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Chen X, Miao H, Cheng M, Lin IC, Li B, Jiang Y, Lei Y, Wang X, Zhou X. Effect of long-term rotation on astigmatism following EVO-toric intraocular collamer lens implantation. Front Med (Lausanne) 2023; 10:1194006. [PMID: 37521343 PMCID: PMC10375410 DOI: 10.3389/fmed.2023.1194006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Accepted: 07/03/2023] [Indexed: 08/01/2023] Open
Abstract
Objective To evaluate the effect of long-term rotation on astigmatism following Evolution-toric intraocular collamer lens (EVO-TICL) implantation. Methods Forty eyes of 22 patients were enrolled in this prospective study. Visual acuity, refractive parameters, and axial position of the EVO-TICL by OPD-Scan III aberrometer were measured preoperatively, 1 month and 3 years postoperatively. Results Last visit, the safety index was 1.32 ± 0.15 and the efficacy index was 1.01 ± 0.23. The best-fitting curve of the attempted versus achieved correction was y = 0.9751x + 0.001. The mean spherical equivalent (SE) decreased from -8.94 ± 2.72D preoperatively to 0.06 ± 0.24D and - 0.36 ± 0.46D 1 month and 3 years postoperatively, respectively. The mean target and surgical induced astigmatism were 1.55 ± 0.61D and 1.67 ± 0.94D 3 years postoperatively. The average expected axis of the TICL was-1.15 ± 9.07 (-21-19°). One month and 3 years postoperatively, the average actual axis was -0.70 ± 9.86 (-20-20°) and - 0.35 ± 11.72 (-25-30°), respectively. The absolute rotation of the TICL was 3.70 ± 4.42 (0-22°) and 6.00 ± 6.70 (0-32°) 1 month and 3 years postoperatively, respectively (p < 0.001). The expected astigmatism was -0.10 ± 0.12D, and the mean actual astigmatism was -0.21 ± 0.30D and - 0.44 ± 0.45D 1 month and 3 years postoperatively, respectively. The mean absolute rotation without postoperative astigmatism was 3.73 ± 2.69 (0-9°) and 1.67 ± 1.66 (0-5°) for low (<2D) and high (≥2D) astigmatic TICL, respectively (p < 0.05). Conclusion EVO-TICL implantation is safe and effective, with good predictability and stability. OPD-Scan is a fast device to detect the axial position of the TICL without mydriasis, and the axial position is relatively stable in the long term postoperatively. A slight rotation of low-astigmatic TICL may not cause postoperative astigmatism, whereas rotation of the high-astigmatic TICL may cause it.
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Affiliation(s)
- Xun Chen
- Fudan University Eye Ear Nose and Throat Hospital, Shanghai, China
- National Health Commission Key Lab of Myopia (Fudan University), Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care (20DZ2255000), Shanghai, China
| | - Huamao Miao
- Fudan University Eye Ear Nose and Throat Hospital, Shanghai, China
- National Health Commission Key Lab of Myopia (Fudan University), Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care (20DZ2255000), Shanghai, China
| | - Mingrui Cheng
- Fudan University Eye Ear Nose and Throat Hospital, Shanghai, China
- National Health Commission Key Lab of Myopia (Fudan University), Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care (20DZ2255000), Shanghai, China
| | - I-Chun Lin
- Fudan University Eye Ear Nose and Throat Hospital, Shanghai, China
- National Health Commission Key Lab of Myopia (Fudan University), Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care (20DZ2255000), Shanghai, China
| | - Boliang Li
- Fudan University Eye Ear Nose and Throat Hospital, Shanghai, China
- National Health Commission Key Lab of Myopia (Fudan University), Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care (20DZ2255000), Shanghai, China
| | - Yinjie Jiang
- Fudan University Eye Ear Nose and Throat Hospital, Shanghai, China
- National Health Commission Key Lab of Myopia (Fudan University), Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care (20DZ2255000), Shanghai, China
| | - Yadi Lei
- Fudan University Eye Ear Nose and Throat Hospital, Shanghai, China
- National Health Commission Key Lab of Myopia (Fudan University), Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care (20DZ2255000), Shanghai, China
| | - Xiaoying Wang
- Fudan University Eye Ear Nose and Throat Hospital, Shanghai, China
- National Health Commission Key Lab of Myopia (Fudan University), Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care (20DZ2255000), Shanghai, China
| | - Xingtao Zhou
- Fudan University Eye Ear Nose and Throat Hospital, Shanghai, China
- National Health Commission Key Lab of Myopia (Fudan University), Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care (20DZ2255000), Shanghai, China
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Huang W, Ji Y, Zheng S, Huang F, Zhang T, Cheng H, Li Z, Gao N, Du M, Zuo H, Wan W, Hu K. The Effectiveness and Rotational Stability of Vertical Implantation of the Implantable Collamer Lens for the Treatment of Myopia. J Refract Surg 2022; 38:641-647. [DOI: 10.3928/1081597x-20220831-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Branger GA, Baenninger P. Late-Onset Toric Implantable Collamer Lens Rotation: A Case Report. Klin Monbl Augenheilkd 2022; 239:416-417. [PMID: 35472781 DOI: 10.1055/a-1785-4276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Bohac M, Biscevic A, Gabric I, Gabric K, Shijakova V, Patel S. A critical evaluation of longitudinal changes of astigmatism following implantation of toric implantable collamer lens (TICL): a comparison between treated and untreated cases over 4 years. Graefes Arch Clin Exp Ophthalmol 2021; 260:1377-1386. [PMID: 34655333 DOI: 10.1007/s00417-021-05449-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Revised: 09/07/2021] [Accepted: 10/06/2021] [Indexed: 11/24/2022] Open
Abstract
PURPOSE To evaluate residual astigmatism following correction with toric implantable collamer lens (TICL) (group I) over a period of 4 years and compare with the change of astigmatism in spectacle wearers (group II). METHODS Groups I (86 cases implanted with TICL [EVO + Visian ICL, Staar Surgical, Nidau, Switzeland], preop refractive error [sphere and cylinder] - 22.25 DS to - 1.00 DS and - 5.50 DC to - 1.00 DC) and II (80 cases initial refractive error [sphere and cylinder] - 18.00 DS to 0.00 DS and - 7.00 DC to - 1.00 DC) were reviewed annually. Refractive and tomography data were subjected to vector analysis to determine surgically induced astigmatism (SIA), angle of error [Δθ° = angle of target-induced astigmatism (TIA) - angle of SIA], and ΔC [TIA-SIA powers] and total corneal astigmatism (TCA) in group I and induced change in astigmatism (ICA) in group II. RESULTS In group I, on all occasions, SIA correlated with TIA (p < 0.05); differences between SIA and TIA means were insignificant and changes in TCA were not correlated with ΔC. Mean (± sd, 95% CI) residual astigmatic powers (RA) in attending group I cases (1-4 years) were - 0.40 DC (0.58, - 0.52 to - 0.28), - 0.40 DC (0.59, - 0.52 to - 0.27), - 0.41 DC (0.58, - 0.54 to - 0.28), and - 0.61 DC (0.74, - 0.82 to - 0.40). In group II, the corresponding ICA powers were - 0.47 DC (0.53, - 0.61 to - 0.32), - 0.49 DC (0.48, - 0.69 to - 0.29), - 0.60 DC (0.40, - 0.76 to - 0.44), and - 0.86 DC (0.71, - 1.19 to - 0.52). Differences between RA and ICA were not significant. Of the group I cases presenting at 1-4 years postop, 23, 18, 16, and 28 had RA powers ≤ - 0.75 DC. Of these 12, 10, 6, and 16 were associated with Δθ° > 5° (ΔC - 0.50 to 0 DC) and 5, 1, 4, and 4 were related to ΔC (Δθ° < 5°). CONCLUSION The development of astigmatism after TICL implantation is on par with the natural change in astigmatism in untreated cases. In about 50% of TICL cases presenting with astigmatism ≤ - 0.75 DC, the residual astigmatism could be neutralized by realigning the TICL.
