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AIM: To observe the efficacy of moderate and high myopia patients with vault greater than 1 000μm after implantation of phakic posterior chamber implantable contact lens(ICL).METHODS: A total of 42 patients(73 eyes)who received ICL implantation in the hospital and had postoperative vault greater than 1 000 μm between January 2014 and January 2017 were selected and retrospectively studied. Changes in visual acuity, intraocular pressure, corneal endothelial cell density, anterior chamber-related parameters(chamber angle, central anterior chamber depth, anterior chamber volume)and vault were compared among patients before surgery, at 1, 3, 6mo and 1a after surgery and at the last follow-up.RESULTS: The uncorrected visual acuity(UCVA)at 1, 3, 6mo and 1a after surgery and at the last follow-up was better than that before surgery(all P<0.05), and the chamber angle, central anterior chamber depth and anterior chamber volume were smaller or lower than those before surgery(all P<0.05), but there were no statistical differences in UCVA, chamber angle, central anterior chamber depth and anterior chamber volume at each time point after surgery(all P>0.05). The intraocular pressure at 1mo after surgery was lower than that before surgery(P<0.05), but the intraocular pressure at 3, 6mo and 1a after surgery and at the last follow-up was not statistically different from that before surgery(all P>0.05). There was no statistical significance in the corneal endothelial cell density at 1, 3, 6mo and 1a after surgery and at the last follow-up compared with that before surgery(all P>0.05). The vault at 1, 3, 6mo and 1a after surgery and at the last follow-up showed a decreasing trend, and the difference was statistically significant at each time point after surgery(all P<0.05).CONCLUSION: The short-term and long-term efficacy are better in moderate and high myopia patients with vault greater than 1 000 μm after ICL implantation, and there are no significant effects on the intraocular pressure and corneal endothelial cell. The postoperative anterior chamber structure is relatively stable and the vault tends to decrease over time. In most cases, close observation is sufficient and intraocular lens replacement is generally not required.
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AIM: To determine the correlation among horizontal ciliary sulcus(HCS)diameter, vertical ciliary sulcus(VCS)diameter and corneal diameter in different anterior chamber depth(ACD)levels from patients with low to moderate myopia.METHODS: Retrospective study. A total of 78 patients(129 eyes)with low to moderate myopia who had preoperative examination of implantable contact lens(ICL)implantation in Shanghai Bright Eye Hospital from April 2021 to April 2022 were included. HCS, VCS and white to white(WTW)were measured and compared. Patients were divided into shallow ACD group(2.8 mm ≤ ACD ≤3.2 mm), medium ACD group(3.2 mm < ACD ≤3.4 mm)and deep ACD group(ACD > 3.4 mm)based on the ACD obtained by Pentacam. The HCS, VCS and WTW within and among groups were compared, and the correlation of WTW, HCS and VCS among each group was analyzed by Pearson and linear regression equation.RESULTS: There was no statistical difference in WTW and HCS overall and in groups with different ACD(P>0.05), while there was difference between VCS and both HCS and WTW(P<0.01). The WTW had a correlation with both HCS and VCS in each group, while correlation between WTW and VCS was weak in the deep ACD group(r=0.470, R2=0.221, P<0.01). Furthermore, the WTW, HCS and VCS in the shallow ACD group were statistically different from those in the medium and deep ACD groups(P<0.01).CONCLUSION: The WTW was suggested predicting HCS rather than perfectly replacing HCS before patients had the ICL operation among patients with low to moderate myopia. The predictability of VCS would decline as the ACD depth increasing, predicting VCS by WTW was not recommended.
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@#High intraocular pressure is the most concerned complication of the implantation surgery of V4c implantable contact lens(ICL). According to the appearance time of intraocular pressure elevation, it can be divided into three periods: the early period(1wk after surgery), the middle period(1-4wk after surgery)and the late period(1-3mo after surgery). During the early period, the intraocular pressure increase is mainly caused by the residue of the intraoperative viscoelastic. In the middle period, the application of the hormone drugs results the elevation of the intraocular pressure. Furthermore, during the late period, persistent increasing of the intraocular pressure may cause the secondary glaucoma. Identifying the mechanism of different periods of intraocular pressure rise correctly and thus formulating a reasonable treatment plan, is of great significance for the prevention of glaucoma and other long-term vision threatening complications. Therefore, this article reviews the appearance time and mechanism of the intraocular pressure rise after surgery.
