Implantable Collamer Lens V4c Research Articles

Long-term follow-up for monovision surgery by Implantable Collamer Lens V4c implantation for myopia correction in early presbyopia

PurposeTo investigate the long-term safety and efficacy of monovision surgery using implantable collamer lens V4c (ICL V4c) implantation in myopic patients with early presbyopia.SettingEye and ENT Hospital of Fudan University, Shanghai, China.DesignProspective case series study.MethodsThis study included 64 eyes of 32 patients with early presbyopia, who underwent bilateral ICL V4c implantation for myopia correction. Parameters, including mean spherical equivalent (SE), uncorrected distance visual acuity, corrected distance visual acuity, intraocular pressure, endothelial cell density, presbyopic add power, visual acuity (logMAR) of dominant eyes (D-eye), nondominant (nD-eye) eyes, and both eyes (Bi) at 0.4 m, 0.8 m, and 5 m were recorded at the last follow-up.ResultsAll surgeries were uneventful. At the last follow-up, the safety indices were 1.23 ± 0.18 (D-eyes) and 1.21 ± 0.18 (nD-eyes) (p > 0.05); the efficacy indices were 0.95 ± 0.27 (D-eyes) and 0.92 ± 0.28 (nD-eyes) (p < 0.05), the SE was -0.62 ± 0.47 D (D-eyes); and − 1.21 ± 0.78D (nD-eyes) (p < 0.05), presbyopic add power was 1.31 ± 0.58 D. The visual acuity (logMAR) of D-eyes, nD-eyes, and binocular (Bi) at 5.0 m were: 0.06 ± 0.15 (D-eye), 0.21 ± 0.18 (nD-eye), (p < 0.01), and 0.04 ± 0.13 (Bi); 0.8 m: 0.03 ± 0.18 (D-eye), 0.08 ± 0.16 (nD-eye), (p > 0.05), and − 0.02 ± 0.11 (Bi); 0.4 m: 0.08 ± 0.09 (D-eye), − 0.02 ± 0.08 (nD-eye), (p < 0.001), and − 0.03 ± 0.09 (Bi). Subjects were very satisfied or felt excellent with their visual acuity at near (81.25%) and far distances (87.50%), respectively (versus preoperative, p < 0.001).ConclusionMonovision surgery using ICL V4c implantation is safe and practicable for correction of myopes with presbyopia, with long-term efficacy at near and far distances and patient satisfaction.

Visual function assessment of posterior-chamber phakic implantable collamer lenses with a central port.

BackgroundTo investigate the short-term visual function of the V4c implantable collamer lens (ICL) for myopia using a Binoptometer 4P.MethodsEighty eyes from 40 patients (age, 28.75±6.57 years) who underwent ICL V4c implantation at Shenzhen Eye Hospital from August 2020 to June 2021 were enrolled. Uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), subjective manifest refraction, intraocular pressure (IOP), and corneal endothelial cell density (ECD) were evaluated 1 month after surgery. Corrected distance visual acuity (CDVA), corrected near visual acuity (CNVA), contrast sensitivity (CS), near stereoacuity (NSA), twilight vision, and glare sensitivity were measured using a Binoptometer 4P.ResultsThe average logMAR (logarithmic minimum angle of resolution) UCVA postoperative was 0.07±0.13, which was significantly better than the preoperative BCVA (P=0.028). At 1 month postoperatively, the mean safety and efficacy indexes were 1.14±0.24 and 0.98±0.16, respectively. The mean spherical equivalent (SE) of all eyes was −8.98±3.20 D preoperatively, and −0.16±0.48 D postoperatively. None of the patients lost one or more lines of BCVA, 62.1% remained unchanged, 10.6% gained one line, and 27.3% gained two or more lines. CDVA, CNVA, CS, and NSA of both eyes were measured using a Binoptometer 4P, which were significantly better than the preoperative values. In addition, some patients had subjective symptoms in the early postoperative period, such as halo, glare, etc.ConclusionsICL V4c implantation is a safe, effective, and predictable solution for myopia. We found that the short-term visual function of patients was improved significantly. The Binoptometer 4P is an effective and convenient visual testing device for assessing postoperative visual function after ICL V4c implantation.

