Comparison of clear lens extraction and collamer lens implantation in high myopia

Abstract

Aim:To compare the outcomes of clear lens extraction and collamer lens implantation in high myopia. Patients and methods: Myopic patients younger than 40 years old with more than 12 diopters of myopia or who were not fit for laser-assisted in situ keratomileusis were included. Group 1 comprised patients undergoing clear lens extraction and Group 2 patients received the Visian implantable collamer lens. Outcome and complications were evaluated. Results: Postoperative best corrected visual acuity was -0.61 ± 0.18 in Group 1 and 0.79 ± 0.16 in Group 2. In Group 1, 71.4% achieved a postoperative uncorrected visual acuity better than the preoperative best corrected visual acuity, while only 51.8% patients achieved this in Group 2. Intraocular pressure decreased by 12.55% in Group 1, and increased by 15.11% in Group 2. Corneal endothelial cell density decreased by 4.47% in Group 1 and decreased by 5.67% in Group 2. Posterior capsule opacification occurred in Group 1. In Group 2, lens opacification occurred in 11.11%, significant pigment dispersion in 3.7%, and pupillary block glaucoma in 3.7%. Conclusion: Clear lens extraction presents less of a financial load up front, and less likelihood of the need for a secondary intervention in the future. Clear lens extraction is a more viable solution in developing countries with limited financial resources.

Refractive Lensectomy and Microinvasive Glaucoma Surgery (MIGS): An Initial Approach in Glaucoma Patients over 50 Years of Age

“…Jean Arne compared phakic intraocular lens (IOL) implantation with clear lens extraction (CLE) in 39 patients aged 30-50 years old and found a lower risk for loss of best correct visual acuity (BCVA) in the phakic IOL group at the one-year follow up [78]. In another study comparing refractive lens exchange (RLE) and Collamer lens (Visian) implantation in patients with myopia younger than 45 years old, the results revealed better outcomes in patients who underwent RLE [79]. In this study, patients in the RLE group experienced no serious complications, while those with the Visian implantation demonstrated pigment dispersion, lens opacity, macular hemorrhage, or pupillary block glaucoma [79].…”

“…In another study comparing refractive lens exchange (RLE) and Collamer lens (Visian) implantation in patients with myopia younger than 45 years old, the results revealed better outcomes in patients who underwent RLE [79]. In this study, patients in the RLE group experienced no serious complications, while those with the Visian implantation demonstrated pigment dispersion, lens opacity, macular hemorrhage, or pupillary block glaucoma [79]. Additional studies examining the efficacy of RLE have demonstrated encouraging results and revealed a rapid and predictable improvement in vision in patients with high myopia as demonstrated by improved corrected distance visual acuity [77,[80][81][82].…”

“…It is recommended that endothelium is coated with viscoelastic prior to phacoemulsification to avoid sudden decompression of the chamber [91]. When compared to the endocapsular technique, the suprascapular approach had an insignificant difference in cell loss, but was more advantageous in cases with zonular weakness and posterior capsular rupture [79]. Accordingly, a successful refractive lens exchange therapy can be achieved with a correctly positioned capsulorrhexis and minimal fluctuations in the anterior chamber [86].…”

Application of glasses-free 3D in Implantable Collamer Lens (ICL) surgery training

“…ICL (implantable collamer lens) implantation provides excellent visual quality in patients with high myopia and thin corneas [1][2][3]. But as an endophthalmologic procedure, the surgeon's learning curve remains a risk factor for some complications [4].…”

Refractive lens exchange: What are the red lines?

“…However, the widespread diffusion of phacoemulsification machines and phaco-trained surgeons have caused the minimum age for RLE to lower. [1][2][3][4][5][6][7][8][9][10] The increased popularity of RLE, 11,12 as for any medical advancement, forces us to redefine our ethical boundaries. The advantages of exchanging a normal, healthy lens for refractive purposes are counterbalanced by specific complications.…”