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Alió del Barrio JL, II Medalle RS, Pederzolli M. Phakic anterior chamber intraocular lens removal with simultaneous posterior chamber phakic intraocular lens implantation and Descemet membrane endothelial keratoplasty. Taiwan J Ophthalmol 2024; 14:117-120. [PMID: 38654997 PMCID: PMC11034693 DOI: 10.4103/tjo.tjo-d-23-00168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 12/20/2023] [Indexed: 04/26/2024] Open
Abstract
The purpose of this study was to describe a case and clinical course of simultaneous anterior chamber phakic intraocular lens (AC-pIOL) removal, implantation of a posterior chamber phakic intraocular implantable collamer lens (ICL), and Descemet membrane endothelial keratoplasty (DMEK). This was a case report of a 44-year-old male with a unilateral decompensated cornea from a displaced Duet-Kelman lens on his left eye that underwent pIOL extraction and implantation of a posterior chamber phakic intraocular ICL and simultaneous DMEK. After 6 months, the cornea of the left eye had regained clarity, the Descemet membrane was graft stable, and the ICL implanted was centered with good vault. Postoperative anisometropia was avoided. There was no development of cataracts or other complications. The simultaneous pIOL extraction, ICL implantation, and DMEK in our case showed good results with full restoration of anterior segment anatomy and return of transparency of the cornea. The current case shows the feasibility of the simultaneous approach instead of sequential as an alternative for patients with endothelial disease associated with AC pIOLs, restoring vision and anatomy and also avoiding postoperative anisometropia.
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Affiliation(s)
- Jorge L. Alió del Barrio
- Department of Cornea and Refractive Surgery, Vissum Grupo Miranza, Alicante, Spain
- Department of Ophthalmology, Universidad Miguel Hernandez, Alicante, Spain
| | - Ronald Steven II Medalle
- Research, Development and Innovation Department, Vissum Grupo Miranza, Alicante, Spain
- Associated Cebu Eye Specialists, Cebu, Philippines
- Department of Ophthalmology, Cebu Institute of Medicine, Cebu, Philippines
| | - Matteo Pederzolli
- Research, Development and Innovation Department, Vissum Grupo Miranza, Alicante, Spain
- Department of Ophthalmology, Cornea and Ocular Surface, IRCCS San Raffaele Scientific Institute, Milan, Italy
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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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] [What about the content of this article? (0)] [Affiliation(s)] [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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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] [What about the content of this article? (0)] [Affiliation(s)] [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 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] [What about the content of this article? (0)] [Affiliation(s)] [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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Packer M. Evaluation of the EVO/EVO+ Sphere and Toric Visian ICL: Six Month Results from the United States Food and Drug Administration Clinical Trial. Clin Ophthalmol 2022; 16:1541-1553. [PMID: 35645557 PMCID: PMC9132105 DOI: 10.2147/opth.s369467] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 05/13/2022] [Indexed: 12/29/2022] Open
Abstract
Purpose To evaluate the safety and effectiveness of Collamer posterior chamber phakic refractive lenses with a central port design (EVO and EVO+ Sphere and Toric Visian ICLs) for correction of moderate-to-high myopia with or without astigmatism. Patients and Methods Six-month results of a multicenter clinical trial performed under United States FDA Investigational Device Exemption. Subjects 21 through 45 years of age with myopia ranging from -3.00 D to -20.00 D and astigmatism up to 4.00 D underwent implantation of EVO or EVO+ Sphere or Toric Visian ICLs. Uncorrected (UDVA) and corrected (CDVA) distance visual acuities, manifest refraction, intraocular pressure (IOP), endothelial cell density, and adverse events were evaluated over 6 months. Results This clinical trial enrolled 629 eyes of 327 subjects with mean age 35.6 ± 5.09 years. Mean preoperative spherical equivalent (SE) measured -7.62 ± 2.75 D (range: -3.00 to -15.62 D). At 6 months, mean SE was -0.079 ± 0.33 D, with 90.5% within ± 0.50 D of target and 98.9% within ±1.00 D of target. Mean postoperative UDVA and CDVA were -0.059 ± 0.10 logMAR and -0.13 ± 0.08 logMAR, respectively. 52.3% of eyes gained lines of CDVA. Efficacy and safety indices were 1.06 and 1.24, respectively. No eye experienced pupillary block, required peripheral iridotomy or iridectomy, developed anterior subcapsular cataract or had elevated IOP due to angle narrowing or pigment dispersion. Mean endothelial cell density declined by 2.3%. Conclusion EVO ICL lenses demonstrated accuracy of refractive correction and achievement of high levels of UDVA. This clinical trial confirmed that the central port design of EVO and EVO+ Sphere and Toric Visian ICL lenses functions effectively to allow physiologic flow of aqueous humor, thus eliminating the requirement for preoperative peripheral iridotomies. The results of this clinical trial resulted in FDA approval on March 25, 2022.
