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With the rapid development of science and technology and the wide application of electronic products, the number of patients with high myopia is gradually increasing. Meanwhile, owing to the continuous optimization of surgical skils and the continuous advancement in materials of posterior chamber intraocular lens and manufacturing processes, implantable collamer lens(ICL)V4c implantation has gradually become one of the main surgeries for the treatment of high myopia. In the rapid era of social information, people pay more attention to the long-term efficacy after ICL V4c implantation, they not only want clear vision, but also the pursuit of visual comfort and durability. Therefore, this paper will specifically discuss the research progress of the post-implantation efficacy of ICL V4c with at least 2 a of follow-up observation within 3 a, aiming to review the latest research progress on the long-term efficacy of ICL V4c implantation from the three dimensions of visual quality, safety, efficacy and stability and possible surgical complications after ICL V4c implantation.
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AIM: To compare the clinical efficacy, vault, and rotational stability of horizontal, oblique, and vertical implantation of Toric implantable collamer lens(TICL).METHODS: Retrospective cohort study. A total of 92 cases(120 eyes)who underwent TICL implantation from July 2018 to March 2022 and had regular follow-up for at least 1 a postoperatively(1 d, 1 wk, 1, 3, 6 mo, and 1 a)at Wuhan Bright Eye Hospital were collected. The patients were divided into three groups, with 34 cases(45 eyes)in horizontal implantation group, 25 cases(29 eyes)in oblique implantation group(29 cases), and 33 cases(46 eyes)in vertical implantation group. Uncorrected distance visual acuity(UDVA), corrected distance visual acuity(CDVA), diopters, vault, and rotation angle(deviation of the actual axis of TICL from the expected axis).RESULTS: All surgeries were uneventful, and there were no complications such as infection, secondary glaucoma, or cataract opacity. Safety and efficacy of the surgery: the CDVA of the three groups of patients was better than or equal to the preoperative CDVA at 1 a postoperatively, and there was no statistically significant differences in postoperative UDVA and CDVA of the three groups(P>0.05). The safety index at 1a postoperatively was 1.34±0.21, 1.34±0.17, and 1.31±0.18 for the horizontal, oblique, and vertical groups, respectively. The efficacy index was 1.26±0.21, 1.33±0.18, and 1.27±0.16 for the three groups, respectively, both with no statistically significant differences(P>0.05). Vault: there was a significant difference in postoperative vault among the three groups(P=0.003), with the vertical group having the lowest vault, followed by the horizontal group and the oblique group. The vaults at different follow-up time points within each group showed significant differences(P<0.001), and all decreased over time. Residual astigmatism: there was no significant difference in residual astigmatism among the three groups(P=0.130), but there were differences at different follow-up time points within each group(P<0.001). Rotation angle: no significant differences in rotation angle were observed among the three groups(P=0.135), but there were differences at different follow-up time points within each group(P<0.001).CONCLUSION: The implantation of TICL in different orientations has good safety and efficacy, the postoperative rotational stability is good, and the appropriate angle can be selected to implant TICL according to the clinical situation.
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AIM:To observe the effect of implantable collamer lens V4c(ICL V4c)implantation on high myopia, and the changes in anterior segment morphology.METHODS:A prospective study was conducted on 100 patients(200 eyes)with high myopia who were treated with ICL V4c implantation in the hospital from February 2018 to March 2021. The best corrected visual acuity(BCVA), uncorrected visual acuity(UCVA), intraocular pressure, higher-order aberration, anterior segment morphology [iridocorneal angle(ICA), central anterior chamber depth(ACD), anterior chamber volume(ACV), central corneal thickness(CCT)and K-value(K)], photopic and scotopic contrast sensitivity before operation and 6 and 12mo after operation were comparatively analyzed.RESULTS:All patients were followed-up. UCVA and BCVA were significantly improved at 6 and 12mo after operation(P<0.05). Total higher-order aberration, horizontal coma and vertical coma showed no significant difference before and after operation(P>0.05). Spherical aberration, ICA, ACD and ACV at 6 and 12mo after operation were significantly smaller than those before operation(P<0.05). Under photopic state, the contrast sensitivity of 3.0 and 6.0 c/d was significantly higher at 6 and 12mo after operation when compared with that before operation(P<0.05). Under scotopic state, the contrast sensitivity of 6.0 c/d was significantly higher at 6 and 12mo after operation when compared with that before operation(P<0.05); there was no significant difference in CCT, K, or intraocular pressure before and after operation(P>0.05).CONCLUSION:Although ICA, ACD and ACV in patients with high myopia are reduced after ICL V4c implantation, the operation can effectively improve visual acuity and visual quality.
