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Zhou J, Li S, He G, Wang W. Predicting the impact of femtosecond-assisted arcuate keratotomy combined with tri-planar clear corneal incisions on astigmatism in implantable collamer lens surgery: one-year follow-up. Graefes Arch Clin Exp Ophthalmol 2024:10.1007/s00417-024-06547-1. [PMID: 38896281 DOI: 10.1007/s00417-024-06547-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 05/30/2024] [Accepted: 06/07/2024] [Indexed: 06/21/2024] Open
Abstract
PURPOSE To investigate the factors associated with and impact on the femtosecond-assisted (FS-assisted) limbal relaxing incision (LRI) combined with the steep-meridian tri-planar clear corneal incision (TCCI) to reduce astigmatism in patients undergoing Implantable Collamer Lens (ICL) surgery. METHODS Retrospective case series. The study reviewed patients with ICL surgery combined with FS-assisted LRIs paired with steep-meridian TCCIs. Correlation analysis examined the relationship between independent variables, including preoperative characteristics (intraocular pressure, corneal thickness, axial length, et al.), TCCI, and LRI surgical parameters. The predictors of surgically induced astigmatism (SIA) were determined using individual-level analysis and accounting for inter-eye correlation with the generalized estimating equation (GEE). RESULTS The study enrolled 69 patients, with 114 eyes (55 right and 59 left). The mean spherical equivalent (SEQ) was - 10.29 ± 2.99D and - 9.99 ± 2.72D for the right and left eye, respectively, while the mean preoperative corneal astigmatism was - 1.54 ± 0.47D and - 1.54 ± 0.46D for the right and left eyes, respectively. After 12 months of follow-up, univariate analysis revealed significant correlations between SIA and intraocular pressure (IOP), astigmatism type, TCCI position (degree), peripheral corneal thickness (PCT), LRI arc incision diameter, post depth (%), and angle, respectively (P = 0.046, 0.016, 0.039, 0.040, 0.009, 0.000, 0.000). Multivariate analysis using GEE demonstrated that axial length (AL), astigmatism type, LRI arc diameter, and angle were independent predictors of SIA (P = 0.000, 0.005, 0.029, 0.000). CONCLUSIONS The type of astigmatism and axial length were independent factors that affected SIA when modifying the LRI arc diameter and angle through FS-assisted steep-meridian TCCI paired with LRI in ICL surgery.
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Affiliation(s)
- Jihong Zhou
- Beijing Aier Intech Eye Hospital, Panjiayuan Plaza, #12 Panjiayuan Nanli, Chaoyang District, Beijing, China.
- Beijing Ophthalmology and Science Key Lab, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, 100730, China.
- Beijing Tongren Hospital, Beijing Tongren Eye Center, Capital Medical University, No. 1 Dongjiaomin Xiang, Dongcheng District, Beijing, 100730, China.
| | - Shaowei Li
- Beijing Aier Intech Eye Hospital, Panjiayuan Plaza, #12 Panjiayuan Nanli, Chaoyang District, Beijing, China
| | - Guoli He
- Beijing Aier Intech Eye Hospital, Panjiayuan Plaza, #12 Panjiayuan Nanli, Chaoyang District, Beijing, China
| | - Wenjuan Wang
- Beijing Aier Intech Eye Hospital, Panjiayuan Plaza, #12 Panjiayuan Nanli, Chaoyang District, Beijing, China
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Dan TT, Liu TX, Li ZZ, Liang CP, Li FY. The comparison of white-to-white via triple person-times caliper measuring and machine-measuring in V4c implantable collamer lens implantation. Sci Rep 2024; 14:13878. [PMID: 38880805 PMCID: PMC11180651 DOI: 10.1038/s41598-024-64647-8] [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: 04/03/2024] [Accepted: 06/11/2024] [Indexed: 06/18/2024] Open
Abstract
This study aimed to compare the differences and characteristics of white-to-white (WTW) values obtained before V4c implantation using triple person-times caliper, IOL-Master 700, Pentacam HR, and UBM, and to assess their correlation with vaulting. A total of 930 myopia patients (1842 eyes) who were interested in undergoing ICL surgery were assessed before the procedure using various instruments. The WTW measurements were obtained using a triple person-times caliper, Pentacam HR, and IOL-Master 700, whereas the angle-to-angle (ATA) measurements were obtained using UBM. The size of the ICL was subsequently calculated using triple person-times caliper measurements. The vault of the ICL was assessed using Pentacam HR three months after the surgery. The WTW was determined to be 11.30 ± 0.29 mm, 11.43 ± 0.29 mm, and11.86 ± 0.38 mm, respectively, using the triple person-times caliper, Pentacam HR, and IOL-Master 700. The measurement of ATA was 11.57 ± 0.51 mm, as done by UBM. The ICL vault was measured to be 400.97 ± 198.46 µm when examined with Pentacam HR three monthsafter the procedure. The linear regression analyses of ICL size and WTW of triple person-times caliper, ICL vault and WTW were (R = 0.703, p < 0.001; R = 0.0969, p < 0.001) respectively. The highest correlation was found between IOL-Master and Pentacam HR (r = 0.766, p = 0.000). The lowest correlation was found between UBM and Pentacam HR (r = 0.358, p = 0.002). Bland-Altman analysis showed that the 95% limits of agreement (LoA) were the triple person-times caliper and Pentacam HR (- 0.573, 0.298) and the triple person-times caliper and UBM (- 1.15, - 0.605). This indicated a strong agreement between the triple person-times caliper and Pentacam HR and a lack of agreement between the triple person-times caliper and UBM. Triple person-times caliper measurements offer excellent maneuverability, practicality, and reliable outcomes for determining ICL vaults. Measurements obtained using the triple-person caliper were less differece than those obtained using the Pentacam HR.
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Affiliation(s)
- Ting-Ting Dan
- Department of Ophthalmology, Affiliated Hospital of Zunyi Medical University, Zunyi, 563000, Guizhou Province, China
- Guizhou Eye Hospital, Zunyi, 563000, Guizhou Province, China
- Guizhou Provincial Branch of National Eye Disease Clinical Research Center, Zunyi, 563000, Guizhou Province, China
- Special Key Laboratory of Ocular Diseases of Guizhou Province, Zunyi Medical University, Zunyi, 563000, Guizhou Province, China
| | - Tai-Xiang Liu
- Department of Ophthalmology, Affiliated Hospital of Zunyi Medical University, Zunyi, 563000, Guizhou Province, China.
- Guizhou Eye Hospital, Zunyi, 563000, Guizhou Province, China.
- Guizhou Provincial Branch of National Eye Disease Clinical Research Center, Zunyi, 563000, Guizhou Province, China.
- Special Key Laboratory of Ocular Diseases of Guizhou Province, Zunyi Medical University, Zunyi, 563000, Guizhou Province, China.
- Department of Ophthalmology, The Affiliated Hospital of Zunyi Medical University, No. 149 Dalian Road, Huichuan District, Zunyi, 563003, Guizhou Province, China.
| | - Zong-Ze Li
- Department of Ophthalmology, Affiliated Hospital of Zunyi Medical University, Zunyi, 563000, Guizhou Province, China
| | - Ceng-Peng Liang
- Special Key Laboratory of Ocular Diseases of Guizhou Province, Zunyi Medical University, Zunyi, 563000, Guizhou Province, China
| | - Fa-Yuan Li
- Special Key Laboratory of Ocular Diseases of Guizhou Province, Zunyi Medical University, Zunyi, 563000, Guizhou Province, China
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Yuan J, Wu S, Hu Z, Chen C, Ye S, Ye J. Clinical Observation of Posterior-Chamber Phakic Implantable Collamer Lens V4c Implantation in Myopic Patients with Shallow Anterior Chamber Depth: A Retrospective, Consecutive Observational Study. J Ophthalmol 2024; 2024:3181569. [PMID: 38812725 PMCID: PMC11136544 DOI: 10.1155/2024/3181569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 03/09/2024] [Accepted: 05/06/2024] [Indexed: 05/31/2024] Open
Abstract
Purpose The reference range for the preoperative anterior chamber angle width for ICL surgery is unclear. Our objective was to assess the clinical effect and the range of anterior chamber angle width of posterior-chamber implantable collamer lens V4c (ICL V4c) implantation in patients with anterior chamber depth (ACD) < 2.8 mm. Methods Patients who underwent ICL V4c implantation with shallow ACD were included in this retrospective study. The patients' uncorrected and corrected distance visual acuity, angle of trabecular-iris (TIA), angle-opening distance (AOD500), trabecular-iris space area (TISA500), corneal endothelial cell density, vault, retinal nerve fiber layer thickness, intraocular pressure, visual field, and complications were analyzed. Results Forty-one patients (68 eyes) completed at least 12 months of follow-up (median follow-up, 30 months). The effectiveness and safety indices were 1.09 ± 0.13 and 1.04 ± 0.21, respectively. The preoperative TIA values on the nasal and temporal sides were 39.78 ± 7.68 degree (range, 25.8-65.1 degree) and 41.54 ± 8.03 degree (range, 28.5-63.00 degree). Forty-seven eyes had uncorrected distance visual acuity ≥1.0, and 55 had corrected distance visual acuity ≥1.0 at the last follow-up visit. The TIA, AOD500, and TISA500 on the nasal and temporal sides were significantly reduced compared to those before surgery (all P < 0.01); no eye had an angle closure or elevated intraocular pressure. The ICL V4c vault was 290.88 ± 153.36 μm (range, 60.0-880.0 μm). No severe complications occurred in any patient. Conclusions In patients with myopia with shallow ACD (2.55-2.79 mm), a preoperative TIA >25.8° is safe and effective for a relatively long time after surgery; however, an extended long-term close follow-up is needed.
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Affiliation(s)
- Juan Yuan
- Department of Ophthalmology, Daping Hospital, Army Medical Center of PLA, Army Medical University, Chongqing, China
- Branch of Chongqing Clinical Research Center for Eye Diseases, Chongqing, China
| | - Shuang Wu
- Department of Ophthalmology, Daping Hospital, Army Medical Center of PLA, Army Medical University, Chongqing, China
- Branch of Chongqing Clinical Research Center for Eye Diseases, Chongqing, China
| | - Zongli Hu
- Department of Ophthalmology, Daping Hospital, Army Medical Center of PLA, Army Medical University, Chongqing, China
- Branch of Chongqing Clinical Research Center for Eye Diseases, Chongqing, China
| | - Chunlin Chen
- Department of Ophthalmology, Daping Hospital, Army Medical Center of PLA, Army Medical University, Chongqing, China
- Branch of Chongqing Clinical Research Center for Eye Diseases, Chongqing, China
| | - Shiyang Ye
- Department of Ophthalmology, Southwest Hospital, Army Medical University, Chongqing, China
| | - Jian Ye
- Department of Ophthalmology, Daping Hospital, Army Medical Center of PLA, Army Medical University, Chongqing, China
- Branch of Chongqing Clinical Research Center for Eye Diseases, Chongqing, China
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Cardoza NJ, Murthy SI, Senthil S. Reverse pupillary block with pigment dispersion and elevated intraocular pressure following bilateral phakic intraocular lens implantation. BMJ Case Rep 2024; 17:e256010. [PMID: 38782424 DOI: 10.1136/bcr-2023-256010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2024] Open
Abstract
The authors describe a case of reverse pupillary block with pigment dispersion following sequential phakic intraocular lens (pIOL) implantation for high myopia, in a young female patient. The intraocular pressure (IOP) elevation began 3 weeks postoperatively, for which Nd-YAG laser peripheral iridotomies (PIs) were attempted elsewhere. Despite maximum medical therapy, the IOP was uncontrolled. She was referred to our institute for further management. Examination showed anteriorly displaced iris-pIOL diaphragm, iris pigment dispersion and raised IOP. The PIs were incomplete. Based on clinical evaluation and investigations, we concluded that the excess area of contact of the posterior iris over the pIOL caused a reverse pupillary block and pigment dispersion. The IOPs were controlled by repeating laser iridotomies and with medical therapy. Subsequently, the patient developed a low lens vault leading to bilateral cataract. Sequential explantation of the pIOL along with cataract extraction was performed and her vision was restored.
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Affiliation(s)
| | - Somasheila I Murthy
- Shantilal Shanghvi Cornea Institute, LV Prasad Eye Institute, Hyderabad, Telangana, India
| | - Sirisha Senthil
- VST Center for Glaucoma, L V Prasad Eye Institute, Hyderabad, Telangana, India
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Nasser T, Hirabayashi M, Virdi G, Abramson A, Parkhurst G. VAULT: vault accuracy using deep learning technology: new image-based artificial intelligence model for predicting implantable collamer lens postoperative vault. J Cataract Refract Surg 2024; 50:448-452. [PMID: 38651696 DOI: 10.1097/j.jcrs.0000000000001386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 12/09/2023] [Indexed: 04/25/2024]
Abstract
PURPOSE To develop an accurate deep learning model to predict postoperative vault of phakic implantable collamer lenses (ICLs). SETTING Parkhurst NuVision LASIK Eye Surgery, San Antonio, Texas. DESIGN Retrospective machine learning study. METHODS 437 eyes of 221 consecutive patients who underwent ICL implantation were included. A neural network was trained on preoperative very high-frequency digital ultrasound images, patient demographics, and postoperative vault. RESULTS 3059 images from 437 eyes of 221 patients were used to train the algorithm on individual ICL sizes. The 13.7 mm size was excluded because of insufficient data. A mean absolute error of 66.3 μm, 103 μm, and 91.8 μm were achieved with 100%, 99.0%, and 96.6% of predictions within 500 μm for the 12.1 mm, 12.6 mm, and 13.2 mm sizes, respectively. CONCLUSIONS This deep learning model achieved a high level of accuracy of predicting postoperative ICL vault with the overwhelming majority of predictions successfully within a clinically acceptable margin of vault.
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Affiliation(s)
- Taj Nasser
- From the Parkhurst NuVision, San Antonio, Texas (Nasser, Parkhurst); University of Missouri Columbia School of Medicine, Columbia, Missouri (Hirabayashi, Virdi); Mason Eye Institute, Columbia, Missouri (Hirabayashi, Virdi); Texas State University, San Marcos, Texas (Abramson)
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Alfonso-Bartolozzi B, Fernández-Vega-Cueto L, Lisa C, Palacios A, Madrid-Costa D, Alfonso JF. Ten-year follow-up of posterior chamber phakic intraocular lens with central port design in patients with low and normal vault. J Cataract Refract Surg 2024; 50:441-447. [PMID: 38085219 DOI: 10.1097/j.jcrs.0000000000001379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 12/05/2023] [Indexed: 04/24/2024]
Abstract
PURPOSE To assess the clinical outcomes and postoperative complications of the implantable collamer lens (ICL) with a central port throughout 10 years of follow-up in patients with low and normal vault. SETTING Fernández-Vega Ophthalmological Institute, Oviedo, Spain. DESIGN Retrospective and comparative case series. METHODS This study included eyes that underwent a V4c ICL implantation with 10 years of follow-up. The eyes were divided into 2 groups according to the vault at 1 year postoperatively: vault <250 μm and between 250 μm and 800 μm. Uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), intraocular pressure (IOP), endothelial cell density (ECD), vault, complications, and secondary surgeries were analyzed. RESULTS 37 and 90 eyes were enrolled in the low and normal-vault groups, respectively. No differences in UDVA, CDVA, and refraction were found between the groups over 10 years of follow-up. No cases developed ICL-induced anterior subcapsular opacity over the follow-up period. 2 (5.4%) and 8 (8.9%) eyes in the low and normal-vault groups, respectively, required ICL exchange. 1 (2.8%) and 2 (2.2%) eyes in the low and normal-vault groups, respectively, required excimer laser to correct residual refractive error. The IOP remained stable throughout the 10-year follow-up. The loss in ECD from that preoperatively to 10 years postoperatively was 3.8% and 4.5% in the low and normal-vault groups, respectively ( P = .4). No pigment dispersion glaucoma or other vision-threatening complications were reported. CONCLUSIONS This study shows good long-term outcomes of the V4c ICL, supporting that the central hole provides safety to the procedure and prevents the potential risk associated with low vault.
