AIM:To compare the postoperative efficacy,safety,predictability,and visual quality of implantable collamer lens(ICL)implantation versus small incision lenticule extraction(SMILE)in myopia eyes.METHODS:Pub Med,EMBASE,W...AIM:To compare the postoperative efficacy,safety,predictability,and visual quality of implantable collamer lens(ICL)implantation versus small incision lenticule extraction(SMILE)in myopia eyes.METHODS:Pub Med,EMBASE,Web of Science,Cochrane Library and several Chinese databases were searched at May 2021 to select relevant studies in comparison of clinical outcomes between ICL implantation and SMILE for myopia.The primary outcomes were efficacy,safety,and predictability.And the secondary outcomes were postoperative higher-order ocular aberrations(HOAs),modulation transfer function cutoff frequency(MTF),objective scatter index(OSI),contrast sensitivity and a quality of vision(Qo V)questionnaire.RESULTS:A total of 1036 eyes from 10 studies,of which 503 eyes underwent ICL implantation and 533 eyes underwent SMILE,were enrolled in this Meta-analysis.Pooled results revealed that ICL group had a better safety index and post-corrected distance visual acuity(CDVA)(P=0.007,<0.00001,respectively),and a lower percentage of eyes with a postoperative CDVA lost 1 line(P=0.007)than the SMILE group.No significant differences were found in comparison of the other primary outcomes.In the longterm follow-up(>6mo),ICL group had a lower total HOA,coma,and spherical aberration than SMILE group(P=0.003,<0.00001,0.04).Yet higher trefoil was found in ICL group at 6mo after surgery(P=0.003).Additionally,ICL group also had a higher MTF value(P=0.02),and a higher contrast sensitivity score for spatial frequencies of 1.5,6,and 12 cpds(P=0.02,0.005,0.02,respectively).And it also had a lower score of bothersome in Qo V questionnaire than SMILE group(P=0.003).CONCLUSION:ICL implantation and SMILE have similar and comparable outcomes in term of the efficacy and predictability for correcting high myopia.However,ICL group is relatively safer and also has better visual quality in comparison of SMILE group.展开更多
AIM:To analyze ultrasound biomicroscopy(UBM)images using random forest network to find new features to make predictions about vault after implantable collamer lens(ICL)implantation.METHODS:A total of 450 UBM images we...AIM:To analyze ultrasound biomicroscopy(UBM)images using random forest network to find new features to make predictions about vault after implantable collamer lens(ICL)implantation.METHODS:A total of 450 UBM images were collected from the Lixiang Eye Hospital to provide the patient’s preoperative parameters as well as the vault of the ICL after implantation.The vault was set as the prediction target,and the input elements were mainly ciliary sulcus shape parameters,which included 6 angular parameters,2 area parameters,and 2 parameters,distance between ciliary sulci,and anterior chamber height.A random forest regression model was applied to predict the vault,with the number of base estimators(n_estimators)of 2000,the maximum tree depth(max_depth)of 17,the number of tree features(max_features)of Auto,and the random state(random_state)of 40.0.RESULTS:Among the parameters selected in this study,the distance between ciliary sulci had a greater importance proportion,reaching 52%before parameter optimization is performed,and other features had less influence,with an importance proportion of about 5%.The importance of the distance between the ciliary sulci increased to 53% after parameter optimization,and the importance of angle 3 and area 1 increased to 5% and 8%respectively,while the importance of the other parameters remained unchanged,and the distance between the ciliary sulci was considered the most important feature.Other features,although they accounted for a relatively small proportion,also had an impact on the vault prediction.After parameter optimization,the best prediction results were obtained,with a predicted mean value of 763.688μm and an actual mean value of 776.9304μm.The R²was 0.4456 and the root mean square error was 201.5166.CONCLUSION:A study based on UBM images using random forest network can be performed for prediction of the vault after ICL implantation and can provide some reference for ICL size selection.展开更多
AIM:To investigate the changes in choroidal thickness(CT)in high myopic eyes after femtosecond laser-assisted in situ keratomileusis(FS-LASIK)surgery or central hole implantable collamer lens(ICL V4c)implantation usin...AIM:To investigate the changes in choroidal thickness(CT)in high myopic eyes after femtosecond laser-assisted in situ keratomileusis(FS-LASIK)surgery or central hole implantable collamer lens(ICL V4c)implantation using swept-source optical coherence tomography(SS-OCT).METHODS:We examined the right eyes of 116 patients with high myopia who were candidates for FS-LASIK surgery and ICL implantation.Sixty eyes underwent ICL V4c implantation and 56 eyes were subjected to FS-LASIK surgery.The CT was measured with SS-OCT.All data were recorded preoperatively and 2 h,1 wk,1 and 3 mo postoperatively.Other demographic information was collected,including age,sex,uncorrected visual acuity(UCVA),best corrected visual acuity(BCVA),spherical equivalent(SE),intraocular pressure(IOP)and axial length(AL).RESULTS:The UCVA improved in both groups and showed no significant differences between groups.There also were no significant differences between the two groups in postoperative BCVA and SE(P=0.581 and 0.203,respectively).The foveal CTs,inner nasal and outer nasal CTs were significantly thicker at 2 h postoperatively in both groups(P<0.05)but returned to baseline levels in 1 wk;after 1 mo,no significant differences were found relative to the preoperative values.At 3 mo in each group,nine regions showed variations in the CT as compared with preoperative thickening,but only the foveal and nasal area CTs preoperative differences were statistically significant(P<0.05).In addition,there was no significant difference in 9 regions of CT between the two groups at all follow-up times(P>0.05).CONCLUSION:The CTs after ICL implantation and FSLASIK surgery are significantly thicker than those before operation,especially in the foveal and nasal areas,but there is no significant difference between the two methods.展开更多
AIM: To compare the optical quality after implantation of implantable collamer lens(ICL) and wavefront-guided laser in situ keratomileusis(WG-LASIK).METHODS: The study included 40 eyes of 22 patients with myopia who a...AIM: To compare the optical quality after implantation of implantable collamer lens(ICL) and wavefront-guided laser in situ keratomileusis(WG-LASIK).METHODS: The study included 40 eyes of 22 patients with myopia who accepted ICL implantation and 40 eyes of 20 patients with myopia who received WG-LASIK. Before surgery and three months after surgery, the objective scattering index(OSI), the values of modulation transfer function(MTF) cutoff frequency, Strehl ratio, and the Optical Quality Analysis System(OQAS) values(OVs) were accessed. The higher order aberrations(HOAs) data including coma, trefoil, spherical, 2^(nd) astigmatism and tetrafoil were also obtained. For patients with pupil size <6 mm, HOAs data were analyzed for 4 mm-pupil diameter. For patients with pupil size ≥6 mm, HOAs data were calculated for 6 mm-pupil diameter. Visual acuity, refraction, pupil size and intraocular pressures were also recorded.RESULTS: In both ICL and WG-LASIK group, significant improvements in visual acuities were found postoperatively, with a significant reduction in spherical equivalent(P< 0.001). After the ICL implantation, the OSI decreasedslightly from 2.34±1.92 to 2.24±1.18 with no statistical significance(P=0.62). While in WG-LASIK group, the OSI significantly increased from 0.68±0.43 preoperatively to 0.91±0.53 postoperatively(Wilcoxon signed ranks test, P=0.000). None of the mean MTF cutoff frequency, Strehl ratio, OVs showed statistically significant changes in both ICL and WG-LASIK groups. In the ICL group, there were no statistical differences in the total HOAs for either 4 mmpupil or 6 mm-pupil. In the WG-LASIK group, the HOA parameters increased significantly at 4 mm-pupil. The total ocular HOAs, coma, spherical and 2^(nd) astigmatism were 0.12±0.06, 0.06±0.03, 0.00±0.03, 0.02±0.01, respectively. After the operation, these values were increased into 0.16±0.07, 0.08±0.05,-0.04±0.04, 0.03±0.01 respectively(Wilcoxon signed ranks test, all P<0.05). At 6 mm-pupil, the induction of total HOAs was not statistically significant in the WG-LASIK group. CONCLUSION: ICL implantation has a less disturbance to optical quality than WG-LASIK. The OQAS is a valuable complementary measurement to the wavefront aberrometers in evaluating the optical quality.展开更多