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Affiliation(s)
- Maja Bohac
- Speciality Eye Hospital Svjetlost, School of Medicine, University of Rijeka, Heinzelova 39, 10000, Zagreb, Croatia.
| | - Alma Biscevic
- Speciality Eye Hospital Svjetlost, School of Medicine, University of Rijeka, Heinzelova 39, 10000, Zagreb, Croatia
| | - Ivan Gabric
- Speciality Eye Hospital Svjetlost, School of Medicine, University of Rijeka, Heinzelova 39, 10000, Zagreb, Croatia
| | - Kresimir Gabric
- Speciality Eye Hospital Svjetlost, School of Medicine, University of Rijeka, Heinzelova 39, 10000, Zagreb, Croatia
| | - Violeta Shijakova
- Speciality Eye Hospital Svjetlost, School of Medicine, University of Rijeka, Heinzelova 39, 10000, Zagreb, Croatia
| | - Sudi Patel
- Speciality Eye Hospital Svjetlost, School of Medicine, University of Rijeka, Heinzelova 39, 10000, Zagreb, Croatia
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Buckhurst PJ, Wolffsohn JS, Davies LN, Naroo SA. Surgical correction of astigmatism during cataract surgery. Clin Exp Optom 2021; 93:409-18. [PMID: 20735787 DOI: 10.1111/j.1444-0938.2010.00515.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Affiliation(s)
- Phillip J Buckhurst
- Aston University, Life and Health Sciences, Ophthalmic Research Group, Birmingham, United Kingdom
E‐mail:
| | - James S Wolffsohn
- Aston University, Life and Health Sciences, Ophthalmic Research Group, Birmingham, United Kingdom
E‐mail:
| | - Leon N Davies
- Aston University, Life and Health Sciences, Ophthalmic Research Group, Birmingham, United Kingdom
E‐mail:
| | - Shehzad A Naroo
- Aston University, Life and Health Sciences, Ophthalmic Research Group, Birmingham, United Kingdom
E‐mail:
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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.
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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.
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Zhang H, Fu M, Wang J. Repeated rotation of a toric implantable collamer lens: A case report. Medicine (Baltimore) 2021; 100:e24986. [PMID: 33725870 PMCID: PMC7969312 DOI: 10.1097/md.0000000000024986] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Accepted: 02/11/2021] [Indexed: 01/05/2023] Open
Abstract
INTRODUCTION Implantable collamer lens have been used widely worldwide, and have been accepted by more and more doctors and patients due to good safety, stability, and effectiveness. However, there is still a problem of crystal rotation. The large angle rotation (over 10°) would weaken the original astigmatism correction effect and even induce irregular astigmatism, seriously affecting the visual quality of patients. Herein, we reported a case who had 2 times of crystal rotations after toric implantable collamer lens (TICL) implantation. PATIENT CONCERNS The patient was a 38-year-old man who underwent TICL implantation for the correction of high myopic astigmatism in eyes. He presented a sudden decrease in the visual acuity (VA) of the left eye 4 months after the TICL implantation. The uncorrected visual acuity (UCVA) was 8/20 (refraction, +2.25 -5.25 × 68). DIAGNOSIS Rotation of TICL was diagnosed. The toric marks with a rotation of 75° counter-clockwise from the original position were observed. INTERVENTIONS The TICL was re-set to the original position, leading to the UCVA of 12/20 in the left eye (refraction, -0.00 -0.75 × 131), with the vaulting of 589 μm. Ten months after the TICL relocation, the patient again presented a sudden decrease in the VA of the left eye, with the UCVA of 2/20 (refraction, +2.25 -5.00 × 66). Again, the toric marks with a rotation of 75° counter-clockwise from the original position was observed, just at the same position as the last rotation. This time, the TICL was removed. The axis and power were recalculated, and a new TICL was implanted, with the rotation of 73° counter-clockwise from the horizontal line of the temporal side. OUTCOMES The patient obtained a final UCVA of 12/20 in the left eye (refraction, +0.50 -0.50 × 26), which remained stable in the 6-month follow-up period, with the vaulting of 602 μm. LESSONS Rotation is a common complication after TICL surgery. Relocation or replacement of TICL are safe and efficient ways to recover VA due to TICL rotation.
