL characteristics, effectiveness indexes, safety indexes, and parameters related to postoperative vault did not differ significantly between the two groups (p > 0.05). Two patients in the normal-sizing group exhibited over-vaulting; these patients had shallow anterior chambers and were implanted with high-dioptric-power ICLs. Conclusions The achievement of acceptable vault in both normal-sizing and under-sizing groups indicates the existence of a buffering zone in V4c ICL sizing. The smaller size of V4c ICLs should be considered in patients susceptible to over-vaulting, such as those with shallow anterior chambers and high-dioptric-power ICLs.
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Affiliation(s)
- Seung Wan Nam
- Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, #81 Irwon-ro, Gangnam-gu, Seoul, 06351, South Korea
| | - Dong Hui Lim
- Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, #81 Irwon-ro, Gangnam-gu, Seoul, 06351, South Korea.,Department of Preventive Medicine, Graduate School, The Catholic University of Korea, Seoul, South Korea
| | - Joo Hyun
- Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, #81 Irwon-ro, Gangnam-gu, Seoul, 06351, South Korea.,Saevit Eye Hospital, Goyang, South Korea
| | - Eui-Sang Chung
- Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, #81 Irwon-ro, Gangnam-gu, Seoul, 06351, South Korea
| | - Tae-Young Chung
- Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, #81 Irwon-ro, Gangnam-gu, Seoul, 06351, South Korea.
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A comparison of visual outcome and rotational stability of two types of toric implantable collamer lenses (TICL) : V4 versus V4c. PLoS One 2017; 12:e0183335. [PMID: 28846701 PMCID: PMC5573270 DOI: 10.1371/journal.pone.0183335] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2017] [Accepted: 08/02/2017] [Indexed: 11/19/2022] Open
Abstract
PURPOSE To compare the efficacy and rotational stability after implantation of two types of toric implantable collamer lenses (Toric ICL™(TICL);V4 and V4c, STAAR Surgical Co.). STUDY DESIGN Retrospective case series. METHODS This retrospective study evaluated total 48 eyes of 48 patients who underwent the implantation with V4 and V4c TICL with a central hole; A twenty-four eyes of 24 patients with V4 TICL and 24 eyes of 24 patients with V4c TICL with a central hole. Visual acuity, manifest refraction, and intraocular pressure were evaluated before and after surgery. Rotational stability (disparity between the intended axis and achieved axis) was assessed in both groups using digital anterior segment photographs, and vector analysis was also performed. RESULTS Uncorrected visual acuity improved in both groups without significant difference (P = .111). There were no statistical differences between two groups in postoperative SE and cylindrical errors (P = .067 and .384, respectively). The mean value of rotation was 4.17±3.31° and 3.39±2.36° in the V4 and V4c TICL groups, respectively without significant difference (P = .364). Vector analysis of astigmatic correction showed no significant diffrence between two groups. CONCLUSION V4 and V4c TICL have similar efficacy with regard to visual acuity and refractive outcomes and rotational stability.
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Agreement of Corneal Diameter Measurements Obtained by a Swept-source Biometer and a Scheimpflug-based Topographer. Cornea 2017; 36:1373-1376. [DOI: 10.1097/ico.0000000000001300] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Titiyal JS, Kaur M, Falera R. Intraoperative optical coherence tomography in anterior segment surgeries. Indian J Ophthalmol 2017; 65:116-121. [PMID: 28345566 PMCID: PMC5381289 DOI: 10.4103/ijo.ijo_868_16] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Intraoperative optical coherence tomography (iOCT) is a noninvasive imaging modality that provides a real-time dynamic feedback of the various surgical steps. Comprehensive literature search was performed in MEDLINE using “intraoperative optical coherence tomography” and “iOCT” as keywords. The use of iOCT as an aid to decision-making has been successfully reported in cases undergoing keratoplasty, implantable Collamer lens (ICL) implantation as well as cataract surgery. iOCT helps to assess the graft-host relationship in penetrating keratoplasty. It helps confirm the presence of a big bubble, detect subclinical big bubbles and guide layer by layer stromal dissection in cases of deep anterior lamellar keratoplasty. It acts as a guide during crucial surgical steps in endothelial keratoplasty, right from scoring of the Descemet membrane to ensuring graft apposition at the end of surgery. The morphological features of the corneal incision in phacoemulsification may be assessed. iOCT is a useful tool in assessing the status of the posterior capsule and may help identify preexisting posterior capsular defects during cataract surgery in various clinical scenarios such as posterior polar cataract, traumatic cataract, and vitrectomized eyes. It allows on-table assessment of the ICL vault and potentially facilitates exchange of ICL in the same sitting in extremes of vault. Ocular surface disorders such as ocular surface squamous neoplasia, pterygium, and dermoid may find an application for iOCT, wherein an iOCT-guided stromal dissection will ensure adequate depth of dissection. Further technological advancements may allow for automatic centration and tracking and address the present limitation of instrument-induced shadowing.
