scholarly journals 3-month surgical outcomes of Implantable Collamer Lens implantation for myopic regression after laser vision correction surgeries: a retrospective case series

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Byunghoon Chung ◽  
Joon Hyun Kim ◽  
David S. Y. Kang ◽  
Dong Jun Kang ◽  
Eung Kweon Kim ◽  
...  

Abstract Background To investigate the surgical outcomes of implantable collamer lens (ICL) implantation in eyes with residual myopia after primary laser vision correction (LVC) surgeries. Methods This study included patients who underwent ICL implantation and had a history of LVC surgery, including photorefractive keratectomy (PRK) or laser-assisted in situ keratomileusis (LASIK). Visual acuity and refractive error were assessed pre and 3-months postoperatively and the efficacy and safety indices calculated accordingly. Results A total of 30 eyes of 17 patients were included in this study. At 3 months, the mean logMAR uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), and spherical equivalent were − 0.03 ± 0.11 (include logMAR), − 0.04 ± 0.09 (include logMAR), and − 0.06 ± 0.33 diopters (D), respectively. The 3-month Snellen UDVA was better than 20/20 for 83% of eyes, and 97% of eyes showed an unchanged or improved CDVA after surgery. The mean efficacy and safety indices were 1.11 ± 0.22 and 1.13 ± 0.20, respectively. Further, 93 and 100% of eyes were within ±0.5 and ± 1.0 D of the attempted spherical equivalent refraction, respectively. Conclusions ICL implantation in eyes with myopic regression after previous LVC surgery showed safe, effective, and predictable outcomes. Trial registration retrospectively registered.

2018 ◽  
Vol 30 (1) ◽  
pp. 139-146 ◽  
Author(s):  
Guilherme Andrade do Nascimento Rocha ◽  
Paulo Ferrara de Almeida Cunha ◽  
Leonardo Torquetti Costa ◽  
Luciene Barbosa de Sousa

Importance: This study shows that a newer long-arc length intrastromal corneal ring segment is efficient and safe for keratoconus treatment. Background: To evaluate visual, tomographic results and complications of a 320-degree intrastromal corneal ring segment implantation with the femtosecond laser for keratoconus treatment. Design: A prospective, nonrandomized, and interventional study. Participants: A total of 34 eyes of 31 patients diagnosed with keratoconus were enrolled. Methods: Patients were divided into two groups based on the strategy used for 320-degree intrastromal corneal ring segment thickness selection. In one group, this selection was based on spherical equivalent (SE group) and in the other on the mean asphericity (Q group). The uncorrected and corrected distance visual acuities, spherical equivalent, K1, K2, Km, Kmax, and mean asphericity ( Q) on corneal tomography were evaluated preoperatively and at 3 and 6 months postoperatively. For astigmatism improvement, we analyzed the corneal tomographic vectorial astigmatism change preoperatively and at 6 months postoperatively. The mean follow-up period was 6.63 ± 0.96 months. Results: The mean uncorrected distance visual acuity and corrected distance visual acuity improved with a significant spherical equivalent improvement ( p < 0.05), with no differences between the 320-degree intrastromal corneal ring segment groups. All corneal tomographic parameters improved significantly ( p < 0.05) between the preoperative and postoperative intervals, with a significant better performance when we used spherical equivalent for the 320-degree intrastromal corneal ring segment thickness selection. Finally, the mean vectorial corneal tomographic astigmatism significantly improved after 6 months, again with no differences between groups. Conclusion: This study suggests that implanting a 320-degree intrastromal corneal ring segment is a safe and effective procedure for treating patients with keratoconus. It also suggests that for thickness selection spherical equivalent is the better strategy.


2018 ◽  
Vol 2018 ◽  
pp. 1-6 ◽  
Author(s):  
Alper Ağca ◽  
İhsan Çakır ◽  
Beril Tülü Aygün ◽  
Dilek Yaşa ◽  
Yusuf Yıldırım ◽  
...  