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Clinical Effect and Rotational Stability of TICL in the Treatment of Myopic Astigmatism. J Ophthalmol 2021; 2020:3095302. [PMID: 33489326 PMCID: PMC7803223 DOI: 10.1155/2020/3095302] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2020] [Revised: 10/28/2020] [Accepted: 12/04/2020] [Indexed: 11/18/2022] Open
Abstract
Purpose To investigate the clinical outcomes and possible risk factors associated with rotational stability after the implantation of a V4c toric implantable Collamer lens (TICL) for the correction of moderate to high myopic astigmatism. Methods A total of 112 eyes of 66 patients with moderate to high myopic astigmatism underwent TICL implantation. All patients were followed up for more than 1 year. The uncorrected and best-corrected visual acuity (UCVA and BCVA), astigmatism and spherical equivalent, intraocular pressure, vault, endothelial cell morphometry, and rotation of the TICL axis were assessed at l day, 1 week, 1 month, 3 months, 6 months, and 12 months postoperatively. Postoperative rotation was defined as the angle between the intended axis and the achieved axis. Regression analysis was used to investigate the possible risk factors for TICL rotation postoperatively. Results The mean efficacy index and safety index 12 months postoperatively were 1.03 ± 0.09 and 1.05 ± 0.10, respectively. All patients had the same or better visual acuity than preoperatively. The mean astigmatism value decreased from -1.86 ± 0.79 D preoperatively to -0.37 ± 0.35 D. The mean absolute axis deviation of the TICL at the last follow-up was 2.75 ± 2.04° (range, 0°∼11°). The mean manifest refraction spherical equivalent (MRSE) changed from -9.04 ± 2.67 D preoperatively to -0.67 ± 0.51 D postoperatively. The logistic regression demonstrated that the absolute degree of TICL rotation had a significant association with the fixation angle of the TICL and the size of the lens (P=0.003, P=0.026, resp.). Conclusion The results of our study support that TICL implantation is safe, effective, and predictable in the treatment of moderate to high myopic astigmatism, with relatively good postoperative rotational stability.
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Nie D, Yan P, Yan Z, Zhang J, He W, Li M, Sun L, Huang M, Liu X, Lin H. Polar value analysis of astigmatic change and rotational stability after implantation of V4c toric implantable collamer lens. ANNALS OF TRANSLATIONAL MEDICINE 2021; 9:139. [PMID: 33569441 PMCID: PMC7867885 DOI: 10.21037/atm-20-7835] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Background To evaluate the clinical results and rotational stability of V4c toric implantable collamer lens (TICL, STAAR Surgical Company, Monrovia, CA, USA) in patients with moderate to high myopic astigmatism. Retrospective, interventional case series was performed at Shenzhen Eye Hospital, Shenzhen, Guangdong, China. Methods This study enrolled 43 patients (72 eyes) who received TICL implantation to correct myopia and myopic astigmatism. The patients underwent visual and refractive examinations before and 1 month after surgery. Astigmatic changes were estimated using polar value analysis. The difference between the achieved axis and the intended axis at the last follow-up was taken as the rotation of the V4c TICL. Results At 1 month postoperatively, the mean safety and efficacy indices were 1.17 and 1.13, respectively. A significant reduction of 8.92±2.58 D was observed in the spherical equivalent refraction (SER), which decreased from −9.29±2.41 D preoperatively to −0.37±0.55 D postoperatively. The astigmatic error of treatment in cylinder format was calculated to 0.50±0.41 @ 15.08° relative to the preoperative stronger meridian at 1 month, postoperatively. At 1 month postoperatively, the mean absolute rotation was 8.30±10.00 degrees (median =5.46 degrees; range, 0.00–58.88 degrees). Conclusions TICL could achieve good astigmatic outcomes for correcting moderate to high myopic astigmatism. After TICL implantation, corneal astigmatism remained unchanged. To optimize postoperative astigmatic outcomes in TICL, polar value analysis can be used to build a nomogram.
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Affiliation(s)
- Danyao Nie
- Shenzhen Eye Hospital, Shenzhen Key Laboratory of Ophthalmology, Shenzhen University School of Medicine, Shenzhen, China
| | - Pisong Yan
- Cloud Intelligent Care Technology (Guangzhou) Co. Ltd., Guangzhou, China
| | - Zonghui Yan
- Shenzhen Eye Hospital, Shenzhen Key Laboratory of Ophthalmology, Shenzhen University School of Medicine, Shenzhen, China
| | - Jing Zhang
- Shenzhen Eye Hospital, Shenzhen Key Laboratory of Ophthalmology, Shenzhen University School of Medicine, Shenzhen, China
| | - Wenling He
- Shenzhen Eye Hospital, Shenzhen Key Laboratory of Ophthalmology, Shenzhen University School of Medicine, Shenzhen, China
| | - Ming Li
- Shenzhen Eye Hospital, Shenzhen Key Laboratory of Ophthalmology, Shenzhen University School of Medicine, Shenzhen, China
| | - Liangnan Sun
- Shenzhen Eye Hospital, Shenzhen Key Laboratory of Ophthalmology, Shenzhen University School of Medicine, Shenzhen, China
| | - Mingquan Huang
- Shenzhen Eye Hospital, Shenzhen Key Laboratory of Ophthalmology, Shenzhen University School of Medicine, Shenzhen, China
| | - Xinhua Liu
- Shenzhen Eye Hospital, Shenzhen Key Laboratory of Ophthalmology, Shenzhen University School of Medicine, Shenzhen, China
| | - Haotian Lin
- State Key Laboratory of Ophthalmology, Clinical Research Center for Ocular Disease, Zhongshan Ophthalmic Centre, Sun Yat-sen University, Guangzhou, China
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Ghoreishi M, Kashfi A, Peyman M, Mohammadinia M. Comparison of Toric Implantable Collamer Lens and Toric Artiflex Phakic IOLs in Terms of Visual Outcome: a Paired Contralateral Eye Study. Am J Ophthalmol 2020; 219:186-194. [PMID: 32621900 DOI: 10.1016/j.ajo.2020.06.021] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2020] [Revised: 06/14/2020] [Accepted: 06/15/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE This study sought to compare the postoperative visual outcomes of toric implantable collamer lens (T-ICL) with toric Artiflex (T-Artiflex) lenses. DESIGN Alternating treatment, contralateral eye matched clinical study. METHODS This study compared 82 eyes of 41 patients with T-ICL lenses in one eye and toric Artiflex implantation in the contralateral eye to correct myopic astigmatism. Safety, efficacy, predictability, astigmatic vector changes, contrast sensitivity, endothelial cell count, and possible adverse events were assessed at least 12 months postoperatively. RESULTS After a mean follow-up of 12 months, the safety index was mean 1.40 ± 0.70 in the T-ICL group and 1.20 ± 0.21 in the T-Artiflex group. Furthermore, their mean efficacy indexes were 1.24 ± 0.42 and 1.08 ± 0.23, respectively (P = .029). A total of 39 eyes (95%) in the T-ICL group and 41 eyes (100%) in the T-Artiflex group were within ±1.00 diopter (D) of emmetropia and 33 eyes (80%) and 34 eyes (83%) were within ±0.5 D of emmetropia, respectively. Vector analysis revealed mean index of success as large as 0.25 ± 0.22 in the T-ICL group and 0.24 ± 0.15 in the T-Artiflex group. Postoperative contrast sensitivities were equal in both groups under mesopic conditions for any given spatial frequency. There was an endothelial loss of 2.18% and 1.95% in the T-ICL and T-Artiflex groups, respectively. There were no significant complications in any of the groups. CONCLUSIONS Both lenses showed promising results in terms of safety, efficacy, and predictability for correction of myopic astigmatism. As shown in this paired-eye study, most outcomes were almost identical, and neither of these lenses were clinically superior to the other.