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Affiliation(s)
- Belén Alfonso-Bartolozzi
- From the Fernández-Vega Ophthalmological Institute, Oviedo, Spain (Alfonso-Bartolozzi, Fernández-Vega-Cueto, Lisa, Palacios, Alfonso); Clinical and Experimental Eye Reseach Group, Faculty of Optics and Optometry, Universidad Complutense de Madrid, Madrid, Spain (Madrid-Costa)
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Yoon HY, Byun YS, Kim HS, Chung SH. Causes and outcomes of implantable collamer lens explantation in patients with corneal endothelial cell loss. J Cataract Refract Surg 2024; 50:453-459. [PMID: 38270485 DOI: 10.1097/j.jcrs.0000000000001406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 01/13/2024] [Indexed: 01/26/2024]
Abstract
PURPOSE To investigate the correlated factors of corneal endothelial cell density (ECD) loss and ECD change in implantable collamer lens (ICL) explantation patients. SETTING Seoul St. Mary's Hospital, Seoul, South Korea. DESIGN Retrospective analysis. METHODS The study cohort consisted of 93 eyes from 50 patients who underwent ICL explantation. Correlation analysis was performed to assess the ocular parameters associated with ECD loss, while percentage of ECD change (ΔECD%) was monitored up to 6 months postoperatively. Receiver operating characteristic (ROC) curve was used to set cutoff values of ocular parameters to prevent ECD loss after explantation. RESULTS In multiple regression analysis, high vaulting, high vaulting/anterior chamber depth (ACD), low anterior chamber angle (ACA), and high iris pigmentations are the significant factors of ECD loss. At postoperative 6 months, 14 eyes (15.1%) had decrease (10.5% loss), 47 eyes (51.0%) were stationary, and 32 eyes (34.4%) had increase (12.7% gain) of ECD. The ROC curve analysis showed that vaulting had the highest area under the curve (AUC = 0.822), followed by vaulting/ACD (AUC = 0.821), ECD (AUC = 0.753), and ACA (AUC = 0.723) (all P < .01). Preoperative ECD showed a sensitivity of 77.6% and specificity of 86.7% in preventing ECD loss after explantation, with a cutoff value of 1722 cells/mm 2 , as determined by ROC curve analysis. CONCLUSIONS Our study demonstrated that high vaulting is a significant factor in ECD loss among ICL-inserted patients. To prevent continuous ECD loss in ICL patients, close monitoring of ECD and making appropriate decisions regarding explantation may be necessary.
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Affiliation(s)
- Hye Yeon Yoon
- From the Department of Ophthalmology and Visual Science, Seoul St. Mary's Hospital, College of Medicine, Catholic University of Korea, Seoul, South Korea
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Ning J, Zhang Q, Liang W, Zhang R, Xing Z, Jin L, Zhang L. Bibliometric and visualized analysis of posterior chamber phakic intraocular lens research between 2003 and 2023. Front Med (Lausanne) 2024; 11:1391327. [PMID: 38651068 PMCID: PMC11034429 DOI: 10.3389/fmed.2024.1391327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2024] [Accepted: 03/27/2024] [Indexed: 04/25/2024] Open
Abstract
Introduction Myopia is causing a major public health concern, with its prevalence increasing globally. This study aimed to discuss posterior chamber phakic intraocular lens (pIOL) research publication trends and hotspots over the past 20 years. Methods Bibliometric analysis was performed using the Web Science Core Collection to investigate posterior-chamber pIOL research publication trends. The extracted records were analyzed, and a knowledge map was built using VOSviewer v.1.6.20. The analysis included visualizing the annual publication count, countries/regions distribution, international and institutional collaborations, author productivity, and journal contribution, in addition to identifying knowledge bases and hotspots. Burst keywords were extracted using CiteSpace v.6.1.R. Results In total, 791 articles on posterior chamber pIOLs published between 2003 and 2023 were retrieved. China had the highest number of publications, whereas Japanese papers received the most citations. Fudan University had the highest number of publications, with articles from Kitasato University having the highest number of citations. Regarding individual research, Xingtao Zhou has published the most significant number of articles, and Shimizu Kimiya had the highest number of citations. The top productive/influential journal was 'Journal of Cataract & Refractive Surgery'. The top cited references primarily focused on reporting the clinical outcomes of implantable collamer lens (ICL) for individuals with moderate to high myopia. The keywords primarily formed four clusters: posterior chamber pIOL clinical outcomes for myopic astigmatism correction, posterior chamber pIOL implantation complications, ICL size selection and postoperative vault predictions, and postoperative visual quality following posterior chamber pIOL implantation. Conclusion This study presents the first bibliometric analysis of research trends in posterior chamber pIOL over the past two decades. We investigated the current state and emerging trends of global collaboration and research focal points in this field, offering fresh insights and guidance for researchers.
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Affiliation(s)
- Jiliang Ning
- Department of Ophthalmology, The Third People’s Hospital of Dalian, Dalian, China
- Department of Ophthalmology, Dalian Municipal Eye Hospital, Dalian, China
- Liaoning Provincial Key Laboratory of Cornea and Ocular Surface Diseases, Dalian, China
- Liaoning Provincial Optometry Technology Engineering Research Center, Dalian, China
| | - Qiaosi Zhang
- Department of Ophthalmology, The Third People’s Hospital of Dalian, Dalian, China
- Department of Ophthalmology, Dalian Municipal Eye Hospital, Dalian, China
- Liaoning Provincial Key Laboratory of Cornea and Ocular Surface Diseases, Dalian, China
- Liaoning Provincial Optometry Technology Engineering Research Center, Dalian, China
| | - Wei Liang
- Department of Ophthalmology, The Third People’s Hospital of Dalian, Dalian, China
- Department of Ophthalmology, Dalian Municipal Eye Hospital, Dalian, China
- Liaoning Provincial Key Laboratory of Cornea and Ocular Surface Diseases, Dalian, China
- Liaoning Provincial Optometry Technology Engineering Research Center, Dalian, China
| | - Rui Zhang
- Department of Ophthalmology, The Third People’s Hospital of Dalian, Dalian, China
- Department of Ophthalmology, Dalian Municipal Eye Hospital, Dalian, China
- Liaoning Provincial Key Laboratory of Cornea and Ocular Surface Diseases, Dalian, China
- Liaoning Provincial Optometry Technology Engineering Research Center, Dalian, China
| | - Zequn Xing
- Department of Ophthalmology, The Third People’s Hospital of Dalian, Dalian, China
- Department of Ophthalmology, Dalian Municipal Eye Hospital, Dalian, China
- Liaoning Provincial Key Laboratory of Cornea and Ocular Surface Diseases, Dalian, China
- Liaoning Provincial Optometry Technology Engineering Research Center, Dalian, China
| | - Lin Jin
- Department of Ophthalmology, The Third People’s Hospital of Dalian, Dalian, China
- Department of Ophthalmology, Dalian Municipal Eye Hospital, Dalian, China
- Liaoning Provincial Key Laboratory of Cornea and Ocular Surface Diseases, Dalian, China
- Liaoning Provincial Optometry Technology Engineering Research Center, Dalian, China
| | - Lijun Zhang
- Department of Ophthalmology, The Third People’s Hospital of Dalian, Dalian, China
- Department of Ophthalmology, Dalian Municipal Eye Hospital, Dalian, China
- Liaoning Provincial Key Laboratory of Cornea and Ocular Surface Diseases, Dalian, China
- Liaoning Provincial Optometry Technology Engineering Research Center, Dalian, China
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Thompson V, Cummings AB, Wang X. Implantable Collamer Lens Procedure Planning: A Review of Global Approaches. Clin Ophthalmol 2024; 18:1033-1043. [PMID: 38601168 PMCID: PMC11005927 DOI: 10.2147/opth.s456397] [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: 12/23/2023] [Accepted: 03/21/2024] [Indexed: 04/12/2024] Open
Abstract
More than 2 million implantable collamer lenses (ICLs) have been implanted worldwide. With a central port to improve aqueous flow through the ICL, the latest iteration of this phakic intraocular lens (pIOL) has been shown to have stable outcomes with very low rates of adverse events. However, correct planning and ICL size selection continue to be important to achieve an optimal vault. Shallow or excessive vaults are not complications in and of themselves but may increase the risk of complications. Historically, surgeons have relied on measurements of anterior chamber depth (ACD) and manual, caliper-measured white-to-white (WTW) distance to select the ICL size. New diagnostic and imaging technologies such as optical coherence tomography (OCT) and ultrasound biomicroscopy (UBM) provide additional opportunities for visualization and measurement of the intraocular dimensions involved in phakic intraocular lens implantation, including sulcus-to-sulcus (STS) and angle-to-angle (ATA) diameters. This paper reviews various approaches to ICL planning and sizing that have been published in the peer-reviewed literature, all of which produce acceptable results for predicting vault and size selection. Surgeons may also want to identify a methodology for patient evaluation and ICL size selection that best aligns with their personal preferences, diagnostic technology, and familiarity with analytical optimization tools.
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Affiliation(s)
- Vance Thompson
- Vance Thompson Vision, Sioux Falls, SD, USA
- Department of Ophthalmology, University of South Dakota Sanford School of Medicine, Vermillion, SD, USA
| | | | - Xiaoying Wang
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, People’s Republic of China
- NHC Key Laboratory of Myopia, Fudan University, Shanghai, People’s Republic of China
- Shanghai Research Center of Ophthalmology and Optometry, Eye & ENT Hospital, Fudan University, Shanghai, People’s Republic of China
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Reinstein DZ, MacGregor C, Archer TJ, Gupta R, Potter JG. A review of posterior chamber phakic intraocular lenses. Curr Opin Ophthalmol 2024; 35:138-146. [PMID: 38059758 DOI: 10.1097/icu.0000000000001018] [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: 12/08/2023]
Abstract
PURPOSE OF REVIEW Posterior chamber phakic intraocular lenses (pIOLs) are increasing in popularity as a viable alternative to laser refractive surgery. The purpose of this review is to evaluate the recent updates to pIOLs and to assess the advancements and safety of the procedure. RECENT FINDINGS Accurate lens sizing is the key determinant to suitable vault prediction, advancements to sizing formulae including the use of very high frequency (VHF) digital ultrasound and the application of artificial intelligence and machine learning has led to improved vault prediction and safety. The introduction of the central aquaport has been shown to reduce the formation of cataract and is now adopted in most myopic pIOLs. Recently published studies have demonstrated that pIOLs have an excellent safety profile with no increased risk of retinal detachment or endothelial cell loss. Advancements have led to the introduction of extended depth of focus pIOLs for the correction of presbyopia, further research is required to evaluate the efficacy of new lens designs. SUMMARY pIOL surgery is experiencing traction with improved lens design and increased lenses choices such as larger optical zone and presbyopic options. Accuracy of implantable collamer lens sizing is paramount to the safety and clinical outcomes, greater predictability is likely to encourage more posterior chamber pIOL users due to fewer sizing related complications.
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Affiliation(s)
- Dan Z Reinstein
- Reinstein Vision
- London Vision Clinic, EuroEyes Group, London, UK
- Columbia University Medical Center, New York, USA
- Sorbonne Université, Paris, France
- Biomedical Science Research Institute, Ulster University, Coleraine, UK
| | | | - Timothy J Archer
- Reinstein Vision
- London Vision Clinic, EuroEyes Group, London, UK
| | - Ruchi Gupta
- Reinstein Vision
- London Vision Clinic, EuroEyes Group, London, UK
| | - Joseph G Potter
- Reinstein Vision
- London Vision Clinic, EuroEyes Group, London, UK
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Gong D, Deng S, Dang K, Yan Z, Wang J. Causes and management strategies for elevated intraocular pressure after implantable collamer lens implantation. Front Med (Lausanne) 2024; 11:1351272. [PMID: 38384405 PMCID: PMC10879591 DOI: 10.3389/fmed.2024.1351272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 01/25/2024] [Indexed: 02/23/2024] Open
Abstract
With the widespread application of Implantable Collamer Lens (ICL) implantation surgery in the field of myopia correction, a comprehensive understanding of its potential complications, especially those related to intraocular pressure (IOP), becomes crucial. This article systematically reviews various complications that may lead to IOP elevation after ICL surgery. Firstly, common complications after ICL surgery, including residual viscoelastic, steroid response, and excessive vault of the ICL, are detailed, emphasizing their potential impact on intraocular pressure. Regarding residual viscoelastic, we delve into its direct relationship with postoperative elevated IOP and possible preventive measures. For steroid response, we stress the importance of timely adjustment of steroid therapy and monitoring intraocular pressure. Additionally, excessive vault of the ICL is considered a significant potential issue, and we elaborate on its mechanism and possible management methods. In further discussion, we focus on relatively rare complications such as Toxic Anterior Segment Syndrome (TASS), Urrets-Zavalia Syndrome (UZS), Pigment Dispersion Syndrome (PDS), and malignant glaucoma. For these relatively rare complications, this review thoroughly explores their potential mechanisms, emphasizes the importance of prevention, and provides guidance for early diagnosis and treatment. This is a comprehensible review that aims to offer eye care professionals a comprehensive understanding and effective management guidance for complications of elevated IOP after ICL surgery, ultimately providing optimal care for patients' visual health.
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Affiliation(s)
- Di Gong
- Shenzhen Eye Hospital, Jinan University, Shenzhen Eye Institute, Shenzhen, Guangdong, China
| | - Simin Deng
- The 2nd Clinical Medical College (Shenzhen People's Hospital) of Jinan University, Shenzhen, China
| | - Kuanrong Dang
- Shenzhen Eye Hospital, Jinan University, Shenzhen Eye Institute, Shenzhen, Guangdong, China
| | - Zonghui Yan
- Shenzhen Eye Hospital, Jinan University, Shenzhen Eye Institute, Shenzhen, Guangdong, China
| | - Jiantao Wang
- Shenzhen Eye Hospital, Jinan University, Shenzhen Eye Institute, Shenzhen, Guangdong, China
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Xiong L, Wu J, Du H, Wang Z. Comparison of formulas in the implantable collamer lens vault prediction. Medicine (Baltimore) 2023; 102:e36542. [PMID: 38115275 PMCID: PMC10727627 DOI: 10.1097/md.0000000000036542] [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: 09/03/2023] [Revised: 11/01/2023] [Accepted: 11/17/2023] [Indexed: 12/21/2023] Open
Abstract
To compare the predictability of different formulas in the postoperative vault of an implantable collamer lens (ICL) surgery and assist physicians for formula selection in ICL implantation. This is a retrospective study. Patients who underwent ICL implantation between August 31, 2021 and October 29, 2021 at our clinic were reviewed. The clinical data, predicted ICL sizes and vaults, actual ICL size implanted and vaults at 1 month after surgery, and corresponding prediction formulas used were collected and analyzed. This study included 140 eyes from 72 patients (15 males and 57 females). Differences between ICL sizes recommended by the Visian ICL Online Calculation & Ordering System (OCOS) and NK formula (Version. 3) or KS formula (Version. 4) were statistically significant (P < .0001), except for the recommended ICL sizes between the NK and KS formulas (P > .05). Better consistency between predicted ICL vaults and achieved ICL vaults was observed when using the KS formula compared to the NK formula. The actual ICL vaults were 250 to 750 μm at 1 month after surgery in 66.4%, 76.5%, and 80.5% eyes of the OCOS, NK, and KS groups, respectively. There was significant difference between the OCOS and KS groups (P < .05), especially in the 12.6 mm ICL group. The KS formula is the most accurate formula for recommending an ICL size and vault prediction when compared to the NK formula and OCOS. Further studies for a more accurate formula are warranted.
