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)