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Chen Q, Zeng Q, Wang Z, Pan C, Lei X, Tan W. Spontaneous rotation of a toric implantable collamer lens related to abnormal ciliary body morphology: a case report. BMC Ophthalmol 2020; 20:350. [PMID: 32859170 PMCID: PMC7455994 DOI: 10.1186/s12886-020-01597-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Accepted: 08/05/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This is a case of spontaneous toric implantable collamer lens (TICL) rotation that occurred twice in the left eye of a patient. CASE PRESENTATION A 24-year-old gentleman received TICL implantation for treatment of myopic astigmatism encountered with spontaneous rotation of approximately 90° from its original position. TICL reposition procedure was performed with visual outcome of 20/16. Surprisingly, a re-rotation of TICL occurred. The patient underwent a replacement of non-toric ICL with a larger size after careful re-evaluation with final visual outcome of 20/20. A short and small ciliary process with shallow ciliary sulcus and posteriorly positioned ciliary body was found by Ultrasound Biomicroscopy (UBM). CONCLUSIONS The unique morphology of the ciliary body may have a potential association with the vault and instability of implanted ICL. Careful examination of the ciliary body morphology is essential in preoperative evaluation.
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Affiliation(s)
- Qian Chen
- Aier Eye Hospital of Wuhan University, Wuhan, Hubei Province, China.,Hankou Aier Eye Hospital, Machang Road, Jianghan District, Wuhan, Hubei Province, China
| | - Qingyan Zeng
- Hankou Aier Eye Hospital, Machang Road, Jianghan District, Wuhan, Hubei Province, China
| | - Zheng Wang
- Aier Institute of Refractive Surgery, Guangzhou, Guangdong Province, China
| | - Chao Pan
- Hankou Aier Eye Hospital, Machang Road, Jianghan District, Wuhan, Hubei Province, China
| | - Xiaohua Lei
- Hankou Aier Eye Hospital, Machang Road, Jianghan District, Wuhan, Hubei Province, China
| | - Weina Tan
- Aier Eye Hospital of Wuhan University, Wuhan, Hubei Province, China. .,Hankou Aier Eye Hospital, Machang Road, Jianghan District, Wuhan, Hubei Province, China.
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Fernández-Vega-Cueto L, Lisa C, Esteve-Taboada JJ, Montés-Micó R, Alfonso JF. Implantable collamer lens with central hole: 3-year follow-up. Clin Ophthalmol 2018; 12:2015-2029. [PMID: 30349185 PMCID: PMC6188208 DOI: 10.2147/opth.s171576] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Purpose To evaluate the long-term predictability, stability, safety, and efficacy of the V4c Visian implantable collamer lens (ICL) with central hole to correct myopia. Patients and methods One hundred and eighty-four eyes of 92 patients were evaluated during 3 years after implantation of the V4c ICL. The refraction, uncorrected distance visual acuity, best-corrected distance visual acuity, IOP, endothelial cell count, vault, and adverse effects were evaluated every 12 months during the whole follow-up. Results The mean spherical equivalent dropped from -8.30±2.98 D preoperatively to −0.37±0.47 D at 36 months post-surgery, with 91.8% eyes being within ±1.00 D of emmetropia. With respect to the astigmatic components J0 and J45, 98.4% and 99.5% of eyes, respectively, were within ±0.50 D of the desired refraction. At 36 months, 78.8% of eyes had no change in the Snellen lines of best-corrected distance visual acuity, while 8.7% gained one line and 6.5% gained two or more lines; mean safety and efficacy indexes were 1.03 and 0.90, respectively. Mean endothelial cell count was 2,742±340 cells/mm2 before and 2,663±366 cells/mm2 at 36 months post-surgery. Mean IOP reduced from 13.7±1.9 mmHg preoperatively to 12.8±1.7 mmHg at 36 months post-surgery. Mean vault varied from 409±196 µm at 12 months to 349±165 µm at 36 months. Conclusion The visual and refractive outcomes were very good and highly stable throughout the follow-up period, indicating that this ICL model may be predictable, stable, safe, and effective to correct myopia in the long term.