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The implantable collamer lens(ICL)is a widely popular option for the correction of refractive errors. ICL implantation brings a whole new dimension to the vision, from the anterior chamber phakic ICL to the posterior and central hole ICL. Even though there are fewer reported complications, ICL size selection remains challenging due to the differences in device measurements and ICL sizing formulas. With the widening comprehensiveness of ICL implantation and the ongoing development of ophthalmic devices and technologies, particularly the advent of artificial intelligence, more and more indicators such as sulcus-to-sulcus(STS), crystalline lens rise(CLR), angle-to-angle(ATA), the iris pigment end to the iris pigment end(PTP), anterior chamber width(ACW), and anterior chamber angle(ACA)are providing references in the selection of ICL size, this article provides a review of ICL size selection.
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With the development of posterior chamber phakic intraocular lenses implantation and the constant improvement of the implantable collamer lens(ICL), ICL V4c implantation has become one of the main methods for correcting moderate and high myopia. Vault is an important indicator to evaluate the security of posterior chamber intraocular lens implantation. In recent years, optimizing surgical procedures to obtain the ideal vault in ICL V4c implantation surgery has become a research hotspot. This paper aims to provide help for improving surgical safety by summarizing and analyzing the optimized programs of ICL V4c implantation surgery. The focus will be on preoperative examination, intraoperative surgical design, and postoperative follow-up.
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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.
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Corneal refractive surgery and intraocular collamer lens(ICL)implantation are the mainstream refractive surgery methods at present. Many studies have proved that ICL implantation can effectively improve the postoperative visual acuity of patients. ICL implantation has gained favor among refractive doctors and patients because of its multiple advantages. Excellent postoperative visual acuity and visual quality are the key factors to improve patients' satisfaction. In order to evaluate the subjective and objective visual quality of patients after operation and avoid complications, this article reviews the visual quality and postoperative complications after ICL implantation.
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AIM: To investigate the short-term visual quality outcomes after femtosecond laser small incision lenticule extraction(SMILE)and evolution implantable collamer lens(EVO-ICL)implantation for the correction of moderate myopia.METHODS: Prospective control study. A total of 51 cases(51 eyes)with moderate myopia who underwent SMILE or EVO-ICL implantation surgery at Weifang Eye Hospital from April 2021 to February 2022 were selected. They were divided into SMILE group(30 patients, 30 eyes)and EVO-ICL group(21 patients, 21 eyes)according to the surgical methods. The changes of visual acuity [uncorrected distance visual acuity(UDVA), corrected distance visual acuity(CDVA)], diopter [spherical equivalent(SE)] and related parameters of optical quality analysis system(OQAS Ⅱ)were observed before surgery and at 1wk, 1 and 3mo after surgery, and the quality of vision(QoV)questionnaire was completed.RESULTS: At 3mo after surgery, the safety index(postoperative CDVA/preoperative CDVA)of SMILE gruop and EVO-ICL group were 1.20(1.00, 1.20)and 1.20(1.00, 1.38), respectively, the efficacy index(postoperative UDVA/preoperative CDVA)were 1.00(1.00, 1.20)and 1.00(1.00, 1.20), respectively, and the percentage of SE within ±0.50D was 87% and 100%, respectively. In SMILE group, the objective scattering index(OSI)was increased after surgery, while modulation transfer function cutoff frequency(MTF cutoff), contrast visual acuity(VA)100%, and VA20% at 1wk and 1mo after surgery, and Strehl ratio(SR)and VA9% at each time point after surgery were all decreased compared with those before surgery(all P&#x003C;0.05). The OSI, MTF cutoff, SR and VA of EVO-ICL group showed no difference at each time point after surgery compared with those before surgery(all P&#x003E;0.05). The most common visual symptoms after SMILE and EVO-ICL implantation were visual haze and halos, respectively.CONCLUSION: Both SMILE and EVO-ICL implantation have good safety, efficacy and predictability in the short term after the correction of moderate myopia. Both groups had visual symptoms after surgery, but the overall satisfaction of patients was high. Furthermore, EVO-ICL implantation has better objective visual quality performance.
