1
|
Vanathi M. Lens sizing calculation in phakic lens implantation - What is the best applicable measurement? Indian J Ophthalmol 2024; 72:923-924. [PMID: 38905456 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
| |
Collapse
|
2
|
Yu NH, Kang KH, Tchah H, Koh K. A comparative study of two phakic posterior chamber implantable lenses. Medicine (Baltimore) 2024; 103:e38194. [PMID: 38758875 PMCID: PMC11098212 DOI: 10.1097/md.0000000000038194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Accepted: 04/18/2024] [Indexed: 05/19/2024] Open
Abstract
This study aimed to compare the postimplantation clinical outcomes of 2 types of posterior chamber phakic intraocular lenses (IOLs): Visian™ implantable collamer lenses (ICL; EVO+ V5; Staar Surgical, Monrovia, CA) and an implantable phakic contact lens (IPCL) (IPCL V2.0, Care Group Sight Solution, India) to correct high myopia and myopic astigmatism. This retrospective study included patients who had undergone phakic IOL implantation performed by a single surgeon between March 2021 and March 2022. Preoperative assessments included slit-lamp examination, fundus examination, spherical equivalent, uncorrected distant visual acuity (UDVA), corrected distant visual acuity (CDVA), specular microscope parameters, and optical quality analysis system parameters. Postoperative assessments after 1 year included slit-lamp examination to detect adverse effects and spherical equivalent, UDVA, CDVA, specular microscope, optical quality analysis system, and anterior-segment optical coherence tomography. Eighty eyes from 42 patients (47 eyes from 24 patients in the ICL group and 33 eyes from 18 patients in the IPCL group) were included. No statistically significant differences were observed between the 2 groups regarding preoperative parameters. At 1-year postoperatively, the mean UDVA in the ICL and IPCL groups was 0.019 ± 0.040 logMAR and 0.019 ± 0.041 logMAR, respectively. The mean CDVA was 0.001 ± 0.008 logMAR and 0.001 ± 0.007 logMAR in the ICL and IPCL groups, respectively, showing no statistically significant differences. The postoperative parameters did not differ significantly between the 2 groups. The visual acuity and refractive results of both groups were excellent, and both groups exhibited similar efficacy and safety profiles.
Collapse
Affiliation(s)
- Na Hyeon Yu
- Department of Ophthalmology, Kim’s Eye Hospital, Konyang University College of Medicine, Seoul, Republic of Korea
| | - Kyoung Hae Kang
- Department of Ophthalmology, Kim’s Eye Hospital, Konyang University College of Medicine, Seoul, Republic of Korea
| | - Hungwon Tchah
- Department of Ophthalmology, Kim’s Eye Hospital, Konyang University College of Medicine, Seoul, Republic of Korea
| | - Kyungmin Koh
- Department of Ophthalmology, Kim’s Eye Hospital, Konyang University College of Medicine, Seoul, Republic of Korea
| |
Collapse
|
3
|
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.].
Collapse
|
4
|
Ouchi M. Vault changes in eyes with a vertically implanted implantable collamer lens. Sci Rep 2024; 14:3484. [PMID: 38346992 PMCID: PMC10861517 DOI: 10.1038/s41598-024-52913-8] [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: 07/19/2023] [Accepted: 01/25/2024] [Indexed: 02/15/2024] Open
Abstract
Sulcus-to-sulcus vertical diameter is longer than the horizontal. However, the effect of vertical positioning of the implantable collamer lens (ICL) on the vault compared to preoperative prediction is unclear. This prospective consecutive case series aimed to examine postoperative and preoperative predicted vaults during vertical ICL fixation. This study assessed 180 right eyes in 180 patients with myopic astigmatism. For the 90 eyes in 90 patients who underwent horizontal fixation (horizontal group) and 90 eyes in 90 patients who underwent vertical fixation (vertical group), biometrics by three-dimensional tomography of the anterior segment optical coherence tomography (A-OCT) was performed before surgery and 2 h, 1 day, 1 week, 1 month and 3 months after surgery. The anterior chamber depth did not change over time in both groups, and there was no significant difference from preoperative values. The postoperative vault values were significantly lower in the vertical group than in horizontal group over time. The difference between vault measurements and preoperative predictions at all postoperative time points was significantly greater in the vertical group than in horizontal group. Vertical fixation of the ICL reduced the vault by > 100 μm compared with horizontal fixation, which was different from the A-OCT preoperative predicted value.
Collapse
Affiliation(s)
- Masayuki Ouchi
- Masayuki Ouchi Eye Clinic, 9-1 Nishikujo Ohkuni-cho, Minami-ku, Kyoto, 601-8449, Japan.
| |
Collapse
|
5
|
Zhong DJ, Wu H, Luo DQ, Chen J, Guo-Chen, Chen JP, Lu-Fang, Wang H. Effect of ciliary sulcus angle on the prediction of the vault for phakic implantable collamer lens in the KS formula. Graefes Arch Clin Exp Ophthalmol 2024; 262:323-330. [PMID: 37490104 DOI: 10.1007/s00417-023-06172-4] [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: 04/07/2023] [Revised: 06/17/2023] [Accepted: 07/10/2023] [Indexed: 07/26/2023] Open
Abstract
PURPOSE We aimed to explore the effects of the ciliary sulcus angle (CSA) on accurate prediction of the vault after phakic implantable collamer lens (EVO ICL Model V4c) using the KS formula. METHODS Patients were classified according to the size of CSA: group A, narrow angle (CSA < 30°); group B, normal angle (CSA = 30-90°); and group C, wide angle (CSA > 90°). Further, differences between the actual vault dimensions at 3 months postoperatively and the preoperatively predicted vault dimensions in the three groups were analyzed. RESULTS This study included 223 eyes of 223 individuals. In groups A-C, the difference in the preoperative vault dimensions of the three groups predicted with the KS formula was not statistically significant (P = 0.056). The actual vault dimensions at 3 months postoperatively were significantly different between the three groups (P < 0.001). Moreover, the difference between the actual and predicted vaults by the KS formula was statistically significant (P < 0.001). In the 3 months, after surgery, the percentages of patients with a low vault (< 250 μm) were 0%, 3%, and 29% in groups A, B, and C, respectively. Further, the percentages of patients with an ideal vault (250-750 μm) in the postoperative period were 66%, 84%, and 71% in groups A, B, and C, respectively. Finally, the percentages of patients with a high vault (> 750 μm) in the postoperative period were 34%, 13%, and 0% in groups A, B, and C, respectively. Notably, the distribution of the vault among the three groups was statistically significant (P < 0.001). CONCLUSION The size of CSA significantly affects the predictiveness of the vault by the KS formula, with the most pronounced effect on the angles < 30° and > 90°. Therefore, CSA should be considered when selecting the lens size using the KS formula preoperatively. CLINICAL TRIAL REGISTRATION NUMBER ChiCTR2200065501.
Collapse
Affiliation(s)
- Ding-Juan Zhong
- The First Affiliated Hospital of Hunan Normal University, Department of Optometry and Ophthalmology, Hunan Provincial People's Hospital, No. 61 West Jiefang Road, Changsha, China
| | - Hao Wu
- The First Affiliated Hospital of Hunan Normal University, Department of Optometry and Ophthalmology, Hunan Provincial People's Hospital, No. 61 West Jiefang Road, Changsha, China
| | - Dong-Qiang Luo
- The First Affiliated Hospital of Hunan Normal University, Department of Optometry and Ophthalmology, Hunan Provincial People's Hospital, No. 61 West Jiefang Road, Changsha, China
| | - Jiao Chen
- The First Affiliated Hospital of Hunan Normal University, Department of Optometry and Ophthalmology, Hunan Provincial People's Hospital, No. 61 West Jiefang Road, Changsha, China
| | - Guo-Chen
- The First Affiliated Hospital of Hunan Normal University, Department of Optometry and Ophthalmology, Hunan Provincial People's Hospital, No. 61 West Jiefang Road, Changsha, China
| | - Jiong-Pu Chen
- The First Affiliated Hospital of Hunan Normal University, Department of Optometry and Ophthalmology, Hunan Provincial People's Hospital, No. 61 West Jiefang Road, Changsha, China
| | - Lu-Fang
- The First Affiliated Hospital of Hunan Normal University, Department of Optometry and Ophthalmology, Hunan Provincial People's Hospital, No. 61 West Jiefang Road, Changsha, China
| | - Hua Wang
- The First Affiliated Hospital of Hunan Normal University, Department of Optometry and Ophthalmology, Hunan Provincial People's Hospital, No. 61 West Jiefang Road, Changsha, China.
| |
Collapse
|
6
|
Yiming Y, Xi C, Huan Y, Liming C, Na Y, Pei C, Ying Y, Yan L, Keming Y. Evaluation of ciliary body morphology and position of the implantable collamer lens in low-vault eyes using ultrasound biomicroscopy. J Cataract Refract Surg 2023; 49:1133-1139. [PMID: 37586102 DOI: 10.1097/j.jcrs.0000000000001285] [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: 12/03/2022] [Accepted: 08/06/2023] [Indexed: 08/18/2023]
Abstract
PURPOSE To investigate the ciliary body anatomy and position of the implantable collamer lens (ICL) in low-vault eyes and analyze factors related to insufficient vault. SETTING Zhongshan Ophthalmic Center, Guangzhou, China. DESIGN Retrospective case-control observational study. METHODS In this study, 73 eyes of 73 patients with an insufficient vault (<250 μm) were matched with 73 eyes with an ideal vault (250 to 750 μm). Ultrasound biomicroscopy was used to determine the ciliary body morphology and ICL position. The biometric parameters acquired by Scheimpflug tomography were compared. The correlation between the vault and these factors was analyzed, and the least absolute shrinkage and selection operator method was used to screen the risk factors for low vault. RESULTS The low-vault group had a steeper corneal curvature, thicker lens thickness (LT), higher crystalline lens rise, and shorter axial length (AL) (all P < .005). The ciliary process length (CPL) and maximum ciliary body thickness (CBTmax) were significantly smaller, and the trabecular-ciliary angle (TCA), iris-ciliary angle (ICA), and ciliary sulcus width (CSW) were significantly greater in the low-vault eyes (all P < .005). The low-vault group had more ICL haptics below the ciliary process, and TCA, ICA, CPL, CBTmax, CSW, and haptic position were related to the postoperative vault (all P < .05). CPL, AL, and LT were identified as predictors of a low vault. CONCLUSIONS Malposition of ICL haptics behind the ciliary process is a risk factor for low vault. A shorter CPL, thicker LT, and shorter AL are significant risk factors for the postoperative low vault.
