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Comparison of central corneal thickness and anterior chamber depth measurements using three imaging technologies in normal eyes and after phakic intraocular lens implantation.

ABSTRACT: BACKGROUND: The repeatability and interchangeability of imaging devices measuring central corneal thickness (CCT) and anterior chamber depth (ACD) are important in the assessment of patients considering refractive surgery. The purpose of this study was to investigate the agreement of CCT and ACD measurements using three imaging technologies in healthy eyes and in eyes after phakic intraocular lens implantation (pIOL). METHODS: In this comparative study, CCT and ACD were measured using anterior segment optical coherence tomography (AS-OCT), Orbscan II, and Pentacam in 33 healthy volunteers (66 eyes) and 22 patients (42 eyes) after pIOL implantation. Intraobserver repeatability was evaluated for all three devices in the healthy volunteer group. RESULTS: Pairwise comparison of CCT measurements showed significant differences between all devices (P < 0.001), except for the AS-OCT and Orbscan II in the healthy volunteer group (P = 0.422) and the Orbscan II and Pentacam in the pIOL group (P = 0.214). ACD measurements demonstrated significant differences between all pairwise comparisons in both groups (P < or = 0.001). Intraobserver reliability was high for CCT and ACD measurements in the healthy volunteer group, with coefficients of variation ranging from 0.6% to 1.2% and 0.4% to 0.5% respectively. CONCLUSIONS: CCT and ACD measurements using AS-OCT, Orbscan II, and Pentacam demonstrated high intraobserver reliability. However, these devices should not be used interchangeably for measurements of CCT and ACD in healthy subject and patients after pIOL implantation.

SUBMITTER: Doors M

PROVIDER: S-EPMC2709228 | biostudies-other | 2009 Aug

REPOSITORIES: biostudies-other

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Long-Term Destiny of Corneal Endothelial Cells in Anterior Chamber Intraocular Lens-Implanted Eyes.

Project description:PurposeTo investigate the long-term changes of corneal endothelial cells (EC) in anterior chamber intraocular lens- (AC-IOL-) implanted eyes.MethodsRetrospective study. We included 37 eyes (25 patients) that received AC-IOL implantation previously in the Eye and ENT Hospital of Fudan University between 1995 and 2016. Follow-up outcomes included the best-corrected visual acuity (BCVA), endothelial cell density, hexagonality, coefficient of variance, and central corneal thickness.ResultsIn total, 23 eyes (62.16%) with phakic and 14 eyes (37.84%) with aphakic AC-IOLs were included. Among these, 3 eyes (8.11%) were angle-supported AC-IOLs and 34 eyes (91.89%) were Artisan iris-fixated AC-IOLs. The mean age of patients was 41.40 ± 17.17 years, and the mean follow-up time was 12.12 ± 4.71 years in our study. At the follow-up time, corneal decompensation existed in 3 angle-supported AC-IOL eyes with a rate of 100% and 15 iris-fixated AC-IOL eyes with a rate of 44.12%. AC-IOL displacement occurred in 14 (41.18%) iris-fixated AC-IOL eyes. In the 19 iris-fixated AC-IOL eyes without corneal decompensation, significant changes also took place in corneal endothelial cells. The endothelial cell density decreased from 2843.26 ± 300.76 to 2015.58 ± 567.99 cells/mm2 (29.1% loss, P < 0.001) and hexagonality decreased from 51.21 ± 7.83 to 42.53 ± 9.17 (%) (16.9% loss, P < 0.001). The Kaplan-Meier survival curve also demonstrated the accumulated expectation rates of corneal endothelial cell decomposition for AC-IOLs with a median survival time of 12 years.ConclusionWe reported a significant chronic loss and long-term decompensation destiny of corneal endothelial cells in AC-IOL eyes. Semiannual or annual follow-up and evaluation of endothelial cells should be conducted in AC-IOL-implanted patients.

| S-EPMC7783513 | biostudies-literature

Prediction of anterior chamber volume after implantation of posterior chamber phakic intraocular lens.

