Prediction of vault after implantable collamer lens implantation and its research progress / 国际眼科杂志(Guoji Yanke Zazhi)

Myopia is considered to be a disease occurred under the influence of genetic and environmental factors, and it can only be restored by corrective surgeries. The current surgical methods include laser surgeries and phakic intraocular lens(PIOL)implantation, and PIOL has the advantages of wide range of correction, repeatable procession and small damage to corneal tissue. Furthermore, good visual acuity can be achieved after implantation of intraocular lens. Implantable collamer lens(ICL)is the most common surgical method in this group. The vertical distance between the highest point of the posterior central surface of the implanted lens and the anterior surface of the crystalline lens is called vault. It will cause serious complications if the vault turns out to be abnormal. Up to now, there is no optimal prediction method. This research focuses on vault, discusses the ideal range of postoperative vault, the safety and effectiveness of this surgery, and analyzes the existing prediction methods to provide directions for future clinical research.

Incidence of Retinal Lesions before and after Refractive Surgery and Preoperative Prophylactic Laser Treatment

PURPOSE: We investigated the incidence of retinal lesions before and after surgery and the percentage of preoperative prophylactic laser treatment in patients who underwent corneal refractive surgery or phakic intraocular lens implantation (pIOLi). METHODS: The medical records of patients who underwent refractive surgery from January 2005 to June 2013 were reviewed retrospectively. We investigated the incidence and type of retinal lesions identified during the preoperative examination. Additionally, the percentage of preoperative prophylactic laser treatment and the incidence of postoperative newly developed retinal lesions were analyzed. RESULTS: A total of 894 eyes of 466 subjects (laser in situ keratomileusis [LASIK] 225 eyes, 117 subjects; laser-assisted subepithelial keratectomy [LASEK] or photorefractive keratectomy [PRK] 450 eyes, 231 subjects; pIOLi 219 eyes, 121 subjects) were enrolled in the present study. Retinal lesions were found in 268 eyes (29.98%) and of those, 144 eyes (16.11%) received prophylactic laser treatment. Postoperative newly developed retinal lesions were detected in 8 cases (LASEK or PRK, 5 cases; pIOLi, 3 cases) during the follow-up period. There was a significant correlation between preoperative spherical equivalent and the presence of retinal lesions. CONCLUSIONS: The patient population of refractive surgery is largely myopic and thus particularly vulnerable to retinal lesions. Additionally, a considerable number of patients required preoperative prophylactic laser treatment. Therefore, both surgeons and patients should be aware of the risks of developing postoperative retinal lesions.

The Change of Retinal Nerve Fiber Layer Thickness after Posterior Chamber Phakic Intraocular Lens Implantation

PURPOSE: In the present study we evaluated the changes of measured retinal nerve fiber layer (RNFL) thickness using optical coherence tomography (OCT) after phakic intraocular lens (implantable collamer lens, ICL) implantation and analyzed the factors correlated with the changes of measured RNFL thickness. METHODS: Forty eyes of 40 patients (Group A: 20 patients using spectral domain OCT and Group B: 20 patients using time domain OCT) who underwent ICL implantation were included in this study. RNFL thickness was measured 1 week before surgery and 1 month postoperatively using OCT. The changes of measured RNFL thickness and the correlation between patients' data were analyzed. RESULTS: The postoperative measured RNFL thickness of the average, inferior, temporal, and superior quadrants were increased compared to preoperative measured RNFL thickness in Group A. Group B had similar results in the average, inferior, and superior quadrants (p 0.05). CONCLUSIONS: The measured RNFL thickness after ICL implantation may increase compared to the preoperative value. Caution should be taken when interpreting the RNFL thickness values measured by OCT in patients with myopia who undergo ICL implantation.

The Change of Retinal Nerve Fiber Layer Thickness after Posterior Chamber Phakic Intraocular Lens Implantation

PURPOSE: In the present study we evaluated the changes of measured retinal nerve fiber layer (RNFL) thickness using optical coherence tomography (OCT) after phakic intraocular lens (implantable collamer lens, ICL) implantation and analyzed the factors correlated with the changes of measured RNFL thickness. METHODS: Forty eyes of 40 patients (Group A: 20 patients using spectral domain OCT and Group B: 20 patients using time domain OCT) who underwent ICL implantation were included in this study. RNFL thickness was measured 1 week before surgery and 1 month postoperatively using OCT. The changes of measured RNFL thickness and the correlation between patients' data were analyzed. RESULTS: The postoperative measured RNFL thickness of the average, inferior, temporal, and superior quadrants were increased compared to preoperative measured RNFL thickness in Group A. Group B had similar results in the average, inferior, and superior quadrants (p 0.05). CONCLUSIONS: The measured RNFL thickness after ICL implantation may increase compared to the preoperative value. Caution should be taken when interpreting the RNFL thickness values measured by OCT in patients with myopia who undergo ICL implantation.

Clinical observation of implantable collamer lens in treatment of super high myopia / 局解手术学杂志

Objective To investigate the clinical effect of implantable collamer lens ( ICL) in the treatment of super high myopia. Methods 20 patients with high myopia were given ICL,and changes in patients with visual acuity,intraocular pressure and corneal endothe-lial cells,and surgery-related complications and outcome were observed. Results Before surgery,the visual acuity of patients was (0. 10±0. 05),and postoperative (0. 60±0. 20),the difference was statistical significance(P<0. 05);the intraocular pressure and corneal endothe-lial cells of patients did not change significantly after surgery,with less postoperative complications. Conclusion The ICL has a very signifi-cant effect in the treatment of super high myopia,which can help to improve the patient's quality of life,and it is worthy of wide promotion and application.

Superiority on visual quality of Phakic intraocular lens implantation in high myopic patients: compared with LARK / 中华实验眼科杂志

Phakic intraocular lens implantation(PIOL)is one of the primary surgery fashions for correcting high myopia.The evaluation of visual quality following the surgery,including visual activity,contrast sensitivity,aberration and corneal Q value,is very important.Researches showed that the visual quality of patients after tradition laser in situ keratomileusis(LASIK)decreased because of the alteration of corneal aspherieity by laser excision cornea；while compared with LASIK,implantation of implantable contact lenses(ICL)is popular due to its excellent safety,effectiveness,reversibility and fewer complication.The visual quality after ICL is also superior than that of LASIK.Therein,the surgical project will furthermore be recommend for the high myopia patients.The purpose is to find the optimal strategy for the high myopia patients to get the best visual quality.

Two Cases of Glare after Iridotomy for Phakic Intraocular Lens Implantation

PURPOSE: The present study is a case report of 2 patients (4 eyes) whose symptoms subsided after corneal tattooing over the iridotomy site for persistent and excessive glare, which developed after iridotomy for phakic intraocular lens implantation. CASE SUMMARY: Two patients developed excessive glare symptoms after receiving iridotomy as a pre-procedure for phakic intraocular lens implantation. Case 1 and Case 2 showed persistent glare symptoms over a period of 6 months. Corneal tattooing was performed on the patients by applying tissue dye to the corneal stroma over the iridotomy site. The symptom was evaluated by comparison of glare scores from 0 to 10 after the procedure with a score of 10 prior to the procedure. After corneal tattooing, patient 1 reported a score of 4 and patient 2 reported a score of 3, showing significant symptom improvements without additional complications. CONCLUSIONS: Corneal tattooing at the peripheral cornea in front of the iridotomy site for patients with persistent glare symptoms after prophylactic iridotomy was shown to be effective.