Collapse
Affiliation(s)
- Ye Yiming
- From the State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | | | | | | | | | | | | | | | | |
Collapse
|
7
|
Assaf JF, Reinstein DZ, Zakka C, Arbelaez JG, Boufadel P, Choufani M, Archer T, Ibrahim P, Awwad ST. Deep Learning-Based Estimation of Implantable Collamer Lens Vault Using Optical Coherence Tomography. Am J Ophthalmol 2023; 253:29-36. [PMID: 37142173 DOI: 10.1016/j.ajo.2023.04.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 03/25/2023] [Accepted: 04/17/2023] [Indexed: 05/06/2023]
Abstract
PURPOSE To develop and validate a deep learning neural network for automated measurement of implantable collamer lens (ICL) vault using anterior segment optical coherence tomography (AS-OCT). DESIGN Cross-sectional retrospective study. METHODS A total of 2647 AS-OCT scans were used from 139 eyes of 82 subjects who underwent ICL surgery in 3 different centers. Using transfer learning, a deep learning network was trained and validated for estimating the ICL vault on OCT. A trained operator separately reviewed all OCT scans and measured the central vault using a built-in caliper tool. The model was then separately tested on 191 scans. A Bland-Altman plot was constructed and the mean absolute percentage error (MAPE), mean absolute error (MAE), root mean squared error (RMSE), Pearson correlation coefficient (r), and determination coefficient (R2) were calculated to evaluate the strength and validity of the model. RESULTS On the test set, the model achieved a MAPE of 3.42%, an MAE of 15.82 µm, a RMSE of 18.85 µm, a Pearson correlation coefficient r of +0.98 (P < .00001), and a coefficient of determination R2 of +0.96. There was no significant difference between the vaults of the test set labeled by the technician vs those estimated by the model: 478 ± 95 µm vs 475 ± 97 µm, respectively, P = .064). CONCLUSIONS Using transfer learning, our deep learning neural network was able to accurately compute the ICL vault from AS-OCT scans, overcoming the limitations of an imbalanced data set and limited training data. Such an algorithm can assist the postoperative assessment in ICL surgery.
Collapse
Affiliation(s)
- Jad F Assaf
- Faculty of Medicine, American University of Beirut (J.F.A., C.Z., P.B., M.C.), Beirut, Lebanon
| | - Dan Z Reinstein
- London Vision Clinic, EuroEyes Group (D.Z.R., T.A.), London, United Kingdom
| | - Cyril Zakka
- Faculty of Medicine, American University of Beirut (J.F.A., C.Z., P.B., M.C.), Beirut, Lebanon
| | | | - Peter Boufadel
- Faculty of Medicine, American University of Beirut (J.F.A., C.Z., P.B., M.C.), Beirut, Lebanon
| | - Mathieu Choufani
- Faculty of Medicine, American University of Beirut (J.F.A., C.Z., P.B., M.C.), Beirut, Lebanon
| | - Timothy Archer
- London Vision Clinic, EuroEyes Group (D.Z.R., T.A.), London, United Kingdom
| | - Perla Ibrahim
- Department of Ophthalmology, American University of Beirut Medical Center (P.I., S.T.A.), Beirut, Lebanon
| | - Shady T Awwad
- Department of Ophthalmology, American University of Beirut Medical Center (P.I., S.T.A.), Beirut, Lebanon.
| |
Collapse
|
8
|
Zhang T, Huang F, Gao N, Du M, Cheng H, Huang W, Ji Y, Zheng S, Wan W, Hu K. Three-Dimensional Quantitative Description of the Implantable Collamer Lens in the Ocular Anterior Segment of Patients With Myopia. Am J Ophthalmol 2023; 252:59-68. [PMID: 36933857 DOI: 10.1016/j.ajo.2023.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 02/22/2023] [Accepted: 03/05/2023] [Indexed: 03/19/2023]
Abstract
PURPOSE To describe the 3-dimensional (3D) location of the implantable collamer lens (ICL) quantitatively in the posterior ocular chamber of patients with myopia. DESIGN Cross-sectional study. METHODS To obtain visualization models before and after mydriasis, an automatic 3D imaging method based on swept-source optical coherence tomography was created. Parameters like the ICL lens volume (ILV), the tilt of the ICL and crystalline lens, the vault distribution index, and topographic maps were evaluated to describe the ICL location. Using a paired sample t test and the Wilcoxon signed rank test, the difference between nonmydriasis and postmydriasis conditions was compared. RESULTS The study investigated 32 eyes from 20 patients. The 3D central vault did not differ significantly before (P = .994) or after mydriasis (P = .549) compared with the 2D central vault. After mydriasis, the 5-mm ILV decreased by 0.85 mm2 (P = .016), and the vault distribution index increased significantly (P = .001). The ICL and the crystalline lens exhibited tilt (nonmydriasis: ICL total tilt 3.78 ± 1.85 degrees, lens total tilt 4.03 ± 1.53 degrees; postmydriasis: ICL total tilt 3.84 ± 1.56 degrees, lens total tilt 4.09 ± 1.64 degrees). The phenomenon of asynchronous tilt of the ICL and lens was found in 5 eyes, leading to the spatially asymmetric distribution of the ICL-lens distance. CONCLUSION The 3D imaging technique provided exhaustive and reliable data for the anterior segment. The visualization models offered multiple perspectives on the ICL in the posterior chamber. Before and after mydriasis, the intraocular ICL position was described by the 3D parameters.
Collapse
Affiliation(s)
- Tong Zhang
- From Chongqing Medical University (T.Z., F.H., N.G., M.D., H.C., W.H., W.W., K.H.) and The First Affiliated Hospital of Chongqing Medical University (Y.J., S.Z., W.W., K.H.), Chongqing Key Laboratory of Ophthalmology, Chongqing Eye Institute, Chongqing Branch (Municipality Division) of National Clinical Research Center for Ocular Diseases, Chongqing, China
| | - Fanfan Huang
- From Chongqing Medical University (T.Z., F.H., N.G., M.D., H.C., W.H., W.W., K.H.) and The First Affiliated Hospital of Chongqing Medical University (Y.J., S.Z., W.W., K.H.), Chongqing Key Laboratory of Ophthalmology, Chongqing Eye Institute, Chongqing Branch (Municipality Division) of National Clinical Research Center for Ocular Diseases, Chongqing, China
| | - Ning Gao
- From Chongqing Medical University (T.Z., F.H., N.G., M.D., H.C., W.H., W.W., K.H.) and The First Affiliated Hospital of Chongqing Medical University (Y.J., S.Z., W.W., K.H.), Chongqing Key Laboratory of Ophthalmology, Chongqing Eye Institute, Chongqing Branch (Municipality Division) of National Clinical Research Center for Ocular Diseases, Chongqing, China
| | - Miaomiao Du
- From Chongqing Medical University (T.Z., F.H., N.G., M.D., H.C., W.H., W.W., K.H.) and The First Affiliated Hospital of Chongqing Medical University (Y.J., S.Z., W.W., K.H.), Chongqing Key Laboratory of Ophthalmology, Chongqing Eye Institute, Chongqing Branch (Municipality Division) of National Clinical Research Center for Ocular Diseases, Chongqing, China
| | - Hong Cheng
- From Chongqing Medical University (T.Z., F.H., N.G., M.D., H.C., W.H., W.W., K.H.) and The First Affiliated Hospital of Chongqing Medical University (Y.J., S.Z., W.W., K.H.), Chongqing Key Laboratory of Ophthalmology, Chongqing Eye Institute, Chongqing Branch (Municipality Division) of National Clinical Research Center for Ocular Diseases, Chongqing, China
| | - Wanyao Huang
- From Chongqing Medical University (T.Z., F.H., N.G., M.D., H.C., W.H., W.W., K.H.) and The First Affiliated Hospital of Chongqing Medical University (Y.J., S.Z., W.W., K.H.), Chongqing Key Laboratory of Ophthalmology, Chongqing Eye Institute, Chongqing Branch (Municipality Division) of National Clinical Research Center for Ocular Diseases, Chongqing, China
| | - Yan Ji
- The First Affiliated Hospital of Chongqing Medical University, Chongqing Key Laboratory of Ophthalmology, Chongqing Eye Institute, Chongqing Branch (Municipality Division) of National Clinical Research Center for Ocular Diseases, Chongqing, China
| | - Shijie Zheng
- The First Affiliated Hospital of Chongqing Medical University, Chongqing Key Laboratory of Ophthalmology, Chongqing Eye Institute, Chongqing Branch (Municipality Division) of National Clinical Research Center for Ocular Diseases, Chongqing, China
| | - Wenjuan Wan
- From Chongqing Medical University (T.Z., F.H., N.G., M.D., H.C., W.H., W.W., K.H.) and The First Affiliated Hospital of Chongqing Medical University (Y.J., S.Z., W.W., K.H.), Chongqing Key Laboratory of Ophthalmology, Chongqing Eye Institute, Chongqing Branch (Municipality Division) of National Clinical Research Center for Ocular Diseases, Chongqing, China.; The First Affiliated Hospital of Chongqing Medical University, Chongqing Key Laboratory of Ophthalmology, Chongqing Eye Institute, Chongqing Branch (Municipality Division) of National Clinical Research Center for Ocular Diseases, Chongqing, China..