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Affiliation(s)
- Mark Packer
- Packer Research Associates, Boulder, CO, USA
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Chen X, Chen Z, Miao H, Wang X, Wang X, Zhou X. One-year analysis of the refractive stability, axial elongation and related factors in a high myopia population after Implantable Collamer Lens implantation. Int Ophthalmol 2022. [PMID: 35590026 DOI: 10.1007/s10792-022-02328-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 04/18/2022] [Indexed: 10/18/2022]
Abstract
PURPOSE To investigate the refractive stability, axial length (AL) changes and their related factors in a high myopia population after Implantable Collamer Lens (ICL) implantation. METHODS This prospective study included 116 eyes of 116 patients divided into several groups based on the spherical equivalent refractive error (SE)-SE > - 6 D, - 12 ≤ SE < - 6 D and SE < - 12 D groups-and AL-AL < 28 mm and AL ≥ 28 mm groups. The uncorrected and corrected distance visual acuity, refraction, AL and intraocular pressure were followed for 1 year. RESULTS SE changed from - 11.53 ± 5.25 D preoperatively to - 0.33 ± 0.70 D at 1 week, and further changed to - 0.48 ± 0.77 D at 1 year after ICL implantation, with average progression being - 0.15 ± 0.37 D from 1 week to 1 year after surgery. AL changed from 27.95 ± 2.33 mm preoperatively to 27.98 ± 2.36 mm 1 year after surgery, with an average axial elongation of 0.03 ± 0.12 mm. The mean axial elongation rate was 0.05 mm/year in the SE < - 12 D group, being significantly faster than the other refractive groups (P < 0.05); it was 0.06 mm/year in the AL ≥ 28 mm group, being significantly faster than the AL < 28 mm group (P < 0.05). CONCLUSION Patients with high myopia and long AL showed a continuous myopic progression and axial elongation at an adult age one year after ICL surgery, especially in those with myopia higher than - 12.00 D and AL longer than 28.00 mm.
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Fernández-Vega-Cueto L, Alfonso-Bartolozzi B, Lisa C, Madrid-Costa D, Alfonso JF. Seven-year follow-up of posterior chamber phakic intraocular lens with central port design. Eye Vis (Lond) 2021; 8:23. [PMID: 34112241 PMCID: PMC8194243 DOI: 10.1186/s40662-021-00247-1] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 05/22/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND To assess the clinical outcomes of the Visian Implantable Collamer Lens (ICL) with a central port throughout 7 years of follow-up. METHODS Eighty-four eyes of 52 patients were evaluated over a follow-up period of 7 years after V4c ICL implantation. Uncorrected (UDVA) and corrected (CDVA) distance visual acuities, refraction, intraocular pressure (IOP), endothelial cell density (ECD) and vault were analysed. RESULTS The mean postoperative UDVA (logMAR) was 0.04 ± 0.11, 0.13 ± 0.19 and 0.17 ± 0.23 at 1-, 5- and 7-years, respectively (P < 0.0001). The mean CDVA (logMAR) remains unchanged throughout a 7-year follow-up period (0.02 ± 0.08 and 0.02 ± 0.08, at 5- and 7-years, respectively, P = 0.2). At all follow-up visits, more than 95% of the eyes achieved a CDVA of 20/25 or better and more than 85% a CDVA of 20/20. At the end of the follow-up (7 years), no eye lost more lines of CDVA, 56 eyes (66.7%) and 28 eyes (33.3%) gained lines of CDVA. At 7-years, the spherical equivalent was - 0.62 ± 0.62 D. No significant increase in IOP (> 20 mmHg or an increase higher than 5 mmHg) occurred in any case throughout the 7-year of follow-up. The loss in ECD from the preoperative baseline at the last follow-up visit was 2.6%. No intraoperative or postoperative complications or adverse events occurred during the follow-up period. CONCLUSIONS The outcomes of this study show the long-term viability of the V4c ICL implantation as a surgical option for the correction of myopia.