AIM:To observe the characteristics of iridociliary cysts in myopic patients and evaluate the influences on the position and safety of implantable collamer lens(ICL)after surgery.METHODS:Totally 270 eyes of 135 patient...AIM:To observe the characteristics of iridociliary cysts in myopic patients and evaluate the influences on the position and safety of implantable collamer lens(ICL)after surgery.METHODS:Totally 270 eyes of 135 patients who underwent ICL surgery for the corrections of myopia were included in this study.Preoperative and postoperative morphology of iridociliary cysts were observed in ultrasonic biomicroscopy(UBM)image.RESULTS:A total of 138 iridociliary cysts were found in 88 eyes of 50 patients among 270 eyes of 135 patients before surgery(37%).Twenty-five patients had cysts in one eye(50%)and 25 had cysts in both eyes(50%).The prevalence of iridociliary cysts was negatively correlated with age,but no gender difference(P>0.05).The incidence of iridociliary cysts was much less in eyes with myopia greater than-9.00 D(P<0.05).The diameter of the largest cyst was 1.96 mm and the smallest cyst was 0.24 mm,with a majority within the range of 0.5 to 1.0 mm.Most of the cysts were located in the inferior temporal quadrant.One year after ICL implantation,51 iridociliary cysts(37%)remained unchanged,47 cysts(34%)decreased in size,and 40 cysts(29%)disappeared.Most of cysts that changed after surgery were smaller than 1.0 mm(P<0.05)and located in the nasal and temporal sides around the haptics of implantable lens.All the ICL were in their original position.CONCLUSION:Iridociliary cysts are commonly seen in myopic eyes.The cysts have no impact on the safety of ICL surgery.Some cysts may decrease in size or disappear after ICL implantation.展开更多
AIM: To evaluate the changes in higher order aberrations(HOAs) after implantable collamer lens(ICL;Staar Surgical, Nidau, Switzerland) implantation. METHODS: Totally 30 eyes of 18 patients with myopia were included in...AIM: To evaluate the changes in higher order aberrations(HOAs) after implantable collamer lens(ICL;Staar Surgical, Nidau, Switzerland) implantation. METHODS: Totally 30 eyes of 18 patients with myopia were included in this study with an average age of 25.77y(min: 21, max: 40). Refraction, uncorrected distance visual acuity(UDVA), corrected distance visual acuity(CDVA), HOAs(entire, corneal and internal) were evaluated preoperatively and three months postoperatively. Ocular aberrations were measured by using iT race(Tracey Technology, Houston, Texas, USA). SPSS(IBM Corp. Released 2013. IBM SPSS Statistics for Windows, Version 22.0. Armonk, NY: IBM Corp) was used for the statistical analysis and the interpretation of the data. P values of less than 0.05 were considered statistically significant. RESULTS: The preoperative mean spherical power was -9.01 D(min:-5.00, max:-13.00) and the mean cylindrical error was -2.40 D(min:-0.50, max:-4.75). The postoperative mean residual spherical power was -0.73 D(min:-0.20, max:-1.75) and the mean cylindrical error was -0.89 D(min:-0.18, max:-2.09). Analyses were made on root mean square(RMS) values of total HOAs(tH OAs), spherical aberration, coma and trefoil as entire, corneal and internal components. The differences in entire t HOAs and in internal t HOAs were significant. There was no significant change found in spherical aberrations. The differences in entire coma and in internal coma were significant. There was no significant change found in corneal coma. With respect to trefoil, the only significant difference was in internal trefoil. CONCLUSION: The ICL implantation corrects the refractive error successfully and changes entire and internal HOAs of the eye.展开更多
AIM:To investigate the clinical characteristics,treatment methods and outcomes of rhegmatogenous retinal detachment(RRD)in highly myopic eyes with implantable collamer lens(ICL).METHODS:High myopia patients who receiv...AIM:To investigate the clinical characteristics,treatment methods and outcomes of rhegmatogenous retinal detachment(RRD)in highly myopic eyes with implantable collamer lens(ICL).METHODS:High myopia patients who received treatment for nontraumatic RRD after ICL implantation surgery at the Retinal Department of Zhongshan Ophthalmic Center from Jan 2018 to Dec 2022 were reviewed.Comprehensive ophthalmologic examinations including visual acuity measurement and digital fundus photography were performed in each patient.RESULTS:A total of nine RRD eyes from nine patients who received V4c-ICL implantation were included.The mean time from ICL implantation surgery to the diagnosis of RRD was 32.44±22.56mo(range,1-60mo).At the initial visit for RRD,giant retinal tear(GRT),horseshoe tear,simple round hole,and horseshoe tear combined with round hole were detected in 3,3,2,and 1 eye(s),respectively,with maculaoff in eyes.Eight patients received surgical treatment,and one patient was treated by retinal laser photocoagulation alone.The ICL was preserved in 7 eyes.At the last followup,the mean best corrected visual acuity(BCVA)improved significantly from 1.76±1.06 logMAR at presentation to 0.81±1.01 logMAR(P=0.035),and no case of recurrent retinal detachment was found.CONCLUSION:The morphological presentation of retinal breaks is diverse in this study.The ICL can be preserved in most cases during the course of retinal detachment repair surgery in our data,companied with acceptable visual and anatomical outcomes.展开更多
AIM:To elucidate the safety and visual quality of implantable collamer lens with central hole(ICL V4c)implantation for correcting moderate and high myopia for at least 5y.METHODS:This retrospective study was conducted...AIM:To elucidate the safety and visual quality of implantable collamer lens with central hole(ICL V4c)implantation for correcting moderate and high myopia for at least 5y.METHODS:This retrospective study was conducted on 58 patients(114 eyes)who were followed up for at least 5y after ICL V4c implantation.The observation was done before and on 1d,1mo,1 and 5y or more after the surgical procedure.The visual acuity,subjective refraction,intraocular pressure,vault,axial length,central hole position,pupil diameter,visual quality,and adverse events were analyzed.The visual quality includes aberration,the modulation transfer function cutoff frequency(MTF cutoff),objective scattering index(OSI),Stroller's ratio(SR),and visual quality questionnaire.RESULTS:The average follow-up period was 69.25±3.80mo(range 60–82mo)and the preoperative spherical equivalent(SE)was-8.66±1.97 D.At 5y after operation,the safety index was 1.01±0.02 and the efficacy index was 0.99±0.42 and SE was-0.65±0.63 D.The 59.6%of the eyes achieved an uncorrected distance visual acuity of 20/20,76.3%of the eyes had SE within±1.0 D at the last visit.The axial length increased by 0.29±0.71 mm 5y after the surgery(t=-3.843,P<0.001).The mean vault at the last follow-up was 510.59±245.61μm.The central hole was on the temporal side in 80 eyes(84.2%).The visual quality questionnaire showed that 98.2%patients were satisfied with the surgical procedure.Adverse events occurred in 4 eyes(3.5%),including the posttraumatic toric ICL rotation(2 eyes),iris incarceration(1 eye),and posttraumatic ICL displacement(1 eye)at the last follow-up.CONCLUSION:Long-term ICL V4c implantation is safe,effective,and stable for correcting moderate and to high myopia,and the visual quality with patients is excellent and satisfactory,but the progression of axial length still needs attention after surgery.展开更多
Dear Editor,To improve humor circulation the latest V4c Visian implantable collamer lens(ICL)was designed with a0.36-mm Aquaport^([1-2]).This design also eliminates the need to perform peripheral iridectomy before ICL...Dear Editor,To improve humor circulation the latest V4c Visian implantable collamer lens(ICL)was designed with a0.36-mm Aquaport^([1-2]).This design also eliminates the need to perform peripheral iridectomy before ICL implantation.Several authors reported rates of secondary surgical intervention related to insufficient vault in the presence or absence of cataract formation and excessive vault in the presence or absence of elevated intraocular pressure(IOP)展开更多