| | - Ke Hu
- From Chongqing Medical University (T.Z., F.H., N.G., M.D., H.C., W.H., W.W., K.H.) and The First Affiliated Hospital of Chongqing Medical University (Y.J., S.Z., W.W., K.H.), Chongqing Key Laboratory of Ophthalmology, Chongqing Eye Institute, Chongqing Branch (Municipality Division) of National Clinical Research Center for Ocular Diseases, Chongqing, China.; The First Affiliated Hospital of Chongqing Medical University, Chongqing Key Laboratory of Ophthalmology, Chongqing Eye Institute, Chongqing Branch (Municipality Division) of National Clinical Research Center for Ocular Diseases, Chongqing, China..
| |
Collapse
|
9
|
Ichikawa K, Ichikawa K, Yamamoto N, Horai R. Flexural and Cell Adhesion Characteristic of Phakic Implantable Lenses. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1282. [PMID: 37512093 PMCID: PMC10385999 DOI: 10.3390/medicina59071282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 07/06/2023] [Accepted: 07/08/2023] [Indexed: 07/30/2023]
Abstract
Background and Objectives: In this study, we aimed to compare the physical properties of hole-implantable collamer lenses (H-ICLs) and implantable phakic contact lenses (IPCLs) and investigate their flexural and cell adhesion characteristics. Materials and Methods: Transverse compression load to achieve lens flexion and static Young's modulus were measured in H-ICLs and IPCLs using designated equipment. Load was measured both with and without restraining the optic section of the lenses. Adhesion of iHLEC-NY2 cells to the lens surfaces was examined using phase-contrast microscopy, and cell proliferation activity was evaluated using WST-8 assay. Results: The H-ICL showed a greater tendency for transverse compression load compared to IPCL, while the IPCL showed a higher Young's modulus with respect to the force exerted on the center of the anterior surface of the optic section. The joint between the optic section and haptic support in the IPCL was found to mitigate the effects of transverse compression load. Both lens types showed minimal cell adhesion. Conclusions: Our findings indicate that H-ICLs and IPCLs exhibit distinct physical properties and adhesive characteristics. The IPCL demonstrated higher Young's modulus and unique structural features, while the H-ICL required greater transverse compression load to achieve the flexion required to tuck the haptic supports into place behind the iris to fix the lens. The observed cell non-adhesive properties for both lens types are promising in terms of reducing complications related to cell adhesion. However, further investigation and long-term observation of IPCL are warranted to assess its stability and potential impact on the iris. These findings contribute to a better understanding of the performance and potential applications of H-ICLs and IPCLs in ophthalmology.
Collapse
Affiliation(s)
| | - Kei Ichikawa
- Chukyo Eye Clinic, Nagoya 456-0032, Aichi, Japan
- General Aoyama Hospital, Toyokawa 441-0103, Aichi, Japan
| | - Naoki Yamamoto
- Support Office for Bioresource Research, Translational Research Headquarters, Fujita Health University, Toyoake 470-1192, Aichi, Japan
| | - Rie Horai
- Chukyo Eye Clinic, Nagoya 456-0032, Aichi, Japan
| |
Collapse
|
10
|
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.
Collapse
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)
| |
Collapse
|
11
|
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.
Collapse
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
| |
Collapse
|
12
|
Niu L, Zhang Z, Miao H, Zhao J, Wang X, He JC, Zhou X. Effects of lighting conditions and accommodation on the three-dimensional position of Visian implantable collamer lens. EYE AND VISION (LONDON, ENGLAND) 2022; 9:42. [PMID: 36329521 PMCID: PMC9635130 DOI: 10.1186/s40662-022-00313-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Accepted: 10/13/2022] [Indexed: 11/06/2022]
Abstract
Background To investigate the effects of lighting conditions and accommodation on the three-dimensional position of Visian implantable collamer lens (ICL V4c). Methods This observational study recruited 62 eyes of 31 myopia patients underwent ICL V4c implantation. Anterior segment optical coherence tomography (AS-OCT) assessed the anterior chamber depth (ACD), ACD-ICL (distance from the corneal endothelium to anterior surface of the ICL V4c), vault (distance between the posterior ICL V4c surface and anterior crystalline lens surface), and crystalline lens tilt under various lighting conditions and accommodation relative to the corneal topographic axis at one year after ICL V4c implantation. Baseline was defined as the scotopic condition, which was also the non-accommodative stimulus condition. The ICL V4c tilt was analyzed using MATLAB. The significance level was set at P < 0.05. Results The ACD-ICL values were similar under various lighting conditions (P = 0.978) but decreased during accommodation (P < 0.001). The vault was significantly smaller under mesopic and photopic conditions than the baseline (P = 0.044 and P < 0.001, respectively) but remained unchanged during accommodation (P = 0.058). The inferotemporal proportion of ICL V4c (88.7%, 55 eyes) and crystalline lens (74.2%, 46 eyes) tilts were not significantly different (P = 0.063). Crystalline lens under various lighting conditions and accommodation exhibited similar tilts. The vertical tilt of ICL V4c was significantly larger under photopic conditions than the baseline (P = 0.038). The horizontal and total tilts were significantly decreased during accommodation (P = 0.043 and 0.013, respectively). Conclusions The axial position of ICL V4c in the anterior chamber was stable under various lighting conditions. Lighting conditions and accommodation may influence vertical, horizontal and total tilts of ICL V4c. Supplementary Information The online version contains supplementary material available at 10.1186/s40662-022-00313-2.
Collapse
Affiliation(s)
- Lingling Niu
- Department of Ophthalmology and Optometry, Eye & ENT Hospital, Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia (Fudan University), Shanghai, China.,Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China.,Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Zhe Zhang
- Department of Ophthalmology and Optometry, Eye & ENT Hospital, Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia (Fudan University), Shanghai, China.,Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China.,Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Huamao Miao
- Department of Ophthalmology and Optometry, Eye & ENT Hospital, Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia (Fudan University), Shanghai, China.,Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China.,Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Jing Zhao
- Department of Ophthalmology and Optometry, Eye & ENT Hospital, Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia (Fudan University), Shanghai, China.,Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China.,Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Xiaoying Wang
- Department of Ophthalmology and Optometry, Eye & ENT Hospital, Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia (Fudan University), Shanghai, China.,Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China.,Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Ji C He
- New England College of Optometry, MA, Boston, USA.
| | - Xingtao Zhou
- Department of Ophthalmology and Optometry, Eye & ENT Hospital, Fudan University, Shanghai, China. .,NHC Key Laboratory of Myopia (Fudan University), Shanghai, China. .,Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China. .,Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China.
| |
Collapse
|
13
|
Zhang H, Gong R, Zhang X, Deng Y. Analysis of perioperative problems related to intraocular Implantable Collamer Lens (ICL) implantation. Int Ophthalmol 2022; 42:3625-3641. [PMID: 35731355 PMCID: PMC9587946 DOI: 10.1007/s10792-022-02355-w] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Accepted: 04/18/2022] [Indexed: 02/05/2023]
Abstract
PURPOSE To introduce a modified procedure of ICL implantation, to summarize the perioperative problems and their corresponding treatment after myopia correction with Implantable Collamer Lens (ICL), and to compare the difference of complications between the no-hole ICL and hole ICL. METHODS We searched all articles on ICL-related perioperative problems and their corresponding treatment in Scopus, Embase, PubMed and Web of Science databases for the last 22 years. RESULTS ICL implantation is safe, effective, stable and predictable in the correction of myopia, hyperopia and astigmatism, but can also cause a series of perioperative problems, including intraoperative and postoperative complications. CONCLUSION There are many kinds of complications related to ICL, but the common intraoperative and postoperative complications mainly include abnormality of arch height, abnormal position of ICL, loss of corneal endothelial cells and corneal decompensation, high intraocular pressure and secondary glaucoma, cataract and night vision symptoms. Compared with ICL without central pore, the incidence of complications such as loss of corneal endothelial cells and corneal decompensation, high intraocular pressure and secondary glaucoma and cataract was relatively lower in central hole ICL, while postoperative complications such as night vision symptoms were obvious.