Comparison of accommodation and accommodative micro-fluctuation after implantable collamer lens and LASIK surgery for myopia

BackgroundTo longitudinally analyze and compare the accommodative micro-fluctuation (MFs) and accommodative function between myopic patients after implantable collamer lens (ICL) implantation and laser in situ keratomileusis (LASIK).MethodsPatients with good corrected visual acuity (20/20 or better) and underwent ICL (V4c) and LASIK for myopic-correction (ranging from − 3.50 to − 8.50 D) were recruited. Refraction, amplitude of accommodation (AMP), accommodative lag, higher-order aberration (HOA), and MFs were recorded before surgery and 1 and 3 months after surgery. The ACOMEREF automatic refractor was used to measure the high-frequency component (HFC) of the MFs, which suggested tension of the ciliary muscle.ResultsThe study comprised 120 eyes. At 3 months after surgery, the manifest refractive spherical equivalent of the ICL and LASIK groups were − 0.11 and − 0.09 D, respectively (p = 0.46). HFC values were significantly higher at 1 month (p = 0.03) and 3 months postoperatively (p = 0.03) in the ICL group compared to that in the LASIK group. The ocular HOA of the ICL group was 1.08 ± 0.43 μm, which was lower than the LASIK group 1.45 ± 0.54 μm (p = 0.01). No significant differences in AMP and accommodative lag between groups were noted at 3 months postoperatively. There was a positive correlation between HFC and vault of the ICL lens (r2 = 0.14, p = 0.005). There were no correlations between HFC and ocular HOA and postoperative MRSE in the two groups (all p>0.05).ConclusionsThe HFC increased significantly after an early period of ICL implantation compared to laser in situ keratomileusis for myopic correction, which indicated increased tension of the ciliary muscle, and had a positive correlation on the vault of the ICL lens; However, studies with longer follow-up time and more structural evaluation are needed.

Effect of pupil size on posterior chamber phakic intraocular lens vault measurements.

Purpose:The aim of this study was to measure the implantable collamer lens (ICL) vault changes with anterior segment optical coherence tomography (AS-OCT) after the implantation of the Visian posterior chamber phakic ICL with a central hole (V4c) in relation to the pupil size.Methods:This retrospective observational pilot study included 32 eyes of 16 patients, who underwent V4c ICL implantation. ICL vault was measured with AS-OCT in undilated and fully dilate state of the pupil. Primary outcome measure was the change in the vault of V4c ICL at the maximum and minimum pupil size.Results:Median (IQR) undilated and post-dilated vault measurement was 393.00 (335.50–493.50) microns and 421.00 (338.50–503.75) microns, respectively, which was not statistically significant (P = 0.44).Conclusion:No statistically significant difference was observed between the undilated and post-dilated ICL vault measurements. Hence, the postoperative vault can be measured either in resting, undilated state or fully dilated state of the pupil and would be similar irrespective of the pupil size.

Changes in ocular parameters the crystalline lens after implantation of a collamer lens

ABSTRACT Clinical relevance Understanding changes in ocular anatomical parameters after intraocular lens implantation will allow a more accurate determination of dioptric power prior to surgery. Background The crystalline lens position might change due to the implantation and removal of an implantable collamer lens (ICL) or toric implantable collamer lens (TICL). This study aimed to assess the effect of ICL implantation on position of the crystalline lens. Methods This retrospective study was conducted on patients who underwent V4c ICL or V4c TICL implantation between March and September, 2018. Preoperative and post-operative (2 weeks, 3 months and 6 months) axial length, central corneal thickness, crystalline lens position, crystalline lens thickness and vault height were analysed. Multivariable linear regression was used to determine the variables associated with 6-month changes in lens position. Results This study included 117 eyes of 117 patients. There were decreases in all vertical distance measures from the central corneal endothelium to the anterior and posterior crystalline lens capsule (all p > 0.05). The amount of reduction was related to the crystalline lens position before the operation and crystalline lens thickness after the operation (all p < 0.01). An error in anterior chamber depth and lens thickness may appear when the ICL/TICL is close to the crystalline lens. Conclusion Phakic intraocular lens implantation resulted in lens thickening and forward movement on day 1 post-operatively, which becomes stable within 6 months. Preoperative lens position and post-operative lens thickness were related to the amount of movement.

Long-term evaluation of anterior lens density after implantable collamer lens V4c implantation in patients with myopia over 40 years old

PurposeTo investigate the long-term safety and efficacy of implantable collamer lens (ICL) V4c implantation and changes in the anterior lens density (ALD) in patients with myopia ≥40 years of age.MethodsThis...

