Visual outcomes of Visian ICL implantation for high myopia in patients with shallow anterior chamber depth

Abstract

Background: High myopia with shallow anterior chamber depth (ACD less than 2.8 mm) is not rare. This observational study aims to evaluate visual outcomes after implantation of the Visian Implantable Collamer Lens with a central hole (ICL V4c) in these patients. Methods: A prospective cohort of consecutive 51 eyes of 31 patients (20 to 42 years old) was followed for at least 12 months (average 15.35 ± 4.90 months, rangers from 12 to 25 months). The preoperative ACD was 2.74 ± 0.04 mm (2.65 to 2.79 mm). Uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), intraocular pressure (IOP), manifest refraction, vault, and endothelial cell density (ECD) were measured during the follow-ups after surgery. Results: All surgeries were performed safely and no complication was observed during the follow-up. At the last follow-up, the safety index (postoperative CDVA / preoperative CDVA) was 1.33 ± 0.60 and the efficacy index (postoperative UDVA / preoperative CDVA) was 1.14 ± 0.54. After the surgery, no eye had decreased CDVA and 59% (30 eyes) of the eyes gained at least one line. Forty-seven eyes (92%) were within ± 1.0 D and 35 eyes (69%) were within ± 0.5 D of the attempted refraction. The mean postoperative vault was 380.00 ± 152.84 µm (90 to 700µm). The ECD was reduced by 8.38 ± 0.06% as compared to the preoperative value (p < 0.001). No significant change was observed in IOP (p = 0.061) at the last follow-up. Ultrasound Biomicroscopy (UBM) showed none of the eyes had trabecular-iris angle closed. Conclusions: In this prospective observational study, ICL V4c implantation in patients with high myopia and shallow ACD achieved satisfying and stable visual outcomes. Its long-term safety and stability require further investigation. Trial Registration: This trial was retrospectively registered on 05/08/2018 under the number (ChiCTR1800017594)

Posterior-Chamber Phakic Intraocular Lens Implantation in Patients over 40 Years of Age

“…Our mean ECD at 1 year showed no statistically significant differences with their corresponding preoperative values (2516 ± 234 vs. 2568 ± 332 cells/mm 2 , p =0.29). These mean values were similar to those found in previous studies, which ranged from 2512 [ 8 ] to 2963 [ 11 ] cells/mm 2 . The percentage loss in our sample amounted to 2.04%, whereas in previous studies it was rather diverse, ranging from 1.7% [ 5 ] to 9.0% [ 7 ].…”

“…If we focus now on predictability, we can consider these procedures to be successful, since 90.6% and 93.9% of the eyes were within the ±0.50 and ± 1.00 D range of postoperative refractive error, respectively. Both values were also comparable and sometimes better (versus Ganesh et al [7], García-de-la-Rosa et al [10], and Niu et al [11]) than those found in previous studies (see Table 3). Similarly, SE was also good, being below a quarter of diopter (−0.09 ± 0.47D).…”

“…e search was limited to publications written in English. e date of the last electronic search was March 24, 2020. e literature search based on these criteria resulted in 8 relevant contributions being considered [5][6][7][8][9][10][11][12]. Table 2 summarizes the information about the sample size (number of eyes), patients' age, and SE values of these studies.…”

The Outcomes of Posterior-Chamber Phakic Intraocular Lens Implantation in Patients with High Myopia

“…Niu et al observed that ICL V4c implantation in patients with high myopia and shallow ACD achieved satisfying and stable visual outcomes. 28 Its long-term safety and stability require further investigation. In our study, postoperative ACD values decreased significantly when compared to preoperative values, however, no problem occurred related to this in 6 months follow-up time, meaning we did not encounter severe ECD loss.…”

​Short-term changes in and preoperative factors affecting vaulting after posterior chamber phakic Implantable Collamer Lens implantation

“…The Implantable Collamer Lens (ICL; STAAR Surgical Co, Monrovia, California) is a safe and effective option for the correction of myopia [1][2][3][4]. With no corneal excision and few high-order aberrations, it is often the rst choice for surgical correction of high myopia [5,6].…”