Collapse
Affiliation(s)
- Hao Zhang
- Department of Ophthalmology, West China Hospital, Sichuan University, No.37, Guoxue Xiang, Chengdu, 610041 Sichuan China
| | - Rui Gong
- Department of Ophthalmology, West China Hospital, Sichuan University, No.37, Guoxue Xiang, Chengdu, 610041 Sichuan China
| | - Xiaolan Zhang
- Department of Ophthalmology, West China Hospital, Sichuan University, No.37, Guoxue Xiang, Chengdu, 610041 Sichuan China
| | - Yingping Deng
- Department of Ophthalmology, West China Hospital, Sichuan University, No.37, Guoxue Xiang, Chengdu, 610041 Sichuan China
| |
Collapse
|
14
|
Martínez-Plaza E, López-Miguel A, López-de la Rosa A, Maldonado MJ. Inter-eye and postoperative prediction of vault after implantation of EVO + Visian phakic implantable collamer lens. Int Ophthalmol 2022; 43:1501-1510. [PMID: 36260197 DOI: 10.1007/s10792-022-02546-5] [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: 08/24/2022] [Accepted: 10/06/2022] [Indexed: 11/25/2022]
Abstract
PURPOSE To assess whether the postoperative outcomes of the implantation of an EVO + implantable collamer lens (ICL) in one eye can be used as a predictor of the vault of the fellow eye, and to evaluate the vault changes of the implantation in both eyes during the postoperative period. METHODS A prospective study including 40 eyes of 20 patients with a bilateral EVO + ICL implantation was performed. Subjects were evaluated before the surgery and 1 day, 1 week and 1, 3 and 6 months postoperatively. Central vault was assessed using spectral-domain optical coherence tomography. The inter-eye and follow-up analyses were performed using lineal models and the Bland-Altman method. RESULTS The vault of the first implanted eye at the 1-day visit highly predicts the vault of the second eye (R2 = .87; P < .001); the mean inter-eye difference was - 0.95 μm, and the superior and inferior limits of agreement were -50.27 μm and 148.37 μm, respectively. This relationship was maintained during the medium-term follow-up, not finding differences in the slopes among visits (P ≥ .09). A progressive decrease of vault was found during the follow-up (P < .001). Larger vault change 6 months after the surgery was associated with higher vault 1 day after the ICL implantation (R2 = .19;P = .005). CONCLUSION One-day postoperative vault in the first eye can help to predict the optimal ICL sizing in the second eye. Vault tends to decrease during the first 6 months after EVO + ICL implantation. Eyes with higher initial vaults will also show larger reductions during the medium-term follow-up.
Collapse
Affiliation(s)
- Elena Martínez-Plaza
- Instituto de Oftalmobiología Aplicada (IOBA), Universidad de Valladolid, Paseo de Belén 17, 47011, Valladolid, Spain
| | - Alberto López-Miguel
- Instituto de Oftalmobiología Aplicada (IOBA), Universidad de Valladolid, Paseo de Belén 17, 47011, Valladolid, Spain.
- Red Temática de Investigación Colaborativa en Oftalmología (OftaRed), Instituto de Salud Carlos III, Madrid, Spain.
| | - Alberto López-de la Rosa
- Instituto de Oftalmobiología Aplicada (IOBA), Universidad de Valladolid, Paseo de Belén 17, 47011, Valladolid, Spain
| | - Miguel J Maldonado
- Instituto de Oftalmobiología Aplicada (IOBA), Universidad de Valladolid, Paseo de Belén 17, 47011, Valladolid, Spain
- Red Temática de Investigación Colaborativa en Oftalmología (OftaRed), Instituto de Salud Carlos III, Madrid, Spain
| |
Collapse
|
15
|
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: 4] [Impact Index Per Article: 2.0] [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.
Collapse
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
| |
Collapse
|
16
|
Wang Y, Yang R, Huang Y, Zhang C, Liu H, Jia Z, Zhao S. Clinical observations of EVO-ICL implantation and changes in corneal astigmatism using a modified technique. BMC Ophthalmol 2022; 22:381. [PMID: 36151534 PMCID: PMC9502894 DOI: 10.1186/s12886-022-02603-8] [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: 05/05/2022] [Accepted: 09/13/2022] [Indexed: 11/23/2022] Open
Abstract
Background Implantable collamer lens (ICL) surgery techniques are constantly progressing. The purpose of this study was to investigate the application effect of the modified technique and its impact on the change in corneal astigmatism in EVO-ICL surgery. Methods The analysis of retrospective cohort data included 153 eyes of 81 patients with myopia from July 2018 to May 2020. An EVO-ICL was inserted by modified surgical skills, including a single 3.0 mm corneal incision and no ophthalmic viscosurgical device (OVD) before the insertion of the ICL (modified technique group: 41 cases, 80 eyes) and standard procedure (standard technique group: 40 cases, 73 eyes). Early postoperative intraocular pressure (IOP) was monitored at 2 and 24 h. IOP, corrected distance visual acuity (CDVA), uncorrected distance visual acuity (UDVA), vault, and anterior chamber depth (ACD) were measured 1, 6, and 12 months following the initial examination. The corneal endothelial cell density (ECD) was monitored at 6 and 12 months after the operation. Surgically induced astigmatism (SIA) in the total, anterior, and posterior corneal surfaces was analysed 1 month after the operation. Results No serious complications were detected. The two groups had no difference in visual outcomes, ICL vaults, or ACD at any time point (P > 0.05). Two hours postoperatively, IOP was significantly lower in the modified technique group (16.22 ± 2.22 vs. 18.37 ± 1.92 mmHg, P < 0.05) than in the standard technique group. IOP decreased gradually after 24 h to preoperative levels. The postoperative IOP remained stable over a 12-month period. The ECD at 6 and 12 months was not significantly different between the groups (P > 0.05). SIA in the total, anterior, and posterior corneal surfaces were assumed to have no clinically meaningful differences between groups at one month after operation (P > 0.05). Conclusions The modified technique is efficient and safe, producing comparable visual and structural outcomes without adversely affecting ECD, and reduces fluctuations in IOP at the early postoperative stages. The auxiliary incision in the standard technique does not increase corneal SIA, which is also a factor to consider for inexperienced surgeons.
Collapse
Affiliation(s)
- Ying Wang
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, 300384, China
| | - Ruibo Yang
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, 300384, China
| | - Yue Huang
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, 300384, China
| | - Chen Zhang
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, 300384, China
| | - Hui Liu
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, 300384, China
| | - Zhe Jia
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, 300384, China
| | - Shaozhen Zhao
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, 300384, China.
| |
Collapse
|
17
|
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.
Collapse
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
| |
Collapse
|
18
|
Moshirfar M, Placide J, Neves da Silva HV, Durnford KM, Ronquillo YC, McCabe SE, Hoopes PC. Assessing the Efficacy of Four Diagnostic Devices and Four Nomograms in Posterior Chamber Phakic Intraocular Lens Size Selection. J Refract Surg 2022; 38:106-111. [DOI: 10.3928/1081597x-20211109-01] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
|
19
|
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.
Collapse
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
| |
Collapse
|
20
|
Srirampur A, Pesala V, Mansoori T, Gadde AK, Kola P. Effect of pupil size on posterior chamber phakic intraocular lens vault measurements. Indian J Ophthalmol 2021; 69:2289-2292. [PMID: 34427202 PMCID: PMC8544034 DOI: 10.4103/ijo.ijo_3429_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Purpose The aim of this study was to measure the implantable collamer lens (ICL) vault changes with anterior segment optical coherence tomography (AS-OCT) after the implantation of the Visian posterior chamber phakic ICL with a central hole (V4c) in relation to the pupil size. Methods This retrospective observational pilot study included 32 eyes of 16 patients, who underwent V4c ICL implantation. ICL vault was measured with AS-OCT in undilated and fully dilate state of the pupil. Primary outcome measure was the change in the vault of V4c ICL at the maximum and minimum pupil size. Results Median (IQR) undilated and post-dilated vault measurement was 393.00 (335.50-493.50) microns and 421.00 (338.50-503.75) microns, respectively, which was not statistically significant (P = 0.44). Conclusion No statistically significant difference was observed between the undilated and post-dilated ICL vault measurements. Hence, the postoperative vault can be measured either in resting, undilated state or fully dilated state of the pupil and would be similar irrespective of the pupil size.
Collapse
Affiliation(s)
- Arjun Srirampur
- Department of Cataract and Refractive Surgery, Anand Eye Institute, Hyderabad, India
| | - Veerendranath Pesala
- Department of Cataract and Refractive Surgery, Anand Eye Institute, Hyderabad, India
| | - Tarannum Mansoori
- Department of Cataract and Refractive Surgery, Anand Eye Institute, Hyderabad, India
| | - Aruna Kumari Gadde
- Department of Cataract and Refractive Surgery, Anand Eye Institute, Hyderabad, India
| | - Pravalika Kola
- Department of Cataract and Refractive Surgery, Anand Eye Institute, Hyderabad, India
| |
Collapse
|
21
|
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.
Collapse
|
22
|
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.