Background:To evaluate the long-term safety,efficacy,predictability,and stability of implantable collamer lens with a central hole(EVO ICL)implantation for correcting high myopia(HM)and super high myopia(SHM).Methods:...Background:To evaluate the long-term safety,efficacy,predictability,and stability of implantable collamer lens with a central hole(EVO ICL)implantation for correcting high myopia(HM)and super high myopia(SHM).Methods:This prospective study evaluated 83 eyes of 46 patients who were divided into groups based on their spherical equivalent refractive error(SE):HM group(−12 D≤SE<−6 D)and SHM group(SE<−12 D).They were followed up for 5 years after ICL implantation;assessments of uncorrected distance visual acuity(UDVA),corrected distance visual acuity(CDVA),manifest refractive error,axial length,intraocular pressure,corneal endothelial cell density,and vault were conducted,and a questionnaire was administered.ResuIts:At 5 years postoperatively,the safety indices of the HM and SHM groups were 1.03±0.10 and 1.32±0.39,and the efficacy indices were 0.83±0.25 and 0.86±0.32,respectively.In the HM group,60.47%and 79.07%of the eyes were within±0.50 D and±1.00 D of the attempted correction,while it was achieved for 22.50%and 47.50%of the eyes in the SHM group,respectively.The SE of the HM group decreased from−9.72±1.41 D preoperatively to 0.04±0.39 D 1 month postoperatively and−0.67±0.57 D 5 years postoperatively,while in the SHM group,it decreased from−15.78±3.06 D preoperatively to−0.69±0.97 D 1 month postoperatively and−1.74±1.19 D 5 years postoperatively.Conclusion:EVO ICL implantation is safe,effective,and predictable for correcting HM and SHM.CDVA improved more after surgery for SHM,but the growth of axial length still needs attention.展开更多
AIM: To evaluate the intra-operator repeatability of time domain and swept-source Fourier domain anterior segment optical coherence tomography(AS-OCT), namely, Visante ASOCT and Casia SS-1000 OCT, in measuring the pre...AIM: To evaluate the intra-operator repeatability of time domain and swept-source Fourier domain anterior segment optical coherence tomography(AS-OCT), namely, Visante ASOCT and Casia SS-1000 OCT, in measuring the preoperative parameters of implantable collamer lens(ICL) in myopic eyes, as well as the agreement between the two devices.METHODS: A total of 97 eyes from 49 myopes were investigated in this prospective case series study. The anterior chamber depth(ACD), angle-to-angle distance(ATA), pupil diameter(PD) and crystalline lens rise(CLR) in all subjects were measured for three times during one session by the same operator. The repeatability was evaluated using the within-subject standard deviation(Sw), repeatability limits and intraclass correlation coefficients(ICC). The agreement between the two systems was evaluated using the Bland-Altman plots and 95% limits of agreement(Lo A).RESULTS: The repeatability limits of Visante AS-OCT in measuring ACD, ATA, PD and CLR were 0.099, 0.141, 0.304, and 0.079 mm, respectively. The repeatability limits of Casia SS-1000 OCT in measuring ACD, ATA, PD, and CLR were 0.105, 0.127, 0.357, and 0.082 mm, respectively. Excellent repeatability could be attained in both devices, with the ICC>0.8 for all the measured variables. The interdevice agreement was excellent(P>0.05) for ACD and ATA, but poor(P<0.05) for PD and CLR.CONCLUSION: Good repeatability can be attained by time domain and swept-source Fourier-domain OCT for all the measured variables. Moreover, interdevice agreement analysis suggests that interchangeable measurements between two devices can be achieved for ACD and ATA, but not for PD and CLR;but the differences in measurements were not clinically significant.展开更多
Dear Editor,I am Dr.Ye Shen from the Department of Ophthalmology,the First Affiliated Hospital,College of Medicine,Zhejiang University,Hangzhou,China.I write to share my experience of full-vision maintenance in patien...Dear Editor,I am Dr.Ye Shen from the Department of Ophthalmology,the First Affiliated Hospital,College of Medicine,Zhejiang University,Hangzhou,China.I write to share my experience of full-vision maintenance in patient with extra-展开更多
AIM:To compare clinical outcomes and refractive stability of implantable collamer lens(ICL)implantation and femtosecond laser assisted laser in situ keratomileusis(FSLASIK)for high myopia correction.METHODS:The Optica...AIM:To compare clinical outcomes and refractive stability of implantable collamer lens(ICL)implantation and femtosecond laser assisted laser in situ keratomileusis(FSLASIK)for high myopia correction.METHODS:The Optical Quality Analysis System(OQAS)was used to evaluate clinical outcomes objectively after operation for high myopia correction.We compared the two procedures in terms of 1-year changes in uncorrected distance visual acuity(UDVA),corrected distance visual acuity(CDVA),safety index,efficacy index,spherical equivalent,modulation transfer function(MTF)cutoff frequency,strehl ratio(SR)and objective scatter index(OSI).RESULTS:At 1 y postoperatively,the safety indices were 1.33±0.27 in ICL group,and 1.17±0.24 in FS-LASIK group.39.58%in the ICL group and 27.59%in the FS-LASIK group gained CDVA in 2 lines or better than that in preoperative CDVA.The efficacy indices were 1.28±0.22 in ICL group,and 1.13±0.26 in FS-LASIK group.The changes of spherical equivalent from 1 wk to 1 y postoperatively was-0.12±0.37 D in ICL group,and-0.79±0.58 D in FS-LASIK group(P<0.05).Spherical equivalent within±0.50 D was achieved in 97.92%in ICL group and 68.97%in FS-LASIK group.MTF cutoff frequency were higher with ICL as compared to FSLASIK(P<0.05)at each postoperative follow-up stage;for postoperative 1 mo later,SR was statistically significant difference between two groups(P<0.05);with no statistically significant difference in OSI between two groups(P>0.05)in postoperative 3 mo later.CONCLUSION:ICL implantation and FS-LASIK procedures both provide good safety and predictability in high myopia correction.ICL implantation provides better clinical outcomes and refractive stability than FS-LASIK.展开更多
AIM:To assess the safety,efficacy,predictability and stability of implantable collamer lens(ICL) for residual refractive error after corneal refractive surgery.METHODS: This study evaluated 19 eyes of 12 patients who ...AIM:To assess the safety,efficacy,predictability and stability of implantable collamer lens(ICL) for residual refractive error after corneal refractive surgery.METHODS: This study evaluated 19 eyes of 12 patients who underwent ICL implantation after corneal refractive surgeries.They were followed up for 1y to 5y of uncorrected distance visual acuity(UDVA),corrected distance visual acuity(CDVA),manifest refractive error,flat and steep K value,axial length,intraocular pressure,corneal endothelial cell density,adverse events after ICL surgery.RESULTS: The mean follow-up period was 39.05 ±19.22 mo(range,1-5y).Spherical equivalent refractive error changed from-7.45±3.02 D preoperatively to-0.85±1.10 D 1wk to 1mo after ICL implantation,with the safety and efficacy indices being 1.12 and 1.15,respectively.A total of 52.63% of eyes were within ±0.5 D of the predicted spherical equivalents,73.68% were within ±1.0 D.A trend of mild regression towards myopia with axial elongation after 5y was observed.One eye with mild anterior capsule opacity and retinal detachment 1y after surgery were observed.CONCLUSION: ICL implantation is safe and effective for the correction of residual refractive error after corneal refractive surgeries,especially in moderate to high residual myopia.展开更多
AIM:To evaluate the clinical outcomes of V4 c implantable collamer lens(Hole ICL) implantation with regard to the optical quality assessed according to different degrees of decentering.METHODS:This included 49 eyes th...AIM:To evaluate the clinical outcomes of V4 c implantable collamer lens(Hole ICL) implantation with regard to the optical quality assessed according to different degrees of decentering.METHODS:This included 49 eyes that received conventional ICL and 94 eyes that received Hole ICL.The eyes that received Hole ICL were divided into three groups according to the degree of decentering:group 1,central hole within 1 hole diameter(HD) from the pupil center;group 2,central hole within 1 HD to 2 HD;and group 3,central hole within 2 HD to 3 HD.Visual acuity(VA),intraocular pressure(IOP),and spherical equivalent(SE) values were assessed at 1wk,1 and 3mo after surgery.The ocular modulation transfer function,Strehl ratio,objective scattering index,and higher order aberrations(HOAs) were measured for 4-mm pupils at 3mo after surgery.RESULTS:There were no significant differences in VA,IOP,and SE among the conventional and Hole ICL groups.With regard to HOAs,values for coma and spherical aberrations showed no differences.The total HOA and trefoil values were significantly higher in group 2 than in group 1(P=0.02,0.03,respectively).There were no significant differences among groups with regard to other optical quality parameter at 3mo after surgery.CONCLUSION:Our results suggest that Hole ICL implantation provides satisfactory visual quality that is equivalent to that provided by conventional ICL,regardless of the presence of central hole and degree of decentering.展开更多
