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

2021 ◽  
Vol 8 (1) ◽  
Author(s):  
Luis Fernández-Vega-Cueto ◽  
Belén Alfonso-Bartolozzi ◽  
Carlos Lisa ◽  
David Madrid-Costa ◽  
José F. Alfonso

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.

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Pedro Tañá-Rivero ◽  
Francisco Pastor-Pascual ◽  
Marceliano Crespo ◽  
José L. Rodríguez-Prats ◽  
José J. Muñoz-Tomás ◽  
...  

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.


2013 ◽  
Vol 39 (7) ◽  
pp. 1023-1028 ◽  
Author(s):  
Necip Torun ◽  
Eckart Bertelmann ◽  
Matthias K.J. Klamann ◽  
Anna-Karina Maier ◽  
Anja Liekfeld ◽  
...  

2007 ◽  
Vol 17 (4) ◽  
pp. 550-556 ◽  
Author(s):  
P.M. Puska ◽  
A.H.A. Tarkkanen

Purpose To evaluate in a retrospective study the long-term usefulness of red 647 nm krypton and 670 nm diode laser for transscleral contact cyclophotocoagulation (CPC) in the treatment of therapy-resistant inflammatory glaucoma. Methods The authors treated 48 eyes of 38 consecutive patients (mean age 36.8 years, range 6–81 years) with therapy-resistant inflammatory glaucoma secondary to chronic uveitis (45/48), chronic scleritis (1/48), or combined scleritis with keratouveitis (2/48) using transscleral red 647 nm Krypton or 670 nm Diode laser. All eyes had failed maximum tolerated medical therapy and 19/48 (40%) eyes also previous antiglaucoma surgery. Laser power at the scleral surface was 0.35 to 0.45 W and the application time 10 seconds each. The follow-up was 42.8± 40.0 (range 2–145) months. Results The mean preoperative intraocular pressure (IOP) of 35.6±8.1 mmHg fell to 6–21 mmHg level in 75% after one or repeated CPC. Among adult patients this was achieved in 85%, among children in 54%. More than one treatment was needed in 52%. No cases of hypotony, phthisis bulbi, or other devastating complications occurred. Conclusions Transscleral CPC using red 647 nm krypton or 670 nm diode laser is an effective and well-tolerated procedure for the treatment of therapy-resistant inflammatory glaucoma in adults. CPC can be considered before incisional antiglaucoma surgery with a shunt or antimetabolites is undertaken


2010 ◽  
Vol 36 (9) ◽  
pp. 1602-1604 ◽  
Author(s):  
Ercüment Bozkurt ◽  
Ahmet T. Yazıcı ◽  
Yusuf Yıldırım ◽  
Cengiz Alagöz ◽  
Hasan Göker ◽  
...  

2021 ◽  
Vol 37 (3) ◽  
Author(s):  
Sana Nadeem

Purpose:  To compare the results of trabeculectomy with subconjunctival Bevacizumab and 5-Fluorouracil (5-FU); with trabeculectomy with 5-FU alone; in terms of intraocular pressure (IOP) lowering, bleb formation, and complications, in the long term. Study Design:  Quasi experimental study. Place and Duration of Study:  Fauji Foundation Hospital, Rawalpindi, from December 2013 to August, 2019. Methods:  A total of 30 eyes (15 in each group) with glaucoma were recruited. Exclusion criteria were previous trabeculectomy, congenital, traumatic, uveitic, neovascular glaucomas, aphakia, or ocular surface disease. Trabeculectomy with 5FU was performed in both groups. In one group, subconjunctival Bevacizumab was injected into the bleb at the end of surgery. The patients were observed for IOP control, bleb configuration, and complications for 1 year. Results:  Primary open angle glaucoma was the predominant diagnosis in 17 (56.7%) eyes. The mean pre-operative IOP in the 5-FU group was 30.8 ± 17.03 mmHg, & in the 5-FU+Bevacizumab group it was 28.9 ± 18.9 mmHg. The mean IOPs of the 5-FU group at 1 Year was 14.5 ± 5.04 mmHg. In 5-FU+Bevacizumab group, mean IOPs at 1 year was 12.7 ± 4.38 mmHg. The differences between pre-operative and post-operative IOPs in both groups at 6, 9 and 12 months were statistically significant. However, differences in mean IOPs between the two groups, bleb morphology and complications were not statistically significant. Conclusion:  No added benefit of subconjunctival Bevacizumab used as an adjunct to 5-FU enhanced trabeculectomy was found at the end of 1 year follow-up. Key Words:  Trabeculectomy, 5-Fluorouracil, Bevacizumab, Glaucoma, Intraocular pressure.