Collapse
Affiliation(s)
- Bu Ki Kim
- Onuuri Smile Eye Clinic, Ara Tower B2F, Seoul, Republic of Korea
| | | |
Collapse
|
23
|
Kim BK, Chung YT. Comparison of clinical outcomes of implantable collamer lens implantation with and without use of an ophthalmic viscosurgical device. J Cataract Refract Surg 2021; 47:198-203. [PMID: 32925657 DOI: 10.1097/j.jcrs.0000000000000417] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 08/13/2020] [Indexed: 11/25/2022]
Abstract
PURPOSE To compare the clinical efficacy of posterior chamber phakic implantable collamer lens (ICL) implantation with and without the use of an ophthalmic viscosurgical device (OVD). SETTING Onnuri Eye Hospital, Jeonju, Jeollabuk-do, South Korea. DESIGN Retrospective case series. METHODS Included were patients who underwent ICL implantation with the use of an OVD (OVD group) and patients who underwent ICL implantation without the use of an OVD (hydro group). Refractive error, endothelial cell density (ECD), intraocular pressure (IOP), vault, and adverse events were evaluated at 1 day, 1 week, 1 month, and 3 months postoperatively. The IOP and vault were checked 1 hour postoperatively, and the surgical time was recorded. RESULTS The OVD group comprised 54 eyes of 27 patients and the hydro group 49 eyes of 25 patients. There were no significant preoperative differences between the 2 groups. At 1 hour postoperatively, the IOP was significantly higher in the OVD group (P < .001); however, there was no significant difference in IOP between the 2 groups at other follow-up timepoints. Surgical time was significantly shorter for the hydro group (P = .032). There was no statistically significant difference in vault, ECD, or refractive error between the 2 groups during the 3-month follow-up period. No adverse events were observed. CONCLUSIONS ICL implantation without the use of an OVD was safe and effective. The advantages of this technique included a short surgical time, prevention of early postoperative IOP spikes, and cost savings due to OVD elimination.
Collapse
Affiliation(s)
- Bu Ki Kim
- From the Onuuri Smile Eye Clinic (Kim), Seoul, Onnuri Eye Hospital (Chung), Jeollabuk-do, South Korea
| | | |
Collapse
|
24
|
Fairaq R, Almutlak M, Almazyad E, Badawi AH, Ahad MA. Outcomes and complications of implantable collamer lens for mild to advance keratoconus. Int Ophthalmol 2021; 41:2609-2618. [PMID: 33772698 DOI: 10.1007/s10792-021-01820-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Accepted: 03/16/2021] [Indexed: 11/30/2022]
Abstract
PURPOSE To evaluate the outcome and safety of implantable collamer lens (ICL; (Visian, STAAR Surgical, Monrovia, CA, USA) in mild to advance keratoconus patients with myopia and myopic astigmatism. METHODS This retrospective study evaluated all patients who underwent ICL implantation for the management of keratoconus at a tertiary care eye hospital from January 2012 to January 2018. The mean duration of follow-up was 15.3 months (range, 3.13 to 38.97 months). Data were collected on preoperative and postoperative uncorrected distance visual acuity (UDVA) and corrected distance visual acuity (CDVA), refraction was compared, and adverse effects were evaluated. RESULTS Thirty-two eyes (32 patients) were evaluated. The median CDVA was 20/30 preoperatively and 20/20 at last follow-up. The median UDVA was 20/25 at last follow-up. Thirteen patients (40.6%) had 20/20 UDVA in comparison to none at baseline. The median spherical equivalent in diopters (D) was -7.875 D (-4.125 to -10.0 D) preoperatively and decreased to -0.3125 D at last follow-up. The median manifest refractive cylinder was 3.00 D (2.25 to 5.25 D) preoperatively and decreased to 1.125 D postoperatively. Cylinder axis rotation of 10° or greater occurred in 3 eyes (9.375%) and required repositioning of the ICL. One patient (3%) developed nonvisually significant anterior subcapsular cataract. One ICL (3.125%) had to be explanted due to residual refractive error and unsatisfactory vision. CONCLUSION ICLs are a suitable refractive option for the correction of refractive error associated with stable, nonprogressive keratoconus even in advance cases. However, the risk of ICL rotation and subsequent repositioning remain. Careful patient selection is necessary for achieving good outcomes and mitigating intraoperative and postoperative complications.
Collapse
Affiliation(s)
- Rafah Fairaq
- Ophthalmology Department, Faculty of Medicine, University of Jeddah, Jeddah, Saudi Arabia.,Cornea and Anterior Segment Division, King Khaled Eye Specialist Hospital, Umm AlHamam AlGharbi, AlUrubah road, Riyadh, Saudi Arabia
| | - Mohammed Almutlak
- Cornea and Anterior Segment Division, King Khaled Eye Specialist Hospital, Umm AlHamam AlGharbi, AlUrubah road, Riyadh, Saudi Arabia
| | - Enmar Almazyad
- Cornea and Anterior Segment Division, King Khaled Eye Specialist Hospital, Umm AlHamam AlGharbi, AlUrubah road, Riyadh, Saudi Arabia
| | - Abdulrahman H Badawi
- Cornea and Anterior Segment Division, King Khaled Eye Specialist Hospital, Umm AlHamam AlGharbi, AlUrubah road, Riyadh, Saudi Arabia
| | - Muhammad Ali Ahad
- Cornea and Anterior Segment Division, King Khaled Eye Specialist Hospital, Umm AlHamam AlGharbi, AlUrubah road, Riyadh, Saudi Arabia.
| |
Collapse
|
25
|
Chaitanya SR, Anitha V, Ravindran M, Ghorpade A, Rengappa R, Uduman MS. Safety and efficacy of toric implantable collamer lens V4c model - A retrospective South Indian study. Indian J Ophthalmol 2020; 68:3006-3011. [PMID: 33229687 PMCID: PMC7856968 DOI: 10.4103/ijo.ijo_1492_20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Purpose: The aim of this study was to evaluate the safety, efficacy, and complications of V4c Toric implantable collamer Lens (TICL) implantation for myopic astigmatism in the south Indian population. Methods: In this retrospective observational case series, a total of 109 eyes of 67 patients who underwent V4c TICL implantation (ICL, V4C Staar Surgical, Nidau, Switzerland) between January 2012 and August 2019 were studied with a minimum follow-up period of 6 months (mean 24 months). The main outcome measures were objective and subjective refraction, uncorrected distance visual acuity, corrected distance visual acuity (CDVA), safety, predictability, adverse events, and postoperative complications. Results: At 6 months, mean manifest refractive spherical equivalent (SE) decreased from - 10.90 ± 3.7D preoperatively to - 0.02 ± 0.13D postoperatively (P < 0.001) and mean cylinder decreased from - 2.3 ± 1.3 D preoperatively to - 0.04 ± 0.2 D postoperatively (P < 0.001). Postoperatively, SE within ± 0.5 D and ± 1.0 D of attempted correction were achieved in 96.3 (105 eyes) and 100% (109 eyes), respectively. Manifest refractive cylinder within ± 0.5 D and ± 1.0 D of attempted correction were achieved in 97.2 (106 eyes) and 100% (109 eyes), respectively. Sixty-two percent (68 eyes) showed no change in CDVA postoperatively, and no eye had lost lines of CDVA. The safety index was 1.12, and the efficacy index was 1.10. Complications were seen in two eyes (1.8%) due to high postoperative vault requiring secondary surgical interventions. Conclusion: V4c TICL is a highly effective, safe, and predictable option in treating myopic astigmatism with excellent improvement in vision and spectacle independence.
Collapse
Affiliation(s)
- S Ravi Chaitanya
- Fellow in Cornea and External Diseases, Aravind Eye Hospitals and Post Graduate Institute, Tirunelveli, Tamil Nadu, India
| | - Venugopal Anitha
- HOD, Cornea and Refractive Services, Aravind Eye Hospitals and Post Graduate Institute, Tirunelveli, Tamil Nadu, India
| | - Meenakshi Ravindran
- HOD, Paediatric and Strabismus Services, Aravind Eye Hospitals and Post Graduate Institute, Tirunelveli, Tamil Nadu, India
| | - Aditya Ghorpade
- Consultant, Cornea and External Diseases, Aravind Eye Hospitals and Post Graduate Institute, Tirunelveli, Tamil Nadu, India
| | - Ramakrishnan Rengappa
- Prof of Ophthalmology, Glaucoma Services, Aravind Eye Hospitals and Post Graduate Institute, Tirunelveli, Tamil Nadu, India
| | - Mahammed Sithiq Uduman
- Statistics, Aravind Eye Hospitals and Post Graduate Institute, Tirunelveli, Tamil Nadu, India
| |
Collapse
|
26
|
Takagi Y, Kojima T, Nishida T, Nakamura T, Ichikawa K. Prediction of anterior chamber volume after implantation of posterior chamber phakic intraocular lens. PLoS One 2020; 15:e0242434. [PMID: 33196664 PMCID: PMC7668562 DOI: 10.1371/journal.pone.0242434] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Accepted: 11/03/2020] [Indexed: 11/18/2022] Open
Abstract
PURPOSE To predict the anterior chamber volume (ACV) after implantable collamer lens (ICL) implantation based on ICL size and parameters of anterior segment optical coherence tomography (AS-OCT). DESIGN Retrospective study. METHODS This study included 222 eyes of 222 patients who underwent ICL implantation at Nagoya Eye Clinic. The patients were divided into two groups: prediction group, for creating the prediction equation (148 eyes, mean age: 32.11 ± 8.04 years), and verification group, for verifying the equation (74 eyes, mean age: 33.03 ± 6.74 years). The angle opening distance (AOD), anterior chamber width (ACW), ACV, anterior chamber depth, lens vault, angle-to-angle distance, angle recess area, and trabecular iris space area were calculated using AS-OCT. A stepwise multiple regression analysis was performed. After the creation of the prediction equation, its accuracy was verified in the verification group. RESULTS The ACV, AOD750, ACW, and ICL size were selected as explanatory variables to predict postoperative ACV. Mean predicted (114.2 ± 21.83 mm3) and actual postoperative ACVs (116.1 ± 25.41 mm3) were not significantly different (P = 0.269); absolute error was 10.59 ± 9.13 mm3. In addition, there was high correlation between actual and predictive ACV (adjusted R2 = 0.6996, p < 0.0001). Bland-Altman plot revealed that there was no addition or proportional error between predicted and actual postoperative ACV. CONCLUSION Postoperative ACV was accurately predicted using AS-OCT parameters and ICL size. This prediction equation may be useful for making decisions regarding ICL size.
