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AIM: To evaluate the binocular visual function in high myopia patients after the implantation of implantable collamer lens(ICL)V4c.METHODS: A total of 35 cases(70 eyes)that received binocular ICL implantation at our hospital from May 2019 to May 2021 were enrolled in this prospective study. Binocular full-range visual acuity, contrast sensitivity, stereopsis, mesopic vision and glare sensitivity, and monocular wavefront and the quality of vision questionnaire were assessed before the surgery and at 1 mo postoperatively.RESULTS: At 1 mo postoperatively, 35 cases(100%)had binocular uncorrected distance visual acuity(UDVA)≤0.00(LogMAR), 16 cases(46%)had binocular UDVA≥preoperative corrected distance visual acuity(CDVA). Binocular UDVA and uncorrected intermediate visual acuity(UIVA,80 cm)were improved compared to preoperative CDVA and distance-corrected intermediate visual acuity(DCIVA,80 cm)(all P<0.05).While there were no differences in the binocular postoperative UIVA(60 cm)and preoperative DCIVA(60 cm),and uncorrected near visual acuity(UNVA,40 cm)and preoperative distance-corrected near visual acuity(DCNVA,40 cm)(all P>0.05). The binocular contrast sensitivity was significantly improved postoperatively(P=0.001), and the postoperative binocular mesopic vision, glare sensitivity(no glare/glare)and binocular stereopsis(5 m/40 cm)had no differences(all P>0.05). The postoperative total higher-order aberration, trefoil aberration, coma and spherical aberration were increased, besides the median of total coma in the right eye with a pupil diameter of 3.0 mm was decreased after surgery. The mean total score of quality of vision questionnaire was significantly increased from 54.87 preoperatively to 80.92 after implantation(P<0.05), with high satisfaction and no obvious visual disturbance in patients.CONCLUSION: Although the monocular high-order aberrations increased in the early stage after ICL V4c binocular implantation in patients with high myopia, the binocular visual function was improved.
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AIM: To study the early outcomes of anterior segment parameters after implantation of an implantable collamer lens with a central hole(ICL V4c)in patients with high myopia.METHODS:A total of 82 cases(160 eyes)with high myopia, including 42 males(82 eyes)and 40 females(78 eyes), aged 26.0±4.6(21 to 37)years, who underwent ICL V4c implantation at our institution from February 2019 to September 2022 and were followed up for 1 a, were included. The general characteristics of the anterior segment of the eye were measured preoperatively: spherical equivalent, mean horizontal corneal curvature, white-to-white(WTW), and axial length(AL); intraocular pressure(IOP), endothelial cell density(ECD), central anterior chamber depth(CACD), anterior chamber volume(ACV)and anterior chamber angle(ACA)were measured preoperatively and at 1 d, 1 wk, 1, 3 and 6 mo postoperatively. Furthermore, the distance from the centre of the posterior surface of the ICL V4c optical zone to the anterior surface of the lens(vault)was measured at 1 d, 1 wk, 1, 6 mo, and 1 a after surgery.RESULTS: The mean preoperative spherical equivalent of the patients was -7.56±2.55 D, mean horizontal corneal curvature was 42.89±1.47 D, WTW was 11.64±0.37 mm, and AL was 26.64±0.93 mm. The baseline IOP was 15.97±2.13 mmHg, and the differences in IOP at each time point after ICL V4c implantation compared to preoperative were not statistically significant(F=0.875, P=0.504); ECD was 2 989.30±140.78 cells/mm2 at baseline, and ECD at 6 mo after ICL V4c implantation was not statistically significant compared with preoperative ECD(t=1.475, P=0.142); CACD was 3.19±0.21 mm at baseline, and ACV was 210.30±27.7 mm3, and CACD and ACV were significantly lower than preoperative at all postoperative time points(F=111.10, 288.38, all P<0.001). The baseline ACA was 35.44°±11.27°, and the ACA at each time point after ICL V4c implantation was significantly lower than preoperatively(F=21.23, P<0.001). The vault was 665.32±184.03 μm at 1 d postoperatively, and continued to be significantly reduced at 1 wk, 1, 6 mo, and 1 a postoperatively compared with 1 d(F=52.10, P<0.001). However, it remained stable at 6 mo and 1 a postoperatively, and the difference was not statistically significant compared with vault at 1 mo postoperatively(P>0.05).CONCLUSION: ICL V4c has certain safety and efficiency in 1 a postoperative follow-up, and the parameters of the anterior segment of the eye stabilized in the early period.
