Clinical Prediction of Excessive Vault After Implantable Collamer Lens Implantation Using Ciliary Body Morphology.
Chen Qian,Tan Weina,Lei Xiaohua,Pan Chao,Jin Lina,Zeng Qingyan,Wang Zheng
Journal of refractive surgery (Thorofare, N.J. : 1995)
PURPOSE:To determine the factors related to the ciliary body that are predictive of outcomes of excessive vault (> 1,000 µm) after Implantable Collamer Lens (ICL V4c; STAAR Surgical) implantation. METHODS:In this retrospective case-control study, 27 eyes of 27 patients who presented with excessive vault (> 1,000 µm) following implantation of an ICL V4c were matched in a 1:2 ratio with those who presented with a normal vault (250 to 1,000 µm) on white-to-white distance, anterior chamber depth, and ICL size. The preoperative biometric parameters and clinical outcomes were compared between the two groups. The relationship between the postoperative vault and various variables was assessed by multiple linear regression analysis. Conditional logistic regression models were used to estimate odds ratios (ORs) and 95% CIs for excessive vault. RESULTS:The vault value 1 month postoperatively was associated with preoperative anterior chamber volume, iris-ciliary angle, and crystalline lens rise (P < .05). In the conditional regression logistic analysis, every 1° reduction in iris-ciliary angle was associated with 4% increased odds of vault greater than 1,000 µm (OR = 0.96; 95% CI = 0.93 to 0.99; P < .001) and the anteriorly positioned ciliary body was associated with an increased risk of excessive vault after ICL implantation (OR = 3.57; 95% CI = 1.67 to 7.63; P < .001). In the excessive vault group, 1 eye underwent the ICL extraction and 3 eyes had an ICL exchange for a smaller ICL. After the ICL exchange, the mean value of postoperative vault decreased from 1,525.67 ± 468.22 to 810.33 ± 254.92 µm. CONCLUSIONS:Eyes with an anteriorly positioned ciliary body were associated with a higher rate of excessive vault after ICL implantation, so the size of the ICL may need to be adjusted in these patients. Assessment of ciliary body characteristics adds significant information to the prediction of excessive vault after surgery. [J Refract Surg. 2020;36(6):380-387.].
10.3928/1081597X-20200513-02
Optical quality comparison between 2 collagen copolymer posterior chamber phakic intraocular lens designs.
Domínguez-Vicent Alberto,Ferrer-Blasco Teresa,Pérez-Vives Cari,Esteve-Taboada Jose J,Montés-Micó Robert
Journal of cataract and refractive surgery
PURPOSE:To compare the optical quality in vitro of 2 designs of the Visian Implantable Collamer Lens phakic intraocular lens (pIOL) for different powers and optical apertures. SETTING:University of Valencia, Valencia, Spain. DESIGN:Experimental study. METHODS:The Nimo TR1504 deflectometry device was used to measure the V4c pIOL, which has a smaller optic diameter, and the V5 pIOL, which has a larger optic diameter. The pIOLs were measured for -3.00 diopters (D), -6.00 D, -9.50 D, and -10.50 D at different optical apertures from 3.00 to 6.00 mm depending on the IOL power and model. The root mean square of higher-order aberrations (RMS HOAs) was analyzed. The Strehl ratio, point-spread functions (PSFs), and simulated images were calculated from wavefront aberrations. RESULTS:There were no statistically significant differences in any Zernike RMS or RMS HOAs between the 2 pIOL models with the same power and optical aperture (P > .05). Both pIOLs had negative spherical aberration that increased with the pIOL power. Strehl ratio values showed no statistically significant differences between the pIOLs with the same power and pupil aperture. Minimal differences were seen in the PSFs and simulated images between the pIOLs. CONCLUSIONS:Both pIOLs showed good and comparable in vitro optical quality similar that of a perfect lens in that they should not affect visual performance after implantation. Patients with larger pupil diameters could benefit from the pIOL with the larger optic diameter because it showed better in vitro optical quality than the previous design with a smaller optic diameter. FINANCIAL DISCLOSURE:No author has a financial or proprietary interest in any material or method mentioned.
10.1016/j.jcrs.2014.09.050
Seven-year follow-up of posterior chamber phakic intraocular lens with central port design.
Fernández-Vega-Cueto Luis,Alfonso-Bartolozzi Belén,Lisa Carlos,Madrid-Costa David,Alfonso José F
Eye and vision (London, England)
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.
10.1186/s40662-021-00247-1
[Prediction of the vaulting after posterior chamber intraocular lens implantation].