Seven-year follow-up of posterior chamber phakic intraocular lens with central port design

BackgroundTo assess the clinical outcomes of the Visian Implantable Collamer Lens (ICL) with a central port throughout 7 years of follow-up.MethodsEighty-four eyes of 52 patients were evaluated over a follow-up period of 7 years after V4c ICL implantation. Uncorrected (UDVA) and corrected (CDVA) distance visual acuities, refraction, intraocular pressure (IOP), endothelial cell density (ECD) and vault were analysed.ResultsThe mean postoperative UDVA (logMAR) was 0.04 ± 0.11, 0.13 ± 0.19 and 0.17 ± 0.23 at 1-, 5- and 7-years, respectively (P < 0.0001). The mean CDVA (logMAR) remains unchanged throughout a 7-year follow-up period (0.02 ± 0.08 and 0.02 ± 0.08, at 5- and 7-years, respectively, P = 0.2). At all follow-up visits, more than 95% of the eyes achieved a CDVA of 20/25 or better and more than 85% a CDVA of 20/20. At the end of the follow-up (7 years), no eye lost more lines of CDVA, 56 eyes (66.7%) and 28 eyes (33.3%) gained lines of CDVA. At 7-years, the spherical equivalent was − 0.62 ± 0.62 D. No significant increase in IOP (> 20 mmHg or an increase higher than 5 mmHg) occurred in any case throughout the 7-year of follow-up. The loss in ECD from the preoperative baseline at the last follow-up visit was 2.6%. No intraoperative or postoperative complications or adverse events occurred during the follow-up period.ConclusionsThe outcomes of this study show the long-term viability of the V4c ICL implantation as a surgical option for the correction of myopia.

A four-year observation of corneal densitometry after implantable collamer lens V4c implantation.

To observe the changes in corneal densitometry (CD) with a Pentacam after implantable collamer lens (ICL) V4c implantation in myopia patients, and to investigate potential influencing factors. We reviewed 65 eyes of 33 patients (mean age, 29.08±5.54 years) with myopia or myopic astigmatism who underwent ICL V4c implantation. Clinic parameters and Pentacam images of corneal topography and CD were obtained pre- and postoperatively. After an average of 52±2.2 months follow-up, the efficacy and safety indexes assessed at the last follow-up were 1.03±0.18 and 1.21±0.21, respectively. Except in the central annular zone of 0-2 mm, the CD values increased significantly at postoperative day 1 and decreased significantly until postoperative 1 year (P<0.05). The increase in CD values at different annular zones at postoperative day 1 was ranked as: 0-2 mm <2-6 mm < 6-10 mm. No significant difference was observed in corneal density at 1 week, 1 month, and 1-year follow-up when compared with the preoperative value (P>0.05). The CD value at 4 years follow-up increased significantly and correlated positively with age and preoperative uncorrected distance visual acuity, and negatively with preoperative spherical equivalent and intraocular pressure (IOP) (P<0.05). ICL V4c implantation demonstrated safety and efficacy for myopia correction. The CD value increased at 4 years postoperatively and correlated with age, preoperative spherical equivalent, uncorrected distance visual acuity, and IOP.

Visual outcomes after small incision lenticule extraction and implantable collamer lens V4c for moderate myopia: 1-year results.

To compare 1-year visual outcomes after implantable collamer lens V4c (EVO-ICL) implantation and small incision lenticule extraction (SMILE) for moderate myopia. In this retrospective study, 67 eyes of 39 patients with a preoperative manifest refraction spherical equivalent between - 3.00 and - 6.00 diopters (D) were selected from a database of SMILE and ICL implantation procedures performed from April 2018 to December 2018. Thirty-two eyes of 20 patients underwent EVO-ICL implantation, and 35 eyes of 19 patients underwent SMILE. At the routine 1-year follow-up appointment, all selected patients were examined for higher-order ocular aberrations, retinal image quality, and a quality of vision (QoV) questionnaire. This data was then analyzed. No complications were observed. Uncorrected and corrected visual acuities at 1 year after surgery were - 0.13 ± 0.07 and - 0.15 ± 0.06 logMAR in the SMILE group, and - 0.10 ± 0.07 and - 0.16 ± 0.05 logMAR in the ICL group. Twenty-nine eyes (90.6%) which underwent ICL implantation and 34 eyes (97.1%) which underwent SMILE were within ± 0.5 D of the attempted spherical equivalent (P = 0.49). Changes in coma after ICL were significantly less than after SMILE (P = 0.002). The leading complaints after ICL and SMILE were halos (84.4%) and blurred vision (65.7%), respectively. Both SMILE and ICL implantation provided good safety, efficacy, and predictability in correcting moderate myopia. The subjective visual complaints consisted mainly of halos after ICL and starbursts and blurred vision after SMILE.