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Affiliation(s)
| | | | - Carlos Lisa
- Fernández-Vega Ophthalmological Institute, Avda. Dres. Fernández-Vega 114, 33012, Oviedo, Spain
| | - David Madrid-Costa
- Optometry and Vision Department, Faculty of Optics and Optometry, University Complutense de Madrid, Madrid, Spain
| | - José F Alfonso
- Fernández-Vega Ophthalmological Institute, Avda. Dres. Fernández-Vega 114, 33012, Oviedo, Spain.
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Chen H, Feng X, Niu G, Fan Y. Evaluation of Dry Eye after Implantable Collamer Lens Surgery. Ophthalmic Res 2020; 64:356-362. [PMID: 32966980 DOI: 10.1159/000511197] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Accepted: 08/23/2020] [Indexed: 11/19/2022]
Abstract
OBJECTIVES To evaluate dry eye (DE) and associated meibomian gland dysfunction parameters after Implantable Collamer Lens (ICL) surgery. METHODS This is a prospective observational case series. Patients who underwent ICL implantation without previous ocular diseases or ophthalmic treatments were enrolled. Their Ocular Surface Disease Index (OSDI), noninvasive breakup time (NIBUT), meibography, slit-lamp examination of the lid margin, corneal fluorescein staining (CFS), and Schirmer test I were examined preoperatively and at 1 and 3 months postoperatively. RESULTS A total of 117 eyes of 60 patients were enrolled, and 107 eyes completed 3-month follow-up period. OSDI, lid marginal abnormality, and meibomian gland (MG) secretion, and meibum quality score were significantly higher at 1 month postoperatively and recovered partially at 3 months after surgeries, while NIBUT was significantly decreased all the time. Patients with previous DE symptoms (OSDI score ≥12) showed not only lower Schirmer and TBUT values but also higher CFS, lid margin score, MG loss, MG secretion, and meibum quality scores compared with those in the control group after operations. Low Schirmer, NIBUT values, and high meibum quality score were determined as risk factors for DE symptoms after ICL surgery. CONCLUSIONS ICL implantation has a bad influence on the ocular surface and MG functions. The influence may be more obvious in patients with existing DE.
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Affiliation(s)
- Haiting Chen
- Department of Ophthalmology, Cangzhou Central Hospital, Cangzhou, China
| | - Xueyan Feng
- Department of Ophthalmology, Cangzhou Central Hospital, Cangzhou, China
| | - Guangzeng Niu
- Department of Ophthalmology, Cangzhou Central Hospital, Cangzhou, China
| | - Yuxiang Fan
- Department of Ophthalmology, Cangzhou Central Hospital, Cangzhou, China,
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Řeháková T, Veliká V, Rozsíval P, Jirásková N. Correction of Myopia and Myopic Astigmatism by Implantation of a Phakic Posterior Chamber Implantable Collamer Lens. Cesk Slov Oftalmol 2019; 74:147-152. [PMID: 30913890 DOI: 10.31348/2018/1/4-4-2018] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
AIM We analysed two years results in patients with correction of moderate-to-high myopia or myopic astigmatism by implantation of posterior chamber phakic intraocular Impantable Collamer Lens (ICL). METHODS To the retrospective study were included 63 eyes of 32 patients (3 men, 29 women), who underwent implantation of ICL between 2007 - 2016 in the outpatient Department of Ophthalmology clinic, University Hospital in Hradec Králové, to correction moderate-to-high myopia or myopic astigmatism. We assess uncorrected visual acuity (UCVA) and best spectacle-corrected visual acuity (BSCVA), subjective refraction, intraocular pressure (IOP), endothelial cell density (ECD) and the incidence of complications in the two years follow-up period. RESULTS At the time of implantation was the mean patients age 28,14 ± 5,35 years (range 21 to 36 years). In 16 eyes was implanted ICM V4 model, in 23 eyes VICMO, in 2 eyes TICM V4, in 13 eyes VTICMO and in 9 eyes VTICM. The mean preoperative subjective refraction improved from -7,8 ± 2,7 D sf (range -14 to -3,25 D sf) and -0,65 ± 0,8 D cyl (range -3,25 to 0 D cyl) to -0,01 ± 0,1 D sf (range -0,75 to 0 D sf) and -0,05 ± 0,16 D cyl (range -0,55 až 0 D cyl). The mean