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Affiliation(s)
- Lu Xiong
- Department of Refractive Surgery, Aier Eye Hospital, Jinan University, Guangzhou, Guangdong Province, China
| | - Jiawei Wu
- Department of Refractive Surgery, Aier Eye Hospital, Jinan University, Guangzhou, Guangdong Province, China
| | - Huiyi Du
- Department of Refractive Surgery, Aier Eye Hospital, Jinan University, Guangzhou, Guangdong Province, China
| | - Zheng Wang
- Department of Refractive Surgery, Aier Eye Hospital, Jinan University, Guangzhou, Guangdong Province, China
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Martínez-Plaza E, López-de la Rosa A, Ossa-Calderon C, Blázquez-Arauzo F, López-Miguel A, Maldonado MJ. Assessment of the iridocorneal angle pigmentation and structures after the implantation of EVO+ Visian Implantable Collamer Lens. Int Ophthalmol 2023; 43:4711-4718. [PMID: 37697080 DOI: 10.1007/s10792-023-02871-3] [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: 03/08/2023] [Accepted: 08/26/2023] [Indexed: 09/13/2023]
Abstract
PURPOSE To evaluate the effect of EVO+ Visian Implantable Collamer Lens (ICL) implantation on the iridocorneal angle pigmentation and structures. METHODS Myopic refractive surgery candidates who underwent posterior chamber EVO+ ICL implantation were evaluated preoperatively and 3 and 6 months postoperatively. High-resolution images of the iridocorneal angle (nasal, superior, temporal and inferior quadrants) were acquired during gonioscopy. A masked observer, blinded to study visits and patients' information, evaluated the angle width, apparent iris root insertion, iris configuration, and trabecular meshwork pigmentation according to the Spaeth scale in two different occasions. The intra-rater reliability was estimated using the weighted Gwet's Agreement Coefficient (AC2). Differences between visits were analyzed using the Cochran Q test or the Friedman test. RESULTS Twenty-one patients (13 females and 8 males) aging 31.3 ± 6.3 years old were recruited. The intra-rater reliability of gonioscopy assessment was excellent for every parameter assessed (AC2 ≥ 0.97). No significant differences were found among the study visits for any quadrant in the angle width (p ≥ 0.74), apparent iris root insertion (p ≥ 0.22), iris configuration (p ≥ 0.21) and trabecular meshwork pigmentation (p ≥ 0.24). Mean pigmentation of trabecular meshwork for the four quadrants did not vary either among visits (p = 0.25). CONCLUSIONS The EVO+ ICL implantation after uneventful procedures appears not to clinically affect the iridocorneal angle pigmentation and/or structures during a short-medium follow-up using gonioscopy assessment. The intra-rater reliability of glaucoma specialists assessing iridocorneal angle structures using gonioscopy images is very high.
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Affiliation(s)
- Elena Martínez-Plaza
- 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
- Departamento de Física Teórica, Atómica y Óptica, Facultad de Ciencias, Universidad de Valladolid, Valladolid, Spain
| | - Carolina Ossa-Calderon
- Instituto de Oftalmobiología Aplicada (IOBA), Universidad de Valladolid, Paseo de Belén 17, 47011, Valladolid, Spain
| | - Francisco Blázquez-Arauzo
- 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.
- Departamento de Cirugía, Oftalmología, Otorrinolaringología y Fisioterapia, Facultad de Medicina, Universidad de Valladolid, 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
- Departamento de Cirugía, Oftalmología, Otorrinolaringología y Fisioterapia, Facultad de Medicina, Universidad de Valladolid, Valladolid, Spain
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Nuliqiman M, Xu M, Sun Y, Cao J, Chen P, Gao Q, Xu P, Ye J. Artificial Intelligence in Ophthalmic Surgery: Current Applications and Expectations. Clin Ophthalmol 2023; 17:3499-3511. [PMID: 38026589 PMCID: PMC10674717 DOI: 10.2147/opth.s438127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 11/09/2023] [Indexed: 12/01/2023] Open
Abstract
Artificial Intelligence (AI) has found rapidly growing applications in ophthalmology, achieving robust recognition and classification in most kind of ocular diseases. Ophthalmic surgery is one of the most delicate microsurgery, requiring high fineness and stability of surgeons. The massive demand of the AI assist ophthalmic surgery will constitute an important factor in boosting accelerate precision medicine. In clinical practice, it is instrumental to update and review the considerable evidence of the current AI technologies utilized in the investigation of ophthalmic surgery involved in both the progression and innovation of precision medicine. Bibliographic databases including PubMed and Google Scholar were searched using keywords such as "ophthalmic surgery", "surgical selection", "candidate screening", and "robot-assisted surgery" to find articles about AI technology published from 2018 to 2023. In addition to the Editorials and letters to the editor, all types of approaches are considered. In this paper, we will provide an up-to-date review of artificial intelligence in eye surgery, with a specific focus on its application to candidate screening, surgery selection, postoperative prediction, and real-time intraoperative guidance.
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Affiliation(s)
- Maimaiti Nuliqiman
- Eye Center, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Zhejiang Provincial Key Laboratory of Ophthalmology, Zhejiang Provincial Clinical Research Center for Eye Diseases, Zhejiang Provincial Engineering Institute on Eye Diseases, Hangzhou, Zhejiang, People’s Republic of China
| | - Mingyu Xu
- Eye Center, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Zhejiang Provincial Key Laboratory of Ophthalmology, Zhejiang Provincial Clinical Research Center for Eye Diseases, Zhejiang Provincial Engineering Institute on Eye Diseases, Hangzhou, Zhejiang, People’s Republic of China
| | - Yiming Sun
- Eye Center, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Zhejiang Provincial Key Laboratory of Ophthalmology, Zhejiang Provincial Clinical Research Center for Eye Diseases, Zhejiang Provincial Engineering Institute on Eye Diseases, Hangzhou, Zhejiang, People’s Republic of China
| | - Jing Cao
- Eye Center, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Zhejiang Provincial Key Laboratory of Ophthalmology, Zhejiang Provincial Clinical Research Center for Eye Diseases, Zhejiang Provincial Engineering Institute on Eye Diseases, Hangzhou, Zhejiang, People’s Republic of China
| | - Pengjie Chen
- Eye Center, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Zhejiang Provincial Key Laboratory of Ophthalmology, Zhejiang Provincial Clinical Research Center for Eye Diseases, Zhejiang Provincial Engineering Institute on Eye Diseases, Hangzhou, Zhejiang, People’s Republic of China
| | - Qi Gao
- Eye Center, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Zhejiang Provincial Key Laboratory of Ophthalmology, Zhejiang Provincial Clinical Research Center for Eye Diseases, Zhejiang Provincial Engineering Institute on Eye Diseases, Hangzhou, Zhejiang, People’s Republic of China
| | - Peifang Xu
- Eye Center, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Zhejiang Provincial Key Laboratory of Ophthalmology, Zhejiang Provincial Clinical Research Center for Eye Diseases, Zhejiang Provincial Engineering Institute on Eye Diseases, Hangzhou, Zhejiang, People’s Republic of China
| | - Juan Ye
- Eye Center, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Zhejiang Provincial Key Laboratory of Ophthalmology, Zhejiang Provincial Clinical Research Center for Eye Diseases, Zhejiang Provincial Engineering Institute on Eye Diseases, Hangzhou, Zhejiang, People’s Republic of China
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Xu Y, Ye Y, Xian Y, Niu L, Zhou X, Zhao J. Comparison of corneal and lens density measurements obtained by Pentacam and CASIA2 in myopes. BMC Ophthalmol 2023; 23:448. [PMID: 37950259 PMCID: PMC10636911 DOI: 10.1186/s12886-023-03199-3] [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: 01/30/2023] [Accepted: 11/03/2023] [Indexed: 11/12/2023] Open
Abstract
PURPOSE To investigate the agreement between Pentacam and CASIA2 in the evaluation of corneal densities (CDs) and lens densities (LDs) in myopes. METHODS Fifty-three patients (106 eyes) underwent comprehensive ophthalmologic examinations. CDs and LDs were measured using Pentacam and CASIA2, respectively, based on the grayscale percentage of the obtained images. Agreement between Pentacam and CASIA2 was evaluated using the consistency intraclass correlation coefficient (ICC) and represented using Bland-Altman plots. RESULTS Compared to Pentacam, CASIA2 showed significantly higher CD and LD values in all measured zones. The ICC of the average CD and LD measured by the Pentacam and CASIA2 were 0.726 and 0.757, respectively. The ICC values of all corneal zones and lenses were above 0.7, except for the measurement of the cornea in the 0-2 mm zone (0.455), suggesting good consistency between the two devices, whose results were of different levels of linear correlation. Bland-Altman plots showed mean percentages of 3.93% for the points falling outside the limits of agreement among the densitometry results. The ICCs in different age groups were similar, but the agreement was poorer in the high myopia group (low and moderate myopia, CD: 0.739, LD: 0.753; high myopia, CD: 0.621, LD: 0.760). CONCLUSIONS CASIA2 demonstrated good consistency with Pentacam in the measurement of CD and LD, except for measurement of CD in the central cornea and in high myopia. Despite difference in the numerical results compared with Pentacam, which made the two devices uninterchangeable, CASIA2 provides a reliable alternative densitometric measurement method.
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Affiliation(s)
- Yijia Xu
- Department of Ophthalmology, NHC Key Laboratory of Myopia, Laboratory of Myopia, Eye and ENT Hospital of Fudan University, Chinese Academy of Medical Sciences, 83 Fenyang Road, Shanghai, 200031, 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
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care, Shanghai, China
| | - Yuhao Ye
- Department of Ophthalmology, NHC Key Laboratory of Myopia, Laboratory of Myopia, Eye and ENT Hospital of Fudan University, Chinese Academy of Medical Sciences, 83 Fenyang Road, Shanghai, 200031, 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
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care, Shanghai, China
| | - Yiyong Xian
- Department of Ophthalmology, NHC Key Laboratory of Myopia, Laboratory of Myopia, Eye and ENT Hospital of Fudan University, Chinese Academy of Medical Sciences, 83 Fenyang Road, Shanghai, 200031, 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
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care, Shanghai, China
| | - Lingling Niu
- Department of Ophthalmology, NHC Key Laboratory of Myopia, Laboratory of Myopia, Eye and ENT Hospital of Fudan University, Chinese Academy of Medical Sciences, 83 Fenyang Road, Shanghai, 200031, 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
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care, Shanghai, China
| | - Xingtao Zhou
- Department of Ophthalmology, NHC Key Laboratory of Myopia, Laboratory of Myopia, Eye and ENT Hospital of Fudan University, Chinese Academy of Medical Sciences, 83 Fenyang Road, Shanghai, 200031, 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.
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care, Shanghai, China.
| | - Jing Zhao
- Department of Ophthalmology, NHC Key Laboratory of Myopia, Laboratory of Myopia, Eye and ENT Hospital of Fudan University, Chinese Academy of Medical Sciences, 83 Fenyang Road, Shanghai, 200031, 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.
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care, Shanghai, China.
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Tan W, Wang Z, Zeng Q, Lei X, Pan C, Shu B, Jin L, Chen Q. The influence of iris -ciliary angle (ICA) on the vault after implantation of V4c implantable collamer lens: a chain mediation model of ICL haptic related factors. BMC Ophthalmol 2023; 23:403. [PMID: 37803302 PMCID: PMC10559582 DOI: 10.1186/s12886-023-03122-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Accepted: 09/01/2023] [Indexed: 10/08/2023] Open
Abstract
BACKGROUND This study aims to identify the relationship between iris -ciliary angle (ICA) and the vault. Additionally, we also seek to investigate the chain mediating effects of the ICL haptic related factors on this relationship. METHODS The participants were categorized into three groups according to the ICA value as follows: low ICA group (< 35°); moderate ICA group (35°-70°); high ICA group (> 70°). We compared the preoperative ocular characteristics and postoperative examinations among the three groups. Multiple variable stepwise regression was performed to establish the vault prediction formula. The Process V4.0 in SPSS and Hayes's PROCESS model 6 was conducted to further elucidate the mediating effects of the final tip point of ICL haptic and the ICL arc-lens arc on the relationship between the ICA and vault. RESULTS There was a significant difference in the positions of the ICL haptic among three ICA groups. The regression vault equation was Vault = 679.42-7.26*TCA + 192.30*ACD-196.37*CLR + 73.21* STS(horizontal).A significant negative correlation was found between the ICA and vault (P < 0.01).The chain mediation model revealed that the final tip point of ICL haptic and the ICL arc-Lens arc were sequential mediators between ICA and vault (effect = -1.63, 95% CI = -2.72--0.73). CONCLUSION The ICA was associated with vault via the mediation effect of the final tip point of the ICL haptic and the ICL arc -lens arc. Assessment of ICL haptic related parameters adds significant information to interpret the vault after surgery.
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Affiliation(s)
- Weina Tan
- Aier Eye Hospital of Wuhan University (Wuhan Aier Eye Hospital), Wuhan, Hubei Province, People's Republic of China
- Hankou Aier Eye Hospital, Wuhan, Hubei Province, People's Republic of China
| | - Zheng Wang
- Aier Institute of Refractive Surgery, Guangzhou, Guangdong Province, People's Republic of China
| | - Qingyan Zeng
- Aier Eye Hospital of Wuhan University (Wuhan Aier Eye Hospital), Wuhan, Hubei Province, People's Republic of China
- Hankou Aier Eye Hospital, Wuhan, Hubei Province, People's Republic of China
| | - Xiaohua Lei
- Aier Eye Hospital of Wuhan University (Wuhan Aier Eye Hospital), Wuhan, Hubei Province, People's Republic of China
- Hankou Aier Eye Hospital, Wuhan, Hubei Province, People's Republic of China
| | - Chao Pan
- Aier Eye Hospital of Wuhan University (Wuhan Aier Eye Hospital), Wuhan, Hubei Province, People's Republic of China
- Hankou Aier Eye Hospital, Wuhan, Hubei Province, People's Republic of China
| | - Bao Shu
- Aier Eye Hospital of Wuhan University (Wuhan Aier Eye Hospital), Wuhan, Hubei Province, People's Republic of China
- Hankou Aier Eye Hospital, Wuhan, Hubei Province, People's Republic of China
| | - Lina Jin
- Aier Eye Hospital of Wuhan University (Wuhan Aier Eye Hospital), Wuhan, Hubei Province, People's Republic of China
- Hankou Aier Eye Hospital, Wuhan, Hubei Province, People's Republic of China
| | - Qian Chen
- Aier Eye Hospital of Wuhan University (Wuhan Aier Eye Hospital), Wuhan, Hubei Province, People's Republic of China.
- Hongshan Aier Eye Hospital, Wuhan, Hubei Province, People's Republic of China.
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Cunha-Pachon S, Rodriguez-Una I, Rodriguez-Calvo PP, Garcia M, Lozano-Sanroma J, Alvarez-Prada M, Merayo-Lloves J, Alfonso JF. Effect of phakic collamer intraocular lens with a central hole on structural tests measurements of retinal nerve fiber layer and macula. Eur J Ophthalmol 2023; 33:1977-1985. [PMID: 36855278 DOI: 10.1177/11206721231155519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2023]
Abstract
AIM To evaluate whether the Visian Implantable Collamer Lens with a central port (V4c ICL®; STAAR Surgical, Switzerland) affects the retinal nerve fibre layer (RNFL), macula and optic nerve head (ONH) measurements obtained by optical coherence tomography (OCT), and Heidelberg Retina Tomography (HRT). METHODS This prospective study included myopic patients undergoing V4c ICL® implantation. RNFL thickness, macular thickness, ganglion cell analysis (GCA) and ONH main parameters were evaluated with RTVue OCT (Optovue Inc., USA) and Cirrus-HD OCT (Carl Zeiss Meditec, USA). ONH variables were also analysed with HRT-3 (Heidelberg Engineering, Germany). All measurements were performed before and 1 week and 12 months after the surgery. RESULTS 31 eyes of 31 patients (mean age 30.1 ± 5.5 years) were included. Comparing with preoperative values, no significant differences in average RNFL thickness were found with RTVue, while a slight increase (4.3 µm) was detected with Cirrus-HD (85.2 ± 10.3 µm, preoperatively) at 1-week postoperatively (89.5 ± 8.3 µm; p < 0.05). Those changes were not observed at the last follow-up visit (86.6 ± 8.6 µm; p = 0.41). Cirrus-HD detected that macular thickness was slightly higher 1 week after surgery, compared with the preoperative examination (3.4% increase; p = 0.04). That difference remained stable at the 12-month postoperative visit (p = 0.01). GCA showed no changes. The ONH analysis with Cirrus-HD determined that rim area (p = 0.03) as well as disc area (p = 0.04) significantly increased. HRT-3 found no significant changes affecting those variables. CONCLUSIONS The implantation of V4c ICL® did not induce a clinically significant impact on the results of the RNFL/ONH analysis with OCT and HRT.