Long-Term Outcomes of Retinal Detachment in Phakic Eyes After Implantation of Implantable Collamer Lens V4c for High Myopia Correction.

Aim: To estimate whether implantable collamer lens (V4c ICL) implantation increases the risk of retinal detachment in high myopia comparing with myopes with Rigid Gas-Permeable (RGP) correction.Methods: This prospective study was comprised of an ICL group (704 eyes) and an RGP group (628 eyes). Patients were enrolled according to the inclusion criteria and exclusion criteria, then divided into the ICL group and RGP group. Patients in the ICL and RGP groups received V4c ICL implantation and RGP fitting respectively. Retinal details, spherical equivalent refraction (SE), uncorrected distance visual acuity (UDVA), corrected distance vision acutivity (CDVA), axis length (AL), anterior chamber depth (ACD) and other relevant parameters were recorded at different time points. Rhegmatogenous retinal detachment (RRD) morbidity and incidence, RRD morphology and relevant parameters were analyzed.Results: All enrolled patients were followed for 3–6 years. Patients characteristics before the refractive procedure did not show a statistical difference. At the end of the follow up, all the RD cases were RRD. The RRD morbidity of the ICL group and RGP group was 1.99% (14 eyes) and 0.96% (6 eyes) respectively, which did not show statistical difference (P = 0.12). During the first year after refractive procedure, the RRD incidence of the ICL group was 0.85% (6/704), while this number of the RGP group was 0.16% (1/628). It did not show statistical difference (P = 0.08).Conclusion: Compared with RGP fitting, V4c ICL implantation for high myopia correction does not add RRD risk in the long term. V4c ICL implantation is a safe method for high myopia correction.

Changes in anterior lens density after Implantable Collamer Lens V4c implantation: a 4-year prospective observational study.

To investigate the changes in anterior lens density with a Pentacam after Implantable Collamer Lens (ICL) V4c implantation in patients with myopia. This prospective case series examined 62 eyes of 32 patients (mean age, 28.5±5.73years) with myopia or myopic astigmatism after ICL V4c implantation. Uncorrected distance vision acuity, corrected distance vision acuity (CDVA), manifest refraction, intraocular pressure, anterior chamber depth (ACD), anterior chamber volume (ACV), anterior chamber angle (ACA), endothelial cell density and Pentacam images of lens density were obtained pre- and postoperatively. The vault was obtained during the follow-ups. Patients were followed up for an average of 51±2.7months (range, 48-57months). All surgeries were uneventful, without any complication. The efficacy and safety indices at the last follow-up were 1.03±0.2 and 1.22±0.22, respectively. No eye had decreased CDVA, and 66% eyes gained ≥1 line. Furthermore, refractive error in 90% eyes was within ±0.50D and that of 100% was within ±1.0D of the attempted refraction. Anterior average lens density (a-ALD) in the 0.5-, 1.0- and 1.5-mm depth zones increased by 10.41±11.51%, 17.1±11.09% and 16.76±10.4%, respectively, compared to preoperative values (all p<0.05). The change in a-ALD between two different age groups was not significant. Moreover, there were no significant correlations between the change in a-ALD and age, preoperative spherical equivalent, ACD, ACA, ACV or vault. Implantable Collamer Lens (ICL) V4c implantation demonstrates safety and efficacy for myopia correction. Although a-ALD increased slightly at 4years postoperatively, no cataract developed during the follow-up. Further studies should investigate the reason for the postoperative increase in a-ALD.

Posterior-chamber phakic implantable collamer lenses with a central port: a review.

We aimed to summarize the outcomes reported following the implantation of the V4c implantable collamer lens with a central port (ICL, STAAR Surgical Inc) for myopia correction. A literature search in PubMed, Web of Science and Scopus was carried out to identify publications reporting clinical outcomes of patients who were implanted with the V4c ICL model and had a follow‐up period of at least 6 months. A total of 35 clinical studies published between 2012 and 2020 were included in the present review. A comprehensive analysis of the available data was performed, focusing on visual and refractive outcomes at different time‐points post‐surgery. In addition, adverse events and other parameters such as endothelial cell density, intraocular pressure and vault measurements—which were evaluated in some of the studies—were also compared. This review encompassed a total of 2904 eyes. The outcomes reported in this review lead us to conclude that ICL V4c implantation for myopia correction is a safe and efficient procedure, with stable visual and refractive outcomes and low adverse event rates. The patient’s anterior segment should be thoroughly characterized, and the ICL parameters should be carefully selected so as to achieve good outcomes and avoid complications.