Purpose. To report long-term visual and refractive results of small-incision lenticule extraction (SMILE) in treatment of high myopia. Materials and Methods. Medical records of patients who underwent SMILE for surgical correction of myopia or myopic astigmatism were retrospectively reviewed. Only patients with a preoperative spherical equivalent of subjective manifest refraction (SE) ≥ 6 D and a postoperative follow-up of 5 years were included in the study. Uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), and SE were analyzed preoperatively and at 1-, 3-, and 5-year postoperative periods. Results. Thirty-seven eyes of 37 patients were included in the study. The mean attempted SE was −7.47 ± 1.10 D (range −6.00 to −10.00 D). At the 5-year visit, the mean difference between achieved and attempted SE was −0.43 ± 0.47 (0.50 to −1.25 D). Mean postoperative UDVA and CDVA were 0.20 ± 0.18 and 0.06 ± 0.08 logMAR, respectively. At the 1-year visit, 70% and 97% of the eyes were within ±0.50 D and ±1.00 D of the intended correction. At the 5-year follow-up, 59% and 92% percent of the eyes were within ±0.50 D and ±1.00 D of the intended SE, respectively. At the 5-year visit, the efficacy index was 0.89 ± 0.26 and the safety index was 1.16 ± 0.20. Fifty-four percent of the eyes gained one or more lines of CDVA. Conclusion. SMILE with an intended correction of up to a spherical equivalent of 10 D is safe and effective. However, there is regression of the refractive effect over extended follow-up.


2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Manhui Zhu ◽  
Linling Zhu ◽  
Qiujian Zhu ◽  
Cailian Xu ◽  
Peng Yu ◽  
...  

Purpose. To investigate the clinical outcomes and possible risk factors associated with rotational stability after the implantation of a V4c toric implantable Collamer lens (TICL) for the correction of moderate to high myopic astigmatism. Methods. A total of 112 eyes of 66 patients with moderate to high myopic astigmatism underwent TICL implantation. All patients were followed up for more than 1 year. The uncorrected and best-corrected visual acuity (UCVA and BCVA), astigmatism and spherical equivalent, intraocular pressure, vault, endothelial cell morphometry, and rotation of the TICL axis were assessed at l day, 1 week, 1 month, 3 months, 6 months, and 12 months postoperatively. Postoperative rotation was defined as the angle between the intended axis and the achieved axis. Regression analysis was used to investigate the possible risk factors for TICL rotation postoperatively. Results. The mean efficacy index and safety index 12 months postoperatively were 1.03 ± 0.09 and 1.05 ± 0.10, respectively. All patients had the same or better visual acuity than preoperatively. The mean astigmatism value decreased from −1.86 ± 0.79 D preoperatively to −0.37 ± 0.35 D. The mean absolute axis deviation of the TICL at the last follow-up was 2.75 ± 2.04° (range, 0°∼11°). The mean manifest refraction spherical equivalent (MRSE) changed from -9.04 ± 2.67 D preoperatively to −0.67 ± 0.51 D postoperatively. The logistic regression demonstrated that the absolute degree of TICL rotation had a significant association with the fixation angle of the TICL and the size of the lens ( P = 0.003 , P = 0.026 , resp.). Conclusion. The results of our study support that TICL implantation is safe, effective, and predictable in the treatment of moderate to high myopic astigmatism, with relatively good postoperative rotational stability.