2021 ◽  
Author(s):  
Faisal A. Almobarak ◽  
Ali H. Alharbi ◽  
Ibrahim Aljadaan ◽  
Hassan Aldhibi

Abstract Purpose To evaluate the outcomes of initial trabeculectomy in granulomatous and non-granulomatous uveitis. Methods Retrospective comparative study of 68 eyes that underwent an initial trabeculectomy. Results The mean follow-up was 74.18 and 74.86 months in both groups (p = 0.95). The intraocular pressure decreased from 40.03 mmHg (± 7.2) and 36.48 mmHg (± 11.3) to 14.00 mmHg (± 6.2) and 13.48 mmHg (± 5.7), the number of medications decreased from 3.73 (± 0.7) and 3.58 (± 0.9) to 1.00 (± 1.4) and 1.13 (± 1.4) on the last follow-up (p < 0.01) in the granulomatous and non-granulomatous groups, respectively. More eyes in the granulomatous uveitis group developed delayed postoperative complications like cataract, transient hypotony and glaucoma progression. Success rates were 64.9 and 71.0%, while failure rates were 35.1 and 29.0% in both groups (p = 0.84). Conclusions Trabeculectomy seems to have comparable IOP control and survival in granulomatous and non-granulomatous uveitis. Nevertheless, more eyes in the granulomatous uveitis group developed late onset complications.


2016 ◽  
Vol 7 (2) ◽  
pp. 164-172 ◽  
Author(s):  
Smita Karandikar ◽  
Vipul Bhandari ◽  
Jagdeesh Reddy

Objective: To evaluate the visual outcomes and intraocular pressure changes after Visian Implantable Collamer Lens (ICL) implantation V4b and V4c (with centraflow technology) for correction of myopia. Materials and methods: A prospective, consecutive, comparative interventional case series of V4b and V4c ICL implantation done for correction of high myopia (>-6 diopter D) in patients unsuitable for laser vision correction. The outcome measures that were evaluated included preoperative and postoperative uncorrected distant visual acuity (UDVA), best spectacle corrected distant visual acuity (CDVA), endothelial cell count (ECC), presence of lens opacification, intraocular pressure (IOP) and ICL vaulting. A follow-up of upto 1 year was done. A questionnaire was given at the end of follow-up period. Results: A total of 30 eyes (24.56±4.8 years) underwent V4b ICL implantation (10 non-toric, 20 toric ICL-TICL) with intraoperative peripheral iridectomy (PI) and 34 eyes (26.13±3.8 years) had implantation of V4c ICL with centraflow (12 non-toric, 22 TICL). The mean preoperative manifest spherical equivalent (MSE) was 8.98±2.8 D and 9.24±2.4 D in the V4b and V4c groups respectively which reduced to postoperative values of -0.28±1.3 D and -0.19±1.18 D respectively. The mean preoperative astigmatism was -1.8±1.2 diopter cylinder (Dcyl) and -1.9±1.6 Dcyl which respectively reduced to -0.8±0.8 Dcyl and -0.9±0.3 Dcyl. At the end of 1 year follow up, mean ECC loss was 7.6% and 7.1%, mean vault was 583.12±231.12 μ and 602±241.24μ respectively in the V4b and V4c groups. Anterior subcapsular opacities were present in 6.66% and 2.94% of eyes with V4b and V4c groups respectively. Two eyes from both V4b (10%) and V4c (8.33%) had rotation of more than 30 degrees and required re-rotation surgery done successfully. Two eyes (6.66%) with V4b ICL implantation had high postoperative IOP (>35 mm Hg) and required Nd:Yag laser iridotomy later done with successful control of IOP. The safety indices were 1.12 and 1.15 and efficacy indices were 1.5 and 1.6 in the V4b and V4c groups respectively at the end of 1 year. The most common visual complaint was glare and haloes in 24% and 27% in the two groups respectively. However, they were not annoying enough to cause visual disability. Conclusions: Both V4b and V4c Visian ICL implantations are comparable in terms of visual outcome and safety profile for correction of high myopia. However, V4c ICL offers these advantages without the requirement of an additional PI. 


