Eight-year follow-up of Artiflex and Artiflex Toric phakic intraocular lens

European Journal of Ophthalmology ◽

10.1177/11206721211035617 ◽

2021 ◽

pp. 112067212110356

Author(s):

Mariano Royo ◽

Ángel Jiménez ◽

Irene Martínez-Alberquilla ◽

José F Alfonso

Keyword(s):

Intraocular Lenses ◽

Physiological Changes ◽

Spherical Equivalent ◽

Efficacy And Safety ◽

Phakic Intraocular Lens ◽

Uncorrected Distance Visual Acuity ◽

Manifest Refraction ◽

Phakic Intraocular Lenses

Purpose: To analyse long-term efficacy, safety, visual and refractive stability and physiological changes of Artiflex Myopia and Toric phakic intraocular lenses (pIOL) separately throughout an 8-year follow-up. Design: Retrospective cohort study. Methods: A total of 67 eyes of 37 patients underwent Artiflex Myopia (47 eyes) or Artiflex Toric (20 eyes) implantation for correcting myopia and/or astigmatism. Follow-up evaluations were performed 1, 3, 5 and 8 years after surgery. Preoperative and postoperative data included corrected (CDVA) and uncorrected distance visual acuity (UDVA), manifest refraction, endothelial cell density (ECD) and intraocular pressure (IOP) assessments. Efficacy and safety indexes were analysed. The vectorial analysis was performed using the Thibos method. Results: Mean CDVA and UDVA of both pIOLs significantly improved from preoperative to 1 year after implantation, and then it remained stable over the 8-year follow-up. The efficacy and safety indexes after 8 years were 0.94 ± 0.16 and 1.07 ± 0.18 for Artiflex Myopia and 1.00 ± 0.11 and 1.10 ± 0.15 for Artiflex Toric, respectively. The spherical equivalent (SE) significantly improved after surgery. J0, J45 and SE refractive components showed no changes between postoperative visits. A total ECD loss of 4.8% ( p < 0.001) and 10.4% ( p = 0.005) was found after 8 years for Artiflex Myopia and Toric, respectively. Conclusions: Artiflex Myopia and Toric pIOLs are a safe, efficient and predictable option for the correction of myopia and/or astigmatism. The vectorial analysis showed excellent rotation stability for the toric version.

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Posterior-Chamber Phakic Intraocular Lens Implantation in Patients over 40 Years of Age

Journal of Ophthalmology ◽

10.1155/2020/7457902 ◽

2020 ◽

Vol 2020 ◽

pp. 1-8

Author(s):

Pedro Tañá-Rivero ◽

Francisco Pastor-Pascual ◽

Marceliano Crespo ◽

José L. Rodríguez-Prats ◽

José J. Muñoz-Tomás ◽

...

Keyword(s):

Crystalline Lens ◽

Posterior Chamber ◽

Spherical Equivalent ◽

Efficacy And Safety ◽

Phakic Intraocular Lens ◽

Implantable Collamer Lens ◽

Lens Implantation ◽

Over 40 Years ◽

Myopic Astigmatism

Purpose. To assess the efficacy, safety, and predictability of the Visian Implantable Collamer Lens (ICL) model having a central port in patients over 40 years of age. Methods. This study included 33 eyes from 21 patients who underwent V4c ICL implantation for the correction of myopia and myopic astigmatism. We assessed uncorrected (UDVA) and corrected (CDVA) distance visual acuity, refraction, intraocular pressure (IOP), endothelial cell density (ECD), vault, and adverse events occurring over a 1-year period. Results. Mean age of the patients at the time of implantation was 43.52 ± 4.49 years (range: 40 to 56 years). Efficacy and safety indexes were 1 and 1.09, respectively. Surgical outcomes for CDVA were as follows: no eye lost any lines, 19 eyes (57.58%) showed no CDVA changes, 7 eyes (21.21%) gained 1 line, 4 eyes (12.12%) gained 2 lines, and 3 eyes (9.09%) gained ≥3 lines. Mean postoperative spherical equivalent (SE) was −0.09 ± 0.47 D. A total of 29 eyes (87.8%) were within ±0.50 D and 31 eyes (93.9%) were within ±1.00 D of the desired SE. At 1-year, mean IOP was 15.27 ± 3.03 mmHg (range: 9 to 20 mmHg, p=0.12 pre vs. post) and mean ECD was 2516 ± 234 cells/mm2 (p=0.29 pre vs. post). Mean postoperative vault was 320 ± 136 μm, with 201–300 μm being the most prevalent vault range for 9 eyes (31.03%). None of the eyes showed a vault >701 μm. There were neither intraoperative nor postoperative complications; in fact, all ICL implantation procedures were uneventful. Conclusions. Our study’s findings support the use of this lens in patients over 40 years of age. A long follow-up period is advisable to monitor ICL position relative to the crystalline lens.