The Relationship between Anterior Chamber Angle and Intraocular Pressure Early after V4c Implantable Collamer Lens Implantation.

Purpose To confirm the relationship between anterior chamber angle (ACA) and intraocular pressure (IOP) early after V4c implantable collamer lens (ICL) implantation. Methods Patients were assigned to two groups: (1) right eyes (control group) and (2) left eyes (experimental group), with miosis conducted immediately after ICL implantation in the left eyes. IOP, angle opening distance (AOD), trabecular-iris angle (TIA), and pupil diameter (PD) were compared between two groups at postoperative hours 1, 2, and 24. The relationship between ACA, PD, and IOP was analyzed by multiple linear regression. Result Thirty-six eyes of 18 patients were enrolled. The prevalence of ocular hypertension (OHT, defined as IOP ≥ 21 mmHg) was 61.11% and 16.67% in the right and left eyes, respectively, (χ2 = 7.481, p=0.006). At postoperative hours 1 and 2, IOP and PD were significantly higher (p < 0.001) in the right eyes, and TIA and AOD were significantly lower (p < 0.05) in the right eyes than in the left eyes. There was no significant difference at 24 h postoperative in these parameters. After the right eye ICL implantation, the changes of AOD 500 and PD were both linearly correlated with postoperative IOP change (β = −23.707 and 1.731, respectively; p = 0.013 and 0.002, respectively). Conclusion The ACA was significantly narrowed immediately after V4c ICL implantation. There was a negative linear correlation between ACA and early IOP and a positive linear correlation between PD and early IOP. We recommend the use of intracameral miotics immediately after V4c ICL implantation to reduce the incidence of IOP spikes.

Posterior-Chamber Phakic Intraocular Lens Implantation in Patients over 40 Years of Age.

Purpose To assess the efficacy, safety, and predictability of the Visian Implantable Collamer Lens (ICL) model having a central port in patients over 40 years of age. Methods This study included 33 eyes from 21 patients who underwent V4c ICL implantation for the correction of myopia and myopic astigmatism. We assessed uncorrected (UDVA) and corrected (CDVA) distance visual acuity, refraction, intraocular pressure (IOP), endothelial cell density (ECD), vault, and adverse events occurring over a 1-year period. Results Mean age of the patients at the time of implantation was 43.52 ± 4.49 years (range: 40 to 56 years). Efficacy and safety indexes were 1 and 1.09, respectively. Surgical outcomes for CDVA were as follows: no eye lost any lines, 19 eyes (57.58%) showed no CDVA changes, 7 eyes (21.21%) gained 1 line, 4 eyes (12.12%) gained 2 lines, and 3 eyes (9.09%) gained ≥3 lines. Mean postoperative spherical equivalent (SE) was −0.09 ± 0.47 D. A total of 29 eyes (87.8%) were within ±0.50 D and 31 eyes (93.9%) were within ±1.00 D of the desired SE. At 1-year, mean IOP was 15.27 ± 3.03 mmHg (range: 9 to 20 mmHg, p=0.12 pre vs. post) and mean ECD was 2516 ± 234 cells/mm2 (p=0.29 pre vs. post). Mean postoperative vault was 320 ± 136 μm, with 201–300 μm being the most prevalent vault range for 9 eyes (31.03%). None of the eyes showed a vault >701 μm. There were neither intraoperative nor postoperative complications; in fact, all ICL implantation procedures were uneventful. Conclusions Our study's findings support the use of this lens in patients over 40 years of age. A long follow-up period is advisable to monitor ICL position relative to the crystalline lens.

Four-year observation of the changes in corneal endothelium cell density and correlated factors after Implantable Collamer Lens V4c implantation

BackgroundTo evaluate the changes in corneal endothelium cell density (ECD) and the correlated factors after Implantable Collamer Lens (ICL) V4c implantation.MethodsIn this retrospective, consecutive study, 48 eyes of 25 patients...