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Affiliation(s)
- Susy Cunha-Pachon
- Ophthalmology Department, Universidade Federal do Triângulo Mineiro, Uberaba, Brazil
| | - Ignacio Rodriguez-Una
- Instituto Oftalmológico Fernández-Vega, Oviedo, Spain
- Instituto Universitario Fernández-Vega, Fundación de Investigación Oftalmológica, University of Oviedo, Oviedo, Spain
| | | | - Montserrat Garcia
- Instituto Universitario Fernández-Vega, Fundación de Investigación Oftalmológica, University of Oviedo, Oviedo, Spain
| | | | | | - Jesus Merayo-Lloves
- Instituto Oftalmológico Fernández-Vega, Oviedo, Spain
- Instituto Universitario Fernández-Vega, Fundación de Investigación Oftalmológica, University of Oviedo, Oviedo, Spain
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Liu X, Zeng Q, Lu T, Wang M, Sun Y, Zhang J. Case report: Spontaneous lens absorption after the implantation of an implantable collamer lens. Front Med (Lausanne) 2023; 10:1202691. [PMID: 37601785 PMCID: PMC10435081 DOI: 10.3389/fmed.2023.1202691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2023] [Accepted: 07/07/2023] [Indexed: 08/22/2023] Open
Abstract
Background Spontaneous lens absorption is rare and usually occurs in eyes with certain syndromes, hyper-mature cataracts, and ocular trauma. The application of an implantable collamer lens (ICL) is widely performed in patients with high myopia for refractive correction. This study reports a case of spontaneous lens absorption after ICL implantation. Case summary A 23-year-old man was referred with complaints of poor vision in his left eye. The patient had undergone binocular ICL implantation for refractive correction of high myopia 1.5 years prior. Approximately 10 months later, he experienced a sudden loss of vision and pain in his left eye, which resolved spontaneously the next day without any treatment. Since then, the visual acuity in his left eye gradually decreased. At presentation, slit-lamp examination revealed an ICL in the posterior chamber of both eyes, with anterior capsular fibrotic proliferation and posterior capsular opacity, and the residual lens cortex sandwiched between the anterior fibrotic membrane and opacified posterior lens capsule in his left eye. The number of corneal endothelial cells in his left eye was 1,337, which was lower than before ICL implantation (2,902). The patient then underwent ICL extraction, anterior capsular capsulotomy, residual cortex aspiration, posterior capsular polishing, and intraocular lens implantation. Conclusions Spontaneous lens absorption may occur in patients with ICL implantation. Patients should undergo routine follow-ups after ICL implantation.
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Affiliation(s)
- Xiaojing Liu
- Department of Ophthalmology, Jiading Branch of the Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qiulin Zeng
- Department of Ophthalmology, Shanghai Xinshijie Eye Hospital, Shanghai, China
| | - Ting Lu
- Department of Ophthalmology, Jiading Branch of the Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Min Wang
- Department of Ophthalmology, Jiading Branch of the Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yong Sun
- Department of Ophthalmology, Jiading Branch of the Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jingfa Zhang
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Beltrán-Murcia J, Capelo LÁR, Blázquez-Sánchez V. Analysis of vault prediction in phakic implantable phakic collamer lenses: manufacturer's calculator vs theoretical formulae vs clinical practice. Graefes Arch Clin Exp Ophthalmol 2023; 261:2403-2409. [PMID: 36914818 DOI: 10.1007/s00417-023-06016-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 12/06/2022] [Accepted: 02/22/2023] [Indexed: 03/15/2023] Open
Abstract
BACKGROUND Implantable collamer phakic (ICL) intraocular lens sizing calculations are necessary to avoid complications associated to inadequate sizing. Historically, Holladay R, Dougherty, Hernández-Matamoros, and other authors have tried to create new formulas that solve calculation problems and provide higher reliability. In addition, in recent years, the appearance of new equipment, parameters, and formulas have led to significant progress. This paper compares the sizing according to manufacturer's method and other methods. METHODS Forty-three eyes of 24 patients with EVO ICL implanted, with at least 1 year of follow-up, were analysed. The analysed variables were white to white (WTW), anterior chamber depth (ACD), ACW (angle-to-angle), crystalline lens rise (CLR), ICL size, vault measured at 1 week and 1 year after surgery, ICL size, and vault predicted by Nakamura-2 as well as vault size predicted by Igarashi. RESULTS Sizing calculation with Online Calculation and Ordering System according to WTW and ACD is a good indicator with 86% success rate. The calculation with Nakamura 2 suggests larger ICL sizes in 32.5% of cases and smaller in 18.6% of cases, while the resulting Vault according to Igarashi obtains better results without significant differences. CONCLUSIONS ICL sizing according WTW and ACD, using the manufacturer's algorithm, seems to be the most predictable method compared to other algorithms using other variables. The surgeon's expertise also has a high importance in the final ICL size election.
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Affiliation(s)
| | | | - Vanesa Blázquez-Sánchez
- Faculty of Optics and Optometry, Complutense University, Madrid, Spain.
- Clínica Rementería, 36 Almagro Street, 28010, Madrid, Spain.
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20
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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.
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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
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21
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Sánchez-Trancón A, Manito SC, Sierra OT, Baptista AM, Serra PM. Prediction model of the horizontal trabecular iris angle after phakic posterior chamber implantable intraocular lens surgery. J Cataract Refract Surg 2023; 49:732-739. [PMID: 36807205 DOI: 10.1097/j.jcrs.0000000000001171] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 02/14/2023] [Indexed: 02/23/2023]
Abstract
PURPOSE To determine the predictors of the postoperative horizontal trabecular iris angle (TIA 750 ) after phakic posterior chamber implantable intraocular lens (IOL) surgery. SETTING Ophthalmology Clinic Vista Sánchez Trancón, Badajoz, Spain. DESIGN Retrospective case series. METHODS 330 eyes implanted with spherical/toric implantable collamer lens (ICL) were included in this study. From 230 eyes implanted with 13.2 mm ICL, these were divided in modeling (n = 180) and evaluation group (n = 50). Two groups implanted with 12.6 mm and 13.7 mm (n = 50 each) were also used as evaluation. Anterior-segment optical coherence tomography was used preoperatively to perform anterior chamber biometry (angle-to-angle [ATA] distance, crystalline lens rise, anterior chamber depth [ACD], cornea sagittal depth, pupil diameter, nasal/temporal TIA 750 ); postoperatively for measuring the vault, pupil diameter and nasal/temporal TIA 750 . Corneal curvature and horizontal visible iris diameter were measured using optical tomography. Bivariate correlation analysis was used to determine associations between preoperative and postoperative horizontal TIA 750 with anterior chamber biometry, ICL-related parameters and age. Finally, a multivariate linear regression model was constructed for predicting the postoperative TIA 750 . RESULTS Horizontal TIA 750 reduced from 42.9 ± 8.0 degrees preoperatively to 24.4 ± 5.6 degrees postoperatively. Postoperative TIA 750 was positively correlated with the preoperative TIA 750 , cornea sagittal depth and ACD, and negatively associated with the vault. The main predictors of the postoperative TIA 750 were the preoperative parameters, TIA 750 , ICLsize - ATA and pupil diameter (adjusted- R2 = 0.39). The limits of agreement between predicted and real TIA 750 were close to ±10 degrees. CONCLUSIONS Implantation of a phakic posterior chamber implantable IOL leads to a reduction in TIA 750 and the main factors contributing for this are the preoperative TIA 750 aperture and the vault.
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Affiliation(s)
- Angel Sánchez-Trancón
- From the Ophthalmology Clinic Vista Sánchez Trancón, Badajoz, Spain (Sánchez-Trancón, Manito, Sierra, Serra); Centre of Physics, University of Minho, Braga, Portugal (Baptista)
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22
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Chen X, Ye Y, Yao H, Liu C, He A, Hou X, Zhao K, Cui Z, Li Y, Qiu J, Chen P, Yang Y, Zhuang J, Yu K. Predicting post-operative vault and optimal implantable collamer lens size using machine learning based on various ophthalmic device combinations. Biomed Eng Online 2023; 22:59. [PMID: 37322471 DOI: 10.1186/s12938-023-01123-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 05/31/2023] [Indexed: 06/17/2023] Open
Abstract
BACKGROUND Implantable Collamer Lens (ICL) surgery has been proven to be a safe, effective, and predictable method for correcting myopia and myopic astigmatism. However, predicting the vault and ideal ICL size remains technically challenging. Despite the growing use of artificial intelligence (AI) in ophthalmology, no AI studies have provided available choices of different instruments and combinations for further vault and size predictions. This study aimed to fill this gap and predict post-operative vault and appropriate ICL size utilizing the comparison of numerous AI algorithms, stacking ensemble learning, and data from various ophthalmic devices and combinations. RESULTS This retrospective and cross-sectional study included 1941 eyes of 1941 patients from Zhongshan Ophthalmic Center. For both vault prediction and ICL size selection, the combination containing Pentacam, Sirius, and UBM demonstrated the best results in test sets [R2 = 0.499 (95% CI 0.470-0.528), mean absolute error = 130.655 (95% CI 128.949-132.111), accuracy = 0.895 (95% CI 0.883-0.907), AUC = 0.928 (95% CI 0.916-0.941)]. Sulcus-to-sulcus (STS), a parameter from UBM, ranked among the top five significant contributors to both post-operative vault and optimal ICL size prediction, consistently outperforming white-to-white (WTW). Moreover, dual-device combinations or single-device parameters could also effectively predict vault and ideal ICL size, and excellent ICL selection prediction was achievable using only UBM parameters. CONCLUSIONS Strategies based on multiple machine learning algorithms for different ophthalmic devices and combinations are applicable for vault predicting and ICL sizing, potentially improving the safety of the ICL implantation. Moreover, our findings emphasize the crucial role of UBM in the perioperative period of ICL surgery, as it provides key STS measurements that outperformed WTW measurements in predicting post-operative vault and optimal ICL size, highlighting its potential to enhance ICL implantation safety and accuracy.
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Affiliation(s)
- Xi Chen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Sun Yat-Sen University, Guangzhou, People's Republic of China
| | - Yiming Ye
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Sun Yat-Sen University, Guangzhou, People's Republic of China
| | - Huan Yao
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Sun Yat-Sen University, Guangzhou, People's Republic of China
| | - Chang Liu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Sun Yat-Sen University, Guangzhou, People's Republic of China
| | - Anqi He
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Sun Yat-Sen University, Guangzhou, People's Republic of China
| | - Xiangtao Hou
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Sun Yat-Sen University, Guangzhou, People's Republic of China
| | - Keming Zhao
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Sun Yat-Sen University, Guangzhou, People's Republic of China
| | - Zedu Cui
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Sun Yat-Sen University, Guangzhou, People's Republic of China
| | - Yan Li
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Sun Yat-Sen University, Guangzhou, People's Republic of China
| | - Jin Qiu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Sun Yat-Sen University, Guangzhou, People's Republic of China
| | - Pei Chen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Sun Yat-Sen University, Guangzhou, People's Republic of China
| | - Ying Yang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Sun Yat-Sen University, Guangzhou, People's Republic of China
| | - Jing Zhuang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Sun Yat-Sen University, Guangzhou, People's Republic of China.
| | - Keming Yu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Sun Yat-Sen University, Guangzhou, People's Republic of China.
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23
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Yang J, Zou Z, Wu M, He R, Nong Y, Li H, Zhou S. Development and validation of a new multivariable prediction model to estimate risk of abnormal vault. BMC Ophthalmol 2023; 23:203. [PMID: 37165326 PMCID: PMC10170721 DOI: 10.1186/s12886-023-02956-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Accepted: 05/03/2023] [Indexed: 05/12/2023] Open
Abstract
PURPOSE To develop and validate a new multivariable prediction model to estimate risk of abnormal vault after EVO Implantable Collamer Lens (EVO-ICL) implantation using the preoperative parameters. METHODS This retrospective study comprised 282 eyes of 143patients who underwent EVO-ICL surgery between May 2021 and April 2022. We measured preoperative parameters before surgery and vaults in 1 week after the operation using swept-source optical coherence tomography (SS-OCT). Risk factors for abnormal vault were determined by univariate and multivariate logistic regression analyses, and a nomogram was developed to forecast the risk of abnormal vault after EVO-ICL implantation. We assessed the performance of nomogram in terms of discrimination and calibration, including concordance index (C-index), receiver operating characteristic curve (ROC), area under the ROC curve (AUC), and decision curve analysis (DCA). Bootstrap resampling was used as an internal verification method. RESULTS The logistic regression analysis revealed the independent risk factors for abnormal vault were white-to-white(WTW), anterior chamber angle(ACA), pupil size, and ICL-size, all of them were used to establish a nomogram based on multivariate logistic regression to predict the risk of abnormal vault. The C-indexes and AUC were 0.669 (95%CI, 0.605, 0.733). The calibration curves of the nomogram showed relatively small bias from the reference line, implicating an acceptable degree of confidence. The DCA indicates the potential clinical significance of the nomogram. CONCLUSIONS We developed a new multivariable prediction model to estimate risk of abnormal vault. The model shows good prediction effect and can provide assistance for clinical decision of ICL size.
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Affiliation(s)
- Jing Yang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, People's Republic of China.
| | - Zongyin Zou
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Minhui Wu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Runzhang He
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Yating Nong
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Hui Li
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Sheng Zhou
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, People's Republic of China.
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24
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Vacalebre M, Frison R, Corsaro C, Neri F, Santoro A, Conoci S, Anastasi E, Curatolo MC, Fazio E. Current State of the Art and Next Generation of Materials for a Customized IntraOcular Lens according to a Patient-Specific Eye Power. Polymers (Basel) 2023; 15:polym15061590. [PMID: 36987370 PMCID: PMC10054364 DOI: 10.3390/polym15061590] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 03/19/2023] [Accepted: 03/20/2023] [Indexed: 03/30/2023] Open
Abstract
Intraocular lenses (IOLs) are commonly implanted after surgical removal of a cataractous lens. A variety of IOL materials are currently available, including collamer, hydrophobic acrylic, hydrophilic acrylic, PHEMA copolymer, polymethylmethacrylate (PMMA), and silicone. High-quality polymers with distinct physical and optical properties for IOL manufacturing and in line with the highest quality standards on the market have evolved to encompass medical needs. Each of them and their packaging show unique advantages and disadvantages. Here, we highlight the evolution of polymeric materials and mainly the current state of the art of the unique properties of some polymeric systems used for IOL design, identifying current limitations for future improvements. We investigate the characteristics of the next generation of IOL materials, which must satisfy biocompatibility requirements and have tuneable refractive index to create patient-specific eye power, preventing formation of posterior capsular opacification.