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AIM:To observe the early variation trend of the vault after phakic posterior chamber implantable collamer lens/toric implantable collamer lens(ICL/TICL V4c)implantation and analyze the related influencing factors.METHODS:In this retrospective study, a total of 49 patients(98 eyes)who underwent ICL/TICL V4c implantation in the Lanzhou Huaxia Eye Hospital from October 2020 to March 2021 were enrolled. Preoperative ocular biometric parameters were collected, including spherical equivalent(SE), intraocular pressure, axial length, anterior chamber depth(ACD), lens thickness(LT), central corneal thickness, anterior chamber angle(ACA), anterior chamber volume(ACV), white to white corneal diameter(WTW), mean keratometry K1 and K2, and intraoperative implantation size of ICL. The vault was measured by anterior segment optical coherence tomography(AS-OCT)at 1, 3d, 1wk and 1mo after surgery. The patients were divided into insufficient vault group(<250μm, 12 eyes), normal vault group(250-750μm, 62 eyes)and excessive vault group(>750μm, 24 eyes)according to the vault at 1mo after surgery. The factors affecting the postoperative vault were analyzed.RESULTS:The mean vault values at 1 and 3d, 1wk and 1mo after surgery were 591.05±293.44, 599.62±309.78, 592.22±301.49 and 586.69±285.63μm, respectively. There were significant differences in WTW, ACA, ACV, ACD, ICL size and LT at 1mo after surgery(all P<0.05). The regression equation of vault at 1mo after surgery was as follows: vault(μm)=-3142.19+388.25×WTW+10.40×ACA-301.63×LT(R=0.674, R2=0.454, adjusted R2=0.436). WTW had the greatest influence on vault at 1mo after surgery(β=0.47, P<0.001), followed by LT(β=-0.34, P<0.001)and ACA(β=0.17, P=0.047).CONCLUSION:WTW, ACA and LT were the main factors that affected and predicted the vault at 1mo after ICL/TICL V4c implantation.
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AIM: To explore the clinical efficacy of the myopic with moderate to high astigmatism correction between corneal topography-guided femtosecond laser in situ keratomileusis(FS-LAISK)and Toric implantable collamer lens(TICL).METHODS: A total of 60 patients(115 eyes)with moderate to high astigmatism in myopia(115 eyes)from June 2019 to June 2021 and treated in the refractive center of Heyuan Aier Eye Hospital were enrolled in the study, then were divided into Group A and Group B according to the operations they would accept. There were 32 patients(62 eyes)in the Group A treated with corneal topography-guided FS-LASIK and 28 patients(53 eyes)in the Group B treated with TICL implantation. Uncorrected visual acuity(UCVA), best corrected visual acuity(BCVA), spherical diopter and residual astigmatism were recorded preoperatively and postoperatively at 3mo, surgical safety and efficacy were evaluated, and the Alpins vector analysis was used to evaluate the astigmatism.RESULTS: The postoperative at 3mo, there were no differences in the safety index(1.163±0.167 vs 1.136±0.194)and the efficacy index(1.145±0.159 vs 1.123±0.196)between the patients of the two groups(P>0.05). However, the astigmatism vector analysis showed that there were statistically differences in the index of success index [0.125(0.091, 0.200)vs 0.200(0.167, 0.250)], the correction index [1.000(0.902, 1.066)vs 0.834(0.783, 0.869)] and the flattening index [1.000(0.922, 1.079)vs 0.835(0.795, 0.870)](P<0.01).CONCLUSION:Corneal topography-guided FS-LASIK and TICL implantation were effective and safe in correcting myopia with moderate to high astigmatism, and corneal topography-guided FS-LASIK perform better than TICL implantation for the astigmatism correction.
