Abstract
Purpose: To compare the safety of the non-ophthalmic viscosurgical device (OVD) technique with that of the minimum OVD technique in EVO Implantable Collamer Lens (EVO-ICL) implantation.Methods: A total of 180 eyes of 90 consecutive patients were enrolled in the study, of which 100 eyes of 50 patients were treated with non-OVD technique, with a 55% success rate. The remaining 80 eyes of 40 patients were treated with min-OVD technique, so they were classified into the min-OVD group. Preoperative and postoperative intraocular pressure (IOP) measurements were collected and analyzed at 1, 2, 3, and 24 h. Visual acuity, corneal endothelial cell density (ECD), and corneal densitometry 24 h postoperatively were evaluated.Results: No significant difference was found in visual outcomes (P = 0.54) or ECD (P = 0.78) between the two groups. The operation time was significantly shorter in the non-OVD group (P < 0.0001). The IOP was significantly higher at 1 h (P < 0.0001), 2 h (P < 0.0001) and 3 h (P = 0.0045) postoperatively in the min-OVD group. The non-OVD group had significantly lower IOP than the min-OVD group at 1 h (P = 0.01) and 2 h (P = 0.013) postoperatively. The temporal corneal densitometry in the non-OVD group were significantly lower than those in the minimum group (P = 0.0063) 1 day after surgery.Conclusion: The non-OVD technique is safe and efficient for ICL implantation. It can be a safer method of ICL implantation in that it completely eliminates ophthalmic viscoelastic devices related complications without causing additional complications in short term.
Highlights
Myopia has become a worldwide public health issue [1, 2]
It has become well accepted that retained viscoelastic materials mechanically obstructs the trabecular outflow pathway and decreases the outflow facility [14,15,16], which is the main reason for the early postoperative intraocular pressure (IOP) elevation
According to the surgical procedures during the operation and the repeated watching of the surgical video postoperatively, we statistically concluded that the success rate of non-Ophthalmic viscosurgical device (OVD) technique in these patients was 55.6%. 100 eyes of 50 patients were treated with non-OVD technique
Summary
Myopia has become a worldwide public health issue [1, 2]. Visian Implantable Collamer Lens (ICL) implantation has been reported to be a safe and effective way to correct myopia [3,4,5,6]. Ophthalmic viscosurgical device (OVD) for ICL implantation is widely used to protect endothelial cells and maintain anterior chamber stability during surgery [7]. Retained OVDs are the major cause of Ophthalmic Viscosurgical Device-Free Technique early (within 24 h postoperatively) acute IOP elevation [8,9,10,11,12,13]. It has become well accepted that retained viscoelastic materials mechanically obstructs the trabecular outflow pathway and decreases the outflow facility [14,15,16], which is the main reason for the early postoperative intraocular pressure (IOP) elevation. IOP spikes of 30 mmHg or higher in the early period after surgery may be associated with corneal epithelial edema and pain and may increase the risk of retinal artery occlusion and anterior ischemic optic neuropathy [17,18,19]. To prevent a postoperative IOP increase, complete removal of the OVD is of high importance
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