Project description:PurposeTo predict the anterior chamber volume (ACV) after implantable collamer lens (ICL) implantation based on ICL size and parameters of anterior segment optical coherence tomography (AS-OCT).DesignRetrospective study.MethodsThis study included 222 eyes of 222 patients who underwent ICL implantation at Nagoya Eye Clinic. The patients were divided into two groups: prediction group, for creating the prediction equation (148 eyes, mean age: 32.11 ± 8.04 years), and verification group, for verifying the equation (74 eyes, mean age: 33.03 ± 6.74 years). The angle opening distance (AOD), anterior chamber width (ACW), ACV, anterior chamber depth, lens vault, angle-to-angle distance, angle recess area, and trabecular iris space area were calculated using AS-OCT. A stepwise multiple regression analysis was performed. After the creation of the prediction equation, its accuracy was verified in the verification group.ResultsThe ACV, AOD750, ACW, and ICL size were selected as explanatory variables to predict postoperative ACV. Mean predicted (114.2 ± 21.83 mm3) and actual postoperative ACVs (116.1 ± 25.41 mm3) were not significantly different (P = 0.269); absolute error was 10.59 ± 9.13 mm3. In addition, there was high correlation between actual and predictive ACV (adjusted R2 = 0.6996, p < 0.0001). Bland-Altman plot revealed that there was no addition or proportional error between predicted and actual postoperative ACV.ConclusionPostoperative ACV was accurately predicted using AS-OCT parameters and ICL size. This prediction equation may be useful for making decisions regarding ICL size.

| S-EPMC7668562 | biostudies-literature

Vertically Fixated Posterior Chamber Phakic Intraocular Lens Implantation Through a Superior Corneal Incision.

Project description:IntroductionTo assess the 1-year outcomes of vertically fixated posterior chamber phakic intraocular lens implantation through a superior corneal incision.MethodsThis pilot study comprised 78 eyes of 53 consecutive patients undergoing vertically fixated implantable collamer lens (ICL) implantation through a superior corneal incision to correct moderate to high myopia and myopic astigmatism. We prospectively determined the safety, efficacy, predictability, stability, and adverse events preoperatively, and at 1 week and 1, 3, and 12 months postoperatively.ResultsThe mean follow-up period was 10.4 ± 5.4 months. Uncorrected and corrected visual acuity were -0.20 ± 0.10 and -0.25 ± 0.07 logMAR, respectively, at 1 year postoperatively. At 1 year postoperatively, 98% and 100% of eyes were within 0.5 and 1.0 D, respectively, of the targeted correction. A nonsignificant change in manifest refraction of -0.01 ± 0.08 D occurred from 1 week to 1 year. The manifest astigmatism decreased significantly, from 0.69 ± 0.73 D preoperatively to 0.21 ± 0.27 D at 1 year postoperatively (Mann-Whitney U test, p < 0.001). No vision-threatening complications occurred at any time in this series.ConclusionsAccording to our experience, the vertically fixated ICL through a superior incision achieved good results, without significant complications. Considering that younger patients requiring ICL surgery tend to have with-the-rule astigmatism, this surgical technique may be a viable option for reducing astigmatism without using toric ICLs.

| S-EPMC8927518 | biostudies-literature

Predicting Postoperative Anterior Chamber Angle for Phakic Intraocular Lens Implantation Using Preoperative Anterior Segment Metrics.

Project description:PurposeThe 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.MethodsRegression 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.ResultsPostoperative 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.ConclusionsWe 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 relevanceUsing the proposed algorithms, surgeons can consider the postoperative ACAs to increase surgical accuracy and safety.

| S-EPMC9836008 | biostudies-literature

Etiology and Management of Raised Intraocular Pressure following Posterior Chamber Phakic Intraocular Lens Implantation in Myopic Eyes.