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Affiliation(s)
| | - Carlos Lisa
- Department of Surgery, Fernández-Vega Ophthalmological Institute, Oviedo, Spain,
| | - José J Esteve-Taboada
- Department of Optics and Optometry and Visual Sciences, University of Valencia, Valencia, Spain
| | - Robert Montés-Micó
- Department of Optics and Optometry and Visual Sciences, University of Valencia, Valencia, Spain
| | - José F Alfonso
- Department of Surgery, Fernández-Vega Ophthalmological Institute, Oviedo, Spain, .,School of Medicine, University of Oviedo, Oviedo, Spain,
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Lee H, Kang DSY, Choi JY, Ha BJ, Kim EK, Seo KY, Kim TI. Rotational Stability and Visual Outcomes of V4c Toric Phakic Intraocular Lenses. J Refract Surg 2018; 34:489-496. [PMID: 30001453 DOI: 10.3928/1081597x-20180521-01] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Accepted: 05/07/2018] [Indexed: 11/20/2022]
Abstract
PURPOSE To investigate the clinical outcomes and rotational stability following implantation of V4c toric implantable collamer lenses (ICLs) (STAAR Surgical Company, Monrovia, CA) and to analyze the factors that influence rotational stability. METHODS In this prospective observational case series, the authors analyzed the visual outcomes and rotational stability in 52 eyes of 52 patients immediately and 3 and 6 months after implantation. Postoperative rotation was defined as the angle between the adjusted axis and alignment axis. Central vaulting of the ICL was measured in a non-accommodative state using Visante optical coherence tomography (Carl Zeiss Meditec, Jena, Germany). Vector analysis of refractive astigmatism was performed. Regression analysis was used to investigate the association between the degree of rotation 6 months postoperatively and the associated variables. RESULTS The mean efficacy index and safety index 6 months postoperatively were 1.35 ± 0.19 and 1.38 ± 0.22, respectively. In vector analysis, the magnitude of error was -0.20 diopters (D), indicating slight undercorrection. Absolute degree of rotation was 2.81° ± 1.87° immediately after the operation and 3.75° ± 2.92° and 3.87° ± 3.07° at 3 and 6 months postoperatively, respectively (P = .009). Bonferroni-adjusted post-hoc comparison showed that the absolute degree of rotation immediately after the operation was significantly smaller than that after 3 (P = .043) and 6 (P = .023) months, with barely any change after 3 months. No explanatory variable relevant to the absolute degree of rotation was discovered. CONCLUSIONS The V4c toric ICL is predictable, safe, and effective in correcting low and high levels of astigmatism, showing relatively good postoperative rotational stability. [J Refract Surg. 2018;34(7):489-496.].
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Abdelmassih Y, el-Khoury S, Chelala E, Slim E, Cherfan CG, Jarade E. Toric ICL Implantation After Sequential Intracorneal Ring Segments Implantation and Corneal Cross-linking in Keratoconus: 2-Year Follow-up. J Refract Surg 2017; 33:610-616. [DOI: 10.3928/1081597x-20170621-02] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2017] [Accepted: 05/24/2017] [Indexed: 11/20/2022]
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A comparison of visual outcome and rotational stability of two types of toric implantable collamer lenses (TICL) : V4 versus V4c. PLoS One 2017; 12:e0183335. [PMID: 28846701 PMCID: PMC5573270 DOI: 10.1371/journal.pone.0183335] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2017] [Accepted: 08/02/2017] [Indexed: 11/19/2022] Open
Abstract
PURPOSE To compare the efficacy and rotational stability after implantation of two types of toric implantable collamer lenses (Toric ICL™(TICL);V4 and V4c, STAAR Surgical Co.). STUDY DESIGN Retrospective case series. METHODS This retrospective study evaluated total 48 eyes of 48 patients who underwent the implantation with V4 and V4c TICL with a central hole; A twenty-four eyes of 24 patients with V4 TICL and 24 eyes of 24 patients with V4c TICL with a central hole. Visual acuity, manifest refraction, and intraocular pressure were evaluated before and after surgery. Rotational stability (disparity between the intended axis and achieved axis) was assessed in both groups using digital anterior segment photographs, and vector analysis was also performed. RESULTS Uncorrected visual acuity improved in both groups without significant difference (P = .111). There were no statistical differences between two groups in postoperative SE and cylindrical errors (P = .067 and .384, respectively). The mean value of rotation was 4.17±3.31° and 3.39±2.36° in the V4 and V4c TICL groups, respectively without significant difference (P = .364). Vector analysis of astigmatic correction showed no significant diffrence between two groups. CONCLUSION V4 and V4c TICL have similar efficacy with regard to visual acuity and refractive outcomes and rotational stability.
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Ganesh S, Brar S, Pawar A. Matched population comparison of visual outcomes and patient satisfaction between 3 modalities for the correction of low to moderate myopic astigmatism. Clin Ophthalmol 2017; 11:1253-1263. [PMID: 28740361 PMCID: PMC5505606 DOI: 10.2147/opth.s127101] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Purpose To compare toric implantable collamer lens (T-ICL), femto-LASIK, and ReLEx SMILE for the treatment of low to moderate myopic astigmatism in terms of long-term visual and refractive outcomes and predictability of astigmatic correction. Materials and methods The study included 30 eyes from 30 patients between the age groups of 21 and 40 years, undergoing bilateral surgery with any of the three procedures – T-ICL, femto-LASIK, or ReLEx SMILE – for correction of myopic astigmatism within the range of −3 to −8 D spherical equivalent (SE), with a minimum astigmatism of −0.75 D. Patients were followed up at day 1, 1 month, 6 months, and 1 year. Results At 1 year, the mean cylinder reduced to −0.21±0.28, −0.17±0.36, and −0.22±0.28 D in the T-ICL, femto-LASIK, and ReLEx SMILE group, respectively. The predictability of astigmatism correction was comparable, with no statistically significant difference between the 3 groups (P>0.05). A total of 97% of eyes in ReLEx SMILE achieved a uncorrected distance visual acuity of 20/20 or better, compared to T-ICL (93%) and FS-LASIK (90%). However, gain in lines of corrected distant visual acuity (CDVA) was maximum in T-ICL group (60%). Four eyes in the femto-LASIK group had loss of CDVA by one line. Three eyes required exchange due to high vault and rotation of the T-ICL, which did not affect the final outcome. Conclusion All 3 modalities were effective for myopic astigmatism at the end of 1 year. Quality of vision and patient satisfaction with T-ICL and ReLEx SMILE were similar and better than FS-LASIK. However, slight chances of postoperative rotation and exchange exist with T-ICL, which warrant thorough preoperative planning.
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Affiliation(s)
- Sri Ganesh
- Phacorefractive Department, Nethradhama Superspeciality Eye Hospital, Bengaluru, Karnataka, India
| | - Sheetal Brar
- Phacorefractive Department, Nethradhama Superspeciality Eye Hospital, Bengaluru, Karnataka, India
| | - Archana Pawar
- Phacorefractive Department, Nethradhama Superspeciality Eye Hospital, Bengaluru, Karnataka, India
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Abstract
Phakic intraocular lenses revolutionize refractive surgery and continue to serve as an excellent option for vision correction in patients who are not ideal candidates for laser vision correction. This article will review special indications of phakic intraocular lenses in the clinical practice.