Visual outcomes and corneal biomechanics after V4c implantable collamer lens implantation in subclinical keratoconus.

To quantitatively evaluate the safety, efficacy, stability, predictability, and corneal biomechanical parameters after V4c implantable collamer lens (ICL) implantation in subclinical keratoconus. Xi'an AIER Eye Hospital, Xi'an, China. Retrospective case series. Patients undergoing V4c ICL/toric ICL implantation were examined. Scheimpflug tomography (Pentacam) was used to measure the Belin-Ambrosio enhanced ectasia total deviation index. Dynamic Scheimpflug biomechanical analysis (CorVis ST) was used to measure the corneal biomechanical parameters and Corvis Biomechanical Index. The Tomographic and Biomechanical Index was measured by combined Pentacam with CorVis ST. Uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), refraction, and adverse effects were also investigated. A total of 60 eyes of 60 patients (mean age ± SD, 27.21 ± 7.24 years) were included. The mean preoperative UDVA and CDVA were 1.08 ± 0.25 and 0.12 ± 0.04 logarithm of the minimum angle of resolution (logMAR) (20/230 and 20/28 Snellen VA), respectively. After 2 years, the mean postoperative UDVA and CDVA were 0.01 ± 0.06 and -0.05 ± 0.03 logMAR (20/20 and 20/18 Snellen VA), respectively. The mean difference between the intended and achieved spherical equivalent (SE) was -0.08 ± 0.47 diopter (D), and the SE was within ±1.00 D of the intended correction in 57 eyes (95%), and 58 eyes (97%) had astigmatism less than 0.50 D. The refractive results were stable 2 years postoperatively, and the corneal biomechanical parameters returned to their preoperative levels at 3 months. The V4c ICL/toric ICL in subclinical keratoconus offered predictable correction of SE refractive error. Refractive results and corneal biomechanics were stable at the 2-year follow-up.

Comparison of objective and subjective visual quality early after implantable collamer lens V4c (ICL V4c) and small incision lenticule extraction (SMILE) for high myopia correction

To investigate differences in the objective and subjective visual quality of patients with high myopia following implantable collamer lens V4c (ICL V4c) versus small incision lenticule extraction (SMILE) early postoperatively. This prospective analysis included 94 eyes of 57 patients (8 males) in the ICL V4c group (mean spherical equivalent (SE), -8.07±1.03 dioptres (D)) and 103 eyes of 57 patients (13 males) in the SMILE group (mean SE, -7.85±0.78 D). Refractive parameters and wavefront aberrations were recorded preoperatively and 6months postoperatively. Subjective visual quality was scored with the Quality of Vision questionnaire, and operation satisfaction was evaluated 6months postoperatively. At 6months postoperatively, the efficacy index was 1.17±0.16 in the ICL and 1.09±0.20 in the SMILE group; the safety index was 1.21±0.18 in the ICL and 1.12±0.16 in the SMILE group. A significant increase in total higher-order aberrations (HOAs) in both the ICL and SMILE groups was observed, but to a lesser degree in ICL (p<0.05). In the ICL group, trefoil significantly increased (p<0.05), whereas in the SMILE group, coma, trefoil and spherical aberration significantly increased (p<0.05). Glare, haloes and blurred vision had the highest incidences after both types of surgery, and postoperative haloes were significantly more common following ICL; 96.1% of ICL-treated and 94.9% of SMILE-treated patients were satisfied with their visual outcomes. ICL V4c caused lower HOAs induction than SMILE. Despite the postoperative visual disturbances, both ICL and SMILE provided good efficacy, safety, predictability and high satisfaction in correcting high myopia.

Anterior chamber angle width, central vault and intraocular pressure changes after 12months of Visian collamer lens implantation.