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Affiliation(s)
- Martina Vacalebre
- Dipartimento di Scienze Matematiche ed Informatiche, Scienze Fisiche e Scienze della Terra (MIFT), Università di Messina, V.le Ferdinando Stagno d'Alcontres 31, 98166 Messina, Italy
| | - Renato Frison
- Optical Consultant SIFI SpA, 95025 Aci Sant'Antonio (CT), Italy
| | - Carmelo Corsaro
- Dipartimento di Scienze Matematiche ed Informatiche, Scienze Fisiche e Scienze della Terra (MIFT), Università di Messina, V.le Ferdinando Stagno d'Alcontres 31, 98166 Messina, Italy
| | - Fortunato Neri
- Dipartimento di Scienze Matematiche ed Informatiche, Scienze Fisiche e Scienze della Terra (MIFT), Università di Messina, V.le Ferdinando Stagno d'Alcontres 31, 98166 Messina, Italy
| | - Antonio Santoro
- Dipartimento di Scienze Chimiche, Biologiche, Farmacologiche ed Ambientali (CHIBIOFARAM), Università di Messina, V.le Ferdinando Stagno d'Alcontres 31, 98166 Messina, Italy
| | - Sabrina Conoci
- Dipartimento di Scienze Chimiche, Biologiche, Farmacologiche ed Ambientali (CHIBIOFARAM), Università di Messina, V.le Ferdinando Stagno d'Alcontres 31, 98166 Messina, Italy
| | - Elena Anastasi
- Innovation and Medical Science, SIFI SpA, 95025 Aci Sant'Antonio (CT), Italy
| | | | - Enza Fazio
- Dipartimento di Scienze Matematiche ed Informatiche, Scienze Fisiche e Scienze della Terra (MIFT), Università di Messina, V.le Ferdinando Stagno d'Alcontres 31, 98166 Messina, Italy
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Li H, Zhang J, Shao T, Wang H, Liu S, Long K. Two-year stability of posterior corneal surface after transepithelial photorefractive keratectomy with a residual stromal thickness less than 350 μm. Graefes Arch Clin Exp Ophthalmol 2023; 261:857-865. [PMID: 36138148 DOI: 10.1007/s00417-022-05814-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 07/16/2022] [Accepted: 08/19/2022] [Indexed: 11/04/2022] Open
Abstract
PURPOSE This study aimed to investigate the stability of posterior corneal surface 2 years after transepithelial photorefractive keratectomy (TPRK) in patients with a residual stromal thickness less than 350 μm. METHODS In total, 408 eyes of 212 patients (160 women, 52 men) who underwent TPRK were enrolled in this retrospective study. All surgeries were performed in the Amaris 750S excimer laser platform with smart pulse technology. The posterior corneal elevation, anterior chamber depth, Q value, and curvature were measured using Pentacam preoperatively and postoperatively. All patients were followed up for 2 years. The relationship between percent tissue altered (PTA), age, and changes in posterior corneal surface was analyzed. RESULTS The mean preoperative spherical equivalent was - 6.80 ± 1.18 D (range: - 9.00 to - 2.63 D). The mean residual stromal thickness was 336.46 ± 7.25 μm (range: 310-348 μm). The mean PTA was 30.93 ± 2.03% (range: 24.29-35.28%). At 2 years after surgery, the elevation of six points in the central area decreased by 1.91 ± 2.97 μm, 2.98 ± 3.23 μm, 1.17 ± 3.85 μm, 1.70 ± 2.88 μm, 1.36 ± 3.19 μm, and 1.65 ± 3.18 μm, compared with the preoperative value (P < 0.05). The elevation of three points in the peripheral area increased by 1.87 ± 6.34 μm, 0.68 ± 6.00 μm, and 0.95 ± 5.50 μm (P < 0.05). There was no significant linear relationship between PTA, age, and changes in posterior corneal surface, anterior chamber depth, and K2 (all P > 0.05). CONCLUSION Within 2 years after TPRK, the posterior corneal surface remained stable in patients with a residual stromal thickness between 310 and 350 μm. There was no sign of iatrogenic ectasia during the follow-up period.
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Affiliation(s)
- Hua Li
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Qingdao Eye Hospital of Shandong First Medical University, Eye Institute of Shandong First Medical University, Qingdao, 266071, Shandong Province, China
| | - Jiafan Zhang
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Qingdao Eye Hospital of Shandong First Medical University, Eye Institute of Shandong First Medical University, Qingdao, 266071, Shandong Province, China
| | - Ting Shao
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Qingdao Eye Hospital of Shandong First Medical University, Eye Institute of Shandong First Medical University, Qingdao, 266071, Shandong Province, China
| | - Huifeng Wang
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Qingdao Eye Hospital of Shandong First Medical University, Eye Institute of Shandong First Medical University, Qingdao, 266071, Shandong Province, China
| | - Sai Liu
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Qingdao Eye Hospital of Shandong First Medical University, Eye Institute of Shandong First Medical University, Qingdao, 266071, Shandong Province, China
| | - Keli Long
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Qingdao Eye Hospital of Shandong First Medical University, Eye Institute of Shandong First Medical University, Qingdao, 266071, Shandong Province, China.
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26
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Kim T, Kim SJ, Lee BY, Cho HJ, Sa BG, Ryu IH, Kim JK, Lee IS, Han E, Kim H, Yoo TK. Development of an implantable collamer lens sizing model: a retrospective study using ANTERION swept-source optical coherence tomography and a literature review. BMC Ophthalmol 2023; 23:59. [PMID: 36765328 PMCID: PMC9921691 DOI: 10.1186/s12886-023-02814-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 02/09/2023] [Indexed: 02/12/2023] Open
Abstract
BACKGROUND Optimal sizing for phakic intraocular lens (EVO-ICL with KS-AquaPort) implantation plays an important role in preventing postoperative complications. We aimed to formulate optimal lens sizing using ocular biometric parameters measured with a Heidelberg anterior segment optical coherence tomography (AS-OCT) device. METHODS We retrospectively analyzed 892 eyes of 471 healthy subjects treated with an intraocular collamer lens (ICL) and assigned them to either the development (80%) or validation (20%) set. We built vault prediction models using the development set via classic linear regression methods as well as partial least squares and least absolute shrinkage and selection operator (LASSO) regression techniques. We evaluated prediction abilities based on the Bayesian information criterion (BIC) to select the best prediction model. The performance was measured using Pearson's correlation coefficient and the mean squared error (MAE) between the achieved and predicted results. RESULTS Measurements of aqueous depth (AQD), anterior chamber volume, anterior chamber angle (ACA) distance, spur-to-spur distance, crystalline lens thickness (LT), and white-to-white distance from ANTERION were highly associated with the ICL vault. The LASSO model using the AQD, ACA distance, and LT showed the best BIC results for postoperative ICL vault prediction. In the validation dataset, the LASSO model showed the strongest correlation (r = 0.582, P < 0.001) and the lowest MAE (104.7 μm). CONCLUSION This is the first study to develop a postoperative ICL vault prediction and lens-sizing model based on the ANTERION. As the measurements from ANTERION and other AS-OCT devices are not interchangeable, ANTERION may be used for optimal ICL sizing using our formula. Because our model was developed based on the East Asian population, further studies are needed to explore the role of this prediction model in different populations.
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Affiliation(s)
| | | | | | | | | | - Ik Hee Ryu
- VISUWORKS, Seoul, South Korea ,Department of Refractive Surgery, B&VIIT Eye Center, 1317-23 Seocho-Dong, Seocho-Gu, Seoul, South Korea
| | - Jin Kuk Kim
- VISUWORKS, Seoul, South Korea ,Department of Refractive Surgery, B&VIIT Eye Center, 1317-23 Seocho-Dong, Seocho-Gu, Seoul, South Korea
| | - In Sik Lee
- Department of Refractive Surgery, B&VIIT Eye Center, 1317-23 Seocho-Dong, Seocho-Gu, Seoul, South Korea
| | - Eoksoo Han
- grid.36303.350000 0000 9148 4899Electronics and Telecommunications Research Institute (ETRI), Daejeon, South Korea
| | | | - Tae Keun Yoo
- VISUWORKS, Seoul, South Korea. .,Department of Refractive Surgery, B&VIIT Eye Center, 1317-23 Seocho-Dong, Seocho-Gu, Seoul, South Korea.
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Lisa Fernández C, Alió Del Barrio J, Alvarez-Rementería Capelo L, Cano Ortiz A, Castaño Manotas A, Fernández-Vega Cueto L, Hernández-Barahona Campos M, Lamarca Mateu J, López-Marín Espigares I, Monteiro T, Pastor Pascual F, Pérez Izquierdo R. State of refractive surgery with Visian ICL posterior chamber phakic lens in Spain. ARCHIVOS DE LA SOCIEDAD ESPANOLA DE OFTALMOLOGIA 2023; 98:98-104. [PMID: 36115821 DOI: 10.1016/j.oftale.2022.06.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 06/10/2022] [Indexed: 02/07/2023]
Abstract
OBJECTIVES To analyse the state of refractive surgery with Visian ICL phakic lens implantation in Spain, indicating the mean ranges of implanted powers, visual and refractive outcomes obtained and safety and efficacy indices. METHOD This is a population-based, cross-sectional, descriptive, analytical, retrospective, multicentre study in which each co-author collected data from at least the last 10 patients (up to a maximum of 30) with Visian ICL phakic lens implantation. One eye from each subject was randomly selected for study inclusion, and the variables analysed were: age, gender, visual acuities with and without correction pre and post-surgery, preoperative and residualrefraction, keratometry, endothelial cellular density, anterior chamber depth from endothelium, central corneal pachymetry, intraocular pressure, white-white, implanted lens (power and size), expected and achieved spherical equivalent (SEQ) post-surgery at one month after surgery. RESULTS A sample of 140 eyes was obtained from 140 patients with a mean age of 31.35 ± 7.28 years. Mean preoperative SEQ was -6.33 ± 3.69D, mean CDVA was 0.96 ± 0.16, ACD was 3.30 ± 0.29 mm, WTW 12.02 ± 0.40 mm, CCT 535.03 ± 37.68 µm, ECD 2684.37 ± 313.74 cels/mm2 and IOP 14.84 ± 2.59 mmHg. 66.4% of the implanted lenses were spherical ICLs and 33.6% toric, with a mean power of -7.81 ± 4.09D and a mean cylinder of 2.27 ± 1.23D. 5.7% of the implanted lenses were hypermetropic. The mean SEQ target selected was +0.04 ± 0.27D. 48.92% of the implanted lenses were of size 13.2 mm, with the remaining 36.69, 10.79 and 3.60% being of sizes 12.6, 12.1 and 13.7 mm, respectively. At one month after surgery a residual SEQ of -0.01 ± 0.31D was obtained. The efficacy and safety indices were 1.06 ± 0.18 and 1.10 ± 0.19, respectively. The mean central vault was 508.80 ± 201.04 µm. The accuracy between the calculated SEQ and the obtained SEQ was 99.3% for spherical lenses and 88.2% for Cyl correction. The mean ECD at 1 month after surgery was 2805.53±273.30céls/mm2, which was a difference from preoperative of 0.11% (p = 0.922), similarly, the mean IOP was 13.98 ± 2.57 mmHg, which was a difference of -0.92 ± 2.80 mmHg. CONCLUSIONS ICL phakic lens surgery is an effective, safe and predictable procedure. There were no significant changes in endothelial cell count or intraocular pressure measurement one month after surgery.
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Affiliation(s)
- C Lisa Fernández
- Instituto Oftalmológico Fernández-Vega, Oviedo, Asturias, Spain.
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Martínez-Plaza E, López-de la Rosa A, López-Miguel A, Holgueras A, Maldonado MJ. EVO/EVO+ Visian Implantable Collamer Lenses for the correction of myopia and myopia with astigmatism. Expert Rev Med Devices 2023; 20:75-83. [PMID: 36708714 DOI: 10.1080/17434440.2023.2174429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
INTRODUCTION Intraocular lens implantation in phakic eyes for the correction of refractive error is currently a widespread procedure. The EVO and EVO+ Visian Implantable Collamer Lenses (ICL) are two of the most prevalent lenses implanted. They incorporate a central orifice to avoid the need for iridotomy. The main difference between both ICL is the higher optical diameter zone provided by the EVO+, allowing a better quality of vision at night. This review aims to provide an overview of the current ICL models available for correcting myopia and myopic astigmatism. AREAS COVERED During the last decade, more than 100 scientific papers analyzing the performance of EVO and EVO+ lenses have been published. This review describes the objective visual performance achieved with the implantation of central hole ICL lenses and the subjective perception of the patients implanted with these lenses. In addition, the safety and the potential complications associated with undergoing an EVO and EVO+ ICL implantation have been addressed. EXPERT OPINION Refractive surgeons and candidates to undergo ICL implantation should be aware of the excellent safety and visual outcomes provided by the implantation of central hole ICL lenses. However, future research could address minor issues currently not resolved.
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Affiliation(s)
- Elena Martínez-Plaza
- Instituto de Oftalmobiología Aplicada (IOBA), Universidad de Valladolid, Valladolid, Spain
| | | | - Alberto López-Miguel
- Instituto de Oftalmobiología Aplicada (IOBA), Universidad de Valladolid, Valladolid, Spain
| | - Alfredo Holgueras
- Instituto de Oftalmobiología Aplicada (IOBA), Universidad de Valladolid, Valladolid, Spain
| | - Miguel J Maldonado
- Instituto de Oftalmobiología Aplicada (IOBA), Universidad de Valladolid, Valladolid, Spain
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Choi H, Kim T, Kim SJ, Sa BG, Ryu IH, Lee IS, Kim JK, Han E, Kim HK, Yoo TK. Predicting Postoperative Anterior Chamber Angle for Phakic Intraocular Lens Implantation Using Preoperative Anterior Segment Metrics. Transl Vis Sci Technol 2023; 12:10. [PMID: 36607625 PMCID: PMC9836008 DOI: 10.1167/tvst.12.1.10] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Purpose The anterior chamber angle (ACA) is a critical factor in posterior chamber phakic intraocular lens (EVO Implantable Collamer Lens [ICL]) implantation. Herein, we predicted postoperative ACAs to select the optimal ICL size to reduce narrow ACA-related complications. Methods Regression models were constructed using pre-operative anterior segment optical coherence tomography metrics to predict postoperative ACAs, including trabecular-iris angles (TIAs) and scleral-spur angles (SSAs) at 500 µm and 750 µm from the scleral spur (TIA500, TIA750, SSA500, and SSA750). Data from three expert surgeons were assigned to the development (N = 430 eyes) and internal validation (N = 108 eyes) datasets. Additionally, data from a novice surgeon (N = 42 eyes) were used for external validation. Results Postoperative ACAs were highly predictable using the machine-learning (ML) technique (extreme gradient boosting regression [XGBoost]), with mean absolute errors (MAEs) of 4.42 degrees, 3.77 degrees, 5.25 degrees, and 4.30 degrees for TIA500, TIA750, SSA500, and SSA750, respectively, in internal validation. External validation also showed MAEs of 3.93 degrees, 3.86 degrees, 5.02 degrees, and 4.74 degrees for TIA500, TIA750, SSA500, and SSA750, respectively. Linear regression using the pre-operative anterior chamber depth, anterior chamber width, crystalline lens rise, TIA, and ICL size also exhibited good performance, with no significant difference compared with XGBoost in the validation sets. Conclusions We developed linear regression and ML models to predict postoperative ACAs for ICL surgery anterior segment metrics. These will prevent surgeons from overlooking the risks associated with the narrowing of the ACA. Translational Relevance Using the proposed algorithms, surgeons can consider the postoperative ACAs to increase surgical accuracy and safety.