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Affiliation(s)
- Roberto Pineda
- Keratorefractive Surgery Service, Massachusetts Eye and Ear Infirmary, Boston MA, USA
| | - Tulika Chauhan
- Keratorefractive Surgery Service, Massachusetts Eye and Ear Infirmary, Boston MA, USA
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Canan J, Akkan U, Tuncer K, Elbay A. Postsurgical Cystoid Macular Edema following Posterior Chamber Toric Phakic Intraocular Lens Implantation Surgery: A Case Report. Case Rep Ophthalmol 2015; 6:223-7. [PMID: 26265909 PMCID: PMC4519595 DOI: 10.1159/000437013] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
PURPOSE To describe a case of cystoid macular edema (CME) developing after posterior chamber toric phakic intraocular lens (PIOL) implantation. METHODS Case report. RESULTS A 33-year-old male underwent implantation of toric implantable collamer lenses (ICL), a new generation of PIOLs, for both eyes. Preoperative best spectacle-corrected distance visual acuity (BCVA) was 20/25 in the right eye and 20/32 in the left eye, with a manifest refraction of -9.25 -4.0 × 4° and -9.75 -4.25 × 171°, respectively. On day 1 postoperatively, the left eye had an uncorrected distance visual acuity (UDVA) of 20/60 with a refraction of +2.0 -3.5 × 11°. Despite the rotation of the PIOL, the cylindrical refractive component persisted in the left eye with a refraction of +2.0 -3.5 × 11°. Two weeks after the initial surgery, he presented with a decrease in his visual acuity in the left eye. The UDVA and BCVA were both 20/100 in the left eye with a refraction of +2.0 -4.25 × 3°. Dilated fundus examination and macular optical coherence tomography revealed a CME in the left eye. Following topical nepafenac therapy and explantation of the ICL, we observed a complete resolution of the CME at 3 months with an improvement in BCVA to 20/32 in the left eye. CONCLUSIONS To our knowledge, this is the first reported case of postsurgical CME following toric ICL implantation. In cases of phakic eyes with an intact posterior capsule, postsurgical CME can develop, thus highlighting the purpose of this report.
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Affiliation(s)
- Julide Canan
- Department of Ophthalmology, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey
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Price MO, Price FW. Evaluation of the toric implantable collamer lens for simultaneous treatment of myopia and astigmatism. Expert Rev Med Devices 2014; 12:25-39. [PMID: 25418502 DOI: 10.1586/17434440.2015.984685] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Myopic astigmatism is a prevalent condition that can be treated with spectacles, contact lenses, or laser refractive surgery. However, these treatment options have functional limitations at higher levels of refractive error. The toric implantable collamer lens is designed to treat a broad range of refractive error, generally up to -18 diopters with +1 to +6 diopters of astigmatism. Approval for a more limited treatment range of up to 15 diopters of myopia with +1 to +4 diopters of astigmatism is being sought in the US, where this device has not yet received marketing approval. Surgical correction of high-myopic astigmatism can be life-altering and allow people to participate in activities that were not previously feasible because of visual limitations. The toric implantable collamer lens is implanted behind the iris and in front of the natural crystalline lens. With earlier lens designs, it was necessary to create an iridectomy or iridotomy to prevent pupillary block. The newest toric implantable collamer lens model has a small central hole that is not visually noticeable. This eliminates the need to create a hole in the iris, thereby enhancing the safety of the procedure.
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Affiliation(s)
- Marianne O Price
- Cornea Research Foundation of America, 9002 N. Meridian St, Suite 212, Indianapolis, IN 46260, USA
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Alfonso JF, Lisa C, Alfonso-Bartolozzi B, Pérez-Vives C, Montés-Micó R. Collagen copolymer toric phakic intraocular lens for myopic astigmatism: One-year follow-up. J Cataract Refract Surg 2014; 40:1155-62. [DOI: 10.1016/j.jcrs.2013.11.034] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2013] [Accepted: 11/11/2013] [Indexed: 10/25/2022]
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Liu TX, Luo X. Stability of axis and patient satisfaction after toric implantable collamer lens implantation for myopic astigmatism. Pak J Med Sci 2014; 29:1371-4. [PMID: 24550956 PMCID: PMC3905361 DOI: 10.12669/pjms.296.3986] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2013] [Revised: 08/05/2013] [Accepted: 08/10/2013] [Indexed: 11/21/2022] Open
Abstract
Objectives: To assess the stability of axis and patient satisfaction after toric visian implantable collamer lens (TICL) implantation for moderate to high myopic astigmatism. Methods: Total 33 eyes of 21 consecutive patients who underwent implantation of TICL for the correction of moderate to high myopic astigmatism were recorded and a minimum follow-up of six months was performed. The deviation of axis of TICL was detected from one week to six months postoperatively. The evaluation of the visual functions was done by the same clinician at six months after surgery. Results: The mean refractive cylinder decreased from -2.48±0.91 diopters (D) preoperatively to -0.54±0.25D and -0.50±0.19D at one week and six months after surgery respectively. Mean changes in astigmatism from one week to six months after surgery was 0.03±0.17D. The mean deviation of axis of TICL from one week to six months postoperatively was 2.48±1.25°(range,1°~ 6°) and no TICL required secondary repositioning. 14.3% patients felt difficult about the middle distant visual function (Reading Computer Screen). Evaluations of other visual functions were positive or very positive. Conclusions: Six months after implantation of the TICL, it showed slightly axis rotation and high satisfaction about the visual functions.
