A novel ophthalmic viscosurgical device-free phakic intraocular lens implantation makes myopic surgery safer

Abstract

Purpose: To assess the efficacy and safety of a novel ophthalmic viscosurgical device-free (OVD-free) method for posterior chamber phakic intraocular lens (PIOL) implantation in myopic eyes. Methods: In this retrospective cohort study, the medical records of myopic eyes that underwent PIOL (Implantable Collamer Lens, ICL) implantation for myopia correction at the Eye Hospital of Wenzhou Medical University between May 2015 and March 2017 were reviewed. A total of 49 eyes with complete data that met follow up requirements (2 h, 1 day, 1 week, 3 months postoperatively) were recruited. Based on the surgical techniques used, the eyes were divided into the OVD-free method group and the standard method group. The clinical data, including intraocular pressure (IOP), corrected distance visual acuity (CDVA) and spherical equivalent (SE), at each follow-up were collected for comparison. Endothelial cell loss and complications were also investigated. Results: Twenty-one eyes received the standard method, and 28 eyes received the OVD-free method. A rise in IOP > 22 mmHg at 2 h was noted in 14 eyes (66.7%) in the standard group and none (0%) in the OVD-free group (p < 0.001). The rise in IOP from baseline was significantly higher at 2 h in the standard group (10.5 ± 5.2 mmHg vs. 2.2 ± 3.3 mmHg, difference: 8.3, 95% CI 5.8 to 10.8; p < 0.001). There was a significant difference in the time course of LogMAR CDVA changes between the two groups (p = 0.047). The LogMAR CDVA was significantly better in the OVD-free method group compared to the standard group at 1 day (− 0.076, 95% CI − 0.134 to − 0.018; p = 0.012), 1 week (− 0.071, 95% CI − 0.135 to − 0.007; p = 0.03), but not at 3 months (− 0.046, 95% CI − 0.107 to 0.015; p = 0.134). There was no significant difference in the time course of SE changes between the two groups (p = 0.471; p = 0.705). In the OVD-free group, mean endothelial cell loss was 4.6% at 3 months (2522 ± 281 vs. 2407 ± 226 cells/ mm 2 , difference:-115, 95% CI − 295 to 65; p = 0.187). No complications were reported in both groups except for the early IOP elevation in the standard group during the observation period. Conclusions: The OVD-free method is safe and efficient for ICL implantation. It can be a safer method of ICL implantation compared to the standard method in that it completely eliminates ophthalmic viscoelastic devicesrelated complications without causing additional complications.

Short‐term changes in and preoperative factors affecting vaulting after posterior chamber phakic Implantable Collamer Lens implantation

“…More than 120,000 ICL implantation surgeries are performed in over 60 countries annually, making the vault, an indicator of postoperative safety, particularly important [ 23 ]. In the current study, we aimed to assess the early changes in the ICL vault in the first month, starting at 2 h after ICL implantation.…”

Pure ICL Implantation: A Novel Ophthalmic Viscosurgical Device-Free Technique

“…Lisa [36] reported a rate of 1.7% at 12 months after surgery. Pan [25] found that the rate was approximately 4.6% at 3 months after surgery. In this study, the loss rate of corneal endothelial cells in the pure group was approximately 2%, whereas that in the standard group was approximately 2.3%, at 3 months after surgery.…”

“…Bluementhal [21] , Tak [22] , Fatih [23] , Bardoloi [24] and other researchers have used various ACM devices to avoid the use of OVDs during phacoemulsi cation cataract extraction or intraocular lens implantation. Pan [25] introduced ICL implantation with continuous infusion and a single-handed ACM. Its safety and effectiveness have been con rmed.…”

Pure ICL Implantation: A Novel Ophthalmic Viscosurgical Device-Free Method

“…Bluementhal [ 22 ], Tak [ 23 ], Fatih [ 24 ], Bardoloi [ 25 ], and other researchers have used various ACM devices to avoid the use of OVDs during phacoemulsification cataract extraction or intraocular lens implantation. Pan [ 26 ] introduced ICL implantation with continuous infusion and a single-handed ACM. Its safety and effectiveness have been confirmed.…”