ECD value was 3270,5 ± 454,7 cells/mm2 (range 2155 to 4201 cells/mm2) compared to 2803,4 ± 441,8 cells/mm2 (range 2079 to 4184 cells/mm2) at the end of our follow-up period. The percentage loss of ECD two years after the surgery was 13,5%. The mean preoperative value of intraocular pressure (IOP) was 15,0 ± 2,9 mmHg (range 10 to 20 mmHg) and 15,2 ± 2,5 mmHg (range 10 to 20 mmHg) at the end of follow-up period. We observed the elevation of IOP over 21 mmHg 1 month postoperatively in 11 eyes. In 9 eyes was IOP until 35 mmHg (27,7 ± 3,74, range 22 to 34 mmHg), in a one case (both eyes of the same patient) over 50 mmHg. Postoperatively we observed following complications: IOP elevation (11 eyes), decentration of ICL with development of subcapsular opacity in the crystallin lens periphery (1 eye), pigment dispersion without elevation of IOP (1 eye) and incidence of optical phenomenon (4 patients). The explantation of ICL was indicated in one patient bilaterally. CONCLUSIONS According to our experience is the correction of moderate-to-high myopia or myopic astigmatism by implanation of ICL an effective, relative safe and predictable method. It has an important place in the modern refractive surgery, especially in patients, who are not able to undergo the photorefractive corneal surgery to correct their refractive errors. Key words: Implantable Collamer Lens, phakic intraocular lens, myopia, myopic astigmatism.
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Zhang X, Chen X, Wang X, Yuan F, Zhou X. Analysis of intraocular positions of posterior implantable collamer lens by full-scale ultrasound biomicroscopy. BMC Ophthalmol 2018; 18:114. [PMID: 29743110 PMCID: PMC5944172 DOI: 10.1186/s12886-018-0783-5] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2017] [Accepted: 05/03/2018] [Indexed: 11/29/2022] Open
Abstract
Background To analyze the positions of intraocular posterior Implantable Collamer Lens (ICL) and its possible relationship with vault. Methods This cross-sectional study included 72 patients with high myopia (134 eyes) who were followed up after phakic intraocular lens implantation. The postoperative time ranged from 1 week to 7 years. We obtained the images of ICL by using Compact Touch STS UBM and observed the position of ICL in posterior chamber and ciliary sulcus. The horizontal lines vault was measured and recorded. Results There were various positions in the posterior chamber as observed by full-scale ultrasound biomicroscopy and the haptics were inserted at different positions. -Eight seven eyes (64.9%) that obtained ideal vault, 29 eyes (21.6%) had insufficient vaults and 18 eyes (13.4%) had excessive vault. The vault with various positions of haptics was in ideal range (250 μm–750 μm) almost in each group. Three eyes in this study with haptics on the top of ciliary sulcus obtained excessive vault (mean vault, 850.00 ± 70.71 μm) and one eye appeared one side haptics pushing forward the iris. Among five eyes (3.7%) with iridociliary body cysts, three eyes (60%) obtained ideal vault. One eye (0.7%) with ICL decentralization after implantation surgery had an ideal vault, but the patient had serious glare. Conclusions Though ICL in the posterior chamber had different positions and the haptics in most cases were not in the ciliary sulcus, the postoperative vault was almost in the ideal range.
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Affiliation(s)
- Xi Zhang
- Department of Ophthalmology, Zhongshan Hospital of Fudan University, Shanghai, People's Republic of China.,Department of Ophthalmology, Eye and ENT Hospital of Fudan University, Shanghai, People's Republic of China.,Department of Ophthalmology, Myopia Key Laboratory of the Health Ministry, Shanghai, People's Republic of China
| | - Xun Chen
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, Shanghai, People's Republic of China.,Department of Ophthalmology, Myopia Key Laboratory of the Health Ministry, Shanghai, People's Republic of China
| | - Xiaoying Wang
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, Shanghai, People's Republic of China. .,Department of Ophthalmology, Myopia Key Laboratory of the Health Ministry, Shanghai, People's Republic of China.