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Affiliation(s)
- Tai-Xiang Liu
- Tai-xiang Liu, Zhongshan Ophthalmic centre of Sun Yat-Sen University, Guangzhou 510060, China. Department of Ophthalmology, Affiliated Hospital of Zunyi Medical College, Zunyi 563003, China
| | - Xin Luo
- Xin Luo, Department of Ophthalmology, Affiliated Hospital of Zunyi Medical College, Zunyi 563003, China
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Wissiak E, Lackner EM, Vidic B, Ardjomand N. Phakic intraocular lenses: past and present. SPEKTRUM DER AUGENHEILKUNDE 2013. [DOI: 10.1007/s00717-013-0190-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Hashemian SJ, Soleimani M, Foroutan A, Joshaghani M, Ghaempanah J, Jafari ME. Toric implantable collamer lens for high myopic astigmatism in keratoconic patients after six months. Clin Exp Optom 2012; 96:225-32. [PMID: 22963113 DOI: 10.1111/j.1444-0938.2012.00800.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2011] [Revised: 04/06/2012] [Accepted: 05/05/2012] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND The aim was to evaluate the safety, efficacy, stability and predictability of posterior chamber collagen copolymer phakic intraocular lens (pIOL) implantation to correct myopia and myopic astigmatism associated with keratoconus. METHODS The unaided vision and visual acuity, refraction and adverse events were measured in 22 keratoconic eyes of 14 patients after using an implantable collamer lens (ICL) (STAAR Surgical Inc.) to correct refractive error. The outcome was evaluated over six months. RESULTS The mean pre-operative spherical equivalent (SE) and cylinder changed from -4.98 ± 2.63 DS and -2.77 ± 0.99 DC to -0.33 ± 0.51 DS and -1.23 ± 0.65 DC, respectively at the end of six months. Before the surgery the mean Snellen decimal visual acuity was 0.63 ± 0.20. The mean unaided vision and visual acuity changed to 0.76 ± 0.23 and 0.85 ± 0.21, respectively at the end of six months. The mean safety and efficacy indices were 1.40 ± 0.32 and 1.24 ± 0.34, respectively. No eye lost a line of visual acuity and 17 eyes (77.3 per cent) gained one or more lines. Fifteen eyes (68.2 per cent) were within 0.50 D and 20 (90.9 per cent) were within 1.00 D of the desired spherical equivalent refraction. There was a change in manifest refraction of 0.09 ± 0.21 (ranging from -0.25 to +0.75) from one week to six months after the surgery. CONCLUSION The clinical outcomes of the current study demonstrate the safety, efficacy and predictability of toric implantable collamer lens in the correction of myopia and myopic astigmatism associated with keratoconus. The patients' refractions achieved early stability and remained stable during the course of the study.
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Affiliation(s)
- Seyed Javad Hashemian
- Eye Research Center, Rassoul Akram Hospital, Tehran University of Medical Sciences, Tehran, Iran
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Espinosa-Mattar Z, Gomez-Bastar A, Graue-Hernández EO, Navas A. DSAEK for implantable collamer lens dislocation and corneal decompensation 6 years after implantation. Ophthalmic Surg Lasers Imaging Retina 2012; 43 Online:e68-72. [PMID: 22823028 DOI: 10.3928/15428877-20120712-04] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2011] [Accepted: 04/02/2012] [Indexed: 11/20/2022]
Abstract
A 39-year-old woman with a history of high myopia underwent uneventful implantation of phakic posterior chamber implantable collamer lenses (ICLs) 6 years earlier in both eyes with a visual acuity of 20/20 bilaterally. The patient presented as an emergency with sudden decreased vision in her right eye after blunt trauma. Slit-lamp examination showed a partially dislocated ICL in the anterior chamber, associated with ocular hypertension. It was decided to treat her with topical ocular hypotensive agents and surgical repositioning of the ICL. There was a progressive loss of endothelial cells and decreased visual acuity. Descemet stripping automated endothelial keratoplasty was needed to correct the endothelial failure. This case presents a potential complication of the ICL several years after implantation, and should be considered in these types of procedures.
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Affiliation(s)
- Zoraida Espinosa-Mattar
- Department of Cornea and Refractive Surgery, Institute of Ophthalmology "Conde de Valenciana", Mexico City, Mexico
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Factors affecting rotation of a posterior chamber collagen copolymer toric phakic intraocular lens. J Cataract Refract Surg 2012; 38:568-73. [PMID: 22342008 DOI: 10.1016/j.jcrs.2011.11.028] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2011] [Revised: 11/03/2011] [Accepted: 11/04/2011] [Indexed: 11/23/2022]
Abstract
PURPOSE To evaluate the correlation between postoperative rotation of the toric Implantable Collamer Lens phakic intraocular lens (pIOL) and associated factors. SETTING Nagoya Eye Clinic, Nagoya, Japan. DESIGN Case series. METHODS The toric pIOL axis was analyzed by calculating the ocular internal cylinder power and axis from the total refractive cylinder and corneal astigmatism using vector analysis (Jaffe and Clayman method). The correlation between the toric pIOL rotation over 6 months postoperatively and the associated factors (ie, age, preoperative manifest refractive sphere, preoperative manifest spherical equivalent, mean keratometric power, axial length, toric pIOL intraoperative fixation angle, postoperative toric pIOL vault [distance between toric pIOL and anterior surface of crystalline lens], toric pIOL spherical power) were evaluated. RESULTS The mean age of the 34 patients (58 eyes) was 35.7 years ± 6.5 (SD). The mean rotation 6 months postoperatively was 4.82 ± 6.98 degrees (range 0.0 to 47.2 degrees). The intraoperative toric pIOL fixation angle and postoperative toric pIOL rotation were significantly correlated (Spearman rank correlation: P=.0096 and R(2) = 0.1140; multiple logistic regression analysis: P=.009). In the 1 eye with significant rotation (47.2 degrees), the toric pIOL was exchanged for a larger toric pIOL. CONCLUSIONS A small toric pIOL rotation occurred during the 6-month follow-up. One cause of rotation could be the intraoperative fixation angle of the toric pIOL. A toric pIOL with a minimum intraoperative fixation angle should be used to prevent postoperative rotation.
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Astigmatism correction: Laser in situ keratomileusis versus posterior chamber collagen copolymer toric phakic intraocular lens implantation. J Cataract Refract Surg 2012; 38:574-81. [PMID: 22321354 DOI: 10.1016/j.jcrs.2011.10.034] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2011] [Revised: 10/10/2011] [Accepted: 10/14/2011] [Indexed: 11/24/2022]
Abstract
PURPOSE To compare the stability and predictability of astigmatism correction between toric phakic intraocular lens (pIOL) implantation and laser in situ keratomileusis (LASIK). SETTING Nagoya Eye Clinic, Nagoya, Japan. DESIGN Comparative case series. METHODS Consecutive patients who had Implantable Collamer Lens pIOL implantation or LASIK were divided into 3 subgroups according to the amount of refractive cylinder correction (low, 0.00 to 1.25 diopters [D]; moderate, 1.50 to 2.75 D; high, ≥ 3.00 D). Manifest refraction was measured preoperatively and 1, 3, 6, and 12 months postoperatively. Based on these data, the predictability and stability of the refractive cylinder correction, error of the refractive cylinder correction, and error of the refractive cylinder correction axis were evaluated. RESULTS The study comprised 338 eyes (196 patients) in the toric pIOL group and 351 eyes (202 patients) in the LASIK group. In the moderate cylinder subgroup, more eyes were corrected within ± 0.50 D of the postoperative refractive cylinder in the LASIK group (132 eyes [91%]) than in the toric pIOL group (111 eyes [79%]). In the high refractive cylinder subgroup, the error of the refractive cylinder correction in the LASIK group was significantly higher than in the toric pIOL group (P=.032). The postoperative manifest refractive cylinder did not change in either group during the follow-up period. CONCLUSIONS The stability of the refractive cylinder after toric pIOL implantation was as high as after LASIK. Although predictability in the LASIK group was higher than in the toric pIOL group in eyes with moderate refractive cylinder, the toric pIOL group had higher predictability than the LASIK group in eyes with high refractive cylinder.