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@#Refractive errors are a common ophthalmic disease, which can be corrected by wearing glasses, laser refractive surgery and so on. However, there are some limitations of these methods for treating high myopia, keratoconus, <i>etc</i>. The implantation of the posterior chamber implantable collamer lens(ICL)is one of the most common surgry for correcting refractive errors(mainly apply to high myopia and astigmatism). This study aim to explore the safety and effectiveness of implanting ICL to correct low to moderate and high myopia or hyperopia. This review will summarize the research progress of implanting ICL to correct refractive errors.
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Objective:To investigate the stability of anterior chamber following implantable collamer lens (ICL) V4c implantation for one year in moderate and high myopic eyes.Methods:An observational case series study was conducted.Medical data of 19 patients (37 eyes) who received ICL V4c implantation in Xuzhou First People's Hospital from March 2016 to October 2017 were collected.The patients were 20 to 29 years old, with the preoperative spherical equivalent (SE) of -5.875 to -15.750 D, with an average of (-9.743±3.220)D.All eyes were followed up for one year, and the changes of visual acuity, SE and intraocular pressure were observed.Pentacam anterior eye segment analyzer was used to measure the anterior chamber depth (ACD), anterior chamber volume (ACV) and anterior chamber angle (ACA) before operation and at 1 month, 6 months and 1 year after operation, and to evaluate the vaults of the ICL V4c at different time points after implantation.This study protocol adhered to the Declaration of Helsinki and was approved by an Ethics Committee of Xuzhou First People's Hospital (No.xxy11[2015]-XJS-004). Written informed consent was obtained from each subject.Results:There were statistically significant differences in visual acuity between before and after operation ( F=5.057, P=0.007), and the one-year postoperative uncorrected visual acuity (UCVA) was significantly better than the best corrected visual acuity (BCVA) before operation ( P<0.05). There were no significant differences in SE and intraocular pressure among different time points ( F=1.294, 1.302; both at P>0.05). There were significant differences in ACD, ACV and ACA among different time points ( F=44.811, 889.971, 196.096; all at P<0.001). ACD, ACV and ACA at 1 month, 6 months and 1 year after operation were significantly lower than those before operation (all at P<0.001). There was a significant difference in the 1-month, 6-month and 1-year postoperative ICL vault ( F=7.256, P=0.001). The ICL vault at 1 year after operation was (433.784±168.550)μm, which was significantly decreased in comparison with (484.860±183.634)μm at 1 month and (464.351±170.167)μm at 6 months after operation ( P=0.006, 0.041). Conclusions:The anterior chamber is stable in one year after ICL V4c implantation, and the UCVA is better than preoperative BCVA.ICL V4c is safe and effective for moderate and high myopia.
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@#AIM:To investigate the relationship between crystalline lens rise(CLR)measured by anterior segment-optical coherence tomography(AS-OCT)and parameters of the anterior segment. And also measure the effects of CLR on the vault after phakic posterior chamber implantable collamer lens(PPC-ICL)implantation.<p>METHODS:The study included 80 eyes of 40 patients who underwent PPC-ICL implantation at the Department of Ophthalmology, the Second Affiliated Hospital of Anhui Medical University, from July 2017 to July 2018, to measure the sulcus-to-sulcus(hSTS)distance of the eyes using a Compact Touch STS ultrasound biomicroscope and lens curvature(LC), Pentacam was used to measure horizontal-white-to-white(hWTW), anterior chamber depth(ACD)and the vault one year after the operation. Moreover, AS-OCT was used to measure the CLR and horizontal iridocorneal angle-to-iridocorneal angle diameter(ATA).<p>RESULTS:CLR was negatively correlated with ACD(<i>r</i>= -0.706, <i>P</i><0.01)and vault one year after the operation(<i>r</i>= -0.509, <i>P</i><0.01); however, it was positively correlated with LC(<i>r</i>=0.667, <i>P</i><0.01). There was no correlation between CLR and hWTW(<i>r</i>=0.123, <i>P</i>=0.275), ATA(<i>r</i>=0.208, <i>P</i>=0.065)and hSTS(<i>r</i>=0.147, <i>P</i>=0.194). One year after the operation, there was a positive correlation between the vault and ACD(<i>r</i>=0.680, <i>P</i><0.01).<p>CONCLUSION:CLR has obvious correlation with ACD and LC, arch height after PPC-ICL and has a specific effect on the prediction of the vault after PPC-ICL implantation.
