Long-term assessment of crystalline lens transparency in eyes implanted with a central-hole phakic collamer lens developing low postoperative vault

Abstract

Purpose: To assess long-term crystalline lens transparency in eyes implanted with phakic collamer intraocular lens (pIOL) with a central port and low postoperative vault for correction of myopia. Setting: Clinica Baviera, Madrid, Spain. Design: Retrospective cross-sectional single-center study. Methods: Using a noninvasive Fourier-domain swept-source anterior segment optical coherence tomography system, shifts in myopic and astigmatic myopic eyes implanted with a pIOL with vaulting lower than 100 μm in miosis and more than 4 years of follow-up were dynamically evaluated. Main outcome measures were pIOL dynamic vault (vault interval and vault range [VR]), crystalline lens density, and anterior subcapsular lens opacities. Crystalline lenses were examined under slitlamp microscopy, and lens density was evaluated using quantitative Scheimpflug images. Scheimpflug images were compared with those of a control group comprising eyes that were candidates for pIOL implantation. Results: The study population comprised 24 eyes from 16 patients previously implanted with a pIOL (5.82 ± 0.9 years) with central vault lower than 100 μm under photopically induced miosis. The mean vault value was 52 ± 19 µm under photopic light conditions and 113 ± 37 µm under scotopic conditions. The mean VR was 58 ± 24 μm. Anterior subcapsular lens opacities were found in only 1 eye (4.17%). The mean lens density was 7.94 ± 0.43, and no statistically significant differences were observed compared with the control group. Conclusions: Long-term low vaulting in eyes implanted with a pIOL with a central port for correction of myopia was associated with a low risk for developing anterior crystalline lens opacities.

Seven-year follow-up of posterior chamber phakic intraocular lens with central port design

“…Nakamura et al [16] reported that 10.5% of the eyes developed an anterior cataract during the 5-to 10-year follow-up period. The prevalence of cataracts after ICL V4c implantation has been reported to be around 0.17% [1], however, the longest follow-up studies published to date only reached a maximum of 5 years follow-up [6][7][8]. In this study, extending the follow-up to 7 years, we did not find cataract formation in any cases.…”

“…Compared to the previous ICL models, the incidence of reported complications has significantly decreased with the V4c model [1,4]. For example, the reported incidence of cataracts, which is the most common and significant complication with the previous model [4], has been reduced to almost 0 with the V4c model [1,5], even for those cases with a low vault [6]. These findings support the idea that aqueous humour flow through the central hole of the lens maintains the normal physiology of the anterior segment of the eye, preventing potential complications.…”

“…These findings support the idea that aqueous humour flow through the central hole of the lens maintains the normal physiology of the anterior segment of the eye, preventing potential complications. However, it should be noted there have been only a few long-term studies (spanning more than 3 years) [6][7][8][9][10][11] on the clinical outcomes of the V4c ICL implantation, and only three studies reached 5-years follow-up [6][7][8]. In contrast, several of the long-term studies (spanning more than 5 years) of the previous ICL design have been published [12][13][14][15][16][17][18][19].…”

Development of a Web-Based Ensemble Machine Learning Application to Select the Optimal Size of Posterior Chamber Phakic Intraocular Lens

“… 4 Implantation of a recently developed ICL with a center hole (aquaport) was reported to have a low risk of anterior subcapsular cataract and angle-closure glaucoma. 5 However, it is associated with several other complications, such as increased intraocular pressure, abnormal pupil size, or lens dislocation. In cases with severe complications, ICL exchange or removal can be indicated.…”

Dynamic assessment of variations in pupil diameter using swept-source anterior segment optical coherence tomography after phakic collamer lens implantation

“…Advances in myopic lens design in 2011 with the development of a central port measuring 0.36 mm in diameter (ICMV4c model) have simplified surgery and reduced postoperative complications, such as pupillary block and the formation of anterior subcapsular cataracts [ 1 , 4 – 7 ]. However, in some cases, dysphotopsia, understood as an unwanted image that patients perceive after posterior chamber phakic intraocular lens (pIOL) surgery, may remain.…”