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Seven-year follow-up of posterior chamber phakic intraocular lens with central port design

Eye and Vision ◽

10.1186/s40662-021-00247-1 ◽

2021 ◽

Vol 8 (1) ◽

Author(s):

Luis Fernández-Vega-Cueto ◽

Belén Alfonso-Bartolozzi ◽

Carlos Lisa ◽

David Madrid-Costa ◽

José F. Alfonso

Keyword(s):

Intraocular Pressure ◽

Posterior Chamber ◽

Spherical Equivalent ◽

Phakic Intraocular Lens ◽

Implantable Collamer Lens ◽

Port Design ◽

The Mean ◽

Surgical Option

Abstract Background To assess the clinical outcomes of the Visian Implantable Collamer Lens (ICL) with a central port throughout 7 years of follow-up. Methods Eighty-four eyes of 52 patients were evaluated over a follow-up period of 7 years after V4c ICL implantation. Uncorrected (UDVA) and corrected (CDVA) distance visual acuities, refraction, intraocular pressure (IOP), endothelial cell density (ECD) and vault were analysed. Results The mean postoperative UDVA (logMAR) was 0.04 ± 0.11, 0.13 ± 0.19 and 0.17 ± 0.23 at 1-, 5- and 7-years, respectively (P < 0.0001). The mean CDVA (logMAR) remains unchanged throughout a 7-year follow-up period (0.02 ± 0.08 and 0.02 ± 0.08, at 5- and 7-years, respectively, P = 0.2). At all follow-up visits, more than 95% of the eyes achieved a CDVA of 20/25 or better and more than 85% a CDVA of 20/20. At the end of the follow-up (7 years), no eye lost more lines of CDVA, 56 eyes (66.7%) and 28 eyes (33.3%) gained lines of CDVA. At 7-years, the spherical equivalent was − 0.62 ± 0.62 D. No significant increase in IOP (> 20 mmHg or an increase higher than 5 mmHg) occurred in any case throughout the 7-year of follow-up. The loss in ECD from the preoperative baseline at the last follow-up visit was 2.6%. No intraoperative or postoperative complications or adverse events occurred during the follow-up period. Conclusions The outcomes of this study show the long-term viability of the V4c ICL implantation as a surgical option for the correction of myopia.

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Myopic Correction with Iris-Fixated Phakic Intraocular Lenses: Twelve-Year Results

Journal of Ophthalmology ◽

10.1155/2021/7027793 ◽

2021 ◽

Vol 2021 ◽

pp. 1-10

Author(s):

Iveta Nemcova ◽

Jiri Pasta ◽

Katerina Hladikova ◽

Martin Komarc ◽

Darina Pospisilova ◽

...

Keyword(s):

Endothelial Cells ◽

Cohort Study ◽

Intraocular Lenses ◽

University Hospital ◽

Safety Index ◽

Uncorrected Distance Visual Acuity ◽

Phakic Intraocular Lenses ◽

The Mean ◽

Mean Time

Purpose. To evaluate a 12-year follow-up of myopic patients after iris-fixated phakic intraocular lenses (IF pIOLs) implantation. Setting. Ophthalmology Department, Military University Hospital in Prague (Czech Republic). Design. Single-center retrospective cohort study. Methods. We describe the results of a cohort study that included 85 eyes of 46 myopic patients who underwent implantation of Verisyse myopia, Veriflex, and Verisyse myopia toric (all Abbott Medical Optics, Inc.) intraocular lenses. Refractive functions and adverse events were assessed preoperatively, at 6 months, and 1, 2, 5, and 12 years after IF pIOL implantation. Results. Mean spherical equivalent was measured as −9.37 ± 2.87 D, 0.14 ± 0.61 D, and −0.42 ± 1.08 D, preoperatively, at 6 months and 12 years postoperatively, respectively. There was a significant reduction in the cylinder after surgery. At 12 years postoperatively, 90% of eyes had uncorrected distance visual acuity (UDVA) of 20/40 and 64% of 20/20. The safety index was 1.10 for the whole postoperative follow-up period. We found cataract formation in 3 eyes (3.5%). The endothelial cells loss (EC loss) directly caused by IF pIOL implantation was 6.0%, 8.10%, 12.8%, and 11.9%, at 1, 2, 5, and 12 years, respectively. In our cohort, 95% of eyes lost a higher percentage of EC than would be expected from a physiological loss at 12 years postoperatively. We found a significant negative interaction between preoperative pachymetry and EC loss, indicating that the lower pachymetry leads to a faster decline in endothelial cells density (ECD). IF pIOL re-enclavation was found in 28% of eyes. 7% of subluxations were caused by trauma. The mean time of nontraumatic re-enclavation was 6 years postoperatively. Conclusions. The study confirmed the advantages of IF pIOL implantation due to rapid visual recovery and stable visual function over the 12-year follow-up and also showed the influence of lower corneal pachymetry regarding EC loss.

