ABSTRACT
Implantable collamer lens(ICL)and toric ICL(TICL)are clinically common types of posterior chamber phakic intraocular lenses, they are mainly used to correct high myopia and low-to-moderate myopia of eyes whose corneal conditions are not suitable for corneal laser surgery. Accurate preoperative measurement, safe intraoperative implantation and appropriate postoperative location of lenses are critical to ensure the outcome of ICL implantable, and the appearance of V4c ICL with a central hole ensures the safety of this surgery to a greater extent. However, the intraocular position of both ICL and TICL is not invariable. Some studies have shown that the vault has a trend of decreasing year by year after ICL surgery, but its reason is unknown. And spontaneous rotation may occur after the TICL surgery, thereby causing visual loss, which is one of the main causes of TICL replacement. And postoperative changes in the position of the central hole also need attention. In addition, the visual quality of the operated eye will change after ICL/TICL implantation, but whether the change of intraocular positions of implanted lenses will affect the postoperative visual quality is also a problem that needs to be paid attention to and explored. Therefore, this paper reviewed the postoperative changes in vault, TICL axis, position of the central hole and their causes, as well as the effects of these changes on postoperative visual quality, offering valuable clinical guidance for accurate preoperative selection of ICL/TICL and surgical design, so as to improve the effectiveness and stability of ICL implantation in correction of myopic refractive error.
ABSTRACT
@#AIM: To observe the efficacy and safety of central hole phakic posterior chamber intraocular lens(ICL V4c)implantation for correction high myopia.<p>METHODS: Fifty-eight high myopia patients(116 eyes)who underwent the ICL V4c implantation in our hospital from January 2016 to June 2017 were observed 1wk, 1mo and 1a after operation respectively. Uncorrected visual acuity(UCVA), best corrected visual acuity(BCVA), equivalent spherical mirrors(SE), intraocular pressure(IOP), corneal endothelial cell count, ICL-vault, adverse reaction and complication were investigated.<p>RESULTS: Postoperative UCVA and BCVA were significantly higher than that in preoperative group(<i>P</i><0.01). Significant differences were found between postoperative groups except between 1mo and 1a(<i>P</i>>0.05). Postoperative SE at all time points were lower than that in preoperative group(<i>P</i><0.01). SE at 1mo and 1a after operation were close to 0 diopter. The safety index in 1a postoperative was 1.33±0.67 and the effective index was 1.32±0.69. No significant differences were found in IOP and endothelial cell density after surgery comparing to that in preoperative group(<i>P</i>>0.05). None of subjects developed cataract, glaucoma and decompensation of corneal endothelium. The degree of postoperative satisfaction was 100%.<p>CONCLUSION: ICL V4c implantation is a safe and effective method for correction of high myopia. The visual acuity stabilized 1mo after operation.
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@#AIM: To observe the efficacy and safety of central hole phakic posterior chamber intraocular lens(ICL V4c)implantation for correction low to moderate myopia.<p>METHODS: Twenty low to moderate myopia patients(forty eyes)who underwent the ICL V4c implantation in our hospital from January 2016 to June 2017 were observed 1wk, 1mo and 1a after operation respectively. Uncorrected visual acuity(UCVA), best corrected visual acuity(BCVA), equivalent spherical mirrors(SE), intraocular pressure, corneal endothelial cell count, ICL-vault, adverse reaction and complication were investigated.<p>RESULTS: Postoperative UCVA and BCVA were significantly higher than that in preoperative group(<i>P</i><0.01). Significant difference was found in UCVA between postoperative groups except between 1mo and 1a. No significant difference were found in BCVA among postoperative groups(<i>P</i><0.05). Postoperative SE at all time points were lower than that in preoperative group(<i>P</i><0.01). Average SE after 1wk after operation were close to 0 diopter. The safety index in 1a postoperative were 1.05±0.14 and the effective index was 1.07±0.14. No significant difference was found in intraocular pressure and endothelial cell density after surgery comparing to that in preoperative group(<i>P</i>>0.05). None of subjects developed cataract, glaucoma and decompensation of corneal endothelium. The degree of postoperative satisfaction was 100%.<p>CONCLUSION: ICL V4c implantation is a safe and effective method for the correction of low to moderate myopia. The visual acuity stabilized 1mo after operation.
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@#AIM: To explore the application of improved skills in central hole ICL V4c implantation and its clinical efficacy. <p>METHODS: This study included 141 eyes of 72 patients with myopia from September 2015 to August 2016. An implantable contact lens with a central hole(ICL V4c)was inserted by improved surgical skills including single 2.8mm clear corneal incision, no anterior chamber viscoelastics before ICL implantation. The intraocular pressure(IOP)was measured at the early stage within 6h after operation. The visual acuity, diopter, intraocular pressure and corneal endothelial cell density were observed after operation and follow up 2a. <p>RESULTS: ICL V4c was implanted successfully in all patients by this improved skills and fine clinical results were achieved. Elevated IOP is possible at early stage post-operation, especially within 2h after operation. 95.7% had normal IOP 6h after operation. The postoperative IOP was stable within 2a follow-up period. The cumulative corneal endothelial loss rates of 6mo, 1a and 2a were 4.70%, 7.59% and 9.63% respectively. There was no complications such as subcapsular cataract during the 2a follow-up period.<p>CONCLUSION: The improved skills used in our study is safe and feasible.