| | - Fei Yuan
- Department of Ophthalmology, Zhongshan Hospital of Fudan University, Shanghai, People's Republic of China
| | - Xingtao Zhou
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, Shanghai, People's Republic of China.,Department of Ophthalmology, Myopia Key Laboratory of the Health Ministry, Shanghai, People's Republic of China
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Chen H, Niu G, Fan Y, Ma J. Comparison of intraocular pressure andvault after implantation of implantable collamer lens with and without a central hole. BMC Ophthalmol 2016; 16:203. [PMID: 27852246 PMCID: PMC5112696 DOI: 10.1186/s12886-016-0375-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2016] [Accepted: 11/01/2016] [Indexed: 02/07/2023] Open
Abstract
BACKGROUD The Implantable Collamer Lens (ICL) has been used widely for refractive errors, We performed this prospective randomized comparative study to compare postoperative intraocular pressure (IOP) and vaults of the eyes implanted with conventional ICL and central hole ICL. METHODS This study evaluated 44 eyes of 22 patients who underwent central hole ICL implantation in one eye and conventional ICL implantation in the other eye by randomization assignment. noncontact intraocular pressure were performed on 6 h, 1 day, 3 days, 1 week, 2 weeks, 1 month, 3 months and 6 months, while ICL vaults were measured on 1 day, 1 week, 1 month and 6 months. RESULTS The IOP of both eyeswithcentral hole and conventional ICLrosetemporarily during the first month after surgeries, especially on 1 day and 2 weeks points postoperatively. The IOP ofeyes with central hole ICL was higher than that of conventionl ICL. The vaults ofeyes with central hole and conventional ICL decreased slightly with time but did not significantly affect the postoperative IOP. CONCLUSIONS Despite the sensitivity of viscoelastic agents or inflammation, this newly developed central hole ICL implantation appears to be equivalent in safty and effcacy to conventional ICL implantation for the correction of ametropia. TRIAL REGISTRATION Current Controlled Trials ChiCTR-INR-16008896 . Retrospectively registered 24 July 2016.
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Affiliation(s)
- Haiting Chen
- Department of Ophthalmology, Cangzhou CentralHospital, Hebei, China.,Department of Ophthalmology, Second Hospital of Hebei Medical University, Hebei, China
| | - Guangzeng Niu
- Department of Ophthalmology, Cangzhou CentralHospital, Hebei, China
| | - Yuxiang Fan
- Department of Ophthalmology, Cangzhou CentralHospital, Hebei, China
| | - Jingxue Ma
- Department of Ophthalmology, Second Hospital of Hebei Medical University, Hebei, China.
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Chen X, Miao H, Naidu RK, Wang X, Zhou X. Comparison of early changes in and factors affecting vault following posterior chamber phakic Implantable Collamer Lens implantation without and with a central hole (ICL V4 and ICL V4c). BMC Ophthalmol 2016; 16:161. [PMID: 27604229 PMCID: PMC5015244 DOI: 10.1186/s12886-016-0336-8] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2016] [Accepted: 08/23/2016] [Indexed: 12/04/2022] Open
Abstract
Background To objectively compare the early changes in vault over time following implantation of an Implantable Collamer Lens without (ICL V4) and with (ICL V4c) a central hole and the respective factors affecting vault change in moderate to high myopia. Methods This prospective study comprised of 38 eyes of 38 patients implanted with ICL V4 and 39 eyes of 39 patients implanted with ICL V4c intraocular lenses. We quantitatively assessed the postoperative values of vault and pupil size at 1 day, 1 week, and 1 month following implantation using a rotating Scheimpflug camera (Pentacam). We compared these postoperative values within and between the two groups and identified the factors affecting vault change. Results The mean vaults at 1 day, 1 week, and 1 month following ICL V4 implantation were 303.68 ± 185.11, 517.89 ± 160.07 and 521.32 ± 155.72 μm respectively, and those following ICL V4c were 316.67 ± 186.89, 495.13 ± 180.84 and 510.77 ± 175.51 μm, respectively. There was a significant difference in vault between 1 day and 1 week postoperatively. There was a significant association between the vault change and the pupil size change in both groups from 1 day to 1 month postoperatively (Pearman correlation coefficient; ICL V4: r = 0.585, P = 0.001; ICL V4c: r = 0.588, P <0.001). The vault value 1 month after implantation of ICL V4 and ICL V4c was associated with the preoperative anterior chamber depth, horizontal corneal diameter, horizontal and vertical sulcus-to-sulcus. Conclusions Pupil movement is a critical factor in vault change, with increasing vault observed postoperatively from 1 day to 1 week associated with the declining effects of pharmacological miosis and increasing pupil size. The anterior chamber depth, horizontal corneal diameter, horizontal and vertical sulcus-to-sulcus show some correlation with vault. Electronic supplementary material The online version of this article (doi:10.1186/s12886-016-0336-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Xun Chen
- Key Lab of Myopia, Ministry of Health, Shanghai, China.,EYE & ENT Hospital of Fudan University, Shanghai, China
| | - Huamao Miao
- Key Lab of Myopia, Ministry of Health, Shanghai, China.,EYE & ENT Hospital of Fudan University, Shanghai, China
| | | | - Xiaoying Wang
- Key Lab of Myopia, Ministry of Health, Shanghai, China. .,EYE & ENT Hospital of Fudan University, Shanghai, China. .,Department of Ophthalmology, Myopia Key Laboratory of the Health Ministry, Eye and ENT Hospital of Fudan University, No. 19 BaoQing Road, Shanghai, 200031, China.