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@#AIM: To investigate the refractive outcomes and changes of corneal astigmatism and higher-order aberrations(HOAs)after Toric implantable Collamer lens implantation(Toric ICL).<p>METHODS: Prospective nonrandomized clinical trial studies. This study included 102 eyes of 57 patients underwent Toric ICL for myopic astigmatism correction. Uncorrected visual acuity(UCVA), manifest refraction, best spectacle-corrected visual acuity(BSCVA), manifest refractive cylinder, the corneal astigmatism and HOAs were measured preoperatively and up to 6mo after surgery. The vectors were measured using corneal topography, the Pentacam HR system and Wavefront analyzer.<p>RESULTS:Postoperative, the percentage of eyes had a spherical equivalent refraction within -1.00 D were 93.80%. The percentage of eyes within -0.50 D of emmetropia were 85.30%. The percentage of eyes which postoperative UCVA ≥20/25 was 66.30% and the percentage of eyes which postoperative UCVA ≥20/20 was 65.50%. The corneal astigmatism and aberrations preoperatively showed no statistical significance compared with postoperative. The total eyes aberrations and coma resulted in slight changes and had no statistically significant.<p>CONCLUSION:The corneal incision of Toric ICL implantation caused no changes in astigmatism and higher-order wavefront aberrations of cornea.
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@#AIM: To study the clinical changes related to dry eye and evaluate the severity of ocular surface diseases in patients with posterior chamber intraocular lens(ICL)implantation. <p>METHODS: Prospective study. Totally 50 eyes of 50 cases with myopia who were underwent ICL surgery from September 2019 to October 2019. Ocular surface disease index questionnaire(OSDI), fluoresceine staining of cornea tear break up time(TBUT), Schirmer Ⅰ test(SⅠt), and tear meniscus were measured before and 1wk, 1 and 3mo after surgery.<p>RESULTS: The scores of OSDI questionnaire and corneal staining were significantly increased at 1wk and 1mo after operation(<i>P</i><0.05). There was a difference between 3mo and 1wk pastoperatve(χ<sup>2</sup>=5.267,<i>P</i>=0.022), and recovered to the preoperative level at about 3mo. Corneal staining scores were significantly positively correlated with OSDI questionnaire scores at all time points(<i>r<sub>s</sub></i>>0, <i>P</i><0.05). TBUT decreased significantly at 1wk and 1mo after operation(<i>P</i><0.05), and returned to the preoperative level 3mo after operation. There was no significant difference in the basal tear volume(SⅠt)and the height of lacrimal river in the middle of lower eyelid between before and after operation(<i>P</i>>0.05). <p>CONCLUSION: The stability of tear film on the ocular surface will be affected by ICL implantation in the early postoperative period, and the patients will have different degrees of dry eye related symptoms. OSDI questionnaire score can be used to evaluate their subjective discomfort symptoms. However, at 3mo after operation, the stability of tear film on the surface of eyes recovered to the preoperative level. The higher the positive score of corneal staining was, the more obvious the subjective discomfort was.