2016 ◽  
Vol 2016 ◽  
pp. 1-9 ◽  
Author(s):  
Tamer H. Massoud ◽  
Osama Ibrahim ◽  
Kitty Shehata ◽  
Moones F. Abdalla

Purpose. To evaluate the visual and refractive outcomes after small incision lenticule extraction (SMILE) for treating myopia and myopic astigmatism after penetrating keratoplasty (PKP).Design. Case-series.Methods. Ten eyes of 10 patients with previous PKP and residual myopic astigmatism for whom pentacam imaging and thickness measurements were acceptable for laser vision correction. Manifest refraction (MR), uncorrected distance visual acuity (UDVA), and corrected distance visual acuity (CDVA) were obtained preoperatively and one day, one week, and one, 3, and 6 months postoperatively. Cases were operated on the VisuMax® femtosecond laser platform with 500 kHz repetition rate.Results. The mean correction ratio for spherical errors was0.84±0.19 D and for the mean refractive spherical equivalent (MRSE) was0.79±0.13 D. Vector analysis showed a mean astigmatism reduction at the intended axis of67±25.25%, a correction index of0.81±0.21, and an overall mean percentage of success of astigmatism surgery of53±37.9%. The postoperative MRSE was stable throughout the 6-month follow-up period. The efficacy index was 0.93 and the safety index was 1.12.Conclusion. SMILE for correction of post-PKP myopia and astigmatism is effective, safe, and stable with moderate accuracy and predictability. Centration of the treatment within the grafts was easily performed.


2019 ◽  
Vol 4 (1) ◽  
pp. e000242 ◽  
Author(s):  
Chung Shen Chean ◽  
Boon Kang Aw Yong ◽  
Samuel Comely ◽  
Deena Maleedy ◽  
Stephen Kaye ◽  
...  

ObjectivePrediction errors are increased among patients presenting for cataract surgery post laser vision correction (LVC) as biometric relationships are altered. We investigated the prediction errors of five formulae among these patients.Methods and analysisThe intended refractive error was calculated as a sphero-cylinder and as a spherical equivalent for analysis. For determining the difference between the intended and postoperative refractive error, data were transformed into components of Long's formalism, before changing into sphero-cylinder notation. These differences in refractive errors were compared between the five formulae and to that of a control group using a Kruskal-Wallis test. An F-test was used to compare the variances of the difference distributions.Results22 eyes post LVC and 19 control eyes were included for analysis. Comparing both groups, there were significant differences in the postoperative refractive error (p=0.038). The differences between the intended and postoperative refractive error were greater in post LVC eyes than control eyes (p=0.012), irrespective of the calculation method for the intended refractive error (p<0.01). The mean difference between the intended and postoperative refractive error was relatively small, but its variance was significantly greater among post LVC eyes than control eyes (p<0.01). Among post LVC eyes, there were no significant differences between the mean intended target refraction and between the intended and postoperative refractive error using five biometry formulae (p=0.76).ConclusionBiometry calculations were less precise for patients who had LVC than patients without LVC. No particular biometry formula appears to be superior among patients post LVC.


2021 ◽  
Author(s):  
masoumeh ahadi ◽  
Afsaneh Ebrahimi ◽  
Shahrokh Ramin

Abstract Purpose: To measure and compare distance and near visual acuity in amblyopic patients.Methods: This study was evaluated 167 patients with amblyopia between ages of 6 and 55 years. In all subjects, a comprehensive ophthalmic examination including visual acuity, refraction, slit lamp biomicroscopy, and funduscopy was performed. Distance visual acuity (DVA) was measured by Snellen chart at 4 m and near visual acuity (NVA) was measured by Snellen chart at 40 cm, and then DVA and NVA were compered and analyzed.Results:In our subjects, the mean distance and near visual acuity was 0.39± 0.30 log MAR and 0.30± 0.32 log MAR respectively. The mean NVA was 0.12±0.12 log MAR better than DVA and difference between them was statistically significant (P<0.001). In 40% of patients, there were no difference between DVA and NVA, and in 60% of them, NVA was 0.1 or more log MAR better than DVA. The difference between DVA and NVA was not significantly related with age (p=0.225), spherical equivalent (P=.820) and strabismus (P=.336) and type of amblyopia (P=.405). Although all of these subjects had subnormal DVA, but 43 subjects (26%) had normal NVA. In mild and moderate amblyopic groups, difference between DVA and NVA was 0.14±0.10 log MAR and 0.15±0.14 log MAR respectively, but in severe amblyopic group it was 0.03±0.08 log MAR. The difference between DVA and NVA showed a significant relation with severity of amblyopia (P<0.001). The difference between DVA and NVA was 0.16±0.11 log MAR in patients with history of amblyopia therapy and 0.07.± 0.11 log MAR in patients without treatment. This difference was statistically significant (P<0.001).Conclusion: Our results showed that near visual acuity in amblyopia especially in mild to moderate types was significantly better than distance visual acuity. More than 50% of subjects with mild amblyopia had normal near visual acuity. The difference between DVA and NVA showed no relation with age, spherical equivalent, strabismus, and type of amblyopia. Also, difference between the DVA and NVA in patients with history of amblyopia therapy was better than of it in non-treated subjects.