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Affiliation(s)
- Hannuy Choi
- Department of Refractive Surgery, B&VIIT Eye Center, Seoul, South Korea
| | - Taein Kim
- Research and Development Department, VISUWORKS, Seoul, South Korea
| | - Su Jeong Kim
- Research and Development Department, VISUWORKS, Seoul, South Korea
| | - Beom Gi Sa
- Research and Development Department, VISUWORKS, Seoul, South Korea
| | - Ik Hee Ryu
- Department of Refractive Surgery, B&VIIT Eye Center, Seoul, South Korea,Research and Development Department, VISUWORKS, Seoul, South Korea
| | - In Sik Lee
- Department of Refractive Surgery, B&VIIT Eye Center, Seoul, South Korea
| | - Jin Kuk Kim
- Department of Refractive Surgery, B&VIIT Eye Center, Seoul, South Korea
| | - Eoksoo Han
- Electronics and Telecommunications Research Institute (ETRI), Daejeon, South Korea
| | - Hong Kyu Kim
- Department of Ophthalmology, Dankook University Hospital, Dankook University College of Medicine, Cheonan, South Korea
| | - Tae Keun Yoo
- Department of Refractive Surgery, B&VIIT Eye Center, Seoul, South Korea,Research and Development Department, VISUWORKS, Seoul, South Korea
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Qian T, Du J, Ren R, Zhou H, Li H, Zhang Z, Xu X. Vault-Correlated Efficacy and Safety of Implantable Collamer Lens V4c Implantation for Myopia in Patients with Shallow Anterior Chamber Depth. Ophthalmic Res 2023; 66:445-456. [PMID: 36596292 DOI: 10.1159/000528616] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Accepted: 11/27/2022] [Indexed: 01/04/2023]
Abstract
INTRODUCTION The aim of the study was to evaluate efficacy and safety outcomes after implantation of the Visian Implantable Collamer Lens (ICL V4c) in myopia patients with shallow anterior chamber depth (ACD). METHODS This retrospective study followed 163 eyes of 94 patients for at least 24 months. Uncorrected distance visual acuity (UDVA), corrected distance visual acuity, intraocular pressure (IOP), manifest refraction, vault, endothelial cell density (ECD), anterior chamber angle (ACA), anterior chamber volume, and the distance from the corneal endothelium to the central ICL (C-ICL) were measured during follow-ups. Spearman's correlation and logistic regression were used to identify variables correlated with changes in ECD and potential risk factors for ineffective outcomes, respectively. RESULTS All surgeries were performed safely. High IOP of 9 eyes and anterior capsular opacity of 5 eyes were observed. The last follow-up ACA had a significant difference between the high and normal IOP groups (p = 0.0003). The mean ECD and vault were 2,855.76 ± 270.82 cells/mm2 and 388.01 ± 135.28 μm at the last follow-up, respectively. The vault and C-ICL were significantly associated with ΔECD (all p < 0.05). Furthermore, the vault was most responsible for the ECD loss. Twenty-two eyes had unsatisfactory postoperative UDVA, and the low vault at the last follow-up was a significant risk factor for this ineffective outcome (p < 0.001, OR = 14.739). CONCLUSIONS ICL V4c implantation in patients with shallow ACD achieved stable visual outcomes. The vault is related to postoperative visual acuity and ECD loss, which needs to be paid attention during follow-up.
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Affiliation(s)
- Tianwei Qian
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, China
- National Clinical Research Center for Eye Diseases, Shanghai, China
- Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai, China
- Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, China
- Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Disease, Shanghai, China
| | - Jingxiao Du
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, China
- National Clinical Research Center for Eye Diseases, Shanghai, China
- Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai, China
- Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, China
- Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Disease, Shanghai, China
| | - Ruixia Ren
- Shanghai Xinshijie Zhongxing Eye Hospital, Shanghai, China
| | - Hao Zhou
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, China
- National Clinical Research Center for Eye Diseases, Shanghai, China
- Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai, China
- Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, China
- Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Disease, Shanghai, China
| | - Haiyan Li
- Shanghai Xinshijie Zhongxing Eye Hospital, Shanghai, China
| | - Zhihua Zhang
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, China
- National Clinical Research Center for Eye Diseases, Shanghai, China
- Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai, China
- Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, China
- Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Disease, Shanghai, China
| | - Xun Xu
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, China
- National Clinical Research Center for Eye Diseases, Shanghai, China
- Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai, China
- Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, China
- Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Disease, Shanghai, China
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Zhang W, Li F, Li L, Zhang J. A quantitative study of the effect of ICL orientation selection on post-operative vault and model-assisted vault prediction. Front Neurol 2023; 14:1136579. [PMID: 36937516 PMCID: PMC10020497 DOI: 10.3389/fneur.2023.1136579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 02/14/2023] [Indexed: 03/06/2023] Open
Abstract
Background Appropriate vault height of implantable collamer lens (ICL) implantation matters for it has risks of corneal endothelial cell loss, cataract formation and intraocular pressure elevation, which could lead to irreversible damage to optic nerve. Therefore, pre-operative prediction for an ideal vault height is a hotspot. However, few data exist regarding quantitative effect of ICL orientation on vault height. This study is aimed to quantitatively investigate the effect of ICL implantation orientation on vault height, and built a machine-learning (ML)-based vault prediction model taking implantation orientation into account. Methods 473 consecutive case series treated with ICL implantation were retrospectively analyzed (408 were horizontally implanted, and 65 were vertically implanted). Multivariable logistic regression analysis was performed to determine the association between ICL orientation and achieved vault. ML was performed to develop a new vault height prediction model taking ICL orientation into account. Receiver operating characteristic curve (ROC) and net reclassification index (NRI) were obtained to assess the prediction ability. Results 95% of all the patients achieved 20/20 uncorrected distance visual acuity (UDVA) or better. No complications including cataract formation, dispersion or optic nerve injury were observed in any cases. Sex, sphere power, cylinder power, axis, ICL size and ICL orientation were all significant risk factors associated to vault height, and age was positively co-related. Of note, ICL size and ICL orientation were the top-ranking risk factors. Comparing to conventional horizontal implantation, vertical implantation could reduce the achieved vault by 81.187 μm (p < 0.001). In regarding to different ICL sizes, vertical implantation had no good to vault reduction when using ICL of 12.1 mm. However, it could reduce the vault by 59.351 μm and 160.992 μm respectively when ICL of 12.6mm and 13.2 mm were implanted (p = 0.0097 and p = 0.0124). For prediction of vault height, ML based model significantly outperformed traditional multivariable regression model. Conclusion We provide quantitative evidence that vertical implantation of ICL could effectively reduce the achieved vault height, especially when large size ICL was implanted, comparing to traditional horizontal implantation. ML is extremely applicable in development of vault prediction model.
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Affiliation(s)
- Weijie Zhang
- Department of Ophthalmology, Ninth People's Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China
| | - Fang Li
- Department of Ophthalmology, Ninth People's Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China
| | - Lin Li
- Department of Ophthalmology, Ninth People's Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China
- Lin Li
| | - Jing Zhang
- Department of Ophthalmology, Ninth People's Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China
- *Correspondence: Jing Zhang
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Jiang Y, Luo Y, Li Y, Lu T. The long-term observation of the rotation of implantable collamer lens as the management of high postoperative vault. Front Med (Lausanne) 2023; 10:1104047. [PMID: 36910497 PMCID: PMC9995363 DOI: 10.3389/fmed.2023.1104047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 02/02/2023] [Indexed: 02/25/2023] Open
Abstract
Purpose This study aimed to describe the effectiveness and stability of implantable collamer lens (ICL) rotation in reducing high postoperative vault. Setting This study was conducted in the Peking Union Medical College Hospital, Chinese Academy of Medical Sciences. Design This is a retrospective case series. Methods Twenty-two eyes from 22 patients who had ICL (V4c EVO) implantation with high postoperative vault (>=750 μm) were recruited for our study. All the lenses were rotated from a horizontal to an oblique position. The vault, SSA, AOD500, AOD750, TISA500, and TISA750 at 180° and 0° were measured pre-rotation, 1-week post-rotation, and in the at-least 1-year-follow-up. Results Twenty female patients and two male patients were recruited, with a mean age of 28.68 ± 6.08 years. The mean vault had declined significantly from 951.81 ± 154.26 μm pre-rotation to 772.27 ± 119.40 μm 1 week post-rotation (p < 0.001). The SSA, AOD500, AOD750, TISA500, and TISA750 at 180° and 0° pre-rotation and 1-week post-rotation were 30.40 ± 7.91° and 45.14 ± 6.75°, 32.37 ± 7.48° and 46.23 ± 6.39°, 303.27 ± 87.99 and 522.45 ± 122.16 μm, 323.81 ± 89.15 and 536.13 ± 121.66 μm, 387.95 ± 99.43 and 630.81 ± 133.59 μm, 435.68 ± 106.72 and 643.36 ± 132.82 μm, 0.109 ± 0.034 and 0.202 ± 0.053 mm2, 0.123 ± 0.034 and 0.212 ± 0.051 mm2, 0.194 ± 0.056 and 0.345 ± 0.083 mm2, and 0.216 ± 0.055 and 0.358 ± 0.079 mm2 (all p < 0.001). The mean vault value had changed from 747.50 ± 116.07 μm 1-week post-rotation to 586.87 ± 132.65 μm in the 1-year follow-up. However, the SSA, AOD500, AOD750, TISA500, and TISA750 at 180° and 0° had remained stable (p > 0.05). Conclusion Non-toric ICL rotation is a novel and effective technique in the treatment of high postoperative vault. Our results are more robust given the extended period of follow-up.
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Affiliation(s)
- Yang Jiang
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Yan Luo
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Ying Li
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Thomas Lu
- School of Medicine, University of New South Wales, Kensington, NSW, Australia
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Zhang H, Gong R, Zhang X, Deng Y. Analysis of perioperative problems related to intraocular Implantable Collamer Lens (ICL) implantation. Int Ophthalmol 2022; 42:3625-3641. [PMID: 35731355 PMCID: PMC9587946 DOI: 10.1007/s10792-022-02355-w] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Accepted: 04/18/2022] [Indexed: 02/05/2023]
Abstract
PURPOSE To introduce a modified procedure of ICL implantation, to summarize the perioperative problems and their corresponding treatment after myopia correction with Implantable Collamer Lens (ICL), and to compare the difference of complications between the no-hole ICL and hole ICL. METHODS We searched all articles on ICL-related perioperative problems and their corresponding treatment in Scopus, Embase, PubMed and Web of Science databases for the last 22 years. RESULTS ICL implantation is safe, effective, stable and predictable in the correction of myopia, hyperopia and astigmatism, but can also cause a series of perioperative problems, including intraoperative and postoperative complications. CONCLUSION There are many kinds of complications related to ICL, but the common intraoperative and postoperative complications mainly include abnormality of arch height, abnormal position of ICL, loss of corneal endothelial cells and corneal decompensation, high intraocular pressure and secondary glaucoma, cataract and night vision symptoms. Compared with ICL without central pore, the incidence of complications such as loss of corneal endothelial cells and corneal decompensation, high intraocular pressure and secondary glaucoma and cataract was relatively lower in central hole ICL, while postoperative complications such as night vision symptoms were obvious.
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Affiliation(s)
- Hao Zhang
- Department of Ophthalmology, West China Hospital, Sichuan University, No.37, Guoxue Xiang, Chengdu, 610041 Sichuan China
| | - Rui Gong
- Department of Ophthalmology, West China Hospital, Sichuan University, No.37, Guoxue Xiang, Chengdu, 610041 Sichuan China
| | - Xiaolan Zhang
- Department of Ophthalmology, West China Hospital, Sichuan University, No.37, Guoxue Xiang, Chengdu, 610041 Sichuan China
| | - Yingping Deng
- Department of Ophthalmology, West China Hospital, Sichuan University, No.37, Guoxue Xiang, Chengdu, 610041 Sichuan China
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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: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Accepted: 09/04/2022] [Indexed: 11/10/2022]
Abstract
BACKGROUND To compare the measurements obtained from the Orbscan II, IOLMaster 700, Pentacam AXL, and Castroviejo caliper and their effects on calculating the recommended implantable collamer lens (ICL) size and postoperative vault measurements. METHODS This is a retrospective cross-sectional study of patients who underwent ICL surgery by a single surgeon from March 1, 2018 to July 31, 2021. Records were reviewed for the anterior chamber depth (ACD) and white-to-white (WTW) measurements obtained from the Orbscan II, IOLMaster 700, Pentacam AXL, and Castroviejo caliper (WTW only). These were used to calculate the recommended ICL size. The actual ICL size implanted, and vault measurements obtained one month postoperatively were also collected. RESULTS One hundred seven eyes with a mean age of 27.9 ± 7.7 years were included in the study. Mean WTW measurements were significantly different between devices (P < 0.0001), with the IOLMaster 700 having the highest value (12.14 ± 0.04 mm) and the caliper having the lowest value (11.45 ± 0.04 mm). Mean ACD measurements were the lowest in Orbscan II (3.12 ± 0.25 mm) and the highest in Pentacam AXL (3.16 ± 0.24 mm). The Pentacam AXL produced an ICL size similar to the Orbscan in 69.2% of eyes. The IOLMaster yielded an ICL measurement one size larger than Orbscan-based calculations in 64.5% of eyes. Using the Orbscan WTW and ACD, the desired vault of 0.25 to 0.75 mm and 0.25 to 1.00 mm was achieved in 70% and 91% of eyes, respectively. Substituting caliper WTW to IOLMaster 700 or Pentacam AXL WTW increases the percentage of achieving the desired vault to 80%, similar to the Orbscan. CONCLUSIONS The Orbscan II, IOLMaster 700, and Pentacam AXL cannot be used interchangeably for calculating ICL sizing. Combining the WTW from caliper measurement with the ACD of the IOLMaster 700 or Pentacam AXL could improve ICL sizing and achieve a higher percentage of eyes with the desired vault.
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Affiliation(s)
- Robert Edward T. Ang
- grid.476917.a0000 0004 9154 7342Asian Eye Institute, Phinma Plaza, Rockwell Center, 8Th Floor, 1200 Makati, Philippines ,Cardinal Santos Medical Center, 10 Wilson St., Greenhills, 1502 San Juan, Philippines
| | | | - Fernando Amado J. Ayuyao
- grid.476917.a0000 0004 9154 7342Asian Eye Institute, Phinma Plaza, Rockwell Center, 8Th Floor, 1200 Makati, Philippines
| | - Maria Isabel N. Umali
- grid.476917.a0000 0004 9154 7342Asian Eye Institute, Phinma Plaza, Rockwell Center, 8Th Floor, 1200 Makati, Philippines
| | - Emerson M. Cruz
- grid.476917.a0000 0004 9154 7342Asian Eye Institute, Phinma Plaza, Rockwell Center, 8Th Floor, 1200 Makati, Philippines
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Goes S, Delbeke H. Posterior chamber toric implantable collamer lenses vs LASIK for myopia and astigmatism: systematic review. J Cataract Refract Surg 2022; 48:1204-1210. [PMID: 36179351 DOI: 10.1097/j.jcrs.0000000000001007] [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: 05/03/2022] [Accepted: 07/05/2022] [Indexed: 11/26/2022]
Abstract
This systematic review compares the visual and refractive outcome of laser in situ keratomileusis with (toric) implantable collamer lens (ICL) in the treatment of myopic astigmatism. An electronic literature search led to 19 comparative articles. Refractive outcome, efficacy, safety, predictability, and stability as well as differences in contrast sensitivity and higher-order aberrations (HOAs) were analyzed for moderate (-3 to -6 diopters [D]) and high (≥-6 D) myopia. Results were either significantly in favor of (toric)-ICL or equal. Fewer HOAs and better contrast sensitivity after (toric)-ICL seem to be the largest asset in its refractive and clinical superiority. However, longer follow-up studies are indicated, specifically for systematically comparing long-term adverse effects.
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Affiliation(s)
- Stéphanie Goes
- From the Department of Ophthalmology, University Hospitals Leuven, Leuven, Belgium (Goes, Delbeke); KU Leuven, Biomedical Sciences Group, Department of Neurosciences, Research group Ophthalmology, Leuven, Belgium (Delbeke)
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Alfonso-Bartolozzi B, Lisa C, Fernández-Vega-Cueto L, Baamonde B, Madrid-Costa D, Alfonso JF. Three-year follow-up of posterior chamber phakic intraocular lens with a central port design after deep anterior lamellar keratoplasty. EYE AND VISION 2022; 9:34. [PMID: 36068603 PMCID: PMC9450313 DOI: 10.1186/s40662-022-00306-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 08/17/2022] [Indexed: 11/10/2022]
Abstract
Abstract
Background
To evaluate clinical outcomes of the Visian implantable collamer lens (ICL) with a central port to correct myopia and astigmatism after deep anterior lamellar keratoplasty (DALK) for keratoconus throughout 3 years of follow-up.
Methods
This study included 20 eyes of 20 patients that underwent V4c ICL (13 eyes with a spherical ICL and 7 eyes with a toric ICL) implantation after DALK. Uncorrected (UDVA) and corrected (CDVA) distance visual acuities, refraction, intraocular pressure (IOP), endothelial cell density (ECD), and vault were analyzed.