| | - Xingtao Zhou
- Key Lab of Myopia, Ministry of Health, Shanghai, China.,EYE & ENT Hospital of Fudan University, Shanghai, China
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Karimian F, Baradaran-Rafii A, Hashemian SJ, Hashemloo A, Jafari ME, Yaseri M, Ghahari E, Akbarian S. Comparison of three phakic intraocular lenses for correction of myopia. J Ophthalmic Vis Res 2015; 9:427-33. [PMID: 25709766 PMCID: PMC4329701 DOI: 10.4103/2008-322x.150805] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2013] [Accepted: 09/13/2013] [Indexed: 11/11/2022] Open
Abstract
Purpose: To compare the visual outcomes and complications of three different types of phakic intraocular lenses (PIOLs), for correction of moderate to high myopia. Methods: We reviewed 112 myopic eyes undergoing PIOL implantation using Artisan (40 eyes), Artiflex (36 eyes), and implantable collamer lens (ICL, 36 eyes). Best corrected visual acuity (BCVA), intraocular pressure (IOP), pachymetry, corneal endothelial cell (CEC) loss, and higher order aberrations (HOA) were compared. Results: Mean follow-up period was 30 ± 11 months. Preoperatively, spherical equivalent (SE) refractive error was −11.6 ± 3.7, −9.59 ± 1.97, and −12.3 ± 4.8 D in the Artisan, Artiflex and ICL groups, respectively. SE was comparable among the study groups at final follow-up (P = 0.237). Mean astigmatic reduction was 0.31 ± 0.72, 0.45 ± 0.62, and 0.0 ± 0.57 in the Artisan, Artiflex and ICL groups, respectively (P = 0.007). Emmetropia (±1 D) was achieved in 60%, 91.7% and 77.8% of eyes in the Artisan, Artiflex and ICL groups, respectively, the difference was significant between the Artisan and Artiflex groups (P = 0.017). BCVA improvement more than one line occurred in 25%, 19.4% and 38.9% of eyes (P = 0.158); pachymetric changes were minimal with no difference among the three groups (P = 0.754), and mean CEC loss was 10 ± 9%, 9 ± 6% and 9 ± 10% in the Artisan, Artiflex and ICL groups, respectively (P = 0.694). HOAs (P = 0.039), vertical trefoil (P = 0.032) and spherical aberration (P = 0.001) were higher with Artisan group as compared to ICL. Total aberrations (P = 0.028) and spherical aberration (P = 0.001) was also higher with Artisan group as compared to Artiflex. Conclusion: Visual and refractive outcomes were comparable with Artisan, Artiflex and ICL. In terms of HOAs and quality of vision, ICL and Artiflex seem to be better choices in highly myopic eyes.
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Affiliation(s)
- Farid Karimian
- Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Seyed Javad Hashemian
- Department of Ophthalmology, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Ali Hashemloo
- Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Ebrahim Jafari
- Department of Ophthalmology, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Mehdi Yaseri
- Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran ; Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Elham Ghahari
- Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Shadi Akbarian
- Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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