Safety of the Minimum Ophthalmic Viscosurgical Device Technique in Phakic Implantable Collamer Lens Implantation

Abstract

PURPOSE: To compare the safety of the minimum ophthalmic viscosurgical device (OVD) technique with the standard procedure in phakic Visian Implantable Collamer Lens (ICL) (STAAR Surgical AG, Nidau, Switzerland) implantation. METHODS: This retrospective cohort study evaluated a total of 147 eyes of 74 patients who underwent ICL implantation with the minimum OVD technique (minimum OVD group) and 154 eyes of 77 patients with the standard procedure (standard OVD group). Intraoperative and postoperative complications were recorded. Preoperative and postoperative visual acuity, intraocular pressure (IOP), aqueous depth (AQD), and central corneal endothelial cell density (ECD) were collected and analyzed over the 12-month follow-up. Lens vault and occurrence of paracentesis after surgery were also recorded. RESULTS: No intraocular complications were observed. No difference was found in visual outcomes, lens vault, and AQD at all time points between the two groups ( P > .05). The minimum OVD group had significantly lower IOP than the standard OVD group at 2 hours (17.04 ± 4.21 vs 19.40 ± 6.78 mm Hg, P < .001) and 3 hours (15.12 ± 3.38 vs 17.15 ± 5.09 mm Hg, P < .001) postoperatively. The IOP gradually returned to the preoperative level after 24 hours postoperatively. The occurrence rate of paracentesis was significantly less in the minimum OVD group compared with the standard group (0.68% [1 of 147] vs 3.2% [5 of 154], P < .001). ECD was not significantly different between groups at all time points ( P > .05). CONCLUSIONS: The minimum OVD technique could achieve visual and structural outcomes comparable to the standard procedure without additional damage to the corneal endothelial cells, while reducing the IOP fluctuations after surgery. [ J Refract Surg. 2020;36(1):42–48.]

One-year Observation of Safety of Implantable Collamer Lens V4c Implantation Without Using an Ophthalmic Viscosurgical Device

“…The average change in ECD in Chen et al's. ( 12 ) study of the minimum OVD method was −42 cell/mm 2 . In Kamiya et al's.…”

“…( 14 ) work gained one and two lines of CDVA, respectively, and the UDVA of 97% eyes reached 20/20 or more. In the 12-month studies of ICL V4c implantation with minimum OVD, Chen et al ( 12 ) followed 147 eyes, and the UDVA of 88% eyes was 20/20 or more. And 80 and 98% of eyes were within ±0.50 D and ±1.00 D of target refraction.…”

“…However, OVD shortcomings may also appear in clinical practice, including prolonged surgery duration, increased number of surgical steps, and increased rate of OVD-related complications such as anterior capsule cataract and pupillary block glaucoma (7)(8)(9)(10). After decades of development, some surgeons have begun trying to decrease the usage of OVD in ICL implantation, and the established works have proven the safety of this method (11,12). Hence, it is worthwhile to investigate the possibility of ICL implantation without any OVDs.…”

Safety of EVO ICL Implantation With an Ophthalmic Viscosurgical Device-Free Technique in the Early 24 h After Surgery

“…Chen et al inserted an ICL by making a two-step corneal incision and used BSS instead of OVD. In addition, OVD is still needed when adjusting the ICL position ( 21 ). Peng et al ( 23 ) described a technique using BSS to load the ICL and maintain the anterior chamber.…”

“…The min-OVD technique has been applied by experienced surgeons in recent years ( 20 , 21 ). The application of this technique can greatly reduce the occurrence of high IOP after surgery, and postoperative recovery is rapid.…”