Effects of White-To-White Diameter and Anterior Chamber Depth on Implantable Collamer Lens Vault and Visual Outcome

PurposeTo investigate the long-term safety and efficacy of implantable collamer lens (ICL) V4c implantation and changes in the anterior lens density (ALD) in patients with myopia ≥40 years of age.MethodsThis prospective study included 104 eyes of 52 patients >40 years of age before ICL V4c implantation. Spherical equivalent (SE), uncorrected distance visual acuity, corrected distance visual acuity (CDVA), intraocular pressure, endothelial cell density, anterior chamber depth, anterior chamber volume and anterior chamber angle preoperatively, at 1 and 3 months, and at 3 years postoperatively were recorded. Pentacam HR was used to analyse ALD changes at a depth of 0.5, 1.0 and 1.5 mm within a 3 mm diameter range around the pupil’s centre.ResultsThe overall follow-up was uneventful at 42±7.1 months; the safety index at last follow-up was 1.26±0.35 and the efficacy index was 0.91±0.41. No eye lost the Snellen line of CDVA, 76% of the eyes had an increase in CDVA for ≥1 line and 62% had an SE within ±0.50 dioptre. The increase in ALD at 0.5, 1 and 1.5 mm was 16.52%±10.46%, 16.72%±9.85% and 17.28%±11.93%, respectively. Preoperative, 1-month and 3-month postoperative ALDs showed correlations with SE and age, and ALD at last follow-up was correlated only with age. There was no correlation between ALD and any other parameters.ConclusionICL V4c shows long-term safety and efficacy in people ≥40 years of age. ALD increased in such patients, which may be related to age and SE.

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15-month outcomes of Visian ICL implantation for high myopia in patients with shallow anterior chamber depth

10.21203/rs.2.497/v1 ◽

2019 ◽

Author(s):

Lingling Niu ◽

Huamao Miao ◽

Tian Han ◽

Lan Ding ◽

Xiaoying Wang ◽

...

Keyword(s):

Visual Acuity ◽

Observational Study ◽

Anterior Chamber ◽

High Myopia ◽

Anterior Chamber Depth ◽

Implantable Collamer Lens ◽

Distance Visual Acuity ◽

Icl V4c ◽

Shallow Anterior Chamber

Abstract Background: High myopia with shallow anterior chamber depth (ACD < 2.8 mm) is not rare. This observational study aims to: evaluate clinical outcomes after implantation of the Visian Implantable Collamer Lens with a central hole (ICL V4c) in these patients. Methods: A prospective cohort of consecutive 51 eyes of 31 patients (20 to 42 years old) was followed for 15.35 ± 4.90 months (12 to 25 months). The preoperative ACD was 2.74 ± 0.04 mm (2.65 to 2.79 mm). Uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), intraocular pressure (IOP), manifest refraction, vault, and endothelial cell density (ECD) were measured during the follow-ups after the surgery. Results: All surgeries were performed safely and no complication was observed during the follow-ups. At the last follow-up, the safety index (postoperative CDVA / preoperative CDVA) was 1.33 ± 0.60 and the efficacy index (postoperative UDVA / preoperative CDVA) was 1.14 ± 0.54. After the surgery, no eye had decreased CDVA and 59% (30 eyes) of the eyes gained at least one line. Forty-seven eyes (92%) were within ± 1.0 D and 35 eyes (69%) were within ± 0.5 D of the attempted refraction. The mean postoperative vault was 380.00 ± 152.84 µm (90 to 700µm). The ECD was reduced by 8.38 ± 0.06% compared to the preoperative value (p < 0.001). No significant change was observed in IOP (p = 0.061) at the last follow-up. Ultrasound Biomicroscopy (UBM) showed none of the eyes had trabecular-iris angle closed. Conclusions: In this prospective observational study, ICL V4c implantation in patients with high myopia and shallow ACD achieved satisfying and stable visual outcomes. Its long-term safety and stability require further investigation. Trial Registration: This trial was retrospectively registered on 05/08/2018 under the number (ChiCTR1800017594)

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Two-Year Outcomes of Visian Implantable Collamer Lens with a Central Hole for Correcting High Myopia

Journal of Ophthalmology ◽

10.1155/2018/8678352 ◽

2018 ◽

Vol 2018 ◽

pp. 1-9 ◽

Cited By ~ 5

Author(s):

Zhipeng Yan ◽

Huamao Miao ◽

Feng Zhao ◽

Xiaoying Wang ◽

Xun Chen ◽

...

