Abstract
PurposeTo assess the efficacy and safety of a novel ophthalmic viscosurgical device-free (OVD-free) method for posterior chamber phakic intraocular lens (PIOL) implantation in myopic eyes.MethodsIn this retrospective cohort study, the medical records of myopic eyes that underwent PIOL (Implantable Collamer Lens, ICL) implantation for myopia correction at the Eye Hospital of Wenzhou Medical University between May 2015 and March 2017 were reviewed. A total of 49 eyes with complete data that met follow up requirements (2 h, 1 day, 1 week, 3 months postoperatively) were recruited. Based on the surgical techniques used, the eyes were divided into the OVD-free method group and the standard method group. The clinical data, including intraocular pressure (IOP), corrected distance visual acuity (CDVA) and spherical equivalent (SE), at each follow-up were collected for comparison. Endothelial cell loss and complications were also investigated.ResultsTwenty-one eyes received the standard method, and 28 eyes received the OVD-free method. A rise in IOP > 22 mmHg at 2 h was noted in 14 eyes (66.7%) in the standard group and none (0%) in the OVD-free group (p < 0.001). The rise in IOP from baseline was significantly higher at 2 h in the standard group (10.5 ± 5.2 mmHg vs. 2.2 ± 3.3 mmHg, difference: 8.3, 95% CI 5.8 to 10.8; p < 0.001). There was a significant difference in the time course of LogMAR CDVA changes between the two groups (p = 0.047). The LogMAR CDVA was significantly better in the OVD-free method group compared to the standard group at 1 day (− 0.076, 95% CI − 0.134 to − 0.018; p = 0.012), 1 week (− 0.071, 95% CI − 0.135 to − 0.007; p = 0.03), but not at 3 months (− 0.046, 95% CI − 0.107 to 0.015; p = 0.134). There was no significant difference in the time course of SE changes between the two groups (p = 0.471; p = 0.705). In the OVD-free group, mean endothelial cell loss was 4.6% at 3 months (2522 ± 281 vs. 2407 ± 226 cells/mm2, difference: -115, 95% CI − 295 to 65; p = 0.187). No complications were reported in both groups except for the early IOP elevation in the standard group during the observation period.ConclusionsThe OVD-free method is safe and efficient for ICL implantation. It can be a safer method of ICL implantation compared to the standard method in that it completely eliminates ophthalmic viscoelastic devices-related complications without causing additional complications.
Highlights
Myopia is one of the most common disorders of the eye in the world, and its prevalence is continuing to increase [1,2,3,4]
The anterior chamber can be well infused and maintained without the use of ophthalmic viscosurgical devices (OVDs). We demonstrate that this patented OVD-free method (IP Australia 2,016,234,979, http:// pericles.ipaustralia.gov.au/ols/auspat/applicationDetails. do?applicationNo=2016234979), which uses a continuous infusion with balanced salt solution (BSS) through a side-port produces no OVD-related complications and can simplify the surgical procedure
There was a significant difference in the time course of LogMAR corrected distance visual acuity (CDVA) changes between the two groups (p = 0.047)
Summary
Myopia is one of the most common disorders of the eye in the world, and its prevalence is continuing to increase [1,2,3,4]. Posterior chamber phakic intraocular lens (PIOL) implantation has been reported to be a safe and effective surgical option for myopia correction [6,7,8,9,10]. With the increasing performance of ICL implantation, the potential complications such as early (within 24 h postoperatively) acute intraocular pressure (IOP) elevation should be minimized [15, 16]. Acute IOP elevation was reported to be relatively frequent due to the retained ophthalmic viscosurgical devices (OVDs) [15, 17,18,19]. The prolonged surgery and extra aggressive steps of irrigating the OVDs may increase the chance of inadvertent ICL-crystalline lens contact and will lead to early lens opacification after surgery [15, 21, 22]
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