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Refractive Outcomes of Posterior Chamber Phakic Intraocular Lens Implantation for Correction of Myopia and Myopic Astigmatism.

ABSTRACT: The aim was to examine efficacy and safety after Implantable Collamer Lens (ICL) implantation for correction of myopia et myopic astigmatism.This prospective clinical study included 28 eyes of 16 patients which underwent implantation of ICL for correction of myopia up to -18,00 diopters (D) and myopic astigmatism up to -6,00 D in the Eye Clinic Svjetlost Sarajevo, from January 2013 to January 2016. Uncorrected distance visual acuity (UDVA), spherical equivalent (SE), corrected distance visual acuity (CDVA), intraocular pressure (IOP), endothelial cell (EC) density were evaluated at one, six and twelve months. For statistical analysis SPSS for Windows and Microsoft Excel were used.Out of 16 patients, with mean age of 28,21 ± 4,06 years, 12 of them had binocular and 4 of them had monocular procedure. After 12 months mean UDVA was 0,76 ± 0,16 compared to UDVA 0,04 ± 0,03 preoperatively. Mean SE preoperatively was -0,21 ± 0,27 D compared to -9,52 ± 3,69 D preoperatively. At 12 months one eye (3,57%) lost 2 Snellen lines. In this study 8 eyes (28,57%) gained 1 line, 5 eyes gained (17,56%) 2 lines, and 3 eyes (10,72%) gained 3 lines. EC loss was 5,50±4.71% after 12 months. There was no significant change of IOP by the end of 12 months follow up period. One haptic crack was reported as the only intraoperative complication. Three postoperative complications were: two lens rotations and one retinal detachment.Implantation of ICL is an effective and safe method for reducing or correcting myopia and myopic astigmatism.

SUBMITTER: Pjano MA

PROVIDER: S-EPMC5511534 | biostudies-other | 2017 Apr

REPOSITORIES: biostudies-other

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Project description:Purpose:To assess the efficacy and safety of a novel ophthalmic viscosurgical device-free (OVD-free) method for posterior chamber phakic intraocular lens (PIOL) implantation in myopic eyes. Methods:In this retrospective cohort study, the medical records of myopic eyes that underwent PIOL (Implantable Collamer Lens, ICL) implantation for myopia correction at the Eye Hospital of Wenzhou Medical University between May 2015 and March 2017 were reviewed. A total of 49 eyes with complete data that met follow up requirements (2?h, 1?day, 1?week, 3?months postoperatively) were recruited. Based on the surgical techniques used, the eyes were divided into the OVD-free method group and the standard method group. The clinical data, including intraocular pressure (IOP), corrected distance visual acuity (CDVA) and spherical equivalent (SE), at each follow-up were collected for comparison. Endothelial cell loss and complications were also investigated. Results:Twenty-one eyes received the standard method, and 28 eyes received the OVD-free method. A rise in IOP >?22?mmHg at 2?h was noted in 14 eyes (66.7%) in the standard group and none (0%) in the OVD-free group (p?<?0.001). The rise in IOP from baseline was significantly higher at 2?h in the standard group (10.5?±?5.2?mmHg vs. 2.2?±?3.3?mmHg, difference: 8.3, 95% CI 5.8 to 10.8; p <?0.001). There was a significant difference in the time course of LogMAR CDVA changes between the two groups (p?=?0.047). The LogMAR CDVA was significantly better in the OVD-free method group compared to the standard group at 1?day (-?0.076, 95% CI -?0.134 to -?0.018; p?=?0.012), 1?week (-?0.071, 95% CI -?0.135 to -?0.007; p?=?0.03), but not at 3?months (-?0.046, 95% CI -?0.107 to 0.015; p?=?0.134). There was no significant difference in the time course of SE changes between the two groups (p?=?0.471; p?=?0.705). In the OVD-free group, mean endothelial cell loss was 4.6% at 3?months (2522?±?281 vs. 2407?±?226 cells/mm2, difference: -115, 95% CI -?295 to 65; p?=?0.187). No complications were reported in both groups except for the early IOP elevation in the standard group during the observation period. Conclusions:The OVD-free method is safe and efficient for ICL implantation. It can be a safer method of ICL implantation compared to the standard method in that it completely eliminates ophthalmic viscoelastic devices-related complications without causing additional complications.

Project description:BackgroundTo describe the very early vault changes in the first month after Implantable Collamer Lens (ICL) implantation and to evaluate the effect of preoperative biometric factors on vault.MethodsEighty-three eyes from eighty-three subjects with complete data who met follow-up requirements were recruited in this retrospective study between May 2019 and March 2020. We quantitatively assessed the postoperative vault at 2 h, 1 day, 1 week, and 1 month following implantation. Associations between the postoperative vault and age, ICL size, spherical equivalent (SE), axial length (AL), central corneal thickness (CCT), flat keratometry (K), steep K, mean K, anterior chamber depth (ACD), crystalline lens thickness (LT), white-to-white (WTW) diameter obtained by three devices, horizontal and vertical sulcus-to-sulcus (STS) diameter, bright and dark pupil sizes (BPS and DPS) and DPS-BPS were investigated using Spearman's correlation analysis and stepwise multiple regression analysis.ResultsThe mean vault values at 2 h, 1 day, 1 week, and 1 month after ICL implantation were 672.05 ± 30.72, 389.15 ± 28.33, 517.23 ± 30.76 and 530.12 ± 30.22 μm, respectively. Significant differences were found in the vault values at 2 h, 1 day and 1 week after the operation. The ICL size (β = 0.942; p < 0.001), followed by horizontal STS (β = -0.517; p < 0.001), crystalline LT (β = -0.376; p < 0.001) and vertical STS (β = -0.257; p = 0.017), significantly influenced the vault at 1 month after the operation. The multiple regression equation was expressed as follows: central vault (µm) = -1369.05 + 657.121 × ICL size- 287.408 × horizontal STS - 432.497 × crystalline LT - 137.33 × vertical STS (adjusted R2 = 0.643).ConclusionsAfter ICL implantation, the vault decreased and then increased, but it did not return to the vault value 2 h after surgery. The ICL size, horizontal and vertical STS and crystalline LT are key factors for predicting postoperative vaulting.

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Refractive Outcomes of Posterior Chamber Phakic Intraocular Lens Implantation for Correction of Myopia and Myopic Astigmatism.

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