Anterior subcapsular cataract caused by forceful irrigation during implantation of a posterior chamber phakic intraocular lens with a central hole

Steinwender, Gernot; Varna-Tigka, Kleopatra; Shajari, Mehdi; Kohnen, Thomas

doi:10.1016/j.jcrs.2017.03.045

Cited by 24 publications

(10 citation statements)

References 15 publications

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“…surgical procedure-related factors, such as the learning curve and the required skill, which are essential) or an inappropriate ICL vault. Cases of anterior subcapsular cataract due to the irrigation technique have been reported (Steinwender et al 2017). Surgeons should avoid causing trauma to the crystalline lens during ICL implantation.…”

Section: Adverse Events/complicationsmentioning

confidence: 99%

Posterior‐chamber phakic implantable collamer lenses with a central port: a review

Montés‐Micó

Ruíz-Mesa

Rodríguez‐Prats

et al. 2020

Acta Ophthalmologica

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We aimed to summarize the outcomes reported following the implantation of the V4c implantable collamer lens with a central port (ICL, STAAR Surgical Inc) for myopia correction. A literature search in PubMed, Web of Science and Scopus was carried out to identify publications reporting clinical outcomes of patients who were implanted with the V4c ICL model and had a follow-up period of at least 6 months. A total of 35 clinical studies published between 2012 and 2020 were included in the present review. A comprehensive analysis of the available data was performed, focusing on visual and refractive outcomes at different time-points post-surgery. In addition, adverse events and other parameters such as endothelial cell density, intraocular pressure and vault measurements-which were evaluated in some of the studies-were also compared. This review encompassed a total of 2904 eyes. The outcomes reported in this review lead us to conclude that ICL V4c implantation for myopia correction is a safe and efficient procedure, with stable visual and refractive outcomes and low adverse event rates. The patient's anterior segment should be thoroughly characterized, and the ICL parameters should be carefully selected so as to achieve good outcomes and avoid complications.

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Section: Adverse Events/complicationsmentioning

confidence: 99%

Posterior‐chamber phakic implantable collamer lenses with a central port: a review

Montés‐Micó

Ruíz-Mesa

Rodríguez‐Prats

et al. 2020

Acta Ophthalmologica

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“…Steinwender et al reported cataract in eleven eyes of eight patients in the immediate postoperative period as a result of an irrigation technique, “… producing an enforced stream through the pIOL hole onto the lens capsule …” The authors noted that “after changing surgical technique to very gentle irrigation and keeping the cannula near the main incision, more than 90 pIOL implantations were performed in the clinic during a follow-up of 14 months, with no further case of anterior subcapsular cataract occurring.”37 We have therefore attributed these events to the surgical technique and not to the EVO ICL and have not included these events in the overall rates reported in this review. This report highlights the importance of avoiding operative trauma to the crystalline lens during implantation.…”

Section: Introductionmentioning

confidence: 99%

The Implantable Collamer Lens with a central port: review of the literature

Packer¹

2018

OPTH

144

110

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The purpose of this review is to summarize preclinical and clinical data from publications appearing in the peer-reviewed scientific literature relevant to the safety and effectiveness of the EVO Implantable Collamer Lens (ICL) posterior chamber phakic refractive lens with a central port (V4c Visian ICL with KS Aquaport, STAAR Surgical, Inc.). A literature search was conducted using PubMed.gov to identify all articles relating to the EVO ICL. Articles were examined for their relevance, and the references cited in each article were also searched for additional relevant publications. On the basis of a total of 67 preclinical studies and clinical reports, including effectiveness data on 1,905 eyes with average weighted follow-up of 12.5 months and safety data on 4,196 eyes with weighted average follow up of 14.0 months, the EVO ICL is safe and effective for the correction of a broad range of refractive errors. High levels of postoperative uncorrected visual acuity, refractive predictability, and stability demonstrate the effectiveness of the EVO ICL. Safety data suggest reduced rates of anterior subcapsular cataract and pupillary block compared with earlier models. Improved safety and proven effectiveness make EVO an attractive option for surgeons and patients.

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“…The suction hole was vigorously directed toward the central hole during irrigation and aspiration, and we thought that the ASC was caused by the contact of the anterior surface of the lens with the posterior surface of the ICL during aspiration. Steinwender et al 20 reported similar cases and noted that after changing the surgical technique to a very gentle irrigation and keeping the cannula near the main incision, more than 90 phakic IOL implantations were performed in the clinic during a follow-up period of 14 months, with no further occurrence of ASC. This may imply that ASC can easily occur by mechanical contact with the lens in older patients, since no ASCs have been observed in young patients using this technique.…”

Section: Discussionmentioning

confidence: 94%

Multicenter clinical outcomes of hole implantable collamer lens implantation in middle-aged patients

Igarashi

Kamiya

Ichikawa

et al. 2022

Sci Rep

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To assess the multicenter clinical outcomes of the implantation of hole implantable collamer lens (Hole ICL, ICL KS-AquaPORTTM; STAAR Surgical, Nidau, Switzerland) in patients of 45 years or more. We retrospectively assessed the surgery’s safety, efficacy, predictability, stability, and adverse events before surgery and after the surgery at 1 week; 1, 3, and 6 months; and 1 year, followed by once every year for approximately 2.2 years. A total of 118 eyes of 65 patients aged 45–65 years with myopic refractive errors ranging from − 2.13 to − 18.75 diopters (D) underwent hole ICL implantation and routine postoperative examinations. The average observation period was 2.2 ± 1.0 years. The safety and efficacy indices were 1.08 ± 0.21 and 0.87 ± 0.25, respectively. Manifest refraction changes of − 0.20 ± 0.43 D occurred from 1 month to the final visit after ICL implantation. Eight eyes (6.8%) developed asymptomatic anterior subcapsular cataract (ASC) immediately after surgery, and three eyes (2.5%) developed clinically significant symptomatic nuclear cataracts during the follow-up period. According to our experience, hole ICL implantation offered favorable outcomes in all measures of safety, efficacy, predictability, and stability, even in middle-aged patients, during the 2.2-year observation period.

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Anterior subcapsular cataract caused by forceful irrigation during implantation of a posterior chamber phakic intraocular lens with a central hole

Abstract: Anterior subcapsular cataract was induced during implantation of a pIOL with a central hole by cannula irrigation with enforced stream onto the capsule through that hole. This entity can be avoided by a change in surgical technique.

Cited by 24 publications

References 15 publications

Posterior‐chamber phakic implantable collamer lenses with a central port: a review

Posterior‐chamber phakic implantable collamer lenses with a central port: a review

The Implantable Collamer Lens with a central port: review of the literature

Multicenter clinical outcomes of hole implantable collamer lens implantation in middle-aged patients

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