AIM:To evaluate the causes of phakic implantable collamer lens(ICL)exchange/explantation in patients with and without keratoconus(KC)at two tertiary hospitals in Riyadh,Saudi Arabia.METHODS:A retrospective chart revie...AIM:To evaluate the causes of phakic implantable collamer lens(ICL)exchange/explantation in patients with and without keratoconus(KC)at two tertiary hospitals in Riyadh,Saudi Arabia.METHODS:A retrospective chart review of all patients who underwent ICL(model V4 c with central port)exchange/explantation was performed using the electronic medical record systems.All available preoperative and postoperative data were documented for each patient.RESULTS:Over 7 y,2283 ICL implantation procedures were performed;46 implants(2%)required exchange(21 implants)/explantation(25 implants),of which 14 cases(30.4%)were patients with KC.Indications for ICL exchange/explantation in non-KC group were vault measurement,cataract formation,increased intraocular pressure,inaccurate refraction,and patient dissatisfaction in 22(68.75%),4(12.5%),3(9.37%),2(6.25%),and 1(3.12%)case,respectively.The most common indication for ICL exchange/explantation in the KC group was inaccurate vault sizing in 11 patients(78.57%),inaccurate refraction in 2 patients(14.28%),and patient dissatisfaction postoperatively in 1(7.14%)case.CONCLUSION:ICL implantation results in predictable refractive outcomes over the long term with exchange/explantation rates comparable to previous literature.Improper vault size is the most common cause of ICL exchange/explantation among patients with or without KC.展开更多
AIM:To evaluate the efficacy,safety and stability of posterior chamber phakic intraocular lens implantation for the correction of high myopia.METHODS:Retrospective case review of 82 eyes(43patients)undergoing implanta...AIM:To evaluate the efficacy,safety and stability of posterior chamber phakic intraocular lens implantation for the correction of high myopia.METHODS:Retrospective case review of 82 eyes(43patients)undergoing implantable Coliamer lens(ICL)placement by a single surgeon(Xiao-Wei Gao)to correct preoperative mean spherical equivalents between-9.00diopter(D)and-23.00D.Main outcome measures included uncorrected visual acuity(UCVA),refraction,best spectacle-corrected visual acuity(BSCVA),endothelial cell density(ECD),intraocular pressure(IOP),lens transparency,postoperative uveitis.Visante anterior segment optical coherence tomography(AS-OCT)was used to measure anterior chamber depth(ACD)and the position of ICL.RESULTS:Mean follow-up was 6.54±3.26 months(range 3-12 months).Predictability of the manifest spherical equivalent(SE)refraction to within±1.OOD was achieved in 88%of eyes and±0.50D in 72.5%of eyes.The mean postoperative manifest SE refraction was-1.85±0.72D,with 96.34%of eyes maintaining or gaining≥1 line(s)of BSCVA.The mean 3-month postoperative ECD decreased but had no statistically difference compared with the preoperative ECD.Of the 7 eyes(8.54%)with a mild transient increase in intraocular pressure(up to 30mmHg),none required a second surgical procedure or prolonged topical medication.There was no loss of lens transparency.Pigmented precipitates were observed in 5 eyes(6.09%).The mean preoperative ACD measured with AS-OCT was 3.28±0.14mm,three months after surgery,the mean ACD was2.45±0.22mm.Anterior chamber depth showed astatistically significant reduction.One eye(1.22%)had ICL spontaneous rotation,81 eyes(98.78%)of the lens remained correctly centered.CONCLUSION:The implantation of ICL is an effective surgical option for the management of high myopia.But its long time effect and safety still need more time to prove.展开更多
AIM: To compare Visian lens(model V4 c) and Artiflex lens regarding quality(contrast sensitivity) and quantity(efficacy, predictability, safety and stability) of vision in correcting high myopia with recording and ana...AIM: To compare Visian lens(model V4 c) and Artiflex lens regarding quality(contrast sensitivity) and quantity(efficacy, predictability, safety and stability) of vision in correcting high myopia with recording and analysis of complications. METHODS: The comparative prospective study included 39 eyes of 23 patients with high myopia, 19 eyes had Visian lens implantation(model V4 c) and 20 eyes had Artiflex lens implantation. The inclusion criteria were high myopia(higher than 6.0 D) and stable refraction(<0.5 D change over one year). Outcomes included assessment of safety and efficacy indices, predictability, stability, contrast sensitivity and analysis of complications at postoperative 1 d, 1 wk and 1, 3, 6 and 12 mo. Selection of the type of phakic intraocular lens for patients was based on surgeons' preferences, which was no specific selection criteria. RESULTS: After 12 mo of follow up, difference in uncorrected and corrected distant visual acuity(CDVA) between both groups was statistically insignificant(UDVA for VisianV4 c and Artiflex lens were 0.33±0.2 logMAR and 0.37±0.2 logMAR respectively, P=0.59, CDVA for VisianV4 c and Artiflex lens were 0.155±0.1 logMAR and 0.147± 0.1 logMAR respectively, P=0.87). The efficacy index was 1.25 for VisianV4 c lens and 0.8 for Artiflex lens, 78.9% of eyes were within one diopter spherical equivalent in Visian V4 c lens group compared to 70% in the Artiflex lens group. No eye lost lines of CVDA proving a good safety index for both lenses(safety index was 1.67 for VisianV4 c lens and 1.34 for Artiflex lens). Difference in contrast sensitivity between both groups was statistically insignificant(P=0.15, 0.88, 0.27, 0.32 and 0.82 at five spatial frequencies). CONCLUSION: Both Visian ICL V4 c and Artiflex lensesare safe and effective with stable and predictable refraction and they have comparable contrast sensitivity outcomes with no vision threatening complications.展开更多
AIM: To evaluate the surgical results of sulcus intraocular lens(IOL) implantation in children with unilateral anterior persistent fetal vasculature(PFV) underwent primary vitrectomy combined with lensectomy and prese...AIM: To evaluate the surgical results of sulcus intraocular lens(IOL) implantation in children with unilateral anterior persistent fetal vasculature(PFV) underwent primary vitrectomy combined with lensectomy and preservation of the peripheral anterior capsule.METHODS: Twenty-two eyes of 22 children with unilateral anterior PFV who underwent sulcus secondary IOL implantation were analyzed. Main outcome measures were preoperative and postoperative visual acuity, and complications both intraoperatively and postoperatively. RESULTS: Review of 22 consecutive patients identified best-corrected visual acuity(BCVA) improvement from 1.37±0.84 to 0.73±0.57 logarithm of the minimal angle of resolution(logMAR) after IOL implantation(P<0.001) with a mean follow-up was 16.55±5.86 mo. Average age at secondary IOL implantation was 41.05±15.41 mo. Three eyes(13.64%) achieved BCVA of 0.3 logMAR at the final visit. Transient intraocular pressure rise(4 eyes; 18.18%), postoperative increased inflammation(3 eyes; 13.64%) and postoperative hypotony(2 eyes; 9.09%) were common complications.CONCLUSION: Properly preservation of the anterior lens capsule during the primary surgery facilitated secondary sulcus IOL implantation in pediatric patients with anterior PFV, with favorable postoperative visual outcomes and compatible percentage of complications.展开更多
AIM: To evaluate the efficacy and safety of a modified technique [trocar opening(TO)] for silicone oil removal(SOR) in combination with phacoemulsification and intraocular lens(IOL) implantation.METHODS: A total of 60...AIM: To evaluate the efficacy and safety of a modified technique [trocar opening(TO)] for silicone oil removal(SOR) in combination with phacoemulsification and intraocular lens(IOL) implantation.METHODS: A total of 60 eyes of 60 patients with cataract and silicone oil-filled eyes were enrolled in this study. The patients were divided into two groups: the patients in the control group underwent 23-gauge pars plana active SOR surgery with phacoemulsification and IOL implantation, while the patients in the TO group underwent TO methods during surgery. Best corrected visual acuity(BCVA), surgery time, intraocular pressure, and operative complications were observed 6 mo after surgery.RESULTS: There was no significant difference between the two groups in terms of age, gender, preoperative, intraocular pressure, or time of silicone oil stay. Prior to surgery, the mean BCVA for the control and TO groups was 1.34±0.44 and 1.36±0.42. At 6 mo following surgery, the mean BCVA improved to 0.74±0.36 and 0.77±0.32, respectively(P<0.001). There was no significant difference between the two groups. The mean SOR time was 6.9±2.3 min and 4.8±1.2 min in the control and TO groups(P=0.008). The total operation time was 28.2±8.5 min and 24.6±6.4 min, respectively(P=0.035). Posterior capsule rupture occurred in four eyes of control and none of TO group(P<0.01). Late recurrent retinal detachment occurred in one eye in the control group(2 mo after surgery) and in one eye in the TO group(4 mo after surgery). CONCLUSION: TO is a simple, effective, time-saving, and safe method for SOR combined with phacoemulsification and IOL implantation.展开更多