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@#AIM: To observe the changes of the vault height and the correlation analysis of visual quality under different pupil diameters after ICL surgery.<p>METHODS: Retrospective case study. Selected 43 patients(86 eyes)who implanted V4c ICL surgery successfully at Shanghai Aier Eye Hospital and followed up regularly to meet the measurement requirements from January 2018 to January 2019, Routine parameters and iTrace were checked before and 1wk, 1mo, and 3mo after surgery. Visante-OCT was used to measure the vault height under the pupils of 3mm and 5mm. <p>RESULTS: The vault height under the 3mm pupil at 1wk, 1mo and 3mo after surgery were(586.06±24.49, 560.16±21.31, 508.19±21.17)μm, the values under the 5mm pupil were(698.13±20.98, 667.69±20.16, 613.28±19.79)μm(<i>F</i><sub>Time</sub>=40.160,<i>P</i><sub>Time</sub><0.001; <i>F</i><sub>Groups</sub>=56.835,<i>P</i><sub>Groups</sub><0.001). The wave of vaule under the different pupils was(112.06±8.91, 107.53±6.94,101.01±10.64)μm(<i>F</i>=16.875, <i>P</i>>0.05). The total high-order aberration(HOA)and RMS of the whole eye after ICL were significantly reduced(<i>F</i>=29.847, 85.019; <i>P</i><0.001). The MTF and SR value were significantly higher than before surgery(<i>F</i>=47.653, 33.264; <i>P</i><0.001), and there was no statistical difference after ICL. At 3mo after surgery, the RMS and MTF values at 3mm and 5mm pupils were compared. The RMS value of the total HOA under the pupil of 5mm is significantly higher than that at 3mm, and the increase of spherical and trefoil aberration is significant(<i>t</i>=21.812, 17.136; <i>P</i><0.001). No significant difference in coma value(<i>t</i>=2.028, <i>P</i>>0.05). The MTF at 5mm pupils were significantly lower than those at 3mm at spatial frequencies of 5, 10, 15, 20, 25, 30c/d(<i>t</i>=15.138, 9.147, 7.018, 4.693, 3.814 and 3.075, all <i>P</i><0.05).<p>CONCLUSION: The impact of pupil movement on vault height fluctuation is about 110μm. It is recommended that the minimum vault height should be above 300μm. It can significantly reduce the root mean square value of total high-order aberration and aberration of the whole eye, and significantly increase the MTF and SR values after ICL surgery. The pupil size has a significant effect on visual quality after ICL. The spherical aberration and trefoil aberration increase under the condition of large pupil, and the MTF value generally decreases.
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@#AIM: To analyze the changes in the central vault after implantable contact lens(ICL)implantation and its impact in patients with high myopia.<p>METHODS: The clinical data of 27 patients(54 eyes)with high myopia were recievd ICL implantation in our hospital from January 2016 to July 2017 were retrospectively analyzed, the vault was examined by Pentacam scheimpflug system at 1mo and 12mo after operation. The effects of white to white distance, ICL length, ICL degree, equivalent spherical mirror degree(spherical equivalent, SE)and pupil diameter on the change of arch height were analyzed by multiple linear regression analysis.<p>RESULTS: One month after ICL implantation, the vault was 582.45±173.18μm, 12mo after the operation, the vault was 509.47±163.82μm, 12mo after operation was significantly lower than that of 1mo after the operation, the difference was statistically significant(<i>t</i>=2.099, <i>P</i><0.05); The results of multivariate linear regression analysis showed that the length of ICL, the degree of ICL and the equivalent spherical lenses were independent factors affecting the arch height at 1mo and 12mo after ICU implantation in high myopia patients(<i>P</i><0.05); The length of ICL and the white to white distance of cornea(WTW)were factors that were significantly associated with a decrease in the vault(<i>P</i><0.05).<p>CONCLUSION: The vault was reduced in 12mo after ICL implantation, and the length of ICL and WTW had a significant influence decrease in the vault. The length of ICL, the degree of ICL and the degree of the equivalent sphere had a significant influence on the vault.