Zhu Q J,Chen W J,Zhu W J,Chen Q,Yu P,Shi L L,Ma L,Xiao H X,Yuan Y
[Zhonghua yan ke za zhi] Chinese journal of ophthalmology
To investigate the influencing factors on the vaulting one month after implantable collamer lens (ICL) implantation, and to develop and verify a prediction formula. The first half of this study was retrospective case series study, and the second half was cross-sectional stydy. A total of 83 eyes of 83 patients who underwent ICL implantation in the Lixiang Eye Hospital of Soochow University were included in the first half of the study, with an average age of (27±5) years, from August 1, 2019 to December 30, 2019. All patients underwent a complete preoperative examination, including axis length, anterior chamber depth, comprehensive optometry, intraocular pressure, central corneal thickness, white-to-white diameter, horizontal and vertical sulcus-to-sulcus diameter (STS), crystalline lens thickness (LT), corneal curvature, and bright and dark pupil diameter. Multiple linear regression (stepwise) was used to develop a prediction formula. In the validation part, a total of 65 people (65 eyes) were included, with an average age of (26±5) years, from March 1, 2020 to June 1, 2020. The accuracy and reliability of the formula were verified by the intergroup correlation coefficient and Bland-Altman consistency test. At 1 month after surgery, ICL size had the greatest impact on the vaulting (β=0.942, <0.001), followed by horizontal STS (β=-0.517, <0.001), LT (β=-0.376, <0.001), and vertical STS (β=-0.257, =0.017). The influence of other factors was not statistically significant (all >0.05). The regression equation was as follows: the vaulting (μm)=-1 369.05+657.12×ICL size-287.41×horizontal STS-432.50×LT-137.33×vertical STS (the fitting degree =0.813, =0.660, and corrected =0.643). In the verification part, the predicted average vaulting was (497.31±102.75) μm, while the actual vaulting was (514.62±152.99) μm. About 96.92% (63/65) of the patients were fitted in the moderate vault, and 3.08% (2/65) were in the high vault. The intergroup correlation coefficient was 0.581. According to the Bland-Altman test, the actual vaulting was 17.31 μm, higher than the predicted value, and the 95% confidence interval of the difference was -260.28 to 294.90 μm. The ICL size, horizontal and vertical STS and LT are the factors that affect and predict the vaulting one month after ICL implantation, and our prediction formula has good accuracy and reliability. .
10.3760/cma.j.cn112142-20201222-00837
Changes in ocular parameters of the crystalline lens after implantation of a collamer lens.
Clinical & experimental optometry
CLINICAL RELEVANCE:Understanding changes in ocular anatomical parameters after intraocular lens implantation will allow a more accurate determination of dioptric power prior to surgery. BACKGROUND:The crystalline lens position might change due to the implantation and removal of an implantable collamer lens (ICL) or toric implantable collamer lens (TICL). This study aimed to assess the effect of ICL implantation on position of the crystalline lens. METHODS:This retrospective study was conducted on patients who underwent V4c ICL or V4c TICL implantation between March and September, 2018. Preoperative and post-operative (2 weeks, 3 months and 6 months) axial length, central corneal thickness, crystalline lens position, crystalline lens thickness and vault height were analysed. Multivariable linear regression was used to determine the variables associated with 6-month changes in lens position. RESULTS:This study included 117 eyes of 117 patients. There were decreases in all vertical distance measures from the central corneal endothelium to the anterior and posterior crystalline lens capsule (all p > 0.05). The amount of reduction was related to the crystalline lens position before the operation and crystalline lens thickness after the operation (all p < 0.01). An error in anterior chamber depth and lens thickness may appear when the ICL/TICL is close to the crystalline lens. CONCLUSION:Phakic intraocular lens implantation resulted in lens thickening and forward movement on day 1 post-operatively, which becomes stable within 6 months. Preoperative lens position and post-operative lens thickness were related to the amount of movement.
10.1080/08164622.2021.1958654
In vivo optical quality of posterior-chamber phakic implantable collamer lenses with a central port.
Eye and vision (London, England)
BACKGROUND:The aim of this review is to summarize the optical quality results in patients following the implantation of the V4c implantable collamer lens with a central port (ICL, STAAR Surgical Inc.). MAIN TEXT:A literature search in several databases was carried out to identify those publications, both prospective, retrospective and/or comparative with other refractive surgery procedures, reporting optical outcomes of patients who were implanted with the V4c ICL model. A total of 17 clinical studies published between 2012 and 2021 were included in this review. A detailed analysis of the available data was performed including number of eyes, follow-up and preoperative spherical equivalent. Specifically, the review focused on several optical parameters including higher-order aberrations (HOAs), modulation transfer function (MTF) cut-off frequency and Strehl ratio. This review encompassed a total of 817 eyes measured using different optical devices based on Hartmann-Shack, retinal image quality measurement and ray-tracing technologies at different follow-ups. CONCLUSIONS:The outcomes found in this review lead us to conclude that the ICL V4c model provides good optical quality, by means of different metrics, when implanted.