基金Supported by National Natural Science Foundation of China(No.82070937,No.81870640)National Science Foundation for Young Scientists of China(No.82101097)。
文摘AIM:To compare the postoperative efficacy,safety,predictability,and visual quality of implantable collamer lens(ICL)implantation versus small incision lenticule extraction(SMILE)in myopia eyes.METHODS:Pub Med,EMBASE,Web of Science,Cochrane Library and several Chinese databases were searched at May 2021 to select relevant studies in comparison of clinical outcomes between ICL implantation and SMILE for myopia.The primary outcomes were efficacy,safety,and predictability.And the secondary outcomes were postoperative higher-order ocular aberrations(HOAs),modulation transfer function cutoff frequency(MTF),objective scatter index(OSI),contrast sensitivity and a quality of vision(Qo V)questionnaire.RESULTS:A total of 1036 eyes from 10 studies,of which 503 eyes underwent ICL implantation and 533 eyes underwent SMILE,were enrolled in this Meta-analysis.Pooled results revealed that ICL group had a better safety index and post-corrected distance visual acuity(CDVA)(P=0.007,<0.00001,respectively),and a lower percentage of eyes with a postoperative CDVA lost 1 line(P=0.007)than the SMILE group.No significant differences were found in comparison of the other primary outcomes.In the longterm follow-up(>6mo),ICL group had a lower total HOA,coma,and spherical aberration than SMILE group(P=0.003,<0.00001,0.04).Yet higher trefoil was found in ICL group at 6mo after surgery(P=0.003).Additionally,ICL group also had a higher MTF value(P=0.02),and a higher contrast sensitivity score for spatial frequencies of 1.5,6,and 12 cpds(P=0.02,0.005,0.02,respectively).And it also had a lower score of bothersome in Qo V questionnaire than SMILE group(P=0.003).CONCLUSION:ICL implantation and SMILE have similar and comparable outcomes in term of the efficacy and predictability for correcting high myopia.However,ICL group is relatively safer and also has better visual quality in comparison of SMILE group.
文摘AIM:To analyze ultrasound biomicroscopy(UBM)images using random forest network to find new features to make predictions about vault after implantable collamer lens(ICL)implantation.METHODS:A total of 450 UBM images were collected from the Lixiang Eye Hospital to provide the patient’s preoperative parameters as well as the vault of the ICL after implantation.The vault was set as the prediction target,and the input elements were mainly ciliary sulcus shape parameters,which included 6 angular parameters,2 area parameters,and 2 parameters,distance between ciliary sulci,and anterior chamber height.A random forest regression model was applied to predict the vault,with the number of base estimators(n_estimators)of 2000,the maximum tree depth(max_depth)of 17,the number of tree features(max_features)of Auto,and the random state(random_state)of 40.0.RESULTS:Among the parameters selected in this study,the distance between ciliary sulci had a greater importance proportion,reaching 52%before parameter optimization is performed,and other features had less influence,with an importance proportion of about 5%.The importance of the distance between the ciliary sulci increased to 53% after parameter optimization,and the importance of angle 3 and area 1 increased to 5% and 8%respectively,while the importance of the other parameters remained unchanged,and the distance between the ciliary sulci was considered the most important feature.Other features,although they accounted for a relatively small proportion,also had an impact on the vault prediction.After parameter optimization,the best prediction results were obtained,with a predicted mean value of 763.688μm and an actual mean value of 776.9304μm.The R²was 0.4456 and the root mean square error was 201.5166.CONCLUSION:A study based on UBM images using random forest network can be performed for prediction of the vault after ICL implantation and can provide some reference for ICL size selection.
基金Supported by the Cross-disciplinary Research Fund of Shanghai Ninth People’s Hospital,Shanghai Jiao Tong University School of Medicine(No.JYJC201907)。
文摘AIM:To investigate the changes in choroidal thickness(CT)in high myopic eyes after femtosecond laser-assisted in situ keratomileusis(FS-LASIK)surgery or central hole implantable collamer lens(ICL V4c)implantation using swept-source optical coherence tomography(SS-OCT).METHODS:We examined the right eyes of 116 patients with high myopia who were candidates for FS-LASIK surgery and ICL implantation.Sixty eyes underwent ICL V4c implantation and 56 eyes were subjected to FS-LASIK surgery.The CT was measured with SS-OCT.All data were recorded preoperatively and 2 h,1 wk,1 and 3 mo postoperatively.Other demographic information was collected,including age,sex,uncorrected visual acuity(UCVA),best corrected visual acuity(BCVA),spherical equivalent(SE),intraocular pressure(IOP)and axial length(AL).RESULTS:The UCVA improved in both groups and showed no significant differences between groups.There also were no significant differences between the two groups in postoperative BCVA and SE(P=0.581 and 0.203,respectively).The foveal CTs,inner nasal and outer nasal CTs were significantly thicker at 2 h postoperatively in both groups(P<0.05)but returned to baseline levels in 1 wk;after 1 mo,no significant differences were found relative to the preoperative values.At 3 mo in each group,nine regions showed variations in the CT as compared with preoperative thickening,but only the foveal and nasal area CTs preoperative differences were statistically significant(P<0.05).In addition,there was no significant difference in 9 regions of CT between the two groups at all follow-up times(P>0.05).CONCLUSION:The CTs after ICL implantation and FSLASIK surgery are significantly thicker than those before operation,especially in the foveal and nasal areas,but there is no significant difference between the two methods.
基金Supported by the Research Grant of Guangxi Natural Science Foundation(No.2015GXNSFCB139012No.2017GXNSFBA198320)the Research Grant of Guangxi Technology and Science Agency(No.Z2015316)
文摘AIM: To compare the optical quality after implantation of implantable collamer lens(ICL) and wavefront-guided laser in situ keratomileusis(WG-LASIK).METHODS: The study included 40 eyes of 22 patients with myopia who accepted ICL implantation and 40 eyes of 20 patients with myopia who received WG-LASIK. Before surgery and three months after surgery, the objective scattering index(OSI), the values of modulation transfer function(MTF) cutoff frequency, Strehl ratio, and the Optical Quality Analysis System(OQAS) values(OVs) were accessed. The higher order aberrations(HOAs) data including coma, trefoil, spherical, 2^(nd) astigmatism and tetrafoil were also obtained. For patients with pupil size <6 mm, HOAs data were analyzed for 4 mm-pupil diameter. For patients with pupil size ≥6 mm, HOAs data were calculated for 6 mm-pupil diameter. Visual acuity, refraction, pupil size and intraocular pressures were also recorded.RESULTS: In both ICL and WG-LASIK group, significant improvements in visual acuities were found postoperatively, with a significant reduction in spherical equivalent(P< 0.001). After the ICL implantation, the OSI decreasedslightly from 2.34±1.92 to 2.24±1.18 with no statistical significance(P=0.62). While in WG-LASIK group, the OSI significantly increased from 0.68±0.43 preoperatively to 0.91±0.53 postoperatively(Wilcoxon signed ranks test, P=0.000). None of the mean MTF cutoff frequency, Strehl ratio, OVs showed statistically significant changes in both ICL and WG-LASIK groups. In the ICL group, there were no statistical differences in the total HOAs for either 4 mmpupil or 6 mm-pupil. In the WG-LASIK group, the HOA parameters increased significantly at 4 mm-pupil. The total ocular HOAs, coma, spherical and 2^(nd) astigmatism were 0.12±0.06, 0.06±0.03, 0.00±0.03, 0.02±0.01, respectively. After the operation, these values were increased into 0.16±0.07, 0.08±0.05,-0.04±0.04, 0.03±0.01 respectively(Wilcoxon signed ranks test, all P<0.05). At 6 mm-pupil, the induction of total HOAs was not statistically significant in the WG-LASIK group. CONCLUSION: ICL implantation has a less disturbance to optical quality than WG-LASIK. The OQAS is a valuable complementary measurement to the wavefront aberrometers in evaluating the optical quality.