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@#AIM: To investigate the correlation between horizontal corneal diameter(WTW), horizontal anterior chamber diameter(HACD)and horizontal ciliary sulcus diameter(S-S). <p>METHODS: A total of 62 cases(115 eyes)with high myopia were collected from those who were examined in our hospital from August 2015 to August 2016. Their WTW and HACD were measured with SIRIUS, while S-S was measured with UBM, and the results were compared and analyzed. <p>RESULTS: In all patients, WTW was 11.91±0.37mm, HACD was 12.45±0.43mm, S-S was 11.78±0.46mm. There was negative correlation between HACD or S-S and age(<i>r</i>=-0.423 and <i>r</i>=-0.386 respectively, all <i>P</i><0.05). Correlation comparison with central anterior chamber depth(ACD)showed in group with ACD≤3.5mm, WTW and HACD were related with S-S; while in group with ACD>3.5mm, there was no significant correlation between WTW or HACD and S-S. <p>CONCLUSION: 1)WTW and S-S has better correlation, but due to the influence of age and anterior chamber depth, S-S is recommended to be measured with reference to the UBM to determine ICL when the patient is equal to or over 40 years old or with ACD>3.5mm; 2)SIRIUS Anterior Segment System is safe, simple and repeatability in measuring WTW and HACD.
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@#Posterior chamber intraocular lens implantation was effective for correcting refractive errors. More scientific studies about subjective visual quality(visual acuity, contrast sensitivity)and objective visual quality(wave front aberration, point spread function, Strehl ratio, modulmion transfer function)had showed that the improvement of subjective visual acuity was accompanied with the improvement of objective visual acuity after phakic intraocular lens implantation. However, the complications, such as anterior subcapsular cataract, glaucoma and decomposition of corneal endothelium needed to be long-term followed up. This article summarized the visual quality research after posterior chamber phakic intraocular lens implantation.
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AIM:To study the efficacy and safety of Toric implantable contact lens (TICL) implantation in the treatment of patients with high myopia and astigmatism.METHODS: Totally 90 patients (178 eyes) diagnosed as this disease were selected in our hospital during September 2012 to September 2016 by the method of random.The UCVA, BCVA, refraction, astigmatism coefficient, corneal endothelial cell, intraocular pressure, manifest refraction examination were accessed and compared before and after 3 and 9mo of surgery.RESULTS: After 3 and 9mo of the surgery, the UCVA and BCVA were much higher than those before treatment, which the difference was statistically significant (P0.05).The corneal endothelial cells at 3 and 9mo after operation were compared with those of before treatment, and we found that the differences were statistically significant (P0.05).CONCLUSION: TICL implantation in the treatment of patients with high myopia and myopic astigmatism has a more obvious clinical efficacy and safety and reliability.