10.1186/s40662-021-00251-5
Effect of pupil size on posterior chamber phakic intraocular lens vault measurements.
Indian journal of ophthalmology
PURPOSE:The aim of this study was to measure the implantable collamer lens (ICL) vault changes with anterior segment optical coherence tomography (AS-OCT) after the implantation of the Visian posterior chamber phakic ICL with a central hole (V4c) in relation to the pupil size. METHODS:This retrospective observational pilot study included 32 eyes of 16 patients, who underwent V4c ICL implantation. ICL vault was measured with AS-OCT in undilated and fully dilate state of the pupil. Primary outcome measure was the change in the vault of V4c ICL at the maximum and minimum pupil size. RESULTS:Median (IQR) undilated and post-dilated vault measurement was 393.00 (335.50-493.50) microns and 421.00 (338.50-503.75) microns, respectively, which was not statistically significant (P = 0.44). CONCLUSION:No statistically significant difference was observed between the undilated and post-dilated ICL vault measurements. Hence, the postoperative vault can be measured either in resting, undilated state or fully dilated state of the pupil and would be similar irrespective of the pupil size.
10.4103/ijo.IJO_3429_20
One-step viscoelastic agent technique for ICL V4c implantation for myopia.
Miao Hua-Mao,Zhao Feng,Niu Ling-Ling,Zhao Jing,Wang Xiao-Ying,Zhou Xing-Tao
International journal of ophthalmology
AIM:To investigate the safety and efficacy of using a one-step viscoelastic agent technique for posterior chamber phakic implantable collamer lens with a central hole (ICL V4c) implantation for myopia correction. METHODS:The one-step viscoelastic agent technique for ICL V4c implantation was used in 100 eyes of 52 patients. Refractive outcomes, intraocular pressure (IOP), corneal endothelial cell, and corneal densitometry values were evaluated at 1d, 1wk, 1 and 3mo postoperatively. RESULTS:All the surgeries were uneventful. No corrected distance visual acuity was lost after 3mo. IOP was 16.12±3.18 mm Hg before surgery, and 14.74±3.08 mm Hg at 1d and 14.50±2.56 mm Hg at 3mo after surgery (<0.05). Corneal endothelial cell density was 2580±242 cell/mm, the coefficient of variation in cell size was 42.11%±7.92%, and the percentage of hexagonal cells was 40.98%±9.46% before surgery. No significant difference was found when these outcomes were compared between the studied time points (>0.05). The corneal densitometry values of the central 2 mm and 2 to 6 mm areas showed similar regularities. After surgery, the values significantly increased at 1d, then decreased to the preoperative values at 1wk, and then continued to decrease at 3mo (<0.05). CONCLUSION:The one-step viscoelastic agent technique for ICL V4c implantation is found to be safe and effective for myopia correction and causes little disturbance to the cornea.
10.18240/ijo.2021.09.10
Posterior chamber collamer phakic intraocular lens implantation: Comparison of efficacy and safety for low and moderate-to-high myopia.
European journal of ophthalmology
PURPOSE:To compare visual, refractive and safety outcomes of central-hole posterior chamber collamer phakic intraocular lens implantation for low and moderate-to-high myopia. SUBJECTS/METHODS:This retrospective cohort study included 338 eyes submitted to posterior chamber collamer phakic intraocular lens implantation that completed a 12-month postoperative follow-up. Two groups were defined depending on preoperative spherical equivalent: group 1 comprised 106 eyes with manifest spherical equivalent of -6.00 D or less; group 2 comprised 232 eyes with manifest spherical equivalent higher than -6.00 D. Effectiveness, predictability, stability and safety outcomes were compared preoperatively and at 1, 6 and 12 months postoperatively. RESULTS:At 1-year postoperative, uncorrected and corrected visual acuities were 0.02 ± 0.17 and -0.01 ± 0.12 logMAR (group 1) and 0.04 ± 0.20 and 0.01 ± 0.16 logMAR (group 2), with an efficacy index of 1.05 ± 0.17 and 1.17 ± 0.28. Respectively, 92 (86.8%) and 199 (85.8%) eyes were within ±0.50 D of targeted refraction, and postoperative manifest refraction changes were -0.07 ± 0.25 D and -0.07 ± 0.35 D. Intraocular pressure did not change significantly. The mean rate of endothelial cell loss was 1.12% and 1.10%, respectively. One case of anterior subcapsular cataract (group 2) was observed. ICL exchange occurred in one case (group 1) and three cases (group 2). No vision-threatening complications were reported. CONCLUSION:The posterior chamber collamer phakic intraocular lens implantation demonstrated high visual and refractive efficacy with an excellent safety profile for the correction of both low and moderate-to-high myopia, revealing equivalent 1-year outcomes regardless of the degree of preoperative myopia.
10.1177/11206721211012861