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@#AIM: To compare the differences of corneal diameter measured with wavelight anterior segment analyzer(Wavelight),IOL-master optical bio-measurement(LS900), anterior segment OCT(AS-OCT)and gauge.<p>METHODS: Totally 89 patients(177 eyes)with myopia who want to accept ICL were examined before operation with more than five kinds of instruments respectively, white to white(WTW)were examined with Wavelight, IOL-master, LS900 and gauge, angle to angle(ATA)with AS-OCT. Then the size of ICL was calculated based on the value of gauge. The vault of ICL was examined with OCT 3mo after operation.<p>RESULTS: WTW was(12.45±0.73, 11.96±0.39, 11.92±0.36, 11.49±0.30)mm measured by Wavelight, IOL-Master, LS900 and gauge respectively, ATA was(11.80±0.44)mm with AS-OCT. The value of gauge was the smallest one among them(all <i>P</i><0.01). Among four instruments, there was no statistical difference between LS900 and AS-OCT(<i>P</i>=0.098), they can instead of each other; there were differences among other instruments(<i>P</i><0.01). The size of ICL based on gauge was(12.77±0.37)mm. The vault of ICL is(537.41±181.22)μm 3mo after implantation obtained by OCT.<p>CONCLUSION: Gauge is ideal tool for measuring corneal diameter, it cannot be instead. Wavelight, IOL Master, LS900 and AS-OCT can be taken as reference.
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@#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 investigate the stability of ICL V4c for moderate and high myopia and its effect on high order aberrations.<p>METHODS: The differences of uncorrected visual acuity(UCVA), best corrected visual acuity(BCVA), spherical equivalent(SE), cylinder equivalent(CE), intraocular pressure(IOP), corneal endothelial cell count, total high order aberration(RMS), spherical aberration, vertical coma, horizontal coma, coma were compared among high myopia patients who treated with ICL V4c intraocular lens implantation(research group: 17 cases, 34 eyes)and femtosecond small incision matrix lens extraction(SMILE)(control group: 18 cases, 34 eyes)before operation(T0), 1d after operation(T1), 1wk after operation(T2), 1mo after operation(T3), 3mo after operation(T4)respectively.<p>RESULTS: SE and CE in research group were higher than those in control group at T3-T4(<i>P</i><0.05), RMS of higher order aberration and coma at T2-T4 were lower than those in control group(<i>P</i><0.05), spherical aberration and horizontal coma at T4 were lower than those in control group(<i>P</i><0.05).<p>CONCLUSION: ICL V4c implantation is stable in the correction of moderate and high myopia, and has little effect on high order aberration.
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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.
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·AIM: To evaluate the effectiveness of visian implantable collamer lens with central hole (ICL V4c) implantation for the correction of high myopia using the double- pass visual quality analysis system. ·METHODS: Totally 60 eyes of 30 high myopia patients who underwent ICL V4c implantation were enrolled into this prospective randomized control study. Myopic degree of selected patients was -6. 0D to -12. 0D, age 18 to 35 years old, best corrected visual acuity ( BCVA ) ≥0. 6, preoperative corneal astigmatism acuities ≤1. 0D. All patients were taken the temporal side transparent corneal incision. The patients were evaluated postoperatively 1wk, 1 and 3mo respectively. The evaluating items included preoperative BCVA, postoperative uncorrected visual acuity ( UCVA), objective scattering index ( OSI), and modulation transfer function ( MTF ) cut off frequency, Strehl ratio (SR), and 100%, 20%, 9% Optical Quality Analysis System ( OQAS ) Value ( OV, contrast visual acuity ). All statistical analyses were performed with SPSS19. 0 statistical software. Variance analysis of repeated measurement data was employed. ·RESULTS: The UCVA gradually improved at 1wk, 1 and 3mo after surgery. There was statistical significance compared with the preoperative BCVA ( P < 0. 01 ). The postoperative OSI, MTF cut off, SR, OV 100%, OV 20% and OV 9% at 1wk, 1 and 3mo showed statistically differences compared with the preoperative values (P<0. 05). ·CONCLUSION: ICL V4c implantation can effectively correct high myopia range from -6. 0D to -12. 0D. The postoperative OSI were smaller than the preoperative OSI. The postoperative UCVA were better than the preoperative BCVA. The value of postoperative MTF cut off, SR, and OV value of 100% , 20% and 9% improved.