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Background Phakic posterior chamber implantable contact lens (PPC-ICL) or phakic posterior chamber Toric implantable contact lens (PPC-TICL) implantation is an effective way for the correction of high myopia or high myopia with astigmia,but it often has residual myopic power.Excimer laser-assisted subepithelial keratectomy (LASEK) can correct the residual myopia following PPC-ICL or PPC-TICL,but its effectiveness and safety deserve attention.Objective This study was to analyze the clinical effectiveness and safety of LASEK for residual myopia after PPC-ICL implantation for extreme high myopia.Methods A prospective cases-observational study was performed,and written informed consent was obtained from each patient before any surgery.Fourteen eyes of 9 patients with residual myopia following PPC-ICL or PPC-TICL for the eyes with spherical equivalent refraction of ≥-20.00 D were collected in the Affiliated Hospital of Guizhou Medical University from July 2010 to March 2015,including PPCICL implantation in 8 eyes and PPC-TICL implantation in 6 eyes.LASEK were performed on the eyes to correct the residual myopic power.Uncorrected visual acuity (UCVA),best corrected visual acuity (BCVA),haze,the distance of intraocular lens to lens,corneal thickness,corneal topography,corneal endothelial cell counting,intraocular pressure (IOP) and fundus were examined and compared before and after surgery.The effectiveness and safety of the surgery were evaluated.Results The operation was smooth and no complication was found after surgery in all of the eyes.The UCVA and BCVA were significantly different in the eyes among before surgery,6 months after PPC-ICL implantation and 12 months after LASEK (F =31.360,1.778;both at P＜0.05),and the UCVA after LASEK was higher than BCVA before LASEK.The refractive powers were (-22.27-±4.29),(-3.75±2.25) and (-0.42±0.63) D before surgery,6 months after PPC-ICL implantation and 12 months after LASEK,showing a significant difference among them (F=46.370,P＜0.05),and the refractive power was considerably lower after LASEK than that before surgery and after PPC-ICL implantation (both at P＜0.05).No significant difference was found in IOP or corneal endothelial cell counting in operated eyes among before surgery,6 months after PPC-ICL implantation and 12 months after LASEK (F=1.663,1.055;both at P＞0.05).The distance of intraocular lens to lens was (0.69±0.26)mm in the eyes after LASEK and (0.71 ±0.29)mm in the eyes after PPC-ICL implantation,with no significant difference between them (t =0.192,P＞0.05).Conclusions PPC-ICL or PPC-TICL implantation for the correction extreme high myopia often remains a certain degree of myopia,and LASEK for the correction of residual refractive power is safe and effective.
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PURPOSE: To report a case of decreased endothelial cell density 7 years after posterior chamber phakic intraocular lens implantation. CASE SUMMARY: A 45-year-old man with high myopia combined with astigmatism was treated with Toric implantable Collamer Lens (ICL) implantation. The patient's best corrected visual acuity was 0.7 in both eyes before the operation. After the treatment, his uncorrected visual acuity was 0.9 and corrected visual acuity was 1.0 in both eyes, indicating an improvement in visual function. Preoperative endothelial cell density measured 3,063 cells/mm2 in the right eye and 3,126 cells/mm2 in the left eye. At 5 years postoperatively, measurements were 2,897 cells/mm2 in the right eye and 2,974 cells/mm2 in the left, showing little change. However, a 6-year postoperative measurement of 2,198 cells/mm2 in the right eye and 2,803 cells/mm2 in the left showed a slight decrease in endothelial cell density in the right eye, and a follow-up measurement one year later displayed a rapid decline to 1,272 cells/mm2 in the right eye and 2,852 cells/mm2 in the left eye. The Toric ICL lens was removed from the right eye and phacoemulsification and posterior chamber intraocular lens implantation was performed. Two-month postoperative endothelial cell density was 1,257 cells/mm2 and endothelial cell damage from the operation itself was minimal. CONCLUSIONS: ICL implantation may cause complications related to corneal endothelial cells as well as glaucoma. Patients should receive regular follow-up examinations for endothelial cell density.