Collapse
Affiliation(s)
- Yuki Takagi
- Department of Ophthalmology, Iida Municipal Hospital, Nagano, Japan
| | - Takashi Kojima
- Nagoya Eye Clinic, Nagoya, Japan
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
- * E-mail:
| | | | | | | |
Collapse
|
27
|
Kato S, Shimizu K, Igarashi A. Assessment of low-vault cases with an implantable collamer lens. PLoS One 2020; 15:e0241814. [PMID: 33147267 PMCID: PMC7641440 DOI: 10.1371/journal.pone.0241814] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Accepted: 10/20/2020] [Indexed: 11/27/2022] Open
Abstract
This study aimed to examine clinical results in low-vault eyes after implementation of a Hole implantable collamer lens (KS-AquaPORT™, STAAR Surgical Company) in terms of visual outcomes and complications over a one-year follow-up period. This was a retrospective cohort study of subjects who underwent Hole implantable collamer lens surgery at Sanno Hospital, exhibited low vault, and were followed up for 1 year. Patients were included if they met the following criteria: 20≤ age ≤55 years; stable refraction ≥6 months; -1.0 to -20.0 diopters of myopia; endothelial cell density ≥1800 cells/mm2; and no history of ocular surgery, progressive corneal degeneration, cataract, glaucoma, or uveitis. Main outcome measurements were the safety and efficacy indices, predictability, and vault. Values were indicated as the mean ± standard deviation. Subjects included 16 patients (age: 38 ± 8 years; 6 males; 25 eyes). Toric lenses were utilized for 10 eyes. Implantable collamer lens size was 12.1, 12.6, and 13.2 mm for 18, 6, and 1 eye(s), respectively. One year postoperatively, the safety index was 1.07; for 22 eyes with a target refraction of that of emmetropic eyes, the efficacy index was 0.90; and 96% of eyes were within ± 0.50 diopters of attempted versus achieved spherical equivalent correction. Postoperative vault was 142 ± 60 μm. One year postoperatively, no additional surgery was required for rotation of toric implantable collamer lens, and no advanced cataracts, increased intraocular pressure, or decreased endothelial cells were observed. In conclusion, Hole implantable collamer lens yielded satisfactory visual outcomes and no postoperative complications for low-vault eyes, suggesting its suitability for such cases.
Collapse
Affiliation(s)
- Sayaka Kato
- Eye Center, Sanno Hospital, Tokyo, Japan
- * E-mail:
| | | | | |
Collapse
|
28
|
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
| |
Collapse
|
29
|
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.
Collapse
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.
| |
Collapse
|
30
|
Gargallo-Martinez B, Garcia-Medina JJ, Rubio-Velazquez E, Fernandes P, Villa-Collar C, Gonzalez-Meijome JM, Gutierrez-Ortega R. Vault changes after cyclopentolate instillation in eyes with posterior chamber phakic intraocular lens. Sci Rep 2020; 10:9646. [PMID: 32541775 PMCID: PMC7296012 DOI: 10.1038/s41598-020-66146-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2020] [Accepted: 04/14/2020] [Indexed: 11/09/2022] Open
Abstract
Posterior chamber phakic intraocular lens (pIOL) implantation is a common option for correcting moderate-to-high ocular refractive defects. Because this pIOL is implanted on ciliary sulcus, the distance between the back surface of the pIOL and the anterior surface of the crystalline lens, that it is known as vault, should be measured in different conditions to ensure the technique's safety. Cyclopentolate is a drug that dilates the pupil and relaxes accommodation (cycloplegia). It is often used for different ocular examinations and for other medical purposes. However, there is no evidence of the effect of this drug on vault. This study quantified central vault changes associated with cyclopentolate instillation. We measured the vault under normal conditions (pre-cycloplegic instillation) and after instilling cyclopentolate on 39 eyes of 39 patients with implanted pIOL. Our results suggest that cyclopentolate instillation may induce changes to vault in eyes with implanted pIOL. These changes seem safe and are mainly associated with vault under normal conditions, but also with anterior chamber depth, pupillary diameter and pIOL size.
Collapse
Affiliation(s)
- Beatriz Gargallo-Martinez
- Department of Ophthalmology, Clínica Novovisión, Murcia, Spain. .,Departament of Condensed Matter Physics, University of Sevilla, Sevilla, Spain.
| | - Jose Javier Garcia-Medina
- Departament of Ophthalmology, General University Hospital Morales Meseguer, Murcia, Spain. .,Department of Ophthalmology and Optometry, University of Murcia, Murcia, Spain.
| | - Elena Rubio-Velazquez
- Department of Ophthalmology, Clínica Novovisión, Murcia, Spain.,Departament of Ophthalmology, General University Hospital Morales Meseguer, Murcia, Spain
| | - Paulo Fernandes
- Clinical & Experimental Optometry Research Lab, Center of Physics, University of Minho, Braga, Portugal
| | - César Villa-Collar
- Department of Ophthalmology, Clínica Novovisión, Murcia, Spain.,Faculty of Biomedicine and Health, European University of Madrid, Madrid, Spain
| | - José M Gonzalez-Meijome
- Clinical & Experimental Optometry Research Lab, Center of Physics, University of Minho, Braga, Portugal
| | - Ramón Gutierrez-Ortega
- Department of Ophthalmology, Clínica Novovisión, Murcia, Spain.,Department of Ophthalmology and Optometry, University of Murcia, Murcia, Spain
| |
Collapse
|
31
|
Anterior chamber angle width, central vault and intraocular pressure changes after 12 months of Visian collamer lens implantation. Int Ophthalmol 2020; 40:2047-2053. [DOI: 10.1007/s10792-020-01381-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2020] [Accepted: 04/10/2020] [Indexed: 12/30/2022]
|
32
|
Vault Changes Caused by Light-Induced Pupil Constriction and Accommodation in Eyes With an Implantable Collamer Lens. Cornea 2019; 38:217-220. [PMID: 30371566 PMCID: PMC6344073 DOI: 10.1097/ico.0000000000001785] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE An appropriate vault after implantation of a posterior chamber phakic intraocular lens with a central hole (ICL KS-AP) is important for successful long-term outcomes. In the present study, we used anterior segment optical coherence tomography (AS-OCT) to examine dynamic pupil and vault changes under photopic and scotopic conditions and during accommodation in eyes with ICL KS-AP. METHODS This retrospective study included patients at an outpatient ophthalmology clinic who underwent ICL KS-AP implantation >1 month before enrollment. All patients underwent dynamic AS-OCT imaging under photopic and scotopic conditions. Patients aged <40 years also underwent imaging in the accommodative and nonaccommodative states. Primary outcome measures were the pupil size and vault at the maximum and minimum pupil sizes. RESULTS This study included 91 eyes of 47 patients (35.5 ± 8.6 years, 21 men). Accommodation was examined in 51 eyes of 26 patients (28.9 ± 5.0 years, 10 men) younger than 40 years. The pupil size was significantly smaller under photopic conditions (3.64 ± 0.77 mm) than under scotopic conditions (4.91 ± 0.75 mm, P < 0.001) and during accommodation (3.88 ± 0.64 vs. 4.10 ± 0.61 mm, P < 0.001). Vault was also significantly lower under photopic conditions (476.1 ± 219.6 μm) than under scotopic conditions (521.1 ± 220.4 μm, P < 0.001) and during accommodation (454.8 ± 224.9 vs. 481.6 ± 219.1 μm, P < 0.001). CONCLUSIONS Vault can be significantly lowered by light-induced pupil constriction and accommodation in eyes with ICL KS-AP.