Keyword(s):

Intraocular Pressure ◽

Anterior Chamber ◽

High Myopia ◽

Imaging System ◽

Anterior Chamber Depth ◽

Central Hole ◽

Implantable Collamer Lens ◽

Chamber Volume ◽

Anterior Chamber Volume ◽

Icl V4c

Purpose. To investigate two-year outcomes of Visian Implantable Collamer Lens with a central hole (ICL V4c) implantation for correcting high myopia.Methods. Sixty-one eyes of 32 patients went through ICL V4c implantation. Safety, efficacy, predictability, and intraocular pressure were evaluated 2 years postoperatively. Anterior chamber volume (ACV), anterior chamber depth (ACD), anterior chamber angle width (ACAW), and vault were measured using a Scheimpflug tomography imaging system.Results. At 2 years, the spherical equivalent refraction decreased from preoperative −14.62 ± 4.29 D to −0.90 ± 0.95 D, with 79% of the eyes within ±0.50 D and 98% within ±1.00 D of the intended correction. The efficacy index was 1.03 ± 0.23, and the safety index was 1.24 ± 0.26. Corrected distance visual acuity (CDVA) remained unchanged in 23% of the eyes, 75% gained one or more lines of CDVA, and 2% lost one line. The ACV, ACD, and ACAW, respectively, decreased from 193.28 ± 29.15 mm3, 3.15 ± 0.23 mm, and 36.51 ± 6.54 degree to 112.48 ± 17.01 mm3, 2.99 ± 0.23 mm, and 22.54 ± 5.27 degree (p=0.0008, 0.008, and 0.0003, resp.). Intraocular pressure was 15.39 ± 2.88 mmHg before surgery and was 15.86 ± 4.11 mmHg at 2 years (p=0.11).Conclusion. Implantation of ICL V4c is a safe, effective, and predictable procedure for correcting high myopia. Reduction of anterior chamber space after surgery did not induce intraocular pressure increase during the 2-year follow-up.

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A study of evaluation of anterior segment changes in eyes with pseudo exfoliation syndrome including anterior chamber depth status of lens anterior chamber angle preoperatively

MedPulse International Journal of Ophthalmology ◽

10.26611/10091934 ◽

2021 ◽

Vol 19 (3) ◽

pp. 38-44

Author(s):

Girish Surlikar ◽

Keyword(s):

Cataract Surgery ◽

Anterior Chamber ◽

Intraoperative Complications ◽

Systemic Disease ◽

Anterior Segment ◽

Anterior Chamber Depth ◽

Visual Outcome ◽

Pseudoexfoliation Syndrome ◽

Small Incision Cataract Surgery ◽

Small Incision

Background: Pseudoexfoliation syndrome is an important ocular manifestation of a systemic disease, found to be common in cataract patients as well as in 50% of glaucoma patients. Present study was intended to assess the profile of Pseudoexfoliation syndrome and evaluate the surgical outcome of Manual Small Incision Cataract Surgery in Pseudoexfoliative eyes. Material and Methods: Present study was prospective, observational, hospital-based study, conducted in patients with age more than 50 years, with Pseudoexfoliation, admitted for cataract surgery, posted for Manual Small incision cataract surgery(MSICS). All patients underwent a manual small incision cataract surgery, and visual outcomes of the procedures were recorded on the first postoperative day. Results: In present study, maximum numbers of patients were from the age group of 70-79 years (62.5%) and 56 (70%) patients were males and 24 (30%) were females. In this study of 80 patients with Pseudoexfoliation Syndrome, 60 patients had Bilateral Pseudoexfoliation i.e. 120 eyes (85.71%) while 20 patients had Unilateral Pseudoexfoliation i.e. 20 eyes (14.29%). In majority of the eyes 111 (79.29%) had involvement of lens with Pseudoexfoliation while 109 (77.86%) had pupillary involvement. Mean Anterior Chamber Depth in Pseudoexfoliative eyes was 2.50±0.22 mm. Majority of the eyes i.e. 74 (52.9%) were having IOP between 16 – 20 mm Hg. 61 eyes (43.6%) had IOP between 11 – 15 mm Hg. 80 eyes of 80 patients underwent MSICS, 17 (21.25%) patients developed Intraoperative Complications. Conclusion: There is significant association between Pseudoexfoliation syndrome and age, male preponderance and bilateral involvement of eyes. MSICS provides significant improvement in visual outcome in patients with Pseudoexfoliation syndrome with cataract.