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Humains , Adulte d'âge moyen , Astigmatisme , Cellules endothéliales , Études de suivi , Glaucome , Pose d'implant intraoculaire , Lentilles intraoculaires , Myopie , Phacoémulsification , Lentilles intraoculaires phaques , Acuité visuelleRÉSUMÉ
Objective To observe the effect of postoperative central vault on the anterior chamber after implantation of im-plantable contact lens V4c .Methods To carry out a retrospective study of 56 eyes with implantable contact lens V4c implantation in Chongqing Bright Eye Hospital from November 2 ,2014 to February 5 ,2015 ,examined anterior chamber angle before surgery ,the anterior chamber angular width (ACA) and anterior chamber volume (ACV) were measured by pentacam .the postoperative central vault and ACA and ACV during the first and third and sixth months after surgery were measured ,the pigment grade in anterior chamber after operation were recorded .The change of ACA and ACV of the 56 eyes was correlation analyzed .Results At first month after surgery ,the postoperative central vault was 250 ~ 765 μm ,the reduced amount of ACA was (13 .67 ± 1 .67)° ,the re-duced amount of ACV was (94 .23 ± 17 .02)mm3 .At the third month ,the postoperative central vault of the 55 eyes was 239 ~ 761μm ,the reduced amount of ACA was (13 .70 ± 1 .68)° ,The reduced amount of ACV was (93 .6 ± 17 .48)mm3 .At the sixth month , the postoperative central vault of the 51 eyes was 246 ~ 761 μm ,the reduced amount of ACA was (13 .60 ± 1 .69)° ,the reduced a-mount of ACV was(94 .29 ± 17 .80)mm3 .No case of pigment was found for grade Ⅱ .The statistical comparison of the amount of ACV and ACA decreased in different postoperative central vaults showed that the difference was statistically significant ,there were statistically significant differences in the amount of ACV and ACA between different central postoperative central vault(P< 0 .05) . Conclusion Anterior chamber angle was narrowed and anterior chamber volume decreased in the posterior chamber intraocular lensimplant-ation after implantable contact lens V4c implantation ,the postoperative central vault is related to the change of anterior chamber angle and ACV .Appropriate postoperative central vault has positive clinical significance for keeping anterior chamber angle open .
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Objective To assess the clinical outcomes about the visual qulitity of toric implantable contact lens ( TICL) implantation for high myopia with astigmatism. Methods Fifty-two eyes of 27 patients that underwent TICL implantation were examined. Uncorrected visual acuity( UCVA) ,best corrected visual acuity( BCVA) ,refraction,contrast sensitivity ( CS) with and without glare were evaluated before and after the treatment. Results Significant improvement in UCVA and BCVA were found at 1 month and 6 months after treatment (P0. 05), and the astigmatism at 1 month ( -0. 35 ± 0. 60)D and 6 months ( -0. 31 ± 0. 42)D after treatment were of no significant difference either (P>0. 05). The CS with and without glare were all significantly better than results before operation for 6. 0,12. 0 and 18. 0 cycles/degree (P0. 05). No significant difference were found preoperatively,1 month after treatment and 6 months after treatment in terms of CS with and without glare (P>0. 05). The satisfaction of this investigation was 100%. Conclusion The TICL performed well in correcting high myopia with astigmatism,and it is a good surgical option for the treatment.
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Background Implantable contact lens (ICL) surgery is a primary intraocular refractive corrective surgery for high myopia.However,whether there will be enough distance between ICL and anterior face of lens to avoid the occurrence of anterior capsular cataract in non-accommodated and the largest physiological accommodated state after ICL implantation is worthy of investigation.Objective The purpose of this study was to investigate the alteration of lens vault after ICL implantation and explore the relationship between accommodation and change of lens vault.Methods A observational study was carried out.Sixty-six eyes of 33 patients with high myopia who received ICL implantation were enrolled in Affiliated First Hospital of Guiyang Medical College from May to November,2012.Best corrected visual acuity (BCVA),uncorrected visual acuity (UCVA),refractive diopter were regularly examined using synthetical optometry,and crystalline lens rise (CLR) and lens vault in non-accommodative or accommodative condition were observed by the anterior segment OCT (Visante OCT) and ultrasound biomicoscopy (UBM) before operation and 1 day,1 week,l month and 3 months after operation.Data were analyzed with SPSS version 16.0.Repeated measurement one-way analysis of variance was used to compare the differences of vision and refractive diopter among various time points.The relationship between accommodation and CLR was assessed using Pearson linear correlation.The alteration of CLR with accommodation change was