Project description:AimTo evaluate the etiology and management of elevated intraocular pressure (IOP) following posterior chamber phakic implantable collamer lens (ICL) surgery.MethodsBetween 2009 and 2015, 638 eyes of 359 subjects with refractive myopia, underwent V4b and V4c (CentraFLOW) model ICL implantation. Ocular hypertension (OHT) was defined as IOP of ≥ 22 mm Hg on two separate occasions and elevated IOP with corresponding optic disc or visual field damage was defined as glaucoma.ResultsElevated IOP ≥ 22 mm Hg was noted in 33 eyes of 30 subjects (33/638; 5.17%). Median age of subjects with raised IOP was 26 years (Inter quartile range (IQR):22, 29) and median refarctive error was -16 diopters (-19.5, -13). The median follow up was 7.8 months (IQR:0.3, 17.6) and median time for postoperative IOP rise was 12 days, (IQR:2, 24). The various etiologies for elevated IOP were steroid response in 21 eyes (64%; 10 eyes with V4b, 11 eyes with V4c), retained viscoelastic in 5 eyes (15%) (3 with V4b, 2 with V4c), pupillary block in four eyes (12%; 3 with V4b, 1 with V4c), malignant glaucoma in one eye (3%, V4b), and missed pre-existing Juvenile open angle glaucoma (JOAG) in two eyes (6% with V4b). Elevated IOP in 31 eyes resolved with conservative management. One eye (centraFLOW design) with central aquaport block by viscoelastic, needed AC wash and one eye with malignant glaucoma needed parsplana vitrectomy and hyaloidotomy. Ten eyes required longterm (>2 months) antiglaucoma medications (AGM) for IOP control. Except the two eyes with JOAG, none had disc and field damage.ConclusionIn our series, OHT was seen in 4.85% and glaucoma in 0.3% eyes that underwent V4b and V4c model ICL implantation. Multiple etiologies were noted and steroid induced ocular hypertension was the most common cause of elevated IOP followed by retained viscoelastic and pupillary block. One third of these eyes required longterm AGM for IOP control.

| S-EPMC5113895 | biostudies-literature

Comparison of axial length, anterior chamber depth and intraocular lens power between IOLMaster and ultrasound in normal, long and short eyes.

Project description:To compare the axial length (AL), anterior chamber depth (ACD) and intraocular lens power (IOLP) of IOLMaster and Ultrasound in normal, long and short eyes.Seventy-four normal eyes (? 22 mm and ? 25 mm), 74 long eyes (> 25 mm) and 78 short eyes (< 22 mm) underwent AL and ACD measurements with both devices in the order of IOLMaster followed by Ultrasound. The IOLP were calculated using a free online LADAS IOL formula calculator.The difference in AL and IOLP between IOLMaster and Ultrasound was statistically significant when all three groups were combined. The difference in ACD between IOLMaster and Ultrasound was statistically significant in the normal group (P<0.001) and short eye group (P<0.001) but not the long eye group (P = 0.465). For the IOLP difference between IOLMaster and Ultrasound in the normal group, the percentage of IOLP differences <|0.5|D, ?|0.5|D<|0.75|D, ?|0.75|D<|1.0|D, and ?|1.0|D were 90.5%, 8.1%, 1.4% and 0%, respectively. For the long eye group, they were 90.5%, 5.4%, 4.1% and 0%, respectively. For the short eye group, they were 61.5%, 23.1%, 10.3%, and 5.1%, respectively.IOLMaster and Ultrasound have statistically significant differences in AL measurements and IOLP (using LADAS formula) for normal, long eye and short eye. The two instruments agree regarding ACD measurements for the long eye group, but differ for the normal and short eye groups. Moreover, the high percentage of IOLP differences greater than |0.5|D in the short eye group is noteworthy.

| S-EPMC5854401 | biostudies-literature

Customized Toric Intraocular Lens Implantation in Eyes with Cataract and Corneal Astigmatism after Deep Anterior Lamellar Keratoplasty: A Prospective Study.

Project description:PurposeTo investigate the effectiveness of toric intraocular lenses (IOLs) for treating corneal astigmatism in patients with cataract and previous deep anterior lamellar keratoplasty (DALK).SettingSan Giovanni-Addolorata Hospital, Rome, Italy.DesignProspective interventional case series.MethodsPatients undergoing cataract surgery after DALK for keratoconus were enrolled. Total corneal astigmatism (TCA) was assessed by a rotating Scheimpflug camera combined with Placido-disk corneal topography (Sirius; CSO, Firenze, Italy). A customized toric IOL (FIL 611 T, Soleko, Rome, Italy) was implanted in all eyes. One year postoperatively, refraction was measured, the IOL position was recorded, and vectorial and nonvectorial analyses were performed to evaluate the correction of astigmatism.ResultsTen eyes of 10 patients were analyzed. The mean preoperative TCA magnitude was 4.92 ± 1.99 diopters (D), and the mean cylinder of the IOL was 6.18 ± 2.44. After surgery, the difference between the planned axis of orientation of the IOL and the observed axis was ≤10° in all eyes. The mean surgically induced corneal astigmatism was 0.35 D at 20°. The mean postoperative refractive astigmatism power was 1.13 ± 0.94 D; with respect to preoperative TCA, the reduction was statistically significant (p < 0.0001). The mean change in astigmatism power was 3.80 ± 1.60 D, corresponding to a correction of 77% of preoperative TCA power. Nine eyes out of 10 had a postoperative refractive astigmatism power ≤ 2D.ConclusionsToric IOLs can effectively correct corneal astigmatism in eyes with previous DALK. The predictability of cylinder correction is partially lowered by the variability of the surgically induced changes of TCA. This trial is registered with NCT03398109.

