Safety and visual outcomes following posterior chamber phakic intraocular lens bilensectomy

Background:To evaluate the safety,efficacy,refractive outcomes and causes for bilensectomy(phakic intraocular lens–pIOL–explantation with cataract surgery and pseudophakic intraocular lens implantation)in patients previously implanted with posterior chamber pIOLs.Methods:This multi-center retrospective study included 87 eyes of 55 patients who underwent bilensectomy for posterior chamber pIOL with a follow up time of 12 months.The uncorrected and best corrected distance visual acuities(UDVA,CDVA),endothelial cell density before and after bilensectomy were assessed,as well as the cause of bilensectomy and intra or postoperative complications.Results:There was a statistically significant improvement in uncorrected and best corrected visual acuities after bilensectomy(p=0.00).The main reason for bilensectomy was cataract development(93.1%of the cases),followed by miscalculation of lens size,and corneal edema.The endothelial cell count remained stable without a statistically significant change after surgery(p=0.67).The refractive efficacy index was 0.8,none of the patients lost lines of CDVA after surgery,73%of the patients were within±1 D(spherical equivalent)of the target refraction.Intraoperative complications were one posterior capsule rupture with the intraocular lens(IOL)implanted in the sulcus,and 3 eyes required the use of pupil expanders for adequate pupil dilation.Postoperatively,one eye developed retinal detachment.The three pIOLs models explanted were the Implantable Collamer Lens(ICL),Implantable Phakic Contact Lens(IPCL)and the Phakic Refractive Lens(PRL).Conclusions:Good safety and visual outcomes were observed 1 year after bilensectomy for posterior chamber phakic intraocular lenses(PC pIOLs).There were few intra and postoperative complications and there was no significant endothelial cell loss after the bilensectomy procedure.

Safety and visual outcomes following posterior chamber phakic intraocular lens bilensectomy

Background:To evaluate the safety,efficacy,refractive outcomes and causes for bilensectomy[phakic intraocular lens(plOL)explantation with cataract surgery and pseudophakic intraocular lens(IOL)implantation]in patients previously implanted with posterior chamber plOLs(PC plOLs).Methods:This multi-center retrospective study included 87 eyes of 55 patients who underwent bilensectomy for PC plOL with a follow-up time of 12 months.The uncorrected and corrected distance visual acuities(UDVA,CDVA),endothelial cell density before and after bilensectomy were assessed,as well as the cause of bilensectomy and intra or postoperative complications.Results:There was a statistically significant improvement in UDVA and CDVA after bilensectomy(P=0.00).The main reason for bilensectomy was cataract development(93.1%of the cases),followed by miscalculation of lens size,and corneal edema.The endothelial cell count remained stable without a statistically significant change after surgery(P=0.67).The refractive efficacy index was 0.8,none of the patients lost lines of CDVA after surgery,73%of the patients were within±1.0D(spherical equivalent)of the target refraction.Intraoperative complications were one posterior capsule rupture with the IOL implanted in the sulcus,and three eyes required the use of pupil expanders for adequate pupil dilation.Postoperatively,one eye developed retinal detachment.The three plOLs models explanted were the implantable collamer lens(ICL);implantable phakic contact lens(IPCL)and the phakic refractive lens(PRL).Conclusions:Good safety and visual outcomes were observed one year after bilensectomy for PC plOLs.There were few intra and postoperative complications and there was no significant endothelial cell loss after the bilensectomy procedure.

优化ICL V4c植入术的临床研究进展

随着有晶状体眼后房型人工晶状体植入术的发展及可植入式接触镜(ICL)的不断改进,ICL V4c植入术目前已经成为矫正中高度近视的主流术式之一。术后拱高是评价手术安全性的重要指标,在常规ICL V4c植入手术的基础上,如何优化手术以获得更理想的拱高是近年来学者们研究的热点。本文以术前检查、术中手术设计以及术后随访为中心,总结分析优化ICL V4c植入手术的方案,为提高手术安全性提供帮助。

对比两种眼内屈光术矫正高度近视术后的视觉质量

目的:对比有晶状体眼虹膜夹型和后房型人工晶状体植入术矫正高度近视术后的视觉质量,为更好的矫正高度近视提供指导。方法:选择2009年12月-2010年12月来本院眼科进行矫正术的高度近视患者56例,根据手术方式不同分为虹膜组和后房组各28例,虹膜组采用有晶状体眼虹膜夹型植入术,后房组采用后房型人工晶状体植入术,对比两组患者术后的视觉质量。结果:虹膜组和后房组患者术前及术后6个月裸眼视力分别为(0.43±0.12)vs(0.99±1.34)、(0.42±0.24)vs(0.84±1.23)(P<0.05);虹膜组和后房组术前及术后6个月最佳矫正视力分别为(0.65±0.32)vs(1.04±0.18)、(0.69±0.11)vs(1.01±0.13),差异均具有统计学意义(P<0.05);术前及术后6个月眩光敏感度、对比敏感度在各个频率段的变化差异均具有统计学意义(P<0.05);两组患者组间术后6个月各观察指标间差异均无统计学意义(P>0.05)。结论:两种植入术术后6个月的视觉质量均能达到预期效果,虹膜夹型植入术的视觉质量略好于后房型,远期视觉质量两组间是否具有差异,还有待进一步研究。

Five‑year outcomes of EVO implantable collamer lens implantation for the correction of high myopia and super high myopia

Background:To evaluate the long-term safety,efficacy,predictability,and stability of implantable collamer lens with a central hole(EVO ICL)implantation for correcting high myopia(HM)and super high myopia(SHM).Methods:This prospective study evaluated 83 eyes of 46 patients who were divided into groups based on their spherical equivalent refractive error(SE):HM group(−12 D≤SE<−6 D)and SHM group(SE<−12 D).They were followed up for 5 years after ICL implantation;assessments of uncorrected distance visual acuity(UDVA),corrected distance visual acuity(CDVA),manifest refractive error,axial length,intraocular pressure,corneal endothelial cell density,and vault were conducted,and a questionnaire was administered.ResuIts:At 5 years postoperatively,the safety indices of the HM and SHM groups were 1.03±0.10 and 1.32±0.39,and the efficacy indices were 0.83±0.25 and 0.86±0.32,respectively.In the HM group,60.47%and 79.07%of the eyes were within±0.50 D and±1.00 D of the attempted correction,while it was achieved for 22.50%and 47.50%of the eyes in the SHM group,respectively.The SE of the HM group decreased from−9.72±1.41 D preoperatively to 0.04±0.39 D 1 month postoperatively and−0.67±0.57 D 5 years postoperatively,while in the SHM group,it decreased from−15.78±3.06 D preoperatively to−0.69±0.97 D 1 month postoperatively and−1.74±1.19 D 5 years postoperatively.Conclusion:EVO ICL implantation is safe,effective,and predictable for correcting HM and SHM.CDVA improved more after surgery for SHM,but the growth of axial length still needs attention.