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@#AIM: To compare the change of anterior chamber angle(ACA)and vault value before and after implantable collamer lens(ICL)in two implant positions.<p>METHODS: Randomized controlled study. A total of 83 patients(154 eyes)underwent ICL(V4c, 12.6mm)surgery from 2018 to 2019 were enrolled and divided into two randomly, including into horizontal group(79 eyes)and into vertical group(75 eyes). Pentacam was used to measure the ACA at 0°, 90°, 180°, 270° points before and after implantation and the ACA changes were calculated.<p>RESULTS: After 12mo, the changes of ACA at 0°, 90°, 180°, 270° position were 15.3°±6.1°, 13.9°±6.3°, 16.5°±5.5° and 12.9°±6.0° in horizontal group while 12.9°±3.7°, 14.5°±6.8°, 14.3°±5.4° and 13.2°±5.9° in vertical group. There was a significant difference in ACA change at 0°-180° position between the two groups(<i>P</i><0.05). The vault value was 486±183μm, 422±203μm, 393±198μm and 345±165μm in the horizontal group and 432±163μm, 418±138μm, 379±133μm and 328±142μm in the vertical group at 1, 3, 6 and 12mo respectively. The vault value of the horizontal group at 1mo was significantly different from that at 6mo and 12mo after implantation(<i>P</i>>0.05). The vault value of the vertical group at 1mo was significantly different from that at 6mo and 12mo after implantation(<i>P</i><0.05).<p>CONCLUSION: During one year after ICL implantation, the ACA changes significantly in horizontal setting than in vertical setting at 0° to 180° points and there is a dynamic decreasing change in vault value.
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@#AIM: To analyze the correlation and agreement of corneal horizontal diameter(WTW)measured with caliper, IOL Master and Oculyzer anterior segment analysis system.<p>METHODS: Totally 41 patients with 80 eyes who underwent ICL V4c implantation in our hospital from July 2018 to January 2019 were enrolled. Compare the correlation and agreement of preoperative WTW measured with caliper, IOL Master and Oculyzer anterior segment analysis system respectively.<p>RESULTS: The mean WTW value measured with caliper, IOL Master and Oculyzer anterior segment analysis system were: 11.73±0.40, 12.03±0.46, 11.54±0.39mm respectively, the value of caliper and IOL Master, caliper and Oculyzer, IOL Master and Oculyzer were highly correlated(<i>r</i>=0.809, 0.826, 0.785, all <i>P</i><0.01), and the 95% <i>LoA</i> of Bland-Altman analysis were(-0.84, 0.22),(-0.27, 0.64),(-0.07, 1.05)mm respectively.<p>CONCLUSION: Among the three measuring instruments, IOL Master has the largest measurement value and Oculyzer is the smallest. The three measurement methods have poor consistency and cannot be replaced in clinical application. Whereas, their measurements are highly correlated. In clinical application, the measurements of IOL Master and Oculyzer can be corrected based on the difference with caliper.
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@#AIM: To observe the changes of anterior chamber angle after posterior chamber intraocular lens(ICL)V4c implantation for high myopia.<p>METHODS: Prospective study. ICL V4c implantation was performed on 150 cases(300 eyes)with high myopia, and the changes of visual acuity, intraocular pressure,vault and anterior chamber angle were recorded before and 1d, 1mo, 3mo, 6mo and 1a after operation. Repeated measurement analysis of variance and LSD-<i>t</i> test were used to analyze the data.<p>RESULTS: After 1d, 1mo, 3mo, 6mo, 1a operation, the recovery of UCVA was significantly higher than that before operation(<i>F</i>=98.2, <i>P</i><0.01); there were statistically significant differences in AOD500, AOD750, TISA500, TISA750 and SSA of nasal side before and after operation(<i>F</i>=108.256, 112.342, 164.856, 316.549, 115.338, <i>P</i><0.01); there were statistically significant differences in AOD500, AOD750, TISA500, TISA750 and SSA of temporal side before and after operation(<i>F</i>=102.68, 548.47, 93.37, 316.549, 117.698, all <i>P</i><0.01); the parameters of each angle decreased gradually in the 1d, 1mo and 3mo after operation on both sides, and there was statistical difference in the two comparisons(all <i>P</i><0.05), but there was no statistical significance in the parameters of each angle in the 3mo, 6mo and 1a after operation(all <i>P</i>>0.05).<p>CONCLUSION: After ICL V4c implantation, the anterior chamber angle parameters in the horizontal direction of 1d, 1mo, 3mo, 6mo and 1a were smaller than those before operation, and tended to be stable after 3mo.