基金Supported by the Research Project of Aier Eye Hospital Group(No.AF1609D3)。
文摘AIM:To observe the characteristics of iridociliary cysts in myopic patients and evaluate the influences on the position and safety of implantable collamer lens(ICL)after surgery.METHODS:Totally 270 eyes of 135 patients who underwent ICL surgery for the corrections of myopia were included in this study.Preoperative and postoperative morphology of iridociliary cysts were observed in ultrasonic biomicroscopy(UBM)image.RESULTS:A total of 138 iridociliary cysts were found in 88 eyes of 50 patients among 270 eyes of 135 patients before surgery(37%).Twenty-five patients had cysts in one eye(50%)and 25 had cysts in both eyes(50%).The prevalence of iridociliary cysts was negatively correlated with age,but no gender difference(P>0.05).The incidence of iridociliary cysts was much less in eyes with myopia greater than-9.00 D(P<0.05).The diameter of the largest cyst was 1.96 mm and the smallest cyst was 0.24 mm,with a majority within the range of 0.5 to 1.0 mm.Most of the cysts were located in the inferior temporal quadrant.One year after ICL implantation,51 iridociliary cysts(37%)remained unchanged,47 cysts(34%)decreased in size,and 40 cysts(29%)disappeared.Most of cysts that changed after surgery were smaller than 1.0 mm(P<0.05)and located in the nasal and temporal sides around the haptics of implantable lens.All the ICL were in their original position.CONCLUSION:Iridociliary cysts are commonly seen in myopic eyes.The cysts have no impact on the safety of ICL surgery.Some cysts may decrease in size or disappear after ICL implantation.
文摘AIM: To evaluate the changes in higher order aberrations(HOAs) after implantable collamer lens(ICL;Staar Surgical, Nidau, Switzerland) implantation. METHODS: Totally 30 eyes of 18 patients with myopia were included in this study with an average age of 25.77y(min: 21, max: 40). Refraction, uncorrected distance visual acuity(UDVA), corrected distance visual acuity(CDVA), HOAs(entire, corneal and internal) were evaluated preoperatively and three months postoperatively. Ocular aberrations were measured by using iT race(Tracey Technology, Houston, Texas, USA). SPSS(IBM Corp. Released 2013. IBM SPSS Statistics for Windows, Version 22.0. Armonk, NY: IBM Corp) was used for the statistical analysis and the interpretation of the data. P values of less than 0.05 were considered statistically significant. RESULTS: The preoperative mean spherical power was -9.01 D(min:-5.00, max:-13.00) and the mean cylindrical error was -2.40 D(min:-0.50, max:-4.75). The postoperative mean residual spherical power was -0.73 D(min:-0.20, max:-1.75) and the mean cylindrical error was -0.89 D(min:-0.18, max:-2.09). Analyses were made on root mean square(RMS) values of total HOAs(tH OAs), spherical aberration, coma and trefoil as entire, corneal and internal components. The differences in entire t HOAs and in internal t HOAs were significant. There was no significant change found in spherical aberrations. The differences in entire coma and in internal coma were significant. There was no significant change found in corneal coma. With respect to trefoil, the only significant difference was in internal trefoil. CONCLUSION: The ICL implantation corrects the refractive error successfully and changes entire and internal HOAs of the eye.
基金Supported by the Fundamental Research Funds of the State Key Laboratory of Ophthalmology(No.303060202400201203).
文摘AIM:To investigate the clinical characteristics,treatment methods and outcomes of rhegmatogenous retinal detachment(RRD)in highly myopic eyes with implantable collamer lens(ICL).METHODS:High myopia patients who received treatment for nontraumatic RRD after ICL implantation surgery at the Retinal Department of Zhongshan Ophthalmic Center from Jan 2018 to Dec 2022 were reviewed.Comprehensive ophthalmologic examinations including visual acuity measurement and digital fundus photography were performed in each patient.RESULTS:A total of nine RRD eyes from nine patients who received V4c-ICL implantation were included.The mean time from ICL implantation surgery to the diagnosis of RRD was 32.44±22.56mo(range,1-60mo).At the initial visit for RRD,giant retinal tear(GRT),horseshoe tear,simple round hole,and horseshoe tear combined with round hole were detected in 3,3,2,and 1 eye(s),respectively,with maculaoff in eyes.Eight patients received surgical treatment,and one patient was treated by retinal laser photocoagulation alone.The ICL was preserved in 7 eyes.At the last followup,the mean best corrected visual acuity(BCVA)improved significantly from 1.76±1.06 logMAR at presentation to 0.81±1.01 logMAR(P=0.035),and no case of recurrent retinal detachment was found.CONCLUSION:The morphological presentation of retinal breaks is diverse in this study.The ICL can be preserved in most cases during the course of retinal detachment repair surgery in our data,companied with acceptable visual and anatomical outcomes.
基金Supported by the Science and Technology Innovation Program of Hunan Province,China(No.2020SK50103)Hunan Clinical Medical Technology Innovation Guiding Project in 2020。
文摘AIM:To elucidate the safety and visual quality of implantable collamer lens with central hole(ICL V4c)implantation for correcting moderate and high myopia for at least 5y.METHODS:This retrospective study was conducted on 58 patients(114 eyes)who were followed up for at least 5y after ICL V4c implantation.The observation was done before and on 1d,1mo,1 and 5y or more after the surgical procedure.The visual acuity,subjective refraction,intraocular pressure,vault,axial length,central hole position,pupil diameter,visual quality,and adverse events were analyzed.The visual quality includes aberration,the modulation transfer function cutoff frequency(MTF cutoff),objective scattering index(OSI),Stroller's ratio(SR),and visual quality questionnaire.RESULTS:The average follow-up period was 69.25±3.80mo(range 60–82mo)and the preoperative spherical equivalent(SE)was-8.66±1.97 D.At 5y after operation,the safety index was 1.01±0.02 and the efficacy index was 0.99±0.42 and SE was-0.65±0.63 D.The 59.6%of the eyes achieved an uncorrected distance visual acuity of 20/20,76.3%of the eyes had SE within±1.0 D at the last visit.The axial length increased by 0.29±0.71 mm 5y after the surgery(t=-3.843,P<0.001).The mean vault at the last follow-up was 510.59±245.61μm.The central hole was on the temporal side in 80 eyes(84.2%).The visual quality questionnaire showed that 98.2%patients were satisfied with the surgical procedure.Adverse events occurred in 4 eyes(3.5%),including the posttraumatic toric ICL rotation(2 eyes),iris incarceration(1 eye),and posttraumatic ICL displacement(1 eye)at the last follow-up.CONCLUSION:Long-term ICL V4c implantation is safe,effective,and stable for correcting moderate and to high myopia,and the visual quality with patients is excellent and satisfactory,but the progression of axial length still needs attention after surgery.
基金Supported by the National Research Foundation of Korea(NRF)grant funded by the Korea government(MSIP)(No.2017R1A2B4012327)
文摘Dear Editor,To improve humor circulation the latest V4c Visian implantable collamer lens(ICL)was designed with a0.36-mm Aquaport^([1-2]).This design also eliminates the need to perform peripheral iridectomy before ICL implantation.Several authors reported rates of secondary surgical intervention related to insufficient vault in the presence or absence of cataract formation and excessive vault in the presence or absence of elevated intraocular pressure(IOP)
基金supported by National Natural Science Foundation of China(Grant No.81770955)Joint Research Project of New Frontier Technology in municipal hospitals(Grant No.SHDC12018103)+3 种基金Project of Shanghai Science and Technology(Grant No.20410710100)Major Clinical Research Project of Shanghai Shenkang Hospital Development Center(Grant No.SHDC-2020CR1043B)Project of Shanghai Xuhui District Science and Technology(Grant No.2020-015)Shanghai Science and Technology Commission(Grant No.19140900700).