Results
The mean UDVA improved from the preoperative 1.18 ± 0.33 logMAR to 0.25 ± 0.14 logMAR at 6 months after surgery (P < 0.0001) and remained unchanged throughout the whole follow-up (P = 0.4). All eyes gained lines of CDVA compared to preoperative values. At the last follow-up visit, all eyes achieved CDVA of 0.2 logMAR or better and 13 eyes (65%) 0.1 logMAR or better. At 6 months post-surgery, all eyes (100%) had a spherical equivalent within ± 1.50 D, and 19 (95%) within ± 1.00 D. The mean manifest spherical equivalent was stable over the postoperative follow-up (P = 0.25). No significant increase in IOP occurred in any case throughout the 3 years of follow-up. The loss in ECD from the preoperative baseline at the last follow-up visit was 2.27%.
Conclusions
The clinical outcomes suggest that the V4c ICL implantation for correction of myopia and regular astigmatism in post-DALK eyes was satisfactory in terms of effectiveness, safety, and stability during 3 years of follow-up.
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Zhang J, Shao J, Zheng L, Zhao X, Chen S. Implantable collamer lens sizing based on measurement of the sulcus-to-sulcus distance in ultrasound biomicroscopy video clips and ZZ ICL formula. BMC Ophthalmol 2022; 22:363. [PMID: 36071422 PMCID: PMC9454160 DOI: 10.1186/s12886-022-02583-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 08/29/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To evaluate a new method of implantable collamer lens (ICL) sizing based on ultrasound biomicroscopy (UBM) video clips. METHODS This observational study included consecutive patients with myopia and myopic astigmatism scheduled for V4c toric ICL (TICL) implantation (STAAR) at Hangzhou MSK Eye Hospital (October 2020 to November 2020). Sulcus-to-sulcus (STS) distance, lens thickness (LT), and clinical refraction were measured preoperatively. The ZZ ICL formula (provides the predicted vault height and refraction based on TICL size, intraocular meridian, power, and eye parameters, including STS distance and LT) was used to select TICL size and predict vault height and residual refraction, which was also compared with the STAAR software recommended. Vault and residual refraction were measured at 3 months postoperatively. RESULTS The analysis included 168 eyes in 84 patients. Postoperative vault size was comparable to that predicted by the ZZ ICL formula (528 ± 193 vs. 545 ± 156 μm, P = 0.227). Vault prediction error (PE) by the ZZ ICL formula was within 100, 300, and 500 μm in 40.48%, 88.10%, and 100% of eyes, respectively. Spherical equivalent (SE) and absolute cylindrical refractive error were 0.36 ± 0.48 and 0.40 ± 0.31 D at 3 months postoperatively. The SE PE, absolute cylindrical PE, and percentages of eyes with an absolute cylindrical PE within ± 0.50 D and ± 1.00 D were lower for the ZZ ICL formula than for the STAAR software (P < 0.01). CONCLUSIONS Combining measurements obtained in UBM video clips with the ZZ ICL formula provides an effective method of sizing TICLs and predicting vault height and residual refractive error.
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Affiliation(s)
- Jun Zhang
- Department of Ophthalmology, Hangzhou MSK Eye Hospital & MSK Eye Hospital of Hangzhou Medical College, Hangzhou, China.
| | - Jie Shao
- Department of Ophthalmology, Hangzhou MSK Eye Hospital & MSK Eye Hospital of Hangzhou Medical College, Hangzhou, China
| | - Li Zheng
- Department of Ophthalmology, Hangzhou MSK Eye Hospital & MSK Eye Hospital of Hangzhou Medical College, Hangzhou, China
| | - Xia Zhao
- Department of Ophthalmology, Hangzhou MSK Eye Hospital & MSK Eye Hospital of Hangzhou Medical College, Hangzhou, China
| | - Shu Chen
- Department of Ophthalmology, Hangzhou MSK Eye Hospital & MSK Eye Hospital of Hangzhou Medical College, Hangzhou, China
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Yang Z, Meng L, Zhao X, Chen Y, Luo Y. Clinical Prediction of Inadequate Vault in Eyes With Thick Lens After Implantable Collamer Lens Implantation Using Iris Morphology. Front Med (Lausanne) 2022; 9:906433. [PMID: 35755051 PMCID: PMC9218336 DOI: 10.3389/fmed.2022.906433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 05/23/2022] [Indexed: 12/01/2022] Open
Abstract
Background Obtaining an ideal vault is crucial in the implantable collamer lens (ICL) surgery. Prediction of the vault value is difficult since it requires the integration of multiple factors. The purpose of this study was to investigate the association between the iris shape and vault value in eyes with thick lens. Methods The study was conducted in Peking Union Medical College Hospital. Patients who received ICL V4c between 2017 and 2021 were screened. Eyes with thick lens (>4.0 mm) and abnormal iris shape (concave or convex) were included. The preoperative biometric parameters and postoperative vault value were compared between eyes with concave shape group and convex shape group. The relationship between various factors and vault was assessed by spearman rank analysis and multiple linear regression analysis. Representative cases our strategies to deal with the abnormal vault were demonstrated. Results Twenty eight eyes of 14 patients with thick lens and concave or convex shape iris were eventually included, with 14 eyes of 7 patients in group 1 (concave shape iris) and the other 14 eyes of 7 patients in group 2 (convex shape iris). The mean vault of group 1 was (0.16 ± 0.07) mm, which was significantly lower than (0.88 ± 0.13) mm in group 2. Multiple linear regression analysis showed iris shape (P < 0.001) was only the explanatory variables associated with the postoperative vault. In group1, 4 eyes showed extremely large ACA, requiring a secondary surgical intervention. So all of them underwent ICL exchange for a larger ICL. In group2, the ICL was implanted in a vertical or oblique position to avoid or rescue an extremely large vault. Conclusion Concave shape iris had a higher risk of low vault and convex shape iris were more likely to demonstrate high vault in eyes with thick lens. Exchanging ICL for the larger size and adjusting ICL to the vertical or oblique orientation are good option to rescue the low or high vault, respectively.
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Affiliation(s)
- Zhikun Yang
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Lihui Meng
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.,Key Lab of Ocular Fundus Diseases, Chinese Academy of Medical Sciences, Beijing, China
| | - Xinyu Zhao
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.,Key Lab of Ocular Fundus Diseases, Chinese Academy of Medical Sciences, Beijing, China
| | - Youxin Chen
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.,Key Lab of Ocular Fundus Diseases, Chinese Academy of Medical Sciences, Beijing, China
| | - Yan Luo
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
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Mahmoud MSED, AttaAllah HR. Clinical Outcomes of Toric Implantable Collamer Lens (T-ICL) and Toric Implantable Phakic Contact Lens (IPCL) for High Myopia with Astigmatism: A Comparative Study. Open Ophthalmol J 2022. [DOI: 10.2174/18743641-v16-e2204050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background:
Our study aimed to compare the clinical, visual outcomes, and efficacy of toric Implantable Collamer Lens (T-ICL) and toric implantable phakic contact lens (IPCL) in patients with high myopia and astigmatism over a follow-up period of 6 months.
Methods:
A prospective interventional randomized comparative study included 60 myopic eyes divided into 2 groups, group A including 30 eyes that were implanted with T-ICL, and group B, including 30 eyes that were implanted with toric IPCL. The refractive results, visual acuity, central corneal endothelial cell count, and intraocular pressure (IOP) were evaluated at baseline and at 1 and 6 months post-surgery. Any complications either during or after surgery were assessed.
Results:
In both study groups, the mean central corneal endothelial cell count was significantly decreased after 1 month and improved to reach near pre-operative values after 6 months postoperatively, indicating good lens biocompatibility. A statistically significant increase in IOP was found in both groups during the early follow-up, and a significant decrease after 6 months postoperatively (p=0.036) was reported in group A. A significant reduction in both spherical and cylindrical refractive errors with good predictability was reported in both groups compared with pre-operative values. Regarding the predictability, In T-ICL group (A), the median spherical and cylindrical errors were significantly improved from (-10 D & -4.5 D) pre-operatively to (-0.3 D & - 0.3 D) at the end of 6 months follow up period. Similarly, in the toric IPCL group (B), the median spherical and cylindrical errors were significantly improved from (-11 D & -4.5 D) pre-operatively to (-0.3 D & - 0.3 D) by the end of follow up period. A statistically significant improvement of UCDVA at 6 months postoperatively was found in both groups, as median preoperative LogMAR UCDVA was 1.1 and 1.3 in groups A and B respectively, which was improved to 0.3 in both groups at the end of follow-up period. There were no reported intra- or postoperative complications such as cataract, keratitis, or lens decentration.
Conclusion:
Toric IPCL is a suitable alternative to T-ICL for the management of high myopia with astigmatism, especially in developing countries, as it is cheaper and easier to implant than T-ICL. However, data over longer follow-up periods are needed to confirm its safety and stability.
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Xu Y, Yang W, Long T, Shang W, Xu X, Wang J, Yao J, Li K. Analysis of Microcirculation Changes in the Macular Area and Para-Optic Disk Region After Implantable Collamer Lens Implantation in Patients With High Myopia. Front Neurosci 2022; 16:867463. [PMID: 35663554 PMCID: PMC9160968 DOI: 10.3389/fnins.2022.867463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Accepted: 04/28/2022] [Indexed: 11/13/2022] Open
Abstract
Myopia has become an important public health problem to be solved urgently. Posterior chamber phakic implantable Collamer lens (ICL) implantation is one of the latest and safest products for myopia correction worldwide. This prospective cross-sectional case series aimed to observe changes in the macular retinal thickness, retinal nerve fiber layer (RNFL) thickness of para-optic disk region, and blood flow density after posterior ICL implantation in patients with high myopia using optical coherence tomography angiography (OCTA). A total of 67 eyes of 67 patients with high myopia, who underwent ICL implantation at The Affiliated Eye Hospital of Nanjing Medical University from January 2020 and December 2020, were included. The spherical equivalent (SE) of the operative eyes was >−6.00 D. The changes in vision, intraocular pressure (IOP), SE, and vault were observed pre-operatively, and follow-up were performed 1 week, 1 month, and 3 months. OCTA was used to observe the changes in the CRT, retinal thickness of paracentral fovea, FAZ, superficial and deep retinal blood flow density in the macular area, RNFL thickness of para-optic disk region, and blood flow density before and after ICL implantation. The uncorrected distance visual acuity (UDVA) and best corrected distance visual acuity (CDVA) of the patients post-operation were significantly improved (P < 0.001). The IOP increased in comparison with other time points at 1 week post-operation (P < 0.05). There were no significant changes in CRT post-operation. The retinal thickness in the upper, lower, nasal, and temporal quadrants of the paracentral fovea increased significantly at 1 month and 3 months post-operation (P < 0.05). The FAZ area at all postoperative time points were decreased (P < 0.001). At 3 months post-operation, the blood flow density of the superficial and deep retinal layers in the upper, lower, and nasal macular area were significantly reduced (P < 0.05). At 1 month post-operation, the RNFL thickness in the temporal para-optic disk region and blood flow density were significantly reduced (P = 0.001 and P < 0.05, respectively). ICL implantation for highly myopic eyes led to an increase of the retinal thickness in the upper, lower, nasal, and temporal regions of the paracentral fovea; reduction of RNFL thickness in the temporal area of para-optic disk; decrease in FAZ area; and decrease in the blood flow density of some deep and superficial retinal layers as well as that of the temporal para-optic disk region.
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Affiliation(s)
- Yingnan Xu
- Department of Ophthalmology, The Affiliated Eye Hospital of Nanjing Medical University, Nanjing, China
| | - Weihua Yang
- Department of Ophthalmology, The Affiliated Eye Hospital of Nanjing Medical University, Nanjing, China
| | - Tan Long
- Department of Ophthalmology, Xi’an No. 1 Hospital, Xi’an, China
| | - Weihong Shang
- Department of Ophthalmology, The Affiliated Eye Hospital of Nanjing Medical University, Nanjing, China
| | - Xiangzhong Xu
- Department of Ophthalmology, The Affiliated Eye Hospital of Nanjing Medical University, Nanjing, China
| | - Jinfan Wang
- School of Marxism, Nanjing Medical University, Nanjing, China
- *Correspondence: Jinfan Wang,
| | - Jin Yao
- Department of Ophthalmology, The Affiliated Eye Hospital of Nanjing Medical University, Nanjing, China
- Jin Yao,
| | - Keran Li
- Department of Ophthalmology, The Affiliated Eye Hospital of Nanjing Medical University, Nanjing, China
- Keran Li,
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Zhang S, Huang C, Miao H, Wu J, Xing C, Dai Z, Sun J. Assessment of biosafety and implantation feasibility of novel phakic refractive lens. Int Ophthalmol 2022; 42:3459-3468. [PMID: 35556204 PMCID: PMC9587979 DOI: 10.1007/s10792-022-02345-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 04/18/2022] [Indexed: 11/25/2022]
Abstract
Purpose We investigated the biosafety and implantation feasibility of a new phakic refractive lens (PRL) in rabbit eyes. Methods Short PRLs (S-PRLs), large PRLs (L-PRLs), and large-grooved PRLs (LG-PRLs), were prepared by molding medical-grade liquid silicon. The cytotoxicity and cellular adhesion of the PRLs was assessed in vitro. To assess implantation feasibility, the S-PRL, L-PRL, and LG-PRL were implanted in the posterior chamber of rabbit eyes and the relative position was assessed by optical coherence tomography. The intraocular pressures (IOP) were compared between the S-PRL, L-PRL, LG-PRL, and control groups to evaluate the PRL biosafety after implantation. Results The in vitro assays showed that cell viability and cellular adhesion in the S-PRL, L-PRL and LG-PRL groups was not significantly different to those in the control group throughout the study. After implantation into the posterior chamber of rabbit eyes, there were no obvious signs of inflammation or increases in IOP at each time point relative to the control group, demonstrating good biosafety of the PRL. The relative positions of the L-PRLs and LG-PRLs in the posterior chamber were appropriate and the retention frequencies were high. Conclusions The newly developed LG-PRL showed good biosafety with negligible in vitro cytotoxicity, ocular inflammation, or fluctuations in IOP. The LG-PRL provided the best implantation feasibility. The grooves on the LG-PRL provided channels for aqueous humor circulation. The LG-PRL is a promising type of PRL with an appropriate size and surface structure for effective correction of refractive errors in rabbit eyes.
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Affiliation(s)
- Shaohua Zhang
- Eye Institute and Department of Ophthalmology, Eye and ENT Hospital, Fudan University, Shanghai, 200031, China
- NHC Key Laboratory of Myopia (Fudan University), Shanghai, 200031, China
- Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, 200031, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, 200031, China
| | - Chang Huang
- Eye Institute and Department of Ophthalmology, Eye and ENT Hospital, Fudan University, Shanghai, 200031, China
- NHC Key Laboratory of Myopia (Fudan University), Shanghai, 200031, China
- Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, 200031, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, 200031, China
| | - Huamao Miao
- Eye Institute and Department of Ophthalmology, Eye and ENT Hospital, Fudan University, Shanghai, 200031, China
- NHC Key Laboratory of Myopia (Fudan University), Shanghai, 200031, China
- Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, 200031, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, 200031, China
| | - Junyao Wu
- Hangzhou Aijinglun Technology Co., Ltd., Zhejiang, 311100, China
| | - Chao Xing
- Eye Institute and Department of Ophthalmology, Eye and ENT Hospital, Fudan University, Shanghai, 200031, China
- NHC Key Laboratory of Myopia (Fudan University), Shanghai, 200031, China
- Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, 200031, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, 200031, China
| | - Zhaoxing Dai
- Shanghai Haohai Biological Technology Co. Ltd., Shanghai, 200052, China.
| | - Jianguo Sun
- Eye Institute and Department of Ophthalmology, Eye and ENT Hospital, Fudan University, Shanghai, 200031, China.
- NHC Key Laboratory of Myopia (Fudan University), Shanghai, 200031, China.
- Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, 200031, China.
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, 200031, China.
