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      Analysis of intraocular positions of posterior implantable collamer lens by full-scale ultrasound biomicroscopy

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          Abstract

          Background

          To analyze the positions of intraocular posterior Implantable Collamer Lens (ICL) and its possible relationship with vault.

          Methods

          This cross-sectional study included 72 patients with high myopia (134 eyes) who were followed up after phakic intraocular lens implantation. The postoperative time ranged from 1 week to 7 years. We obtained the images of ICL by using Compact Touch STS UBM and observed the position of ICL in posterior chamber and ciliary sulcus. The horizontal lines vault was measured and recorded.

          Results

          There were various positions in the posterior chamber as observed by full-scale ultrasound biomicroscopy and the haptics were inserted at different positions. -Eight seven eyes (64.9%) that obtained ideal vault, 29 eyes (21.6%) had insufficient vaults and 18 eyes (13.4%) had excessive vault. The vault with various positions of haptics was in ideal range (250 μm–750 μm) almost in each group. Three eyes in this study with haptics on the top of ciliary sulcus obtained excessive vault (mean vault, 850.00 ± 70.71 μm) and one eye appeared one side haptics pushing forward the iris. Among five eyes (3.7%) with iridociliary body cysts, three eyes (60%) obtained ideal vault. One eye (0.7%) with ICL decentralization after implantation surgery had an ideal vault, but the patient had serious glare.

          Conclusions

          Though ICL in the posterior chamber had different positions and the haptics in most cases were not in the ciliary sulcus, the postoperative vault was almost in the ideal range.

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          Most cited references22

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          United States Food and Drug Administration clinical trial of the Implantable Collamer Lens (ICL) for moderate to high myopia: three-year follow-up.

          To report on 3-year postoperative safety and efficacy outcomes with the Myopic Implantable Collamer Lens (ICL). Prospective nonrandomized clinical trial. Five hundred twenty-six eyes of 294 patients with between 3.0 and 20.0 diopters (D) of myopia participating in the United States Food and Drug Administration clinical trial of the ICL for myopia. Implantation of the ICL. Uncorrected visual acuity (VA), refraction, best spectacle-corrected VA (BSCVA), adverse events, operative and postoperative complications, lens opacity analysis, subjective satisfaction, and patient symptoms. At 3 years, 59.3% had 20/20 or better VA, and 94.7% had 20/40 or better uncorrected VA if BSCVA was 20/20 and patients were targeted for emmetropia; 67.5% of patients were within 0.5 D and 88.2% were within 1.0 D of predicted refraction. The mean improvement in BSCVA ranged between 0.5 and 0.6 lines. At 3 years postoperatively, 3 eyes (0.8%) decreased by >or=2 lines of BSCVA, in contrast to 40 eyes (10.8%) that improved by a similar amount. Contrast sensitivity improved postoperatively. Cumulative 3-year corneal endothelial cell loss was under 10%. Early largely asymptomatic, presumably surgically induced anterior subcapsular opacities (trace or greater) were seen in 14 eyes (2.7%), with only 2 being clinically significant. Five eyes (0.9%) of 3 patients developed nuclear opacities of grade >2 at 2 to 3 years postoperatively. Three (0.6%) ICL removals with cataract extraction and IOL implantation have been performed. Only 0.6% reported dissatisfaction; 97.1% of patients reported they would choose ICL implantation again. Incidences of patient symptoms, glare, halos, double vision, night vision problems, and night driving difficulties decreased or remained unchanged after ICL surgery. Three-year results from this standardized, multicenter clinical investigation support the safety, efficacy, and predictability of ICL surgery to treat moderate to high myopic refractive errors.
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            Toric Implantable Collamer Lens for moderate to high myopic astigmatism.