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3 Years Clinical Outcomes of Aspheric Micro-monovision LASIK for Correction of Presbyopia and Myopic Astigmatism

10.21203/rs.2.15661/v1 ◽

2019 ◽

Author(s):

Fang Liu ◽

Ting Zhang ◽

Quan Liu

Keyword(s):

Visual Acuity ◽

Subjective Rating ◽

Spherical Equivalent ◽

Distance Visual Acuity ◽

Uncorrected Distance Visual Acuity ◽

High Satisfaction ◽

Manifest Refraction ◽

Corrected Distance Visual Acuity ◽

Near Visual Acuity

Abstract Background: To investigate long term safety and efficacy of aspheric micro-monovision LASIK for correction of presbyopia and myop ic astigmatism. Methods: One hundred and fourteen eyes of 57 patients with a mean age 48 ± 4.05 years (range: 43 to 62 years) undergoing aspheric micro-monovision LASIK treatment using the MEL 80 excimer laser (Carl Zeiss Meditec AG, Jena, Germany) were enrolled. Visual acuity, manifest refraction, amplitude of accommodation and patients’ subjective rating was evaluated from 1 day to 3 years postoperatively. Results: There were no eyes in which spherical equivalent changed by over 0.75D between 1 day and 3 years. Ninety five percent of eyes were within ±0.50 D of target correction of spherical equivalent. The percentage of monocular uncorrected distance visual acuity ≧20/20 was 95%,and all eyes achieved 20/25 or better. The percentage of binocular uncorrected near visual acuity ≧J2 was 93%,and all patients achieved J4 or better. Ninety one percent of the patients could see uncorrected both 20/20 and J2 or better binocularly. Six percent (6/108) eyes lost 1 line and no eyes lost 2 lines of corrected distance visual acuity. The overall satisfaction score for surgery was 93±6. Conclusions: The aspheric micro-monovision LASIK using the Carl Zeiss Meditec MEL 80 Platform was an efficacious option for older myopia patients with presbyopia. Three years postoperative outcomes in Chinese population indicated improvements in uncorrected binocular vision at far and near distances with high satisfaction.

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Five Years Follow-up of Riboflavin/Ultraviolet A (370 nm) Corneal Collagen Cross-linking to Halt the Progression of Keratoconus

International Journal of Keratoconus and Ectatic Corneal Diseases ◽

10.5005/jp-journals-10025-1081 ◽

2014 ◽

Vol 3 (2) ◽

pp. 63-68

Author(s):

PS David O’Brart ◽

Parul Patel ◽

Naomi A O’Brart

Keyword(s):

Cross Linking ◽

Spherical Equivalent ◽

Efficacy And Safety ◽

Ultraviolet A ◽

Cone Apex ◽

Collagen Cross Linking ◽

Corneal Collagen ◽

Fellow Eyes

ABSTRACT Aims To determine the long-term efficacy and safety of riboflavin/ultraviolet a corneal cross-linking (CXL) to halt the progression of keratoconus. Materials and methods Thirty-five patients (35 eyes) who had undergone CXL with epithelial removal 5 or more years previously were examined. Results At 5 years, mean spherical equivalent (SEQ) increased by 0.78 diopters (D) (p < 0.001), mean simulated K (Sim K) reduced by 0.86D (p < 0.00001), cone apex power (CAP) reduced by 1.1D (p < 0.0002) and root mean square (RMS) (p < 0.0001), coma (p < 0.0001), and secondary astigmatism (p < 0.001) decreased compared to preoperative values. Compared to values at 1 year, mean refractive cylinder reduced by 0.26D (p < 0.05), mean Sim K reduced by 0.46D (p < 0.0005), CAP reduced by 0.81D (p < 0.01), RMS (p < 0.001), coma (p < 0.002) and secondary astigmatism (p < 0.02) reduced and central pachymetry increased (p < 0.05) at 5 years. No treated eyes showed evidence of progression at 5 years. None lost >1 line of CDVA. Eight untreated fellow eyes progressed during the follow-up period and underwent CXL. Conclusions Corneal cross-linking is an effective treatment to halt the progression of keratoconus at 5 years, with no sight-threatening complications. Improvements in topographic and wave-front indices present at 1 year continue to improve at 5 years. How to cite this article O’Brart PSD, Patel P, O’Brart NA. Five Years Follow-up of Riboflavin/Ultraviolet A (370 nm) Corneal Collagen Cross-linking to Halt the Progression of Keratoconus. Int J Kerat Ect Cor Dis 2014;3(2):63-68.