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Camoriano GD, Aman-Ullah M, Purba MK, Sun J, Gimbel HV. Toric collagen copolymer phakic intraocular lens to correct myopic astigmatism in eyes with pellucid marginal degeneration. J Cataract Refract Surg 2012; 38:256-61. [DOI: 10.1016/j.jcrs.2011.08.040] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2011] [Revised: 08/12/2011] [Accepted: 08/14/2011] [Indexed: 10/14/2022]
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In vivo Assessment of Higher-Order Aberrations after Acrysof Toric Intraocular Lens Implantation: A Comparative Study. Eur J Ophthalmol 2011; 22:531-40. [DOI: 10.5301/ejo.5000090] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/07/2011] [Indexed: 11/20/2022]
Abstract
Purpose To compare higher-order aberrations (HOAs) and optical quality in eyes implanted with AcrySof SN60TT toric intraocular lens (IOL) or with non-toric AcrySof SN60AT IOL (Alcon Laboratories, Inc., Fort Worth, TX). Methods This was a prospective, consecutive, nonrandomized, interventional, comparative study. One hundred eyes with cataract in 56 patients were included (SN60TT group, n=50; SN60AT group, n=50). Patients underwent phacoemulsification through a 2.2-mm temporal corneal incision. Postoperative HOAs, point spread function (PSF) and modulation transfer function (MTF), residual objective refractive astigmatism, and IOL alignment were evaluated using Optical Path Difference (OPD)–Scan II (Nidek, Gamagori, Japan). A novel technique to calculate IOL axis alignment was introduced. Results One year postoperatively, no statistical difference in corneal, intraocular, and total HOAs, Strehl ratio, and MTF based on HOAs was found between groups. Toric IOL patients had a net residual refractive astigmatism (M) of 0.44 D±0.47; the difference between expected and obtained astigmatism (M) was 0.043 D (p=0.16). Toric IOL axis misalignment was 2.65±2.39 degrees and no correlation with HOAs was found. Conclusions AcrySof SN60TT determines HOAs comparable to the non-toric version providing a good optical quality, and predictably corrects corneal cylinder with a stable postoperative alignment. The OPD-Scan II might be regarded as a fast and reliable method of toric IOL analysis.
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Navas A, Muñoz-Ocampo M, Graue-Hernández EO, Gómez-Bastar A, Ramirez-Luquín T. Spontaneous Rotation of a Toric Implantable Collamer Lens. Case Rep Ophthalmol 2010; 1:99-104. [PMID: 21151633 PMCID: PMC2999733 DOI: 10.1159/000322819] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
We present a case of toric implantable collamer lens (TICL) spontaneous rotation in a patient with myopic astigmatism. A 23-year-old female underwent TICL implantation. Preoperative uncorrected visual acuity (UCVA) was 20/800 and 20/1200, respectively, with -7.75 -4.25 × 0° and -8.25 -5.25 × 180°. The left eye achieved an UCVA of 20/30. After 3 months of successful implantation of TICL in the left eye, the patient presented with a sudden decrease in visual acuity in the left eye. UCVA was 20/100 with a refraction of +2.50 -4.50 × 165°. We observed the toric marks with a 30° rotation from the original position and decided to reposition the TICL, obtaining a final UCVA of 20/25, which remained stable at 6 months' follow-up. TICL can present a considerable rotation that compromises visual acuity. The relocation of TICL is a safe and effective procedure to recover visual acuity due to significant spontaneous TICL rotation.
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Affiliation(s)
- Alejandro Navas
- Department of Cornea and Refractive Surgery, Institute of Ophthalmology 'Conde de Valenciana', Mexico City, Mexico
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Kamiya K, Shimizu K, Kobashi H, Komatsu M, Nakamura A, Nakamura T, Ichikawa K. Clinical outcomes of posterior chamber toric phakic intraocular lens implantation for the correction of high myopic astigmatism in eyes with keratoconus: 6-month follow-up. Graefes Arch Clin Exp Ophthalmol 2010; 249:1073-80. [PMID: 20953620 DOI: 10.1007/s00417-010-1540-5] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2010] [Revised: 09/23/2010] [Accepted: 10/02/2010] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND To assess the early clinical outcomes of toric implantable collamer lenses (toric ICL™, STAAR Surgical) for the correction of high myopic astigmatism with keratoconus. METHODS This study evaluated 27 eyes of 14 patients with spherical equivalents of -10.11 ± 2.46 D (mean ± standard deviation) and astigmatism of -3.03 ± 1.58 D who underwent toric ICL implantation for mild keratoconus. Before, and 1, 3 and 6 months after surgery, we assessed the safety, efficacy, predictability, stability, and adverse events of the surgery. RESULTS LogMAR uncorrected visual acuity (UCVA) and LogMAR best spectacle-corrected visual acuity (BSCVA) were -0.09 ± 0.16 and -0.15 ± 0.09 respectively, 6 months after surgery. The safety and efficacy indices were 1.12 ± 0.18 and 1.01 ± 0.25. At 6 months, 85% and 96% of the eyes were within ±0.5 and ±1.0 D respectively of the targeted correction. Manifest refraction changes of 0.00 ± 0.35 D occurred from 1 week to 6 months. No vision-threatening complications occurred during the observation period. CONCLUSIONS Toric ICL implantation was good in all measures of safety, efficacy, predictability, and stability for the correction of spherical and cylindrical errors in eyes with early keratoconus throughout the 6-month follow-up period, suggesting its viability as a surgical option for the treatment of such eyes.
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Affiliation(s)
- Kazutaka Kamiya
- Department of Ophthalmology, University of Kitasato School of Medicine, 1-15-1 Kitasato, Sagamihara, Kanagawa, 228-8555, Japan.
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