2018 ◽  
Vol 12 (1) ◽  
pp. 143-153 ◽  
Author(s):  
Jin Rong Low ◽  
Li Lim ◽  
Jane Chwee Wah Koh ◽  
Daniel Kai Peng Chua ◽  
Mohamad Rosman

Background: LASIK Xtra is a recently described technique which combines LASIK and accelerated corneal cross-linking(CXL) in the same setting. Its long-term outcome in Asians with high myopia is not well described. Objectives: To compare the efficacy, predictability and safety of LASIK Xtra with LASIK in patients with high myopia. Method: This is a retrospective study comparing 50 consecutive eyes undergoing LASIK Xtra for the correction of high myopia and/or myopic astigmatism (-6.63 to -15.50 D manifest spherical equivalent) with a matched control group of 50 eyes undergoing LASIK alone for correction of high myopia (-6.00 to -12.25 D manifest spherical equivalent). Mean follow-up was 5.7 months (range, 1.5-13.3 months) for LASIK Xtra and 3.6 months (range, 1.7-4.2 months) for LASIK only. Outcome measures included Uncorrected Distance Visual Acuity (UDVA), Corrected Distance Visual Acuity (CDVA), refraction and intraoperative and postoperative complications. Results: At post-operative 3 months, all eyes achieved UDVA of 20/40 or better, and 80.0% of LASIK Xtra eyes achieved UDVA of 20/20 or better, compared to 66.0% of LASIK only eyes (p = 0.115). Efficacy indices were 0.99±0.17 for LASIK Xtra and 0.94±0.17 for LASIK only (p = 0.164). The proportion of eyes within ±0.50 D of attempted correction was 84% in the LASIK only group and 72% in the LASIK Xtra group at post-operative 3 months (p = 0.148). Safety indices were 1.11±0.19 and 1.11±0.18 in the LASIK Xtra and LASIK only groups, respectively (p = 0.735). Conclusion: LASIK Xtra achieved comparable safety, predictability and efficacy as LASIK in patients with high myopia. Good refractive stability was attained at 6-12 months. Further long term studies are required to determine whether simultaneous CXL is able to reduce postoperative LASIK keratectasia in high-risk individuals.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Cristina Ariadna Nicula ◽  
Dorin Nicula ◽  
Sorana D. Bolboacă ◽  
Adriana Elena Bulboacă