| S-EPMC6051070 | biostudies-literature

Association between the site of clear corneal Phakic intraocular lens implantation incisions and the inflow of ocular surface fluid into the anterior chamber.

Project description:BackgroundPosterior chamber phakic intraocular implantable collamer lens (ICL) implantation is an effective surgical option for the management of myopia. Over the past few years, the number of ICL surgeries has significantly increased. Postoperative inflammation and endophthalmitis are among the most serious complications after successful ICL surgery. Sometimes, when the blepharospasm is removed at the end of surgery, a small amount of the ocular surface fluid will flow into the anterior chamber, which can lead to an increased risk of infection and inflammation. However, little attention has been paid to this phenomenon.PurposeWe conducted a retrospective study to compare the incidence of extraocular fluid inflow into the eye through the clear corneal incision (CCI) at two different positions (superior and temporal sides).MethodsA total of 116 patients with myopia underwent superior CCI ICL implantation (n = 58) or temporal CCI ICL implantation (n = 58) at our hospital from October to December 2021. The incidence of conjunctival sac fluid entering the anterior chamber after eyelid fixative was removed was compared in both groups.ResultsBoth groups were well matched in all parameters. Ocular surface fluid inflow into the anterior chamber was significantly higher in the superior CCI group (25/58, 47.1%) than in the temporal CCI group (1/58, 1.7%) (p < 0.05).ConclusionIn the patients with ICL implantation, the temporal CCI was better than the superior CCI in avoiding the ocular surface fluid inflow into the anterior chamber, and the potential risk of infection and inflammation was lower.

| S-EPMC10019354 | biostudies-literature

The Relationship between Anterior Chamber Angle and Intraocular Pressure Early after V4c Implantable Collamer Lens Implantation.

Project description:Purpose:To confirm the relationship between anterior chamber angle (ACA) and intraocular pressure (IOP) early after V4c implantable collamer lens (ICL) implantation. Methods:Patients were assigned to two groups: (1) right eyes (control group) and (2) left eyes (experimental group), with miosis conducted immediately after ICL implantation in the left eyes. IOP, angle opening distance (AOD), trabecular-iris angle (TIA), and pupil diameter (PD) were compared between two groups at postoperative hours 1, 2, and 24. The relationship between ACA, PD, and IOP was analyzed by multiple linear regression. Result:Thirty-six eyes of 18 patients were enrolled. The prevalence of ocular hypertension (OHT, defined as IOP???21?mmHg) was 61.11% and 16.67% in the right and left eyes, respectively, (? 2?=?7.481, p=0.006). At postoperative hours 1 and 2, IOP and PD were significantly higher (p < 0.001) in the right eyes, and TIA and AOD were significantly lower (p < 0.05) in the right eyes than in the left eyes. There was no significant difference at 24?h postoperative in these parameters. After the right eye ICL implantation, the changes of AOD 500 and PD were both linearly correlated with postoperative IOP change (??=?-23.707 and 1.731, respectively; p?=?0.013 and 0.002, respectively). Conclusion:The ACA was significantly narrowed immediately after V4c ICL implantation. There was a negative linear correlation between ACA and early IOP and a positive linear correlation between PD and early IOP. We recommend the use of intracameral miotics immediately after V4c ICL implantation to reduce the incidence of IOP spikes.

| S-EPMC7391088 | biostudies-literature

Comparative long-term outcomes of vitrectomy combined with anterior chamber intraocular lens to intra-scleral haptic fixation of posterior chamber intraocular lens

Project description: Not available

| S-EPMC11346030 | biostudies-literature