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A Long Term Follow Up of Posterior Chamber Phakic Intraocular Lenses for Correcting Intractable Pediatric Myopic Anisometropic Amblyopia

10.21203/rs.3.rs-381455/v1 ◽

2021 ◽

Author(s):

Fathy Fawzy Morkos ◽

Nader F. Fawzy ◽

Mohamed El Bahrawy ◽

Nada Fathy ◽

Rania Serag Elkitkat

Keyword(s):

Conventional Therapy ◽

Intraocular Lenses ◽

Posterior Chamber ◽

P Value ◽

Anisometropic Amblyopia ◽

Occlusion Therapy ◽

Phakic Intraocular Lenses ◽

Safety And Stability

Abstract Background Pediatric myopic anisometropic amblyopia is one of the most challenging clinical situations that can face an ophthalmologist. Conventional correction modalities for myopic anisometropic amblyopia, using spectacles, contact lenses, and/or occlusion therapy, may not be suitable for some pediatric patients or for some ocular conditions. This may lead to the development of amblyopia and loss of binocular vision. The aim of the present study was to evaluate the visual and refractive efficacy, safety, and stability of Posterior Chamber Phakic Intraocular Lenses (PC-pIOLs) for correcting pediatric myopic anisometropic amblyopia. Methods This case series, prospective, interventional study was conducted at Watany Eye Hospital, Cairo, Egypt. It comprised 42 eyes of 42 children with myopic anisometropic amblyopia and unsuccessful conventional therapy. After implantation of Intraocular Collamer Lenses “ICLs” (Visian ICL, Model V4c, STAAR Surgical, Monrovia, California, USA), postoperative follow up visits were scheduled, with subjective refraction and Pentacam imaging performed. Results The patients’ age range was 3 to 18 years (mean ± SD = 10.58 years ± 4.23). The mean preoperative SE was − 12.54 D ± 2.93. The results declared a significant improvement in the postoperative CDVA (P value < 0.01) and SE (P value < 0.01). The efficacy index had a value of 1.18 ± 0.3 and the safety index was 1.09 ± 0.24. The follow up visits had a mean ± SD of 14.67 months ± 16.56 (range of 1 to 54 months). The results showed a refractive stability, with slight (statistically insignificant) improvements in the subjective refraction between the first postoperative and the follow up visits. No postoperative complications were encountered. Conclusions The present study, with the longest reported follow up range, declared the long-term efficacy, safety, and stability of Visian ICLs for correcting pediatric myopic anisometropic amblyopia. The reported non-compliance with occlusion therapy validates the early implantation of Visian ICLs in cases of failed conventional therapy to guard against anisometropic amblyopia.

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Long-term results of Descemet-stripping automated endothelial keratoplasty for endothelial failure caused by phakic intraocular lenses

European Journal of Ophthalmology ◽

10.1177/1120672120950936 ◽

2020 ◽

pp. 112067212095093

Author(s):

Diogo Hipólito-Fernandes ◽

Maria Elisa-Luís ◽

Miguel Vieira ◽

Sara Crisóstomo ◽

Nuno Alves ◽

...

Keyword(s):

Endothelial Cell ◽

Young Patients ◽

Case Series ◽

Intraocular Lenses ◽

Long Term Results ◽

Endothelial Keratoplasty ◽

Visual Rehabilitation ◽

Phakic Intraocular Lenses

Purpose: To describe the surgical approach and long-term outcomes of Descemet-stripping automated endothelial keratoplasty (DSAEK) for endothelial failure secondary to phakic intraocular lenses (pIOL). Methods: Retrospective, interventional case series of 18 eyes of 13 patients who developed endothelial failure secondary to pIOL implant. Patients were submitted to pIOL explant and DSAEK for visual rehabilitation, with or without phacoemulsification plus posterior-chamber intraocular lens implant. The minimum follow-up time was 3 years and the main outcome measures were best-corrected visual acuity (BCVA), endothelial cell density (ECD) and percentage of endothelial cell loss (ECL), intraoperative and postoperative complications. Results: Patients’ mean age was 47.44 (7.86) years with a mean follow-up time of 55.61 (14.13) months. Sixteen eyes (88.9%) had an angle-supported pIOL. The mean pIOL implant-to explant time was 8.17 (2.73) years. BCVA improved from 1.00 (0.36) logMAR preoperatively to 0.29 (0.36) logMAR at 1 year of follow-up ( p < 0.001), remaining stable over the entire follow-up period ( p > 0.05). At the last visit, all corneas were clear, with a mean ECD of 724.74 (325.57) cells/mm2. During the follow-up, two eyes (11.1%) required a re-DSAEK due to early graft failure (<3 months). Conclusion: Our outcomes reveal that an individualized and careful approach may result in a stable visual rehabilitation in young patients with corneal decompensation following pIOL implant.

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