Refractive outcomes and safety of the implantable collamer lens in young low-to-moderate myopes

Clinical Ophthalmology, Jan 2017

Refractive outcomes and safety of the implantable collamer lens in young low-to-moderate myopes Paul J Dougherty,1,2 Taylor Priver1 1Dougherty Laser Vision, Westlake Village, CA, USA; 2Jules Stein Eye Institute at the David Geffen School of Medicine at UCLA, Los Angeles, CA, USA Purpose: To evaluate visual and refractive outcomes and safety of implantable collamer lens (ICL) implantation in low-to-moderate myopia. Setting: Private Practice – Dougherty Laser Vision, Westlake Village, CA, USA. Methods: A chart review was performed in 56 (104 eyes) consecutive patients who underwent implantation of the Visian ICL V4 model. Inclusion criteria were age between 21 and 40 years, spherical equivalent between -3.00 D and -10.00 D, and cylinder up to -5 D. Data on visual acuity, refraction, and complications were collected. Results: The mean time to the last postoperative visit was 13.1±14.0 months (range, 2 to 50 months). The mean preoperative spherical equivalent was -6.96±1.60 D and the mean preoperative cylinder was -1.03±0.88 D. The mean preoperative corrected distance visual acuity (CDVA) was 20/20 (range, 20/15 to 20/80) that remained unchanged at last postoperative visit. At the last postoperative visit, the spherical equivalent was -0.08±0.01 D and the cylinder was 0.29±0.71 D. Comparison of postoperative uncorrected distance visual acuity (UCDVA) to preoperative CDVA indicated that 27 eyes (26%) had better postoperative UCDVA and 61 eyes (59%) had UDVA equivalent to the preoperative CDVA. Postoperatively, 4 eyes lost 1 line of CDVA and no eyes lost >1 line of CDVA. There were 32 eyes that gained at least ≥1 of CDVA. There were no intraoperative complications. Postoperatively, 3 patients (6 eyes) had dry eye, and 1 patient complained of nighttime halos in 1 eye. At the last postoperative visit, there were no eyes with lens opacity or glaucoma. Conclusion: ICL implantation for low and moderate myopia up to -10 D in patients up to 40 years of age was safe, accurate, and efficacious. ICL implantation may be a good alternative to laser in situ keratomileusis for young myopes less than -10.00 D. Keywords: ICL, low myopia, Costa Rica, Dougherty Laser Vision

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Refractive outcomes and safety of the implantable collamer lens in young low-to-moderate myopes