文摘Background:To evaluate the long-term safety,efficacy,predictability,and stability of implantable collamer lens with a central hole(EVO ICL)implantation for correcting high myopia(HM)and super high myopia(SHM).Methods:This prospective study evaluated 83 eyes of 46 patients who were divided into groups based on their spherical equivalent refractive error(SE):HM group(−12 D≤SE<−6 D)and SHM group(SE<−12 D).They were followed up for 5 years after ICL implantation;assessments of uncorrected distance visual acuity(UDVA),corrected distance visual acuity(CDVA),manifest refractive error,axial length,intraocular pressure,corneal endothelial cell density,and vault were conducted,and a questionnaire was administered.ResuIts:At 5 years postoperatively,the safety indices of the HM and SHM groups were 1.03±0.10 and 1.32±0.39,and the efficacy indices were 0.83±0.25 and 0.86±0.32,respectively.In the HM group,60.47%and 79.07%of the eyes were within±0.50 D and±1.00 D of the attempted correction,while it was achieved for 22.50%and 47.50%of the eyes in the SHM group,respectively.The SE of the HM group decreased from−9.72±1.41 D preoperatively to 0.04±0.39 D 1 month postoperatively and−0.67±0.57 D 5 years postoperatively,while in the SHM group,it decreased from−15.78±3.06 D preoperatively to−0.69±0.97 D 1 month postoperatively and−1.74±1.19 D 5 years postoperatively.Conclusion:EVO ICL implantation is safe,effective,and predictable for correcting HM and SHM.CDVA improved more after surgery for SHM,but the growth of axial length still needs attention.
基金Supported by the Priming Scientific Research Foundation for the junior researcher in Beijing Tongren Hospital,Capital Medical University(No.2018-YJJ-ZZL-034)。
文摘AIM: To evaluate the intra-operator repeatability of time domain and swept-source Fourier domain anterior segment optical coherence tomography(AS-OCT), namely, Visante ASOCT and Casia SS-1000 OCT, in measuring the preoperative parameters of implantable collamer lens(ICL) in myopic eyes, as well as the agreement between the two devices.METHODS: A total of 97 eyes from 49 myopes were investigated in this prospective case series study. The anterior chamber depth(ACD), angle-to-angle distance(ATA), pupil diameter(PD) and crystalline lens rise(CLR) in all subjects were measured for three times during one session by the same operator. The repeatability was evaluated using the within-subject standard deviation(Sw), repeatability limits and intraclass correlation coefficients(ICC). The agreement between the two systems was evaluated using the Bland-Altman plots and 95% limits of agreement(Lo A).RESULTS: The repeatability limits of Visante AS-OCT in measuring ACD, ATA, PD and CLR were 0.099, 0.141, 0.304, and 0.079 mm, respectively. The repeatability limits of Casia SS-1000 OCT in measuring ACD, ATA, PD, and CLR were 0.105, 0.127, 0.357, and 0.082 mm, respectively. Excellent repeatability could be attained in both devices, with the ICC>0.8 for all the measured variables. The interdevice agreement was excellent(P>0.05) for ACD and ATA, but poor(P<0.05) for PD and CLR.CONCLUSION: Good repeatability can be attained by time domain and swept-source Fourier-domain OCT for all the measured variables. Moreover, interdevice agreement analysis suggests that interchangeable measurements between two devices can be achieved for ACD and ATA, but not for PD and CLR;but the differences in measurements were not clinically significant.
基金Supported partly by the General Natural Science Projects,Department of Education,Zhejiang Province,China(No.Y201636718)
文摘Dear Editor,I am Dr.Ye Shen from the Department of Ophthalmology,the First Affiliated Hospital,College of Medicine,Zhejiang University,Hangzhou,China.I write to share my experience of full-vision maintenance in patient with extra-
基金Supported by the Research Grant of Hunan Provincial Health Commission Project(No.C2017037)。
文摘AIM:To compare clinical outcomes and refractive stability of implantable collamer lens(ICL)implantation and femtosecond laser assisted laser in situ keratomileusis(FSLASIK)for high myopia correction.METHODS:The Optical Quality Analysis System(OQAS)was used to evaluate clinical outcomes objectively after operation for high myopia correction.We compared the two procedures in terms of 1-year changes in uncorrected distance visual acuity(UDVA),corrected distance visual acuity(CDVA),safety index,efficacy index,spherical equivalent,modulation transfer function(MTF)cutoff frequency,strehl ratio(SR)and objective scatter index(OSI).RESULTS:At 1 y postoperatively,the safety indices were 1.33±0.27 in ICL group,and 1.17±0.24 in FS-LASIK group.39.58%in the ICL group and 27.59%in the FS-LASIK group gained CDVA in 2 lines or better than that in preoperative CDVA.The efficacy indices were 1.28±0.22 in ICL group,and 1.13±0.26 in FS-LASIK group.The changes of spherical equivalent from 1 wk to 1 y postoperatively was-0.12±0.37 D in ICL group,and-0.79±0.58 D in FS-LASIK group(P<0.05).Spherical equivalent within±0.50 D was achieved in 97.92%in ICL group and 68.97%in FS-LASIK group.MTF cutoff frequency were higher with ICL as compared to FSLASIK(P<0.05)at each postoperative follow-up stage;for postoperative 1 mo later,SR was statistically significant difference between two groups(P<0.05);with no statistically significant difference in OSI between two groups(P>0.05)in postoperative 3 mo later.CONCLUSION:ICL implantation and FS-LASIK procedures both provide good safety and predictability in high myopia correction.ICL implantation provides better clinical outcomes and refractive stability than FS-LASIK.
基金Supported by the Committee of Science and Technology of Shanghai,China(No.09411962100)the Health and Family Planning Committee of Pudong New District of Shanghai,China(No.PW2014D-1)
文摘AIM:To assess the safety,efficacy,predictability and stability of implantable collamer lens(ICL) for residual refractive error after corneal refractive surgery.METHODS: This study evaluated 19 eyes of 12 patients who underwent ICL implantation after corneal refractive surgeries.They were followed up for 1y to 5y of uncorrected distance visual acuity(UDVA),corrected distance visual acuity(CDVA),manifest refractive error,flat and steep K value,axial length,intraocular pressure,corneal endothelial cell density,adverse events after ICL surgery.RESULTS: The mean follow-up period was 39.05 ±19.22 mo(range,1-5y).Spherical equivalent refractive error changed from-7.45±3.02 D preoperatively to-0.85±1.10 D 1wk to 1mo after ICL implantation,with the safety and efficacy indices being 1.12 and 1.15,respectively.A total of 52.63% of eyes were within ±0.5 D of the predicted spherical equivalents,73.68% were within ±1.0 D.A trend of mild regression towards myopia with axial elongation after 5y was observed.One eye with mild anterior capsule opacity and retinal detachment 1y after surgery were observed.CONCLUSION: ICL implantation is safe and effective for the correction of residual refractive error after corneal refractive surgeries,especially in moderate to high residual myopia.
文摘AIM:To evaluate the clinical outcomes of V4 c implantable collamer lens(Hole ICL) implantation with regard to the optical quality assessed according to different degrees of decentering.METHODS:This included 49 eyes that received conventional ICL and 94 eyes that received Hole ICL.The eyes that received Hole ICL were divided into three groups according to the degree of decentering:group 1,central hole within 1 hole diameter(HD) from the pupil center;group 2,central hole within 1 HD to 2 HD;and group 3,central hole within 2 HD to 3 HD.Visual acuity(VA),intraocular pressure(IOP),and spherical equivalent(SE) values were assessed at 1wk,1 and 3mo after surgery.The ocular modulation transfer function,Strehl ratio,objective scattering index,and higher order aberrations(HOAs) were measured for 4-mm pupils at 3mo after surgery.RESULTS:There were no significant differences in VA,IOP,and SE among the conventional and Hole ICL groups.With regard to HOAs,values for coma and spherical aberrations showed no differences.The total HOA and trefoil values were significantly higher in group 2 than in group 1(P=0.02,0.03,respectively).There were no significant differences among groups with regard to other optical quality parameter at 3mo after surgery.CONCLUSION:Our results suggest that Hole ICL implantation provides satisfactory visual quality that is equivalent to that provided by conventional ICL,regardless of the presence of central hole and degree of decentering.
文摘AIM:To evaluate the causes of phakic implantable collamer lens(ICL)exchange/explantation in patients with and without keratoconus(KC)at two tertiary hospitals in Riyadh,Saudi Arabia.METHODS:A retrospective chart review of all patients who underwent ICL(model V4 c with central port)exchange/explantation was performed using the electronic medical record systems.All available preoperative and postoperative data were documented for each patient.RESULTS:Over 7 y,2283 ICL implantation procedures were performed;46 implants(2%)required exchange(21 implants)/explantation(25 implants),of which 14 cases(30.4%)were patients with KC.Indications for ICL exchange/explantation in non-KC group were vault measurement,cataract formation,increased intraocular pressure,inaccurate refraction,and patient dissatisfaction in 22(68.75%),4(12.5%),3(9.37%),2(6.25%),and 1(3.12%)case,respectively.The most common indication for ICL exchange/explantation in the KC group was inaccurate vault sizing in 11 patients(78.57%),inaccurate refraction in 2 patients(14.28%),and patient dissatisfaction postoperatively in 1(7.14%)case.CONCLUSION:ICL implantation results in predictable refractive outcomes over the long term with exchange/explantation rates comparable to previous literature.Improper vault size is the most common cause of ICL exchange/explantation among patients with or without KC.
文摘AIM:To evaluate the efficacy,safety and stability of posterior chamber phakic intraocular lens implantation for the correction of high myopia.METHODS:Retrospective case review of 82 eyes(43patients)undergoing implantable Coliamer lens(ICL)placement by a single surgeon(Xiao-Wei Gao)to correct preoperative mean spherical equivalents between-9.00diopter(D)and-23.00D.Main outcome measures included uncorrected visual acuity(UCVA),refraction,best spectacle-corrected visual acuity(BSCVA),endothelial cell density(ECD),intraocular pressure(IOP),lens transparency,postoperative uveitis.Visante anterior segment optical coherence tomography(AS-OCT)was used to measure anterior chamber depth(ACD)and the position of ICL.RESULTS:Mean follow-up was 6.54±3.26 months(range 3-12 months).Predictability of the manifest spherical equivalent(SE)refraction to within±1.OOD was achieved in 88%of eyes and±0.50D in 72.5%of eyes.The mean postoperative manifest SE refraction was-1.85±0.72D,with 96.34%of eyes maintaining or gaining≥1 line(s)of BSCVA.The mean 3-month postoperative ECD decreased but had no statistically difference compared with the preoperative ECD.Of the 7 eyes(8.54%)with a mild transient increase in intraocular pressure(up to 30mmHg),none required a second surgical procedure or prolonged topical medication.There was no loss of lens transparency.Pigmented precipitates were observed in 5 eyes(6.09%).The mean preoperative ACD measured with AS-OCT was 3.28±0.14mm,three months after surgery,the mean ACD was2.45±0.22mm.Anterior chamber depth showed astatistically significant reduction.One eye(1.22%)had ICL spontaneous rotation,81 eyes(98.78%)of the lens remained correctly centered.CONCLUSION:The implantation of ICL is an effective surgical option for the management of high myopia.But its long time effect and safety still need more time to prove.
文摘AIM: To compare Visian lens(model V4 c) and Artiflex lens regarding quality(contrast sensitivity) and quantity(efficacy, predictability, safety and stability) of vision in correcting high myopia with recording and analysis of complications. METHODS: The comparative prospective study included 39 eyes of 23 patients with high myopia, 19 eyes had Visian lens implantation(model V4 c) and 20 eyes had Artiflex lens implantation. The inclusion criteria were high myopia(higher than 6.0 D) and stable refraction(<0.5 D change over one year). Outcomes included assessment of safety and efficacy indices, predictability, stability, contrast sensitivity and analysis of complications at postoperative 1 d, 1 wk and 1, 3, 6 and 12 mo. Selection of the type of phakic intraocular lens for patients was based on surgeons' preferences, which was no specific selection criteria. RESULTS: After 12 mo of follow up, difference in uncorrected and corrected distant visual acuity(CDVA) between both groups was statistically insignificant(UDVA for VisianV4 c and Artiflex lens were 0.33±0.2 logMAR and 0.37±0.2 logMAR respectively, P=0.59, CDVA for VisianV4 c and Artiflex lens were 0.155±0.1 logMAR and 0.147± 0.1 logMAR respectively, P=0.87). The efficacy index was 1.25 for VisianV4 c lens and 0.8 for Artiflex lens, 78.9% of eyes were within one diopter spherical equivalent in Visian V4 c lens group compared to 70% in the Artiflex lens group. No eye lost lines of CVDA proving a good safety index for both lenses(safety index was 1.67 for VisianV4 c lens and 1.34 for Artiflex lens). Difference in contrast sensitivity between both groups was statistically insignificant(P=0.15, 0.88, 0.27, 0.32 and 0.82 at five spatial frequencies). CONCLUSION: Both Visian ICL V4 c and Artiflex lensesare safe and effective with stable and predictable refraction and they have comparable contrast sensitivity outcomes with no vision threatening complications.
基金Supported by Beijing Tongren Hospital,Capital Medical University(No.TRZDYXZY201703)
文摘AIM: To evaluate the surgical results of sulcus intraocular lens(IOL) implantation in children with unilateral anterior persistent fetal vasculature(PFV) underwent primary vitrectomy combined with lensectomy and preservation of the peripheral anterior capsule.METHODS: Twenty-two eyes of 22 children with unilateral anterior PFV who underwent sulcus secondary IOL implantation were analyzed. Main outcome measures were preoperative and postoperative visual acuity, and complications both intraoperatively and postoperatively. RESULTS: Review of 22 consecutive patients identified best-corrected visual acuity(BCVA) improvement from 1.37±0.84 to 0.73±0.57 logarithm of the minimal angle of resolution(logMAR) after IOL implantation(P<0.001) with a mean follow-up was 16.55±5.86 mo. Average age at secondary IOL implantation was 41.05±15.41 mo. Three eyes(13.64%) achieved BCVA of 0.3 logMAR at the final visit. Transient intraocular pressure rise(4 eyes; 18.18%), postoperative increased inflammation(3 eyes; 13.64%) and postoperative hypotony(2 eyes; 9.09%) were common complications.CONCLUSION: Properly preservation of the anterior lens capsule during the primary surgery facilitated secondary sulcus IOL implantation in pediatric patients with anterior PFV, with favorable postoperative visual outcomes and compatible percentage of complications.
基金Supported by Shanghai Natural Science Foundation (No.18ZR1440200)
文摘AIM: To evaluate the efficacy and safety of a modified technique [trocar opening(TO)] for silicone oil removal(SOR) in combination with phacoemulsification and intraocular lens(IOL) implantation.METHODS: A total of 60 eyes of 60 patients with cataract and silicone oil-filled eyes were enrolled in this study. The patients were divided into two groups: the patients in the control group underwent 23-gauge pars plana active SOR surgery with phacoemulsification and IOL implantation, while the patients in the TO group underwent TO methods during surgery. Best corrected visual acuity(BCVA), surgery time, intraocular pressure, and operative complications were observed 6 mo after surgery.RESULTS: There was no significant difference between the two groups in terms of age, gender, preoperative, intraocular pressure, or time of silicone oil stay. Prior to surgery, the mean BCVA for the control and TO groups was 1.34±0.44 and 1.36±0.42. At 6 mo following surgery, the mean BCVA improved to 0.74±0.36 and 0.77±0.32, respectively(P<0.001). There was no significant difference between the two groups. The mean SOR time was 6.9±2.3 min and 4.8±1.2 min in the control and TO groups(P=0.008). The total operation time was 28.2±8.5 min and 24.6±6.4 min, respectively(P=0.035). Posterior capsule rupture occurred in four eyes of control and none of TO group(P<0.01). Late recurrent retinal detachment occurred in one eye in the control group(2 mo after surgery) and in one eye in the TO group(4 mo after surgery). CONCLUSION: TO is a simple, effective, time-saving, and safe method for SOR combined with phacoemulsification and IOL implantation.
