Lentes intraoculares fáquicas: recientes avances e innovaciones

Martínez-Plaza, Elena; López-Miguel, Alberto; Holgueras, Alfredo; Barraquer, Rafael I.; Alió, Jorge L.; Maldonado, Miguel J.

doi:10.1016/j.oftal.2020.02.001

Cited by 8 publications

(7 citation statements)

References 45 publications

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“…Phakic Intraocular lens (IOL) have become the basic procedure for high degrees of refractive errors. [1][2][3] Patients with myopia beyond −10 D prefer to undergo phakic IOLs instead of keratorefractive procedures globally. 4 Refractive surgeons have determined that keratorefractive procedures for high myopes (>-8.0 D) and corneas with >40% tissue alteration weaken the cornea, significantly increasing the risk of regression and ectasia.…”

mentioning

confidence: 99%

<p>Safety and Efficacy of a New Posterior Chamber Phakic Intraocular Lens in Cases of High Myopia: Early Results</p>

Subudhi¹,

Patro²,

Agarwal³

et al. 2020

OPTH

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Purpose: To demonstrate the visual outcomes of a foldable, hydroxy ethyl-methacrylate, single-piece, posterior chamber phakic intraocular lens (pIOL). Study Type: Retrospective study. Materials and Methods: Patients presenting with moderate to high myopia who underwent surgical correction with a posterior chamber phakic IOL (refractive intraocular lens, phakic intraocular lens, Appasamy Associates, Chennai, India) were retrospectively reviewed. Only patients with at least one-year follow-up were included. Manifest refraction, uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), endothelial cell density (ECD), and pIOL vault were analyzed 1, 3, 6, and 12 months after surgery. Intraoperative and postoperative events were recorded in all cases. Results: The study included 30 eyes from 15 patients. The mean patient age was 25.8 ± 3 years. The spherical equivalent of manifest refraction was −11.47 ± 4.38 D preoperatively and −0.44 ± 0.55 D postoperatively. The preoperative CDVA was 0.17 ± 0.12 logMAR. The postoperative UDVA was 0.053 ± 0.11 logMAR (min: −0.17 and max: 0.2) and 0.019 ± 0.091 logMAR (min: −0.17 and max: 0.2) at the end of 1 month and 6 months, respectively. At the end of the 12-month visit, the postoperative UDVA was 0.032 ± 0.094, and the safety index was 2.42. The mean ECD was 2639 cells/mm 2 (min: 2389 and max: 2993 with SD: 139.53) at the preoperative visit and 2445 cells/mm 2 (min: 2050 and max: 2701) at the 12-month visit (5.8% loss, p less than 0.001). ECD loss from 6 months to 12 months was not statistically significant. No significant cataract formation, significant endothelial cell loss, glaucoma, uveitis, or any other vision-threatening complication were observed. Conclusion:Based on postoperative experience, we found that RIL phakic IOLs are safe and effective for treating high myopia at short-term follow-up.

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confidence: 99%

<p>Safety and Efficacy of a New Posterior Chamber Phakic Intraocular Lens in Cases of High Myopia: Early Results</p>

Subudhi¹,

Patro²,

Agarwal³

et al. 2020

OPTH

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“…Other authors [ 41 ] conclude that the phakic lenses are the first choice in correcting high ametropia and in cases where the ocular surface or cornea is not suitable for keratorefractive techniques, and the excellent results of safety and efficacy that are obtained are confirmed. After three years of follow-up, Morral et al [ 42 ] show that the Artisan iridian fixation phakic IOL is an effective and safe procedure for correcting moderate-severe refractive errors.…”

Section: Discussionmentioning

confidence: 95%

Comparison of Iris-Claw Phakic Lens Implant versus Corneal Laser Techniques in High Myopia: A Five-Year Follow-Up Study

et al. 2022

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Background. This study aimed to compare the efficacy and safety of Femto-LASIK, PRK, and Artiflex/Artisan phakic lens implantation in the surgical correction of myopia at different moments of postoperative follow-up; to propose a linear predictive model of visual acuity without correction at five years of refractive procedures; and to evaluate its validity. Methods. A retrospective observational analysis was performed. Patients were clinically reviewed after three months, one year, two years, and five years. Univariate and bivariate analyses and a multivariate linear regression model were performed. Results. Six hundred seventy-nine eyes were analyzed: 18.9% Artiflex, 2.8% Artisan, 42.3% Femto-LASIK, and 36.1% PRK. There were significant differences in effectiveness and safety after five years when comparing Artiflex/Artisan versus PRK and Femto-LASIK (p < 0.01). The linear regression model explained 30.32% of the patients’ visual acuity variability after five years. Conclusions. PRK surgery, Femto-Lasik, and Artiflex/Artisan type phakic lens implantation are effective, safe, and predictable techniques with stable refractive results. Phakic lenses magnify myopic patients who improve their UCVA and BCVA. Concerning phakic lens implantation, corneal endothelial cells remain stable. The predictive model calculated that surgery with a phakic lens increased the UCVA result at five years, and surgery with PRK slightly decreased the long-term results.

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“…Weitere kammerwinkelgestützte pIOL-Modelle, wie z. B. Kelman Duet (Tekia, Inc., Irvine, California, USA) mit einer faltbaren Silikonoptik und PMMA-Haptiken sowie I-Care (Cornéal, Pringy, Frankreich), die aus einem hydrophilen Acrylat besteht, wurden ebenfalls vom Markt zurückgezogen [1,7,8].…”

Section: Phake Kammerwinkelgestützte Vorderkammerlinsenunclassified

“…Twelve-year data on the ZB5M pIOL show endothelial loss of 30.3 %; this is significantly higher than the expected physiological loss of endothelial cells, which is just 6.5 % [6]. Other angle-supported pIOL models, such as Kelman Duet (Tekia, Inc., Irvine, California, USA), made with flexible silicone optics and PMMA haptics, as well as the I-Care (Cornéal, Pringy, France), made from hydrophilic acrylate, have also been withdrawn from the market [1,7,8].…”

Section: Angle-supported Anterior Chamber Phakic Intraocular Lensesmentioning

confidence: 99%

Endothelzellverlust bei phaken Intraokularlinsen

Naujokaitis,

Auffarth,

Łabuz

et al. 2024

Klin Monbl Augenheilkd

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ZusammenfassungObwohl die Sicherheit der phaken Intraokularlinsen (pIOLs) über eine bereits 70-jährige Entwicklungsgeschichte kontinuierlich verbessert wurde, können hohe Endothelzellverluste auch bei den aktuellen pIOL-Modellen auftreten. Die Studienergebnisse zeigen, dass die Entfernung einer pIOL zum Hