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Abstract
Purpose To investigate the effects of two different surgical methods of implantable collamer lens (ICL) implantation on the operation time, visual outcomes, corneal endothelial cell count, and intraocular pressure (IOP). Methods This was a contralateral eye comparison study, a total of 192 eyes from 96 patients were included, and the two eyes from the same patient were randomly assigned to two groups (group 1 and group 2, with 96 eyes in each group). In group 1, after making the corneal incision, ophthalmic viscosurgical devices (OVDs) were first injected into the anterior chamber followed by ICL implantation. In group 2, the ICL was first implanted into the anterior chamber followed by OVDs injection. The operation time, uncorrected distance visual acuity, corrected distance visual acuity, spherical equivalent, corneal endothelial cell count, and IOP were recorded and analyzed. Results The operative time in group 1 was significantly longer than that in group 2 (P = 0.002 < 0.05). There were significant differences between IOP measured 2 hours following surgery of the two groups (P = 0.026 < 0.05), Furthermore, the rate of IOP change 2 hours following the operation was significantly higher in group 1 than in group 2 (P = 0.019 < 0.05). There were significant differences in the anterior chamber angle 2 hours after surgery compared with that before surgery in both groups (P = 0.014 < 0.05 and P = 0.029 < 0.05, respectively). No significant differences were observed in the other parameters measured (all P > 0.05). Conclusion The two ICL implantation methods had similar clinical outcomes and effects on the corneal endothelial cell count. Additionally, the implantation of an intraocular lens prior to injecting OVDs reduces the operation time and lowers the rate of IOP rise in the early postoperative period, making it safe and effective for ICL implantation.
Highlights
Correction methods for refractive errors mainly include corneal refractive surgery and intraocular refractive surgery, with the latter primarily being phakic intraocular lens (PIOL) implantation
After making the corneal incision, ophthalmic viscosurgical devices (OVDs) were first injected into the anterior chamber followed by V4c implantable collamer lenses (ICL) implantation in group 1, whereas the ICL was first implanted into the anterior chamber followed by OVDs injection in group 2
Corneal endothelial cells were counted using a corneal endothelium microscope (SP-2000P, TOPCON, Tokyo, Japan). e anterior chamber angle was measured using visante optical coherence tomography (OCT) (Carl Zeiss Meditec, Jena, Germany; 0° and 180° angles were measured. e apex was the scleral spur, and the line length was 500 μm), while the power of the V4c lens was measured using software provided by STAAR Surgical (Monrovia, CA). e size of V4c was determined by the white-to-white distance and the anterior chamber depth. e same instrument was used to measure the corresponding indices following the operation
Summary
Correction methods for refractive errors mainly include corneal refractive surgery and intraocular refractive surgery, with the latter primarily being phakic intraocular lens (PIOL) implantation. PIOLs are considered safe and effective for correcting high myopia [1] and provides many advantages including a speedy visual recovery, retention of the natural lens’ regulation ability, and does not interfere with the normal cornea [2]. The most common forms of this type of intraocular lens are the implantable collamer lenses (ICL; STAAR Surgical, Monrovia, CA). The safety and efficacy of V4c implantation has been recently demonstrated, all previous studies employed classic operation methods; following the corneal incision, ophthalmic viscosurgical devices (OVDs) were injected into the anterior chamber, and the intraocular lens was implanted [4,5,6,7,8,9]. The temporary IOP increase following surgery is tolerable for most eyes, an excessive IOP after surgery greatly
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