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Affiliation(s)
- Jeewan S Titiyal
- Cornea, Cataract and Refractive Surgery Services, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Manpreet Kaur
- Cornea, Cataract and Refractive Surgery Services, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Ruchita Falera
- Cornea, Cataract and Refractive Surgery Services, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
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Refractive Surgery in Pediatric Patients. CURRENT OPHTHALMOLOGY REPORTS 2017. [DOI: 10.1007/s40135-017-0147-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Cao X, Wu W, Wang Y, Xie C, Shen Y. Comparison Over Time of Vault in Chinese Eyes Receiving Implantable Contact Lenses With or Without a Central Hole. Am J Ophthalmol 2016; 172:111-117. [PMID: 27659350 DOI: 10.1016/j.ajo.2016.09.016] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2016] [Revised: 09/11/2016] [Accepted: 09/11/2016] [Indexed: 11/19/2022]
Abstract
PURPOSE To compare the longitudinal vault changes after implantation of a posterior chamber phakic intraocular lens (pIOL) (Visian implantable contact lens) with (ICL V4c) and without (ICL V4) a central artificial hole for moderate to high myopia in Chinese eyes. DESIGN Retrospective case series. METHODS This study comprised 78 eyes implanted with the ICL V4c model and 82 eyes implanted with the ICL V4 model at our department by the same surgeon. The time course of the postoperative pIOL vault changes was quantitatively assessed using ultrasound biomicroscopy over 6 months. RESULTS There was a trend toward a decrease in all measures of central vault, peripheral vault, and the endothelium-anterior pIOL distance for both central hole pIOL and conventional pIOL over time, although the variance was not statistically significant (all P > .05). There were no significant between-group differences in the amount of the pIOL central vault, peripheral vault, or the endothelium-anterior pIOL distance at any time point after surgery (all P > .05). CONCLUSIONS The time course of the central hole pIOL vault changes is essentially equivalent to that of the conventional pIOL vault, suggesting that the presence of the central hole did not significantly affect the pIOL position.
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Affiliation(s)
- Xinfang Cao
- Department of Ophthalmology, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Weiliang Wu
- Department of Orthopedics, Children's Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Yang Wang
- Department of Ophthalmology, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Chen Xie
- Department of Ophthalmology, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Ye Shen
- Department of Ophthalmology, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.
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Chen X, Miao H, Naidu RK, Wang X, Zhou X. Comparison of early changes in and factors affecting vault following posterior chamber phakic Implantable Collamer Lens implantation without and with a central hole (ICL V4 and ICL V4c). BMC Ophthalmol 2016; 16:161. [PMID: 27604229 PMCID: PMC5015244 DOI: 10.1186/s12886-016-0336-8] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2016] [Accepted: 08/23/2016] [Indexed: 12/04/2022] Open
Abstract
Background To objectively compare the early changes in vault over time following implantation of an Implantable Collamer Lens without (ICL V4) and with (ICL V4c) a central hole and the respective factors affecting vault change in moderate to high myopia. Methods This prospective study comprised of 38 eyes of 38 patients implanted with ICL V4 and 39 eyes of 39 patients implanted with ICL V4c intraocular lenses. We quantitatively assessed the postoperative values of vault and pupil size at 1 day, 1 week, and 1 month following implantation using a rotating Scheimpflug camera (Pentacam). We compared these postoperative values within and between the two groups and identified the factors affecting vault change. Results The mean vaults at 1 day, 1 week, and 1 month following ICL V4 implantation were 303.68 ± 185.11, 517.89 ± 160.07 and 521.32 ± 155.72 μm respectively, and those following ICL V4c were 316.67 ± 186.89, 495.13 ± 180.84 and 510.77 ± 175.51 μm, respectively. There was a significant difference in vault between 1 day and 1 week postoperatively. There was a significant association between the vault change and the pupil size change in both groups from 1 day to 1 month postoperatively (Pearman correlation coefficient; ICL V4: r = 0.585, P = 0.001; ICL V4c: r = 0.588, P <0.001). The vault value 1 month after implantation of ICL V4 and ICL V4c was associated with the preoperative anterior chamber depth, horizontal corneal diameter, horizontal and vertical sulcus-to-sulcus. Conclusions Pupil movement is a critical factor in vault change, with increasing vault observed postoperatively from 1 day to 1 week associated with the declining effects of pharmacological miosis and increasing pupil size. The anterior chamber depth, horizontal corneal diameter, horizontal and vertical sulcus-to-sulcus show some correlation with vault. Electronic supplementary material The online version of this article (doi:10.1186/s12886-016-0336-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Xun Chen
- Key Lab of Myopia, Ministry of Health, Shanghai, China.,EYE & ENT Hospital of Fudan University, Shanghai, China
| | - Huamao Miao
- Key Lab of Myopia, Ministry of Health, Shanghai, China.,EYE & ENT Hospital of Fudan University, Shanghai, China
| | | | - Xiaoying Wang
- Key Lab of Myopia, Ministry of Health, Shanghai, China. .,EYE & ENT Hospital of Fudan University, Shanghai, China. .,Department of Ophthalmology, Myopia Key Laboratory of the Health Ministry, Eye and ENT Hospital of Fudan University, No. 19 BaoQing Road, Shanghai, 200031, China.
| | - Xingtao Zhou
- Key Lab of Myopia, Ministry of Health, Shanghai, China.,EYE & ENT Hospital of Fudan University, Shanghai, China
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