Collapse
|
33
|
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]
|
34
|
Prospective Randomized Multicenter Comparison of the Clinical Outcomes of V4c and V5 Implantable Collamer Lenses: A Contralateral Eye Study. J Ophthalmol 2018; 2018:7623829. [PMID: 30254757 PMCID: PMC6145048 DOI: 10.1155/2018/7623829] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Revised: 07/28/2018] [Accepted: 08/02/2018] [Indexed: 11/17/2022] Open
Abstract
Purpose To compare the visual and refractive outcomes and night vision performance questionnaire results between V4c and V5 implantable Collamer lenses in a prospective, randomized, multicenter study. Settings Four refractive surgery centers. Design Prospective randomized multicenter single-masked comparative study. Methods Twenty-three patients were enrolled in this study. A conventional V4c model (EVO Visian ICL) was implanted in one eye, and a V5 model (EVO+ Visian ICL), which has a larger optic diameter than the V4c model, was implanted in the contralateral eye. The uncorrected distance visual acuity (UDVA) and corrected distance visual acuity (CDVA) were evaluated before and 6 months after surgery. At 6 months after surgery, a questionnaire on night vision disturbances was administered. The efficacy, safety, and predictability of the two implanted ICL models were compared. Results There were no significant differences in the postoperative UDVA and CDVA between the two ICL models. The mean efficacy indexes for the V4c and V5 lenses were 1.16 ± 0.22 and 1.03 ± 0.23, respectively. The mean safety indexes of the V4c and V5 lenses were 1.21 ± 0.20 and 1.19 ± 0.20, respectively. The night vision performance questionnaire revealed that 7 patients (37%) noticed a difference in visual performance between the eyes, and all of them reported that they could see better at night with the V5-implanted eye compared with the V4c-implanted eye. Conclusion The V4c and V5 ICL models achieved similar visual and refractive outcomes, whereas the V5 model showed a possible advantage in reducing night vision disturbances.
Collapse
|
35
|
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.
Collapse
|
36
|
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: 3] [Impact Index Per Article: 0.5] [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.
Collapse
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
| |
Collapse
|
37
|
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: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/11/2011] [Indexed: 11/20/2022]
|
38
|
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.
Collapse
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
| |
Collapse
|
39
|
Garcia-De la Rosa G, Olivo-Payne A, Serna-Ojeda JC, Salazar-Ramos MS, Lichtinger A, Gomez-Bastar A, Ramirez-Miranda A, Navas A, Graue-Hernandez EO. Anterior segment optical coherence tomography angle and vault analysis after toric and non-toric implantable collamer lens V4c implantation in patients with high myopia. Br J Ophthalmol 2017; 102:544-548. [PMID: 28729370 DOI: 10.1136/bjophthalmol-2017-310518] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2017] [Revised: 06/12/2017] [Accepted: 06/25/2017] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To assess anterior segment changes, including iridocorneal angle and vault, after toric and non-toric implantable collamer lens (ICL) V4c (STAAR Surgical AG) implantation under different lighting conditions. METHODS Longitudinal, prospective, case series. Patients with high myopia (>6 dioptres) underwent toric and non-toric ICL V4c implantation. Optical coherence tomography measurements were taken under different lighting conditions preoperatively and at 1 week and 1, 6 and 12 months of follow-up. RESULTS Seventy-six eyes of 42 patients underwent ICL V4c implantation. Mean age was 27.4 years (±5.14 years, range 20 to 39 years). The average iridocorneal angle showed a statistically significant decrease (p<0.05) in all mesopic, scotopic and photopic conditions after 1 week of surgery compared with the preoperative measurements; in mesopic conditions, it decreased 14.1°, in photopic conditions 14.8° and scotopic conditions 13.2°. The angle measurement had a statistically significant change only in mesopic conditions (p=0.01) over the 1-year follow-up. The average vault under mesopic conditions was 0.661±0.21 mm at week 1. The vault measurement change was statistically significant over the 1-year follow-up in mesopic conditions (p=0.01). Refractive results showed a significant improvement in both uncorrected and corrected distance visual acuity (p<0.001). CONCLUSION There is a significant reduction in the iridocorneal angle after ICL V4c implantation. Furthermore, there is a change under mesopic conditions in both the iridocorneal angle and vault during long-term follow-up.
Collapse
Affiliation(s)
- Guillermo Garcia-De la Rosa
- Department of Cornea and Refractive Surgery, Instituto de Oftalmologia 'Conde de Valenciana', Mexico City, Mexico
| | - Andrew Olivo-Payne
- Department of Cornea and Refractive Surgery, Instituto de Oftalmologia 'Conde de Valenciana', Mexico City, Mexico
| | - Juan Carlos Serna-Ojeda
- Department of Cornea and Refractive Surgery, Instituto de Oftalmologia 'Conde de Valenciana', Mexico City, Mexico
| | - Maria Sandra Salazar-Ramos
- Department of Cornea and Refractive Surgery, Instituto de Oftalmologia 'Conde de Valenciana', Mexico City, Mexico
| | - Alejandro Lichtinger
- Department of Cornea and Refractive Surgery, Instituto de Oftalmologia 'Conde de Valenciana', Mexico City, Mexico
| | - Arturo Gomez-Bastar
- Department of Cornea and Refractive Surgery, Instituto de Oftalmologia 'Conde de Valenciana', Mexico City, Mexico
| | - Arturo Ramirez-Miranda
- Department of Cornea and Refractive Surgery, Instituto de Oftalmologia 'Conde de Valenciana', Mexico City, Mexico
| | - Alejandro Navas
- Department of Cornea and Refractive Surgery, Instituto de Oftalmologia 'Conde de Valenciana', Mexico City, Mexico
| | - Enrique O Graue-Hernandez
- Department of Cornea and Refractive Surgery, Instituto de Oftalmologia 'Conde de Valenciana', Mexico City, Mexico
| |
Collapse
|
40
|
Lu Y, Yang N, Li X, Kong J. Four-year Follow-up of the Changes in Anterior Segment After Phakic Collamer Lens Implantation. Am J Ophthalmol 2017; 178:140-149. [PMID: 28342721 DOI: 10.1016/j.ajo.2017.03.020] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2016] [Revised: 03/15/2017] [Accepted: 03/15/2017] [Indexed: 10/19/2022]
Abstract
PURPOSE To assess the changes and relationship in central vaulting, flare intensity, and crystalline lens thickness during a follow-up period of 4 years after implantable collamer lens (ICL) implantation in eyes with high myopia. DESIGN Retrospective observational study. METHODS Ninety-eight eyes of 50 patients were followed up with routine measurements of central vaulting, crystalline lens thickness, endothelial cell density, and aqueous flare postoperatively. Data were analyzed by repeated-measures analysis of variance. The relationship between the annual change in crystal lens thickness after surgery and age was evaluated by Pearson correlation coefficient and linear regression. RESULTS There was a continuous reduction in central vaulting and endothelial cell density as well as an increase in crystalline lens thickness in ICL eyes from 1 month onward to 5 years postoperatively (P < .001). Although the trend of variation during the individual visit period was accentuated, the variation turned out to be smaller between 12 and 36 months or 60 months postoperatively (P = .42, P = .65). Aqueous flare intensity increased significantly after surgery and returned to normal 1 year later. Additionally, a positive correlation between patient age and crystalline lens thickness (r = 0.617, P < .0001) was observed in eyes with ICL implantation. CONCLUSIONS The changes in central vaulting, endothelial cell density, and crystalline lens thickness are more prominent during the first year after ICL implantation, tending to be relatively stable afterwards. The anterior inflammation during the early postoperative period synchronizes with the sharp progression of crystalline lens changes within the first year.
Collapse
|
41
|
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: 57] [Impact Index Per Article: 7.1] [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.
Collapse
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
| |
Collapse
|
42
|
Real-time assessment of intraoperative vaulting in implantable collamer lens and correlation with postoperative vaulting. Eur J Ophthalmol 2016; 27:21-25. [PMID: 27405290 DOI: 10.5301/ejo.5000818] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/13/2016] [Indexed: 11/20/2022]
Abstract
PURPOSE To assess the intraoperative vaulting in patients undergoing implantable collamer lens (ICL) implantation with microscope-integrated intraoperative optical coherence tomography (iOCT) and correlate it with the postoperative vaulting. METHODS Forty eyes of 22 consecutive patients undergoing ICL implantation were prospectively evaluated. Vaulting was measured intraoperatively using microscope-integrated iOCT. The ICL-lenticular relationship was dynamically assessed throughout the surgery. Postoperative vaulting was measured using anterior segment optical coherence tomography on the first postoperative day and after 1 month and compared with the intraoperative vaulting. Uncorrected and best-corrected Snellen visual acuity, intraocular pressure (IOP), and anterior and posterior segments were assessed in all cases. RESULTS The mean central vaulting noted intraoperatively was 558.4 ± 122.8 µm. Postoperative mean vaulting was 576.0 ± 131.2 µm on day 1 and 551.1 ± 122.5 µm on day 30. There was a significant correlation between the intraoperative and the postoperative day 1 vaulting (paired samples correlation: 0.969, p<0.001) and day 30 vaulting (paired samples correlation: 0.945, p<0.001). An ICL-lenticular touch was not noted at any time during the surgery. The postoperative course was uneventful and no patient developed raised IOP or lenticular changes by the last follow-up. CONCLUSIONS Intraoperative vaulting correlates well with postoperative vaulting and can aid in on-table detection of extremes of vaulting and decision-making. It enhances the safety of the surgical procedure by providing a real-time display of the intraoperative manipulations.