To evaluate 1-year changes of vault, anterior chamber angle width (ACAW) and intraocular pressure (IOP) after the implantation of implantable collamer lens (ICL) V4c in high myopic patients. Sixty ICL V4c implantation surgeries were included. Patients underwent surgery between January 2014 and June 2017 at Ophthalmology Center Tecnolaser Clinic Vision®, Seville, Spain. All patients had a 12-month follow-up. A preoperative spherical equivalent between -4.00 and -15.00 D was established as inclusion criterion. ACAW and vault were measured with Pentacam single rotation Scheimpflug camera (Oculus Optikgeräte GmbH, Wetzlar, Germany). IOP was measured with CORVIS ST (Oculus Optikgeräte GmbH, Wetzlar, Germany). One-day vault was 553.17 ± 169.80 [268-975]µm; 12-month vault was 515.67 ± 176.46 [169-950]µm (p < 0.01). Preoperative ACAW was 36.85° ± 4.60° [26.7°-46.8°]; postoperative ACAW was 25.98° ± 3.85° [16.4°-32.6°] (p < 0.01). Preoperative IOP was 15.37 ± 1.58 [12.0-18.3] mmHg, postoperative IOP was 15.61 ± 1.60 [12.0-19.0]mmHg (p = 0.35). ICL V4c lens experienced a progressive reduction of vault after 12-month follow-up. ACAW decrease was significant between preoperative and postoperative values. We propose to include a minimum preoperative ACAW and an IOP correction factor for lens size.

Optical quality after posterior chamber Phakic implantation of an intraocular Lens with a central hole (V4c implantable Collamer Lens) under different lighting conditions

BackgroundThe current study compared optical quality before and after implantation of a posterior chamber phakic intraocular lens with a central hole [V4c implantable collamer lens (ICL)] under bright and dark lighting conditions by means of the Optical Quality Analysis System™ (OQAS; Visiometrics, Terrassa, Spain).MethodsThis prospective study involved 91 eyes of 46 consecutive high myopia patients (15 males and 31 females, average spherical equivalent − 10.50 ± 0.33D) undergoing implantation of a V4c ICL. The modulation transfer function (MTF) cutoff frequency, Strehl ratio, objective scattering index (OSI), and predicted visual acuities (PVAs; 100, 20, and 9%), under different lighting conditions, were measured before and 1 week, 1 month, and 3 months after surgery.ResultsAll optical parameters showed significant improvements, at all time points, under dark condition after surgery. We observed no significant changes in PVA 9% at 1 week (mean value 0.539, P = 0.12) or 1 month after surgery (mean value 0.573, P = 0.08) under bright condition; but all other postoperative parameters improved significantly. Comparing the two lighting conditions, the OSI decreased more under dark conditions at 1 week (P = 0.02), 1 month (P = 0.004), and 3 months (P = 0.002), but there was no significant difference in any other parameter. In addition, patients were divided into super high myopia (group S, spherical equivalent greater than − 10 D) and high myopia (group H, spherical equivalent from − 6 D to − 10 D), the group S improved significantly more than group H in all parameters, under both bright and dark conditions.ConclusionsV4c ICL implantation improved optical quality under both bright and dark lighting conditions, and had a better ability to reduce the extent of scattering in the dark. Furthermore, group S achieved greater improvement in visual quality, which should be considered by physicians before surgery.

Safety and efficacy of toric implantable collamer lens V4c model - A retrospective South Indian study.

Purpose:The aim of this study was to evaluate the safety, efficacy, and complications of V4c Toric implantable collamer Lens (TICL) implantation for myopic astigmatism in the south Indian population.Methods:In this retrospective observational case series, a total of 109 eyes of 67 patients who underwent V4c TICL implantation (ICL, V4C Staar Surgical, Nidau, Switzerland) between January 2012 and August 2019 were studied with a minimum follow-up period of 6 months (mean 24 months). The main outcome measures were objective and subjective refraction, uncorrected distance visual acuity, corrected distance visual acuity (CDVA), safety, predictability, adverse events, and postoperative complications.Results:At 6 months, mean manifest refractive spherical equivalent (SE) decreased from - 10.90 ± 3.7D preoperatively to - 0.02 ± 0.13D postoperatively (P < 0.001) and mean cylinder decreased from - 2.3 ± 1.3 D preoperatively to - 0.04 ± 0.2 D postoperatively (P < 0.001). Postoperatively, SE within ± 0.5 D and ± 1.0 D of attempted correction were achieved in 96.3 (105 eyes) and 100% (109 eyes), respectively. Manifest refractive cylinder within ± 0.5 D and ± 1.0 D of attempted correction were achieved in 97.2 (106 eyes) and 100% (109 eyes), respectively. Sixty-two percent (68 eyes) showed no change in CDVA postoperatively, and no eye had lost lines of CDVA. The safety index was 1.12, and the efficacy index was 1.10. Complications were seen in two eyes (1.8%) due to high postoperative vault requiring secondary surgical interventions.Conclusion:V4c TICL is a highly effective, safe, and predictable option in treating myopic astigmatism with excellent improvement in vision and spectacle independence.