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Prediction of anterior chamber volume after implantation of posterior chamber phakic intraocular lens

PLoS ONE ◽

10.1371/journal.pone.0242434 ◽

2020 ◽

Vol 15 (11) ◽

pp. e0242434

Author(s):

Yuki Takagi ◽

Takashi Kojima ◽

Tomoya Nishida ◽

Tomoaki Nakamura ◽

Kazuo Ichikawa

Keyword(s):

Anterior Chamber ◽

Anterior Segment ◽

Anterior Chamber Depth ◽

Absolute Error ◽

Prediction Equation ◽

Stepwise Multiple Regression ◽

Posterior Chamber ◽

Implantable Collamer Lens ◽

Chamber Volume ◽

Anterior Chamber Volume

Purpose To predict the anterior chamber volume (ACV) after implantable collamer lens (ICL) implantation based on ICL size and parameters of anterior segment optical coherence tomography (AS-OCT). Design Retrospective study. Methods This study included 222 eyes of 222 patients who underwent ICL implantation at Nagoya Eye Clinic. The patients were divided into two groups: prediction group, for creating the prediction equation (148 eyes, mean age: 32.11 ± 8.04 years), and verification group, for verifying the equation (74 eyes, mean age: 33.03 ± 6.74 years). The angle opening distance (AOD), anterior chamber width (ACW), ACV, anterior chamber depth, lens vault, angle-to-angle distance, angle recess area, and trabecular iris space area were calculated using AS-OCT. A stepwise multiple regression analysis was performed. After the creation of the prediction equation, its accuracy was verified in the verification group. Results The ACV, AOD750, ACW, and ICL size were selected as explanatory variables to predict postoperative ACV. Mean predicted (114.2 ± 21.83 mm3) and actual postoperative ACVs (116.1 ± 25.41 mm3) were not significantly different (P = 0.269); absolute error was 10.59 ± 9.13 mm3. In addition, there was high correlation between actual and predictive ACV (adjusted R2 = 0.6996, p < 0.0001). Bland-Altman plot revealed that there was no addition or proportional error between predicted and actual postoperative ACV. Conclusion Postoperative ACV was accurately predicted using AS-OCT parameters and ICL size. This prediction equation may be useful for making decisions regarding ICL size.

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Endothelial Cell Changes after Implantable Collamer Lens Surgery in Eyes with Different Anterior Chamber Depth

Benha Journal of Applied Sciences ◽

10.21608/bjas.2020.136687 ◽

2020 ◽

Vol 5 (5) ◽

pp. 1-7

Author(s):

S.R. Abbas ◽

T.I. Salm ◽

A.A. Mahmoud

Keyword(s):

Endothelial Cell ◽

Anterior Chamber ◽

Anterior Chamber Depth ◽

Implantable Collamer Lens ◽

Lens Surgery ◽

Cell Changes

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Correlation between intraoperative and postoperative vaulting of the EVO implantable Collamer lens: a retrospective study of real-time observations of vaulting using the RESCAN 700 system

BMC Ophthalmology ◽

10.1186/s12886-021-02237-2 ◽

2022 ◽

Vol 22 (1) ◽

Author(s):

Nian Guan ◽

Xiao-Nong Zhang ◽

Wan-Jun Zhang

Keyword(s):

Retrospective Study ◽

Anterior Chamber ◽

Multivariable Analysis ◽

Anterior Chamber Depth ◽

Crystalline Lens ◽

Implantable Collamer Lens ◽

Chamber Volume ◽

Anterior Chamber Volume ◽

Intraoperative Optical Coherence Tomography ◽

Corneal Endothelial Cell Density

Abstract Background Implantable Collamer lens (ICL) vaulting is one of the most important parameters for the safety, aqueous humor circulation, and lens transparency after ICL implantation. This study aimed to investigate the factors associated with the actual vaulting after refractive EVO-ICL surgery. Methods This retrospective study included patients who underwent EVO-ICL surgery at a tertiary eye hospital between October and December 2019. A RESCAN 700 was used for the intraoperative and CIRRUS HD-OCT was used for postoperative observation of vaulting. Subjective and objective refractions, anterior ocular segment, corneal morphology, intraocular pressure (IOP), anterior chamber volume (ACV), crystalline lens rise (CLR), white-to-white distance (WTW), anterior chamber depth (ACD), axial length, corneal endothelial cell density (ECD), and fundoscopy were examined. A multivariable analysis was performed to determine the factors independently associated with 1-month postoperative vaulting. Results Fifty-one patients (102 eyes) were included. Compared with the eyes with normal vaulting, those with high vaulting had higher preoperative diopter values (P = 0.039), lower preoperative corrected visual acuity (P = 0.006), lower preoperative IOP (P = 0.029), higher preoperative ACD (P = 0.004), lower preoperative CLR (P = 0.046), higher ICL spherical equivalent (P = 0.030), higher intraoperative vaulting (P < 0.001), and lower IOP at 1 month (P = 0.045). The multivariable analysis showed that the only factor independently associated with high vaulting at 1 month after surgery was the intraoperative vaulting value (odds ratio = 1.005, 95% confidence interval: 1.002–1.007, P < 0.001). The intraoperative and 1-month postoperative vaulting values were positively correlated (R2 = 0.562). Conclusions The RESCAN700 system can be used to perform intraoperative optical coherence tomography to predict the vaulting value of ICL at 1 month.

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