Collapse
|
43
|
Packer M. Meta-analysis and review: effectiveness, safety, and central port design of the intraocular collamer lens. Clin Ophthalmol 2016; 10:1059-77. [PMID: 27354760 PMCID: PMC4907705 DOI: 10.2147/opth.s111620] [Citation(s) in RCA: 176] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
The purpose of this review is to summarize relevant data from publications appearing in the peer-reviewed scientific literature over the past decade since US Food and Drug Administration approval of the implantable collamer lens (ICL), and, in particular, to review studies relating to sizing methodology, safety, and effectiveness, as well as more recent studies reporting clinical outcomes of the V4c Visian ICL with KS Aquaport, VICMO. A literature search was conducted using two databases, PubMed.gov and Science.gov, to identify all articles published after 2005 related to the Visian ICL (STAAR Surgical, Inc.). Articles were examined for their relevance to sizing methodology, clinical safety, and effectiveness, and the references cited in each article were also searched for additional relevant publications. The literature review revealed that all currently reported methods of determining the best-fit size of the ICL achieve similarly satisfactory results in terms of vault, the safe distance between the crystalline lens and the ICL. Specifically, meta-analysis demonstrated that sulcus-to-sulcus and white-to-white measurement-based sizing methods do not result in clinically meaningful nor statistically significant differences in vault (two-sample two-sided t-test using pooled mean and standard deviations; t (2,594)=1.33; P=0.18). The reported rates of complications related to vault are very low, except in two case series where additional risk factors such as higher levels of myopia and older age impacted the incidence of cataract. On the basis of preclinical studies and initial clinical reports, with up to 5 years of follow-up, the new VICMO central port design holds promise for further reduction of complications. Given its safety record and the significant improvement in vision and quality of life that the ICL makes possible, the benefits of ICL implantation outweigh the risks.
Collapse
Affiliation(s)
- Mark Packer
- Mark Packer MD Consulting, Inc., Boulder, CO, USA
| |
Collapse
|
44
|
Effects of Implantable Collamer Lens V4c Placement on Iridocorneal Angle Measurements by Fourier-Domain Optical Coherence Tomography. Am J Ophthalmol 2016; 162:43-52.e1. [PMID: 26582312 DOI: 10.1016/j.ajo.2015.11.010] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2015] [Revised: 11/04/2015] [Accepted: 11/05/2015] [Indexed: 11/20/2022]
Abstract
PURPOSE To assess by Fourier-domain optical coherence tomography (FDOCT) changes produced in iridocorneal angle measurements in patients undergoing Visian Implantable Collamer Lens (ICL) V4c (STAAR Surgical AG) placement. DESIGN Prospective interventional case series. METHODS In 50 eyes of 25 myopic subjects consecutively scheduled for ICL implant, FDOCT (RTVue; Optovue Inc) iridocorneal angle measurements were made before and 1 and 3 months after surgery. Trabecular-iris angle (TIA) and angle opening distance 500 μm anterior to the scleral spur (AOD500) were compared among the quadrants nasal, temporal, and inferior, and correlations with ocular variables including lens vault were examined. RESULTS Preoperative TIA was 48.7 ± 8.7, 48.2 ± 8.7, and 48.7 ± 9.3 degrees for the nasal, temporal, and inferior quadrants, with no differences (P = 1.000). Following ICL implant, corresponding values fell to 31.2 ± 11.5, 30.0 ± 10.7, and 29.7 ± 8.1 degrees at 1 month postsurgery, indicating angle narrowing of 34%-42%, and to 30.6 ± 12.3, 30.1 ± 11.9, and 29.8 ± 12.3 degrees, respectively, at 3 months postsurgery. Angle measurements failed to vary between 1 month and 3 months postsurgery (P = .481). In 8 eyes, iridotrabecular contact attributable to surgery was observed. One month after surgery, vault measurements correlated with TIA (R = -.309; P = .048). Six variables were identified as predictors of TIA at 1 month postsurgery (R(2) = .907). CONCLUSIONS Although considerable angle narrowing was detected 1 month after ICL V4c implant, this narrowing remained stable at 3 months postsurgery. Factors predictive of TIA could serve to identify suitable candidates for ICL placement.
Collapse
|
45
|
Zeng QY, Xie XL, Chen Q. Prevention and management of collagen copolymer phakic intraocular lens exchange: causes and surgical techniques. J Cataract Refract Surg 2015; 41:576-84. [PMID: 25804582 DOI: 10.1016/j.jcrs.2014.06.036] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2014] [Revised: 06/14/2014] [Accepted: 06/20/2014] [Indexed: 11/26/2022]
Abstract
PURPOSE To analyze causes leading to explantation and exchange of Implantable Collamer Lens phakic intraocular lenses (pIOLs) and examine the surgical techniques of pIOL exchange. SETTING Wuhan Aier Eye Hospital, Wuhan, China. DESIGN Retrospective analysis of prospectively collected data. METHODS Different techniques were used to explant the pIOLs based on the amount of vaulting. Preoperative and postoperative data were collected to evaluate possible causes leading to pIOL exchange and the safety of pIOL exchange. RESULTS Of 616 myopic eyes with previous pIOL implantation, 16 eyes of 15 patients having pIOL exchange were reviewed. Eight surgeries (50%) were performed because of low vaulting (≤100 μm) and another 8 (50%) because of too high vaulting (≥1000 μm). The causes leading to low vaulting included increased crystalline lens thickness (≥4.0 mm), low anterior chamber depth (ACD) (<3.1 mm), and a too-small pIOL (<12.0 mm). The high vaulting was primarily the result of oversized white-to-white (WTW) measurements with Scheimpflug pachymetry (Pentacam) or the use of a digital caliper by an unskilled examiner and of ciliary body cysts. Six months after pIOL exchange, the vaulting ranged from 162 to 715 μm. No anterior subcapsular cataracts or other complications occurred during the observation period. CONCLUSIONS The main causes of abnormal vaulting and subsequent pIOL exchange included a thick crystalline lens, low ACD, too-small pIOL, WTW measurement error, and ciliary body cysts. Phakic IOL explantations were individually designed based on the vaulting to achieve proper safety and efficacy. FINANCIAL DISCLOSURE No author has a financial or proprietary interest in any material or method mentioned.
Collapse
Affiliation(s)
- Qing-Yan Zeng
- From the Aier School of Ophthalmology (Zeng), Central South University (Zeng), Changsha, and Wuhan Aier Eye Hospital (Zeng, Xie, Chen), Wuhan, China.
| | - Xiu-Li Xie
- From the Aier School of Ophthalmology (Zeng), Central South University (Zeng), Changsha, and Wuhan Aier Eye Hospital (Zeng, Xie, Chen), Wuhan, China
| | - Qian Chen
- From the Aier School of Ophthalmology (Zeng), Central South University (Zeng), Changsha, and Wuhan Aier Eye Hospital (Zeng, Xie, Chen), Wuhan, China
| |
Collapse
|
46
|
Observing implantable collamer lens dislocation by panoramic ultrasound biomicroscopy. Eye (Lond) 2015; 29:499-504. [PMID: 25613840 DOI: 10.1038/eye.2014.336] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2014] [Accepted: 12/09/2014] [Indexed: 11/08/2022] Open
Abstract
PURPOSE Observe the image characteristics and dislocation of implantable collamer lenses (ICL) following their use to correct high myopia. METHODS A total of 127 patients (242 eyes); 64 females (50.3%) and 63 males (49.7%) were included in this retrospective study with ICL V4 implantation and mean spherical equivalent -9.08±2.04 diopters (D). Panoramic ultrasound biomicroscopy (UBM) was utilized to observe anterior segment morphology and ICL location at various follow-up periods (1 week preoperative, followed by 1, 3, 6, and yearly postoperative). RESULTS Twenty-eight ICL eyes (11.2%) were noted to have abnormal postoperative positioning. The central vault of 12 eyes was too high with ICL decentration, mean central vault 1.14±0.39 mm; 10 eyes were too low but without ICL decentration, mean central vault 0.13±0.11 mm. The remaining subjects were only ICL decentration without abnormal central vault, mean central vault was 0.54±0.28 mm. CONCLUSIONS This study shows the abnormal characteristics regarding ICL locations. The ICL dislocation closely correlates with the central vault. The ICL dislocation is the primary cause of several postoperative complications. Panoramic UBM is one of the most effective imaging means to observe the ICL positioning and its stability after implantable surgery.
Collapse
|
47
|
Kamiya K, Shimizu K, Ando W, Igarashi A, Iijima K, Koh A. Comparison of vault after implantation of posterior chamber phakic intraocular lens with and without a central hole. J Cataract Refract Surg 2015; 41:67-72. [DOI: 10.1016/j.jcrs.2014.11.011] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2014] [Revised: 04/28/2014] [Accepted: 05/28/2014] [Indexed: 02/08/2023]
|
48
|
Evaluation of a Toric Implantable Collamer Lens After Corneal Collagen Crosslinking in Treatment of Early-Stage Keratoconus. Cornea 2014; 33:475-80. [DOI: 10.1097/ico.0000000000000094] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
49
|
Kim WK, Cho EY, Kim HS, Kim DS, Kim JK. The Benefits of One Day, One Eye Surgery in Bilateral ICL Implantation. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2013. [DOI: 10.3341/jkos.2013.54.7.1019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
|
50
|
Kim WK, Cho EY, Kim HS, Kim JK. The Analysis of Vault Change after Posterior Chamber Phakic Intraocular Lens Size Exchange. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2013. [DOI: 10.3341/jkos.2013.54.11.1669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
|