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A Prospective Comparative Study between Implantable Phakic Intraocular Contact Lens and Implantable Collamer Lens in Treatment of Myopia in Adults. J Ophthalmol 2022; 2022:9212253. [PMID: 35388352 PMCID: PMC8979746 DOI: 10.1155/2022/9212253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Revised: 02/07/2022] [Accepted: 03/18/2022] [Indexed: 11/18/2022] Open
Abstract
Purpose To compare implantable collamer lenses (ICLs) and acrylic implantable phakic contact lenses (IPCLs) in the treatment of myopia in adults, as regards refractive outcome and adverse effects. Methods Prospective, randomized comparative study with phakic intraocular lenses (IOLs) was carried out for treatment of myopia. Patients were randomized into two groups: one for ICL and the other for IPCL. Preoperative assessments included a full examination, pentacam, endothelial cell count, and biometry. We compared the adverse effects and refractive outcomes between both groups. The study was registered in clinical trials and the registration number is NCT04624035. Results Sixty eyes of sixty patients (28 in the ICL group and 32 in the IPCL group) with a follow-up period of 12 months. The mean preoperative spherical equivalent was −12.7 ± 3.4 D and −13.6 ± 4.4 D in the ICL and IPCL groups, respectively (P=0.37). The mean postoperative spherical equivalent value was ±0.4 ± 0.2 D and ±0.6 ± 0.1 D in the ICL and IPCL groups, respectively. Uncorrected visual acuity (UCVA) has improved from 1.3 ± 0.06 to 0.15 ± 0.02 Log MAR in the ICL group (P < 0.001) and from 1.3 ± 0.02 to 0.15 ± 0.01 Log MAR in the IPCL group (P < 0.001). The mean endothelial cell count was reduced by 3.3% in the IPCL group and by 3.2% in the IPCL group. Conclusion Both ICL and IPCL are effective methods to correct high myopia in adults with no statistically significant differences between the two lenses as regarding adverse effects.
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Nonpassopon M, Jongkhajornpong P, Phimpho P, Cheewaruangroj N, Lekhanont K, Chuckpaiwong V. Agreement of implantable collamer lens sizes using parameters from different devices. BMJ Open Ophthalmol 2022; 7:e000941. [PMID: 35372697 PMCID: PMC8905975 DOI: 10.1136/bmjophth-2021-000941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 02/25/2022] [Indexed: 11/11/2022] Open
Abstract
Objective To assess agreement and repeatability of white-to-white (WTW) and anterior chamber depth (ACD), and agreement of implantable collamer lens (ICL) size using these measurements from different devices. Methods and analysis A retrospective review of 83 eyes with ICL implantation (42 patients) was conducted. The agreement of WTW (measured with WaveLight Topolyzer and Orbscan IIz) and ACD (measured with WaveLight Oculyzer and Orbscan IIz) was analysed. Correlation of ICL sizes and difference of eyes with unacceptable vaults between two data sets (WaveLight platform; Topolyzer and Oculyzer and Orbscan IIz) were assessed. Results Average WTW measured by Orbscan IIz and Topolyzer demonstrated good agreement (Ρ 0.884) with low systematic bias (−0.03±0.1 mm) and narrow 95% limits of agreement (LoA) of −0.28 to 0.22. Average ACD measured by Orbscan IIz and Oculyzer also showed good agreement (Ρ 0.903) with low systematic bias (−0.04±0.1 mm) and relatively narrow 95% LoA (0.2 to 0.12). ICL size selected according to two data sets showed moderate to strong level of agreement (Kappa=0.81). There was a statistically significant difference (p<0.001) in the proportion of eyes with unacceptable postoperative vaults when using the Wavelight platform data set (five eyes, 6.02%) and the Orbscan IIz data set (12 eyes, 14.46%). Conclusion Although the agreement of WTW and ACD between devices was good, there was a significant difference in proportion of eyes with unacceptable postoperative vaults when using two data sets. Therefore, Topolyzer and Oculyzer might not be suitable for operating interchangeably with Orbscan IIz for ICL size selection.
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Affiliation(s)
- Manachai Nonpassopon
- Department of Ophthalmology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Passara Jongkhajornpong
- Department of Ophthalmology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Prae Phimpho
- Department of Ophthalmology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Nontawat Cheewaruangroj
- Department of Ophthalmology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Kaevalin Lekhanont
- Department of Ophthalmology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Varintorn Chuckpaiwong
- Department of Ophthalmology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
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Evaluation of the anterior chamber angle by anterior segment optical coherence tomography after implantable phakic contact lens implantation in myopic eyes. Int Ophthalmol 2022; 42:2449-2457. [PMID: 35243558 PMCID: PMC9314284 DOI: 10.1007/s10792-022-02244-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 02/08/2022] [Indexed: 11/01/2022]
Abstract
PURPOSE To evaluate the changes in the angle of the AC and lens vault after IPCL implantation by AS-OCT in myopic patients. METHODS This was a prospective observational study involving 30 myopic eyes implanted with IPCL. AS-OCT was used to evaluate lens vault and AC angle parameters including anterior chamber angle, angle opening distance and trabecular-iris space area (TISA) at 1, 3 and 6 months postoperatively. RESULTS All 3 AC angle parameters were significantly reduced at the 1st postoperative month compared to preoperative values, but remained stable thereafter with no significant change at the 3rd or 6th postoperative months. The lens vault showed no significant change over the entire follow-up period. CONCLUSION IPCL implantation is a safe method for correction of myopia with stable AC angle narrowing over the course of 6 months postoperatively as monitored using AS-OCT.
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Kojima T, Kitazawa Y, Nakamura T, Kamiya K, Ichikawa K, Igarashi A, Shimizu K. Multicenter survey on implantable collamer lens dislocation. PLoS One 2022; 17:e0264015. [PMID: 35157743 PMCID: PMC8843229 DOI: 10.1371/journal.pone.0264015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Accepted: 01/31/2022] [Indexed: 11/18/2022] Open
Abstract
This study aimed to investigate the incidence, patient background, and postoperative prognosis of implantable collamer lens (ICL) dislocation. We retrospectively reviewed all cases of ICL dislocation at four major refractive surgery centers in Japan until December 2019. The incidence, patient background, cause of dislocation, complications of repositioning surgery, and postoperative visual function were investigated. Seven ICL dislocations [0.072% of total ICL-implanted eyes (9775 eyes)] occurred at an average of 28.6 months (11–82 months) postoperatively. All patients were male. Five eyes were injured during sports activities, one due to a fall from a bicycle, and another due to ocular blunt trauma caused by a mortuary tablet. Two patients had re-dislocation in the same eye. Retinal detachment occurred after repositioning surgery in one patient, and scleral buckling surgery was performed without ICL removal. ICL dislocation is a rare complication of ICL surgery; repositioning surgery is effective, but retinal complications may occur.
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Affiliation(s)
| | | | | | - Kazutaka Kamiya
- Department of Ophthalmology, University of Kitasato School of Medicine, Kanagawa, Japan
| | | | | | - Kimiya Shimizu
- Department of Ophthalmology, Sanno Hospital, Tokyo, Japan
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Intraoperative Adjustment of Implantable Collamer Lens Vault by Lens Rotation Aided by intraoperative Optical Coherence Tomography. J Cataract Refract Surg 2022; 48:999-1003. [PMID: 35171140 DOI: 10.1097/j.jcrs.0000000000000915] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 02/08/2022] [Indexed: 11/25/2022]
Abstract
PURPOSE To assess the use of intraoperative optical coherence tomography (OCT) to detect high vault during implantation surgery and guide intraoperative vault adjustment by ICL rotation. SETTING Instituto Zaldivar SA. Mendoza, Argentina. DESIGN Prospective, single-arm, observational study. METHODS A total of 25 eyes of 25 consecutive patients showing high intraoperative vault who undergone Implantable Collamer Lens (ICL) rotation from horizontal to vertical or oblique position were evaluated. Central ICL vault was measured both intraoperatively using the microscope-integrated iOCT (Optomedical Technologies GmbH, Luebeck, Germany, merged with Haag-Streit Surgical GmbH & Co. KG in May 2020) mounted on a standard surgical microscope (HS Hi-R NEO 900A NIR, Haag-Streit Surgical GmbH & Co. KG, Wedel, Germany), and postoperatively using the Casia 2 swept-source OCT (Tomey GmbH, Nürnberg, Germany) at 4 hours, 1 day and 1 month. RESULTS Mean vault value obtained intraoperatively was 1147.88±188.36 μm and changed significantly to 739.76 ± 194.97 μm after lens rotation to either vertical (n=19, 76% of cases) or oblique (n=6, 24% of cases) positions (mean difference 408.12 ± 213.57 μm, p < 0.001). There was significant relationship between the amount of change due to lens rotation with white-to-white distance (r=-0.480, p=0.015) and vault before rotation (r=-0.564, p=0.003). Mean vault values were 758.40±187.10 μm, 729.73±227.86 μm and 661.88±275.17 μm at 4 hours, 24 hours and 1-month post-surgery, respectively. CONCLUSIONS Intraoperative adjustment of ICL vault by lens rotation using intraoperative OCT is an effective procedure to obtain an optimal vault.
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Toric intraocular lens for astigmatism correction following keratoplasty in phakic and pseudophakic eyes. J Cataract Refract Surg 2022; 48:1078-1087. [PMID: 35137695 DOI: 10.1097/j.jcrs.0000000000000907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Accepted: 02/03/2022] [Indexed: 11/27/2022]
Abstract
ABSTRACT Residual astigmatism and anisometropia significantly impact patients' vision and quality of life even in clear grafts after corneal transplant. We reviewed and summarized the role of toric intraocular lens (IOL) in phakic and pseudophakic eyes after penetrating keratoplasty (PKP) and deep anterior lamellar keratoplasty (DALK) in correcting residual astigmatism. We included 342 eyes from 20 studies with iris-clipped toric IOL, ciliary sulcus toric implantable collamer lens, piggyback sulcus toric IOL, or posterior chamber toric IOL implantations for phakic, pseudophakic, or eyes undergoing cataract surgery after keratoplasty. Visual, refractive, and predictability outcomes were encouraging. Secondary re-alignment rate and complications were low. Endothelial cell loss secondary to phakic toric IOL might be a concern over the long-term, particularly in iris-clipped IOL in PKP eyes. Toric IOL represent a viable option in the treatment of residual astigmatism in post-keratoplasty eyes, resulting in improved visual acuity and reduced anisometropia.
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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]
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Guan N, Zhang XN, Zhang WJ. Correlation between intraoperative and postoperative vaulting of the EVO implantable Collamer lens: a retrospective study of real-time observations of vaulting using the RESCAN 700 system. BMC Ophthalmol 2022; 22:2. [PMID: 34980022 PMCID: PMC8721482 DOI: 10.1186/s12886-021-02237-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Accepted: 12/22/2021] [Indexed: 12/19/2022] Open
Abstract
Background Implantable Collamer lens (ICL) vaulting is one of the most important parameters for the safety, aqueous humor circulation, and lens transparency after ICL implantation. This study aimed to investigate the factors associated with the actual vaulting after refractive EVO-ICL surgery. Methods This retrospective study included patients who underwent EVO-ICL surgery at a tertiary eye hospital between October and December 2019. A RESCAN 700 was used for the intraoperative and CIRRUS HD-OCT was used for postoperative observation of vaulting. Subjective and objective refractions, anterior ocular segment, corneal morphology, intraocular pressure (IOP), anterior chamber volume (ACV), crystalline lens rise (CLR), white-to-white distance (WTW), anterior chamber depth (ACD), axial length, corneal endothelial cell density (ECD), and fundoscopy were examined. A multivariable analysis was performed to determine the factors independently associated with 1-month postoperative vaulting. Results Fifty-one patients (102 eyes) were included. Compared with the eyes with normal vaulting, those with high vaulting had higher preoperative diopter values (P = 0.039), lower preoperative corrected visual acuity (P = 0.006), lower preoperative IOP (P = 0.029), higher preoperative ACD (P = 0.004), lower preoperative CLR (P = 0.046), higher ICL spherical equivalent (P = 0.030), higher intraoperative vaulting (P < 0.001), and lower IOP at 1 month (P = 0.045). The multivariable analysis showed that the only factor independently associated with high vaulting at 1 month after surgery was the intraoperative vaulting value (odds ratio = 1.005, 95% confidence interval: 1.002–1.007, P < 0.001). The intraoperative and 1-month postoperative vaulting values were positively correlated (R2 = 0.562). Conclusions The RESCAN700 system can be used to perform intraoperative optical coherence tomography to predict the vaulting value of ICL at 1 month.
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Affiliation(s)
- Nian Guan
- Department of Refractive, Wuhan Bright Eye Hospital, Wuhan, 430000, Hubei, China
| | - Xiao-Nong Zhang
- Department of Refractive, Hefei Bright Eye Hospital, Hefei, 230000, Anhui, China
| | - Wan-Jun Zhang
- Department of Refractive, Hefei Bright Eye Hospital, Hefei, 230000, Anhui, China.
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Zhang Z, Niu L, Zhao J, Miao H, Chen Z, Shen Y, Chen X, Ye Y, Wang X, Zhou X. Safety of EVO ICL Implantation With an Ophthalmic Viscosurgical Device-Free Technique in the Early 24 h After Surgery. Front Med (Lausanne) 2021; 8:764653. [PMID: 34869472 PMCID: PMC8635781 DOI: 10.3389/fmed.2021.764653] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 10/21/2021] [Indexed: 12/05/2022] Open
Abstract
Purpose: To compare the safety of the non-ophthalmic viscosurgical device (OVD) technique with that of the minimum OVD technique in EVO Implantable Collamer Lens (EVO-ICL) implantation. Methods: A total of 180 eyes of 90 consecutive patients were enrolled in the study, of which 100 eyes of 50 patients were treated with non-OVD technique, with a 55% success rate. The remaining 80 eyes of 40 patients were treated with min-OVD technique, so they were classified into the min-OVD group. Preoperative and postoperative intraocular pressure (IOP) measurements were collected and analyzed at 1, 2, 3, and 24 h. Visual acuity, corneal endothelial cell density (ECD), and corneal densitometry 24 h postoperatively were evaluated. Results: No significant difference was found in visual outcomes (P = 0.54) or ECD (P = 0.78) between the two groups. The operation time was significantly shorter in the non-OVD group (P < 0.0001). The IOP was significantly higher at 1 h (P < 0.0001), 2 h (P < 0.0001) and 3 h (P = 0.0045) postoperatively in the min-OVD group. The non-OVD group had significantly lower IOP than the min-OVD group at 1 h (P = 0.01) and 2 h (P = 0.013) postoperatively. The temporal corneal densitometry in the non-OVD group were significantly lower than those in the minimum group (P = 0.0063) 1 day after surgery. Conclusion: The non-OVD technique is safe and efficient for ICL implantation. It can be a safer method of ICL implantation in that it completely eliminates ophthalmic viscoelastic devices related complications without causing additional complications in short term.
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Affiliation(s)
- Zhe Zhang
- Department of Ophthalmology, Eye Institute, Eye and 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.,Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care, Shanghai, China
| | - Lingling Niu
- Department of Ophthalmology, Eye Institute, Eye and 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.,Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care, Shanghai, China
| | - Jing Zhao
- Department of Ophthalmology, Eye Institute, Eye and 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.,Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care, Shanghai, China
| | - Huamao Miao
- Department of Ophthalmology, Eye Institute, Eye and 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.,Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care, Shanghai, China
| | - Zhuoyi Chen
- Department of Ophthalmology, Eye Institute, Eye and 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.,Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care, Shanghai, China
| | - Yang Shen
- Department of Ophthalmology, Eye Institute, Eye and 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.,Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care, Shanghai, China
| | - Xun Chen
- Department of Ophthalmology, Eye Institute, Eye and 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.,Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care, Shanghai, China
| | - Yuhao Ye
- Department of Ophthalmology, Eye Institute, Eye and 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.,Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care, Shanghai, China
| | - Xiaoying Wang
- Department of Ophthalmology, Eye Institute, Eye and 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.,Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care, Shanghai, China
| | - Xingtao Zhou
- Department of Ophthalmology, Eye Institute, Eye and 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.,Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care, Shanghai, China
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