Abstract Purpose To report the visual and refractive outcomes of small incision lenticule extraction ReLEX (SMILE) technique using VisuMax femtosecond laser in myopia and myopic astigmatism patients. Material and methods A non-randomized clinical study has been conducted on patients with myopia and myopic astigmatism who underwent ReLEX SMILE technique, using the Zeiss VisuMax Laser system (Carl Zeiss Meditec AG, Jena, Germany) at Oculens Clinic, Cluj-Napoca, Romania. Patients older than 18 years, with ocular astigmatism up to -5 diopters (D), spherical equivalent up to -10.00 D, corrected distance visual acuity (CDVA) of 0.3 or better before the surgery, stable refraction for one year, and with a minimum calculated post operator residual stromal bed of 250μ were included in the study. Results The study involved a total of 25 myopic eyes (median of sphere diopters equal with -4D) and 67 myopic astigmatic eyes (median of cylinder diopters equal with -1.5 D). The mean refractive spherical equivalent (MRSE) on patients with myopic eyes reduced from -4.25D (median) to -0.5D at one month follow-up, -0.25 D at 6 and 12 months. The mean refractive spherical equivalent (MRSE) on patients with astigmatic myopic eyes reduced from-6.25 D to -0.67 D at one month, -0.62 D at six and twelve months. The value of sphere decreased postoperatively on myopic eyes with a median of -0.25D at one, six and twelve months. The value of cylinder decreased postoperatively on myopic astigmatic eyes with a median of -0.50 D at one month, -0.25 D at six months and -0.50 D at 12 months. At 6 and 12 months, 20 (80.0%) of myopic eyes were maintained within ±0.5 D and 22 (88.0%) with ±1D. On both groups (myopic eyes and myopic astigmatic eyes), statistically significant differences were observed when the keratometric baseline values were compared to each follow-up (P-values < 0.0001), without any significant differences between follow-ups (P-values>0.15). At 1-month follow-up, uncorrected distance visual acuity (UDVA) was better than or equal to 0.5 in 88.0% of myopic eyes and 82.1% of myopic astigmatic eyes. UDVA remained stable in all cases of myopic eyes at six months and the percentage increased at 92.0% in myopic eyes. UDVA slightly increased at 6-months (85.1%) and remained at the same value at 12-months in myopic astigmatism eyes. Conclusions SMILE proved an effective and safe refractive corneal procedure and provided a predictable and stable correction of myopia and myopic astigmatism. SMILE technique demonstrated very good outcomes in terms of keratometric, cylinder, spherical measurements.


2021 ◽  
Vol 8 (1) ◽  
Author(s):  
Xun Chen ◽  
Xuanqi Wang ◽  
Yilin Xu ◽  
Mingrui Cheng ◽  
Tian Han ◽  
...  

Abstract 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.


2021 ◽  
pp. 112067212110334
Author(s):  
Olga Reitblat ◽  
Assaf Gershoni ◽  
Michael Mimouni ◽  
Eitan Livny ◽  
Yoav Nahum ◽  
...  

Purpose: To examine the clinical outcomes, efficacy, safety, and predictability of transepithelial photorefractive keratectomy (Trans-PRK) operations performed on the day of the first screening visit in comparison with operations scheduled at a following appointment. Methods: Data of consecutive patients with myopia of various degrees, who underwent Trans-PRK, were retrospectively analyzed. Findings were compared between patients who underwent Trans-PRK on the same day of first consultation to patients that underwent surgery at subsequent visits, following initial consultation on a different day. Results: The study included 599 eyes treated on the initial visit day and 1936 eyes treated on a subsequent visit. Mean final spherical equivalent was close to emmetropia in both groups ( p = 0.183). Efficacy indices were 0.928 ± 0.192 in the initial-visit group and 0.945 ± 0.163 in the second-visit group ( p = 0.152). Safety indices were 0.954 ± 0.156 and 0.955 ± 0.151 ( p = 0.707), respectively. No differences between the groups were seen in uncorrected visual acuity (UDVA) of ⩾20/20, ⩾20/25, and ⩾20/32. Only the sub-analysis of patients reaching UDVA of 20/40 or better was slightly lower in the first-visit (95.5%) compared with the second-visit group (97.9%, p = 0.001). Results of attempted correction within ±0.50 D were: 63.3% and 69.0%, respectively ( p = 0.009). Complications profiles in the two groups were comparable. Conclusions: Trans-PRK completed on the day of the first screening appointment demonstrated a similar safety outcome compared with subsequent-visits procedures, and slightly lower, yet comparable, results regarding efficacy and predictability.


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