2021 ◽  
pp. 112067212110356
Author(s):  
Mariano Royo ◽  
Ángel Jiménez ◽  
Irene Martínez-Alberquilla ◽  
José F Alfonso

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.


2021 ◽  
Vol 62 (8) ◽  
pp. 1043-1052
Author(s):  
Bu Ki Kim ◽  
Young Taek Chung

Purpose: To evaluate the long-term clinical outcomes of implantable collamer lens (ICL) implantation in myopic patients.Methods: This retrospective study included 129 eyes of 68 patients who underwent ICL implantation for correction of myopia with a 10-year follow-up.Results: Ten years after ICL implantation, the mean uncorrected and corrected distance visual acuities (LogMAR) were 0.03 ± 0.13 and -0.07 ± 0.06, respectively. Ten years postoperatively, 52.7% and 84.5% of the eyes were within ± 0.5 and ± 1.0 diopters, respectively. The mean efficacy and safety indices were 0.91 ± 0.22 and 1.07 ± 0.19, respectively. There was no significant difference between mean preoperative (13.52 ± 2.88 mmHg) and postoperative (13.59 ± 3.55 mmHg) intraocular pressures. The endothelial cell density decreased from before surgery to 10 years after surgery (3,074 ± 365 cells/mm2, 2,812 ± 406 cells/mm2, respectively; mean decrease: 8.5 ± 10.8%; p = 0.011). Eight eyes (6.2%) developed cataract during follow-up, which was symptomatic in three eyes (2.3%) and treated with ICL explantation and phacoemulsification. Rhegmatogenous retinal detachment occurred in one eye (0.8%) and was treated with vitrectomy.Conclusions: ICL implantation for the correction of myopia had good efficacy and safety outcomes during long-term follow-up of 10 years. However, patients should be closely monitored for complications such as cataract formation, endothelial cell loss, and retinal detachment.


Author(s):  
Adunola Ogunro ◽  
Godswill Inye Nathaniel

Aims: To evaluate the surgical outcome of combined phacoemulsification cataract surgery plus posterior chamber intraocular and trabeculectomy with adjunctive 5-Fluorouracil versus trabeculectomy with 5-Fluorouracil in the management of Primary open angle glaucoma. Study Design: it was retrospective comparative interventional study Place and Duration of Study: Glaucoma Unit, Eye foundation Hospital Ikeja, Lagos, Nigeria between January 2015, and December 2017 Materials and Methods: A retrospective review of consecutive 29 eyes (29 patients) who had trabeculectomy with 5-Fluorouracil compared with 26 eyes (26 patients) who had combined phacotrabeculectomy with 5-Fluorouracil from 2015 to 2017. All patients had a minimum follow up of 3 months. Results: The mean age of 54.48±14.42 years in Trabeculectomy group was significantly (p>0.001) lower than 70.76±7.22 years for the Phacotrabeculectomy group.  The mean preoperative intraocular pressure (IOP) and number of glaucoma medication were similar for the two groups (19.86±9.63mmHg versus 22.23±8.99mmHg; 2.66±1.20 versus 2.73±0.72 medication, trabeculectomy versus phacotrabeculectomy respectively). The postoperative IOP and glaucoma medication after a mean follow up period of 17.11±9.81 months was not significantly different between the two groups (11.55±2.71mmHg versus 12.31±4.33mmHg, p=0.436 for trabeculectomy versus phacotrabeculectomy respectively). Both groups significantly required fewer number of antiglaucoma medication at final follow-up (1.14±0.92 vs 1.46±1.10, trabeculectomy vs phacotrabeculectomy. In the trabeculectomy group, 25 (86.2%) had IOP of ≤15mmHg with or without topical antiglaucoma drops. In the phacotrabeculectomy, 21 (80.76%) had IOP of ≤15mmHg with or without topical antiglaucoma medication (Qualified success).  On the other hand, 8 (27.58%) had IOP of ≤15mmHg without topical antiglaucoma medication at the end of the follow-up in the trabeculectomy (Complete success). In the phacotrabeculectomy group, 5 (19.23%) had final IOP of ≤15mmHg without topical antiglaucoma medication. Few complications occurred in both groups. Conclusion: Phacotrabeculectomy augmented with 5-Fluorouracil gave comparable surgical success to 5-Fluorouracil augmented trabeculectomy alone.


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