analyzed by linear regression equation.Lens vault was measured and compared between non-accommodation and maximal physical accommodation status by paired t test.Results The postoperative UCVA was improved in comparison with preoperative BCVA,and the postoperative diopter was significantly lower than that of preoperation,with significant differences among various time points (F =16.904,P =0.000 ; F =1.498,P =0.000),and the diopter was stable after operation.A positive correlation was found between the alteration of CLR and accommodation under the physical accommodative stimulation in high myopic eyes (R2 =0.49,P =0.00).Under physiological accommodation,CLR elevated 20 μm for per 1.0 D accommodation.In addition,the difference of lens vault values within postoperative 3 months was statistically significant (F=16.025,P=0.000).The lens vault values lowed with the enlargement of accommodation in 48.5％ eyes,and the lens vault values increased with the enlargement of accommodation in 50.0％ eyes.However,1.5％ of the lens vault were in a stable state under the maximal physiological accommodated condition 3 months after operation.Lens vault were greater than zero in 97.0％ eyes (64/66),and only 3.0％ eyes (2/66) were zero under the maximalphysiological accommodated condition.Significant differences were seen in the lens vault between nonaccommodated and the maximal physiological accommodated state 1 day or 1 week after operation (t =4.755,P =0.000 ;t =3.327,P =0.001) ; but there was no statistical significance in 1 month or 3 months after operation (t =1.544,P=0.127,t=0.621,P=0.537).Conclusions During physiological accommodation,the alteration of CLR with accommodation in high myopic eyes.The location of ICL in the eyes is unstable within 3 months after operation.Majority of operative eyes remain enough vault in the maximal physiological accommodated state,but minority of operative eyes occur contact of ICL with the anterior surface of lens.Whether this contact causes anterior capsular cataract still needs to study.
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AIM: To evaluate the safety, efficacy and stability of posterior chamber phakic intraocular lens ( ICL ) implanation and clear lens extraction for the correction of high myopia. METHODS: The study enrolled 56 cases ( 100 eyes ) of high myopia. Group I comprised 32 cases ( 58 eyes ) receiving ICL implantation and Group II comprised 24 cases (42 eyes) undergoing clear lens extraction. In this study, we evaluated the two groups of subject's the visual and refractive results, intraocular pressure ( IOP ) , endothelial cell density ( ECD ) , anterior chamber depth ( ACD) , lens transparency, the surgical complications as well as visual adverse symptoms before and after surgery. RESULTS: The postoperative subjects in group I and group II were followed, uncorrected vision acuity ( UCVA)>0. 5 were 69. 0% in group I and 71. 4% in group II after 3mo. UCVA>0. 5 were 72. 4% in group I and 73. 8% in group II after 1a. Predictability of the manifest spherical equivalent refraction within±1. 00D was achieved in 62. 1%of eyes in group I and 57. 1% in group II after 1a. The central vault of the ICL ( distance from posterior surface of ICL to the crystalline lens ) measured with anterior segment optical coherence tomography ( AS-OCT ) was 0. 35-0. 54 (0. 40±0. 16) mm. Twelve point one percent of eyes in group I and 7. 1% of eyes in group II had transient mild increase in IOP. Here were statistically significant differences between preoperative and postoperative ECD (PCONCLUSION: ICL implantation and clear lens extraction are effective, safe and predictable surgical option for the management of high myopia. No severe complications occurred, but its long time effect and safety still need more time to prove.
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PURPOSE: To report a case of secondary pigmentary glaucoma after implantable contact lens (ICL) implantation successfully treated with trabeculectomy without ICL removal. CASE SUMMARY: A 29-year-old woman presented with refractory intraocular pressure (IOP) increase in both eyes. IOP was 22 mm Hg in the right eye and 39 mm Hg in the left eye. The patient received posterior chamber phakic intraocular lens implantation in both eyes 22 months prior. Slit lamp examination revealed patent iridotomy sites in both eyes. Gonioscopy revealed open angles with 4-degree pigment deposits on the trabecular meshwork in both eyes. Ultrasound biomicroscopy examination confirmed contact between ICL and the posterior surface of the iris. In spite of well tolerated medical therapy and selective laser trabeculoplasty, IOP was 46 mm Hg in her left eye. Trabeculectomy was performed in her left eye without ICL removal. At 6 months postoperative, IOP measured 6 mm Hg without any anti-glaucoma medication and bleb was maintained in good condition in the left eye. CONCLUSIONS: The results from this case study indicate that ICL implantation can lead to secondary pigmentary glaucoma and trabeculectomy without ICL removal may help to decrease the IOP.
