Postoperative inflammation

Abstract

We read with interest the article by the ICL in Treatment of Myopia Study Group.1ICL in Treatment of Myopia (ITM) Study GroupPostoperative inflammation after implantation of the implantable contact lens.Ophthalmology. 2003; 110: 2335-2341Abstract Full Text Full Text PDF PubMed Scopus (30) Google Scholar The authors have provided us with data regarding postoperative inflammation in patients with an implantable contact lens (ICL) during the first 2 to 3 years. We would be most interested in how patients were recruited into the study, so as to help us select patients if we were to use this type of phakic intraocular lens. We would also like to know the demographics of the patients included. Can the results be generalized to Chinese eyes, for example? Patients included in the study included individuals with relatively mild degrees of myopia. Is there any particular reason why LASIK was not performed on such patients instead of ICL implantation? Or was there any reason why such patients opted for ICL instead of LASIK?The observer assessment of aqueous humor flare and cellular reaction was well standardized; however, it remains a subjective measurement. Whether these measurements were performed by an independent observer or the surgeons themselves may result in unintended systematic or nonsystematic measurement errors. It is important to know who performed the measurements. Use of an independent observer may reduce bias. Objective assessment, such as that by the laser flare and cell meter, would help to eliminate measurement biases. However, such measurements were performed in only 1 center. It would be presumptuous to assume such measurements to be representative of all 12 centers involved. It would be even more informative if objective measurements were used in all 12 centers or in future assessments.We look forward to longer term results from this study. The results do suggest minimal postoperative inflammation in the first 2 to 3 years. Whether this correlates with less cataract formation, less endothelial loss, less chronic inflammation, and less glaucoma in the coming 10 to 20 years or more remains a question that still needs to be addressed and in which we are very much interested. We read with interest the article by the ICL in Treatment of Myopia Study Group.1ICL in Treatment of Myopia (ITM) Study GroupPostoperative inflammation after implantation of the implantable contact lens.Ophthalmology. 2003; 110: 2335-2341Abstract Full Text Full Text PDF PubMed Scopus (30) Google Scholar The authors have provided us with data regarding postoperative inflammation in patients with an implantable contact lens (ICL) during the first 2 to 3 years. We would be most interested in how patients were recruited into the study, so as to help us select patients if we were to use this type of phakic intraocular lens. We would also like to know the demographics of the patients included. Can the results be generalized to Chinese eyes, for example? Patients included in the study included individuals with relatively mild degrees of myopia. Is there any particular reason why LASIK was not performed on such patients instead of ICL implantation? Or was there any reason why such patients opted for ICL instead of LASIK? The observer assessment of aqueous humor flare and cellular reaction was well standardized; however, it remains a subjective measurement. Whether these measurements were performed by an independent observer or the surgeons themselves may result in unintended systematic or nonsystematic measurement errors. It is important to know who performed the measurements. Use of an independent observer may reduce bias. Objective assessment, such as that by the laser flare and cell meter, would help to eliminate measurement biases. However, such measurements were performed in only 1 center. It would be presumptuous to assume such measurements to be representative of all 12 centers involved. It would be even more informative if objective measurements were used in all 12 centers or in future assessments. We look forward to longer term results from this study. The results do suggest minimal postoperative inflammation in the first 2 to 3 years. Whether this correlates with less cataract formation, less endothelial loss, less chronic inflammation, and less glaucoma in the coming 10 to 20 years or more remains a question that still needs to be addressed and in which we are very much interested. Postoperative inflammation: Author replyOphthalmologyVol. 111Issue 7Preview Full-Text PDF