Clinical Ophthalmology refractive outcomes and safety of the implantable collamer lens in young low-to-moderate myopes Paul J Dougherty 0 1 Taylor Priver 1 0 Jules s tein eye institute at the David geffen school of Medicine at UCla , los angeles, Ca, Usa 1 Dougherty l aser Vision , Westlake Village, Ca, Usa 8 1 0 2 - l u J - 2 1 n o 8 4 . 6 9 . 7 3 1 . 9 7 y b / m o c . s rse l.y ep on PowerdbyTCPDF(ww.tcpdf.org) Purpose: To evaluate visual and refractive outcomes and safety of implantable collamer lens (ICL) implantation in low-to-moderate myopia. Setting: Private Practice - Dougherty Laser Vision, Westlake Village, CA, USA. Methods: A chart review was performed in 56 (104 eyes) consecutive patients who underwent implantation of the Visian ICL V4 model. Inclusion criteria were age between 21 and 40 years, spherical equivalent between −3.00 D and −10.00 D, and cylinder up to −5 D. Data on visual acuity, refraction, and complications were collected. Results: The mean time to the last postoperative visit was 13.1±14.0 months (range, 2 to 50 months). The mean preoperative spherical equivalent was −6.96±1.60 D and the mean preoperative cylinder was −1.03±0.88 D. The mean preoperative corrected distance visual acuity (CDVA) was 20/20 (range, 20/15 to 20/80) that remained unchanged at last postoperative visit. At the last postoperative visit, the spherical equivalent was −0.08±0.01 D and the cylinder was 0.29±0.71 D. Comparison of postoperative uncorrected distance visual acuity (UCDVA) to preoperative CDVA indicated that 27 eyes (26%) had better postoperative UCDVA and 61 eyes (59%) had UDVA equivalent to the preoperative CDVA. Postoperatively, 4 eyes lost 1 line of CDVA and no eyes lost .1 line of CDVA. There were 32 eyes that gained at least $1 of CDVA. There were no intraoperative complications. Postoperatively, 3 patients (6 eyes) had dry eye, and 1 patient complained of nighttime halos in 1 eye. At the last postoperative visit, there were no eyes with lens opacity or glaucoma. Conclusion: ICL implantation for low and moderate myopia up to −10 D in patients up to 40 years of age was safe, accurate, and efficacious. ICL implantation may be a good alternative to laser in situ keratomileusis for young myopes less than −10.00 D. O r i g i n a l; r e s e a r C h - Video abstract Point your SmartPhone at the code above. If you have a QR code reader the video abstract wil appear. Or use: http://youtu.be/hjlRT9nrJxI topographic shape. Alternately, patients may have a personal preference for a reversible procedure (ICL implantation) with better visual quality due to the lack of induced higher-order aberrations,5 versus a permanent procedure (LASIK) where corneal shape is altered and dry eye may be induced. The Visian ICL (STAAR Surgical Co., Monorovia, CA, USA) was granted approval by the United States Food and Drug Administration (FDA) in late 2005 for spherical myopia of −3.00 to −20.00 D. In the current study, the visual and refractive outcomes and safety of ICL implantation were investigated in low-to-moderate myopia. 8 1 0 2 l u J 2 1 n o .846 Methods .973 This retrospective study was performed by chart review of .179 56 (104 eyes) consecutive patients with low-to-moderate yb myopia who underwent ICL implantation by a single surgeon /om (PJD). Inclusion criteria were age between 21 and 40 years .rssce l.y (Table 1), myopia between −3.00 and −10.00 D (spherical ep on equivalent), cylinder up to −5 D, no preexisting ocular .vdoww lsunae apnattehroiloorgcyhoamrpbreervdioeupsthey(Ae CsuDr)georfy,$n2o.6s0ysmtemmi(cmdeiasseuarseed, /:sw rseo from the corneal endothelium to the anterior lens capsule), / p p tth ro and endothelial cell count .2,000 cells/mm2. from F A thorough ophthalmic examination was performed dde including measurement of uncorrected distance visual acuity lnoa (UCDVA) and corrected distance visual acuity (CDVA) using odw a Snellen chart, manifest and cycloplegic refractions, corneal lygo topography, central pachymetry, applanation tonometry, lom horizontal corneal diameter (white-to-white), anterior segthah ment ultrasonic biomicroscopy (UBM) for sulcus to sulcus lpO diameter, slit lamp biomicroscopy, ACD, funduscopy, and iilcanC tceonrnaenadlveenrdboatlhienlfioarlmceeldl ccoounsnetn(tcewllass/mobmta2i)n. eAd tbhyotrhoeugsuhrwgeroitnfrom each patient prior to surgery. Patient informed consent to participate in this retrospective study was obtained in writing prior to surgery. Approval was sought from St Vincent’s Hospital institutional review board in Los Angeles, CA, and was deemed not needed. Examinations were performed preoperatively and postoperatively at 4 hours, 1 day, 1, 3, 6, and 12 months, and yearly thereafter. All eyes were targeted for emmetropia except Table 1 Preoperation vs postoperation data Variable Preoperation age range, years 21–40 Myopia, D −6.96±1.60 astigmatism, D 1.03±0.88 UCDVa (% 20/20 or better) 0% Abbreviation: UCDVa, uncorrected distance visual acuity. 274 for (...truncated)


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Paul J Dougherty, Taylor Priver. Refractive outcomes and safety of the implantable collamer lens in young low-to-moderate myopes, Clinical Ophthalmology, 2017, pp. 273-277, DOI: 10.2147/OPTH.S120427