            To assess the efficacy of the Toric Implantable Collamer Lens (ICL) to treat moderate to high myopic astigmatism. Prospective nonrandomized clinical trial. Two hundred ten eyes of 124 patients with between 2.38 and 19.5 diopters (D) of myopia (spherical equivalent [SE]) and 1 to 4 D of astigmatism participating in the United States Food and Drug Administration clinical trial of the Toric ICL. Implantation of the Toric ICL. Uncorrected visual acuity (UCVA), refraction, best spectacle-corrected visual acuity (BSCVA), adverse events, and postoperative complications. At 12 months postoperatively, the proportion of eyes with 20/20 or better UCVA (83.1%) was identical to the proportion of eyes with preoperative 20/20 or better BSCVA (83.1%); 76.5% had postoperative UCVA better than or equal to preoperative BSCVA. The mean manifest refractive cylinder dropped from 1.93 D (+/-0.84) at baseline to 0.51 D (+/-0.48) postoperatively, a 73.6% decrease in astigmatism. Although only 21.0% of eyes had 1-D refractive cylinder preoperatively (none less), 91.4% of cases had or =2 lines of BSCVA after 12 months postoperatively, whereas 18.9% of cases improved by > or =2 lines. A total of 76.4% of cases gained > or =1 lines of BSCVA, whereas only 7.5% of cases lost the equivalent amount. Three ICL removals were performed without significant loss of BSCVA, and 1 clinically significant lens opacity was observed. The results support the efficacy and predictability of Toric ICL implantation to treat moderate to high myopic astigmatism. Important safety concerns were not identified.
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              Ultrasound biomicroscopy for determining visian implantable contact lens length in phakic IOL implantation.

              To assess the efficacy of the ultrasound biomicroscopic (UBM) method in estimating the sulcus-to-sulcus horizontal diameter for Visian Implantable Contact Lens (ICL, model V4) length determination to obtain optimal ICL vault. The results of postoperative ICL vaults in 30 eyes of 18 patients were retrospectively analyzed. In 17 eyes, ICL length was determined using the conventional method, and in 13 eyes, ICL length was determined using the UBM method. The UBM method was carried out by measuring the sulcus to limbus distance on each side by 50 MHz UBM and adding the white-to-white diameter by caliper or Orbscan. The ICL vaults were measured using the UBM method at 1 and 6 months postoperatively and the results were compared between the two groups. Ideal ICL vault was defined as vault between 250 and 750 microm. The relation between the ICL vault, footplate location, and ICL power was also investigated. In the UBM method group, ICL vault was within the ideal range in all 13 (100%) eyes at 1 and 6 months postoperatively, whereas in the conventional method group, 10 (58.8%) eyes showed ideal vault at 1 month postoperatively (P = .01) and 9 (52.9%) eyes showed ideal vault at 6 months postoperatively (P < .01). The ideal ICL footplate location was achieved in the ciliary sulcus in 11 (84.6%) eyes of the UBM method group and 10 (64.7%) eyes of the conventional method group. However, the differences between the two groups were not statistically significant. The ICL vault was not significantly affected by the ICL power. Implantable Contact Lens length determined by the UBM method achieved significantly more ideal ICL vault than that of the conventional white-to-white method. The UBM method is superior to the conventional method in terms of predicting the sulcus-to-sulcus horizontal diameter for ICL length determination.
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                Author and article information

                Contributors
                +86-021-64377134 , doctxiaoyingwang@163.com
                Journal
                BMC Ophthalmol
                BMC Ophthalmol
                BMC Ophthalmology
                BioMed Central (London )
                1471-2415
                9 May 2018
                9 May 2018
                2018
                : 18
                : 114
                Affiliations
                [1 ]ISNI 0000 0004 1755 3939, GRID grid.413087.9, Department of Ophthalmology, , Zhongshan Hospital of Fudan University, ; Shanghai, People’s Republic of China
                [2 ]GRID grid.411079.a, Department of Ophthalmology, , Eye and ENT Hospital of Fudan University, ; Shanghai, People’s Republic of China
                [3 ]Department of Ophthalmology, Myopia Key Laboratory of the Health Ministry, Shanghai, People’s Republic of China
                Article
                783
                10.1186/s12886-018-0783-5
                5944172
                29743110
                8da55433-d785-4d6e-aaa9-04442ccdb644
                © The Author(s). 2018

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 6 November 2017
                : 3 May 2018
                Funding
                Funded by: The project from the Shanghai Shenkang Hospital Development Center
                Award ID: SHDC12016207
                Funded by: The project from the Health and Family Planning Committee of Pudong New District of Shanghai, China
                Award ID: PW2014D-1
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2018

                Ophthalmology & Optometry
                high myopia,phakic intraocular lens,implantable collamer lens,ultrasound biomicroscopy,vault

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