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@#AIM: To evaluate the early objective visual quality and vision related quality of life after implantation of posterior chamber phakic implantable collamer lens with a central hole(ICL V4c)for high myopia by applying the double-pass optical quality analysis system Ⅱ(OQAS Ⅱ)and life quality questionnaire.<p>METHODS: Totally 26 patients(44 eyes)with high myopia were enrolled in this research. The patients were all recieved ICL V4c implantation by the same surgeon in our hospital. The evaluation items included uncorrected visual acuity(UCVA), best corrected visual acuity(BCVA), intraocular pressure, corneal endothelial cell density(ECD), vault, objective scattering index(OSI), modulation transfer function cut off frequency(MTF cut off), Strehl ratio(SR), predicted visual acuity values(OV 100%, OV 20%, OV 9%)at contrasts of 100%, 20%and 9% and vision related quality of life questionnaire. All measurements were performed preoperative and 1wk, 1mo, 3mo postoperatively.<p>RESULTS: Compared with preoperative BCVA, for the high myopia patients, the 1wk, 1mo and 3mo UCVA postoperative were better at all time points, and the differences were statistically significant(<i>P</i><0.001). Postoperative 1wk intraocular pressure was higher than that in preoperative and postoperative 1mo and 3mo(<i>P</i><0.05). Postoperative corneal endothelial cell counts at all time points were lower than that in preoperative(<i>P</i><0.05), but all within the normal range. No significant difference was found in vault(<i>P</i>=0.790). Compared with preoperative OSI, MTF cut off, SR, OV 100%, OV 20% and OV 9%, the situation improved at postoperative 1wk, 1mo and 3mo, with statistical significance(<i>P</i><0.001). The vision related quality of life questionnaire showed that all patients had high satisfaction in the good subjective visual acuity after operation.<p>CONCLUSION: ICL V4c implantation is safe and effective in correcting high myopia. The objective visual quality and vision related quality of life of patients with high myopia was significantly improved after ICL V4c implantation in the early stage. The research laid a foundation for the establishment of “the comprehensive evaluation system of subjective and objective combination” of ICL in the application of high myopia.
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@#AIM: To evaluate the early objective visual quality and vision related quality of life after implantation of posterior chamber phakic implantable collamer lens with a central hole(ICL V4c)for high myopia by applying the double-pass optical quality analysis system Ⅱ(OQAS Ⅱ)and life quality questionnaire.<p>METHODS: Totally 26 patients(44 eyes)with high myopia were enrolled in this research. The patients were all recieved ICL V4c implantation by the same surgeon in our hospital. The evaluation items included uncorrected visual acuity(UCVA), best corrected visual acuity(BCVA), intraocular pressure, corneal endothelial cell density(ECD), vault, objective scattering index(OSI), modulation transfer function cut off frequency(MTF cut off), Strehl ratio(SR), predicted visual acuity values(OV 100%, OV 20%, OV 9%)at contrasts of 100%, 20%and 9% and vision related quality of life questionnaire. All measurements were performed preoperative and 1wk, 1mo, 3mo postoperatively.<p>RESULTS: Compared with preoperative BCVA, for the high myopia patients, the 1wk, 1mo and 3mo UCVA postoperative were better at all time points, and the differences were statistically significant(<i>P</i><0.001). Postoperative 1wk intraocular pressure was higher than that in preoperative and postoperative 1mo and 3mo(<i>P</i><0.05). Postoperative corneal endothelial cell counts at all time points were lower than that in preoperative(<i>P</i><0.05), but all within the normal range. No significant difference was found in vault(<i>P</i>=0.790). Compared with preoperative OSI, MTF cut off, SR, OV 100%, OV 20% and OV 9%, the situation improved at postoperative 1wk, 1mo and 3mo, with statistical significance(<i>P</i><0.001). The vision related quality of life questionnaire showed that all patients had high satisfaction in the good subjective visual acuity after operation.<p>CONCLUSION: ICL V4c implantation is safe and effective in correcting high myopia. The objective visual quality and vision related quality of life of patients with high myopia was significantly improved after ICL V4c implantation in the early stage. The research laid a foundation for the establishment of “the comprehensive evaluation system of subjective and objective combination” of ICL in the application of high myopia.