A systematic review about the impact of phakic intraocular lenses on accommodation

Hernández-Rodríguez, Carlos J.; Piñero, David P.

doi:10.1016/j.optom.2019.08.001

Cited by 5 publications

(5 citation statements)

References 19 publications

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“…Moreover, during the accommodative reaction in the eye with the ICL lens, except when the lens power changes for a specific distance, there were other biometric changes (e.g., in the vault and pupil size) occurring [ 22 , 23 ]. The power of the eye may be different from expected if the optic eye system cannot remain static [ 24 ].…”

Section: Discussionmentioning

confidence: 99%

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

Zhang

Wang

2022

BMC Ophthalmol

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Background To 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). Methods Patients 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. Results The 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). Conclusions The 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.

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Section: Discussionmentioning

confidence: 99%

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

Zhang

Wang

2022

BMC Ophthalmol

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“…This fact assumes special relevance for pre-presbyopic patients, assuming a 0.34 D decay in accommodative amplitude per year of life [25]; +0.25 DS postoperative refraction corresponds to almost one year's loss in accommodative amplitude. Adding to this is the fact that myopic patients implanted with phakic lenses, when observing an object at a near-distance, have to elicit more accommodation than when using spectacles [13,14]. The accommodative demand when observing an object at 0.33 m increases from 0.13 D to 0.83 D for an eye implanted with an ICL of −2.0 DS and −18.0 DS, respectively (Figure S1 in Supplement).…”

Section: Discussionmentioning

confidence: 99%

“…Despite this evidence, small refractive errors, e.g., ±0.50 DS, may produce a decrease in the efficacy index (ratio of the postoperative uncorrected distance visual acuity (UDVA) to the preoperative corrected distance visual acuity (CDVA)) in the case of myopic refractive error or elicit an additional accommodative effort in the case of hyperopic refractive error. Additionally, phakic lens implantation requires the patient to elicit a stronger accommodative effort compared to correction with spectacles [13,14]. This, when associated with hyperopic postoperative refraction and a patient age close to the onset of presbyopia, or poor accommodative amplitude, may hamper near-vision tasks.…”

Section: Introductionmentioning

confidence: 99%

Posterior Chamber Phakic Intraocular Lenses for the Correction of Myopia: Factors Influencing the Postoperative Refraction

Serra

Trancón

Sierra

et al. 2021

Optics

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Posterior chamber phakic intraocular lens implantation is a refractive technique for the correction of myopia. This study aimed to identify those factors contributing to variability in postoperative refraction. Methods: This retrospective study evaluated 73 eyes (one eye per patient) implanted with myopic implantable collamer lenses (ICL). Eyes were divided into two groups, the low myopic group (LMG) (ICL > −9.5 DS) and the high myopic group (HMG) (ICL ≤ −9.5 DS), to compare the predictability, efficacy index, and postoperative refraction between groups. The association of postoperative refraction with anatomical, demographic, and optical features was assessed through correlation analysis and investigated using ray-tracing. Results: Postoperative refraction at 3 months for the whole group was close to emmetropia at −0.02 ± 0.37 DS, the LMG tended toward myopia and the HMG, toward hyperopia. The results showed that 65% and 54% of the eyes had postoperative refraction of within ±0.25 DS, respectively, in the LMG and HMG, and in both groups, 100% were within ±1.00 DS. ICL implantation had a higher efficacy index in the HMG (1.13 ± 0.15) than in the LMG (1.04 ± 0.15). Postoperative refraction was positively associated with the vault (R = 0.408) and negatively correlated with ICL power (R = −0.382). Conclusion: The predictability and effectiveness of ICL implantation is high in a wide range of myopias. Considering the expected vault and including accurate vertex measurements would contribute to improving the predictability of the results.

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“…Second, during the accommodative reaction in the eye with the ICL lens, except when the lens power changes for a speci c distance, there were other biometric changes (e.g., in the vault and pupil size) occurring [22,23]. The power of the eye may be different from expected if the optic eye system cannot remain static [24]. Since the subjective accommodative outcomes were variable and unstable under different observing conditions, perhaps it is more plausible to analyze and evaluate the accommodative function by directly recording the changing of elements, such as crystalline lens, ciliary muscle, etc.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Accommodation and Accommodative Micro-Fluctuation After Implantable Collamer Lens and LASIK Surgery for Myopia

Zhang²,

Wang

2021

Preprint

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Background: To 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).Methods: Patients with good corrected visual acuity (20/20 or better) that underwent ICL (V4c) and LASIK for myopic-correction (ranging from -3.50 to -8.50 D) were recruited. Refraction, amplitude of accommodation (AMP), accommodative lags, high-order aberrations (HOAs), 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.Results: The 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 HOAs 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 lags 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 HOAs and postoperative MRSE in the two groups (all p﹥0.05).Conclusions: The HFC increased significantly after 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.

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A systematic review about the impact of phakic intraocular lenses on accommodation

Cited by 5 publications

References 19 publications

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

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

Posterior Chamber Phakic Intraocular Lenses for the Correction of Myopia: Factors Influencing the Postoperative Refraction

Comparison of Accommodation and Accommodative Micro-Fluctuation After Implantable Collamer Lens and LASIK Surgery for Myopia

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