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Femelle , Humains , Cloque , Oeil , Glaucome à angle ouvert , Gonioscopie , Pression intraoculaire , Iris , Lentilles intraoculaires , Microscopie acoustique , Lentilles intraoculaires phaques , Réseau trabéculaire de la sclère , TrabéculectomieRÉSUMÉ
Background Posterior chamber phakic intraocular lens implantation is a safe and effective method for correction of high myopia.Petacam-assisted observation of the intraocular lens position in the eye after surgery,provides a good way for the evaluation of operation safety.Objective This study was to evaluate the security and effectiveness of posterior chamber (phakic) implantable contact lens (ICL) implantation for high myopia.Methods Twenty-five eyes of eighteen high myopia patients who received ICL implantation were retrospectively analyzed from March 2009 to September 2012.The mean preoperative spherical equivalent (SE) of the patients was (-17.52 ± 1.73) D and the cylinder was (-0.75 ± 0.28) D.The clinical effective indexes included preoperative and postoperative uncorrect visual acuity (UCVA) and best correct visual acuity (BCVA),SE,intraocular pressure (IOP),corneal endothelial cell number and percentage of corneal endothelial hexagon cells.In addition,Pentacam analysis system was used to compare the anterior chamber depth,anterior chamber angle and space between crystal lens and ICL between before and 6 months after operation.Written informed consent was obtained from each patient before any medical procedure.Results ICL was successfully implanted in all the 25 eyes.UCVA was 1.47 ±0.26 and 0.26±0.15 respectively before and after operation,showing a significant difference between them (t =21.71,P =0.00).SE,corneal endothelial cell number and percentage of corneal endothelial hexagon cells were significantly lower than those before operation (SE:t =-48.60,P =0.00 ; corneal endothelial cell number:t =13.07,P =0.00 ;percentage of corneal endothelial hexagon cells:t =10.79,P＜0.05).Anterior chamber angle was (25.02± 4.77)° 6 months after operation and was smaller than (38.43±4.04)° before operation (t=15.32,P=0.00).No significant differences were found in IOP and anterior chamber depth between before and after operation (IOP:t =-1.57,P =0.13 ; anterior chamber depth:t =1.46,P =0.16).The spaces between crystal lens and IOL was (363.33± 44.37) μm 6 months after operation,with a significant decline in comparison with (542.17±39.46) μm 1 week after operation (t =20.86,P =0.00).Glare sense appeared in 2 eyes after operation.Conclusions The results indicated that ICL implantation can retain the natural accommodation of lens.ICL implantation appears to be an effective and safe approach to high myopic eyes.However,the changes of corneal endothelial cells after operation should be payed more attention.
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PURPOSE: To evaluate the parameters affecting vaulting and correlation between preoperative crystalline lens rise and vaulting after implantable collamer lense (ICL) implantation. METHODS: A total of 53 eyes of 34 patients who underwent ICL implantation were examined retrospectively. White-to-white (WTW) and anterior chamber depth (ACD) were obtained from scanning topography (ORB scan) before surgery. Preoperative crystalline lens rise (CLR) and vaulting at 6 months after ICL implantation were measured using anterior segment optic coherence tomography (AS-OCT). Multiple regression analysis was performed to evaluate the factors affecting central vaulting. RESULTS: The mean preoperative crystalline lens rise was -120 +/- 219 microm, and mean central vaulting 6 months after surgery was 544 +/- 175 microm. Preoperative SE, WTW, ACD, and CLR were significantly correlated with vaulting at 6 months after surgery. With the use of meaningful variables, multiple regression analysis showed that CLR, WTW, ACD and SE, in that order of influence, had significant effects on vaulting and the multiple regression equation was obtained as follows: Vaulting (microm) = (160.913 x ACD (mm)) + (170.134 x WTW (mm)) + (-0.338 x CLR (microm)) + (-23.783 x SE (D)) - 2250.184. CONCLUSIONS: CLR had a stronger influence on vaulting after ICL implantation than the previously proven parameters: WTW, ACD, and SE. In addition to WTW, ACD and SE, CLR should also be considered a new criterion for estimating vaulting after ICL implantation.
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Humains , Chambre antérieure du bulbe oculaire , Cristallines , Oeil , Cristallin , Lentilles intraoculaires , Études rétrospectivesRÉSUMÉ
PURPOSE: To evaluate the changes in higher-order aberrations (HOAs) after implantation of an ICL (implantable contact lens). METHODS: Twenty-six eyes that had undergone ICL implantation between February 2008 and October 2009 were included. Ocular higher-order aberrations of all the eyes were measured using the Hartmann-Shack aberrometer (KR9000PW). Examinations were performed preoperatively, as well as one week, one month, and three months after ICL implantation. Changes in ocular total higher-order aberrations, total spherical aberration, coma aberration, trefoil aberration, and S3 and S4 calculated in the central 4-mm zone and expressed as root mean square (RMS) values were analyzed. RESULTS: The mean patient age was 25.4 years, and the mean preoperative spherical equivalent was -6.40 diopters(D). The mean postoperative spherical equivalents were 0.00 +/- 0.13D, 0.03 +/- 0.21D, -0.013 +/- 0.12D at one week, one month,and three months, respectively. There were no statistically significant differences in ocular higher-order aberration RMS,including spherical, coma, or trefoil aberration, at one week, one month, or three months postoperative or between preoperative and postoperative measurements. CONCLUSIONS: There is no significant change of ocular higher order aberration in the central 4-mm zone after ICL implantation.
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Humains , Coma , Oeil , Lentilles intraoculaires , LoteaeRÉSUMÉ
PURPOSE: We compared the results of implanting an implantable contact lens (ICL) and an iris claw lens (Artisan(R) lens) in patients' wtih myopia and sought to determine a basis for choosing between the two lenses. METHODS: ICLs were implanted in 32 eyes of 18 patients, and Artisan(R) lenses were implanted in 40 eyes of 23 patients. Uncorrected visual acuity, refraction, endothelial cell density, intraocular pressure, and slit lamp measurements were taken for 12 months. RESULTS: All the patients had improved UCVA from the day after the operation until the 12th month. The mean spherical equivalent refraction at postoperative month 12 was -0.78+/-0.54D in the ICL group and -0.78+/-0.59D in the Artisan(R) lens group. In the same period, endothelial cell density loss was 5.34% in the ICL group but was not significant in the Artisan(R) lens group. There were no significant complications in either group. CONCLUSIONS: Both ICL and Artisan(R) lens implantation resulted in immediate visual improvement and stability of vision during the follow-up period. There was no significant difference in post-operative results. Further study will be needed to decide which lens is the better choice for delicate conditions in myopic patients.
Sujet(s)
Animaux , Humains , Cellules endothéliales , Oeil , Études de suivi , Sabot et griffe , Pression intraoculaire , Iris , Lentilles intraoculaires , Myopie , Vision , Acuité visuelleRÉSUMÉ
PURPOSE: To evaluate the effectiveness of the Toric implantable contact lens in correcting high myopic astigmatism. METHODS: A 44-year-old woman's uncorrected visual acuity was 0.08 in the right eye and 0.125 in the left eye. The refractive errors of her eyes were -11.75Dsph. : -5.0Dcyl.axis 3 degrees in the right eye and -1.0Dsph.: -3.0Dcyl.axis 178 degrees in the left eye. Her best corrected visual acuity was 0.5 in the right eye and 1.0 in the left eye. Toric implantable contact lenses were implanted in both eyes without any no intra-operative complications. RESULTS: Six months after surgery, her uncorrected visual acuities were 0.8 in the right eye and 1.0 in the left eye. The refractive errors were -0.5Dsph. : -0.5Dcyl.axis 120 degrees in the right eye and -0.25Dsph. : -1.5Dcyl.axis 13 degrees in the left eye. The best corrected visual acuity was 1.0 in the both eyes. In these eyes, there was no cataract or spike of intraocular pressure. CONCLUSIONS: High myopic astigmatism can be corrected with a one-stop operation to implant toric implantable contact lenes.