Posterior vitreous detachment and retinal detachment after implantation of the visian phakic implantable collamer lens

Abstract

Introduction:To evaluate the vitreoretinal complications in myopes after Visian implantable collamer lenses (ICL) implantation.Materials and Methods:This is a retrospective, observational, non-comparative clinical study that evaluated 617 consecutive myopes who underwent ICL implantation at the Department of Refractive Surgery, Yemen Magrabi Hospital, Sana’a, Yemen between July 2006 and May 2010. Follow up ranged from 6 months to 40 months. Preoperative and postoperative patient evaluation included manifest and cycloplegic refractions, uncorrected (UCVA) and best spectacle-corrected visual acuity (BSCVA), slit-lamp biomicroscopy, intraocular pressure and dilated retinal examination. Investigations included corneal topography, central corneal thickness, anterior chamber depth and white to white diameter. Retinal diseases and complications were recorded and analyzed preoperatively and postoperatively.Results:Preoperatively, 61 (9.9%) eyes had posterior segment pathology requiring prophylactic laser photocoagulation. One eye developed spontaneous rhegmatogenous retinal detachment (RRD), one eye developed traumatic retinal detachment and two eyes required laser treatment postoperatively. The overall retinal detachment rate post-ICL was 0.32%.Conclusions:Posterior segment complications are rare after ICL implantation but dilated vitreoretinal assessment is important before and after the procedure. Patients with suspicious retinal lesions need a comprehensive vitreoretinal evaluation by a retinal specialist. If a patient develops floaters or blurry vision he/she requires further assessment by a vitreoretinal specialist.

Refractive Outcomes of Posterior Chamber Phakic Intraocular Lens Implantation for Correction of Myopia and Myopic Astigmatism

“…In a large study Bamashmu ( 13 ) reports 9.9% (61 of 617) eyes required prophylactic laser photocoagulation, with development of one spontaneous rhegmatogenous detachment and one traumatic, which is 0,32% in follow-up up to 40 months. Percentage of posterior segment complications in our study can hardly be compared to Bamashmu ( 13 ) due to much higher number of patients. Patients with high degenerative myopia must undertake prophylactic treatment and even then, there is still a risk of retinal detachment.…”

Assessing oxygen saturation in retinal vessels in high myopia patients pre‐ and post‐implantable collamer lens implantation surgery

“…Firstly, structural abnormalities in high myopia eyes put patients at a high risk for vision-threatening complications (Fig. 2), and sensitive to the ocular perfusion and pressure changes (Bamashmus et al 2012;Jonas & Xu 2014). In these patients, ICL implantation could temporarily destabilize ocular perfusion and pressure during the surgery, thereby decreasing the oxygen delivery to the retina, despite that ICL is a mini-invasive surgical procedure.…”

“…; Bamashmus et al. ; Jonas & Xu ). Impaired retinal microcirculation might involve in this pathological phenomenon.…”

“…High myopic eyes show fundus degeneration that has inherently increased risk for vitreoretinal complications, regardless of any surgical procedure (Akyol et al 1996;Bamashmus et al 2012;Jonas & Xu 2014). Impaired retinal microcirculation might involve in this pathological phenomenon.…”

Vitrector induced lens injury during peripheral iridectomy in implantable collamer lens surgery

“…Faster visual recovery, stability of visual quality, preservation of accommodation, and reversibility 4 . However, the safety of ICL implantation has been questioned due to potential complications, such as cataract formation 5 , trauma to the crystalline lens 3 glaucoma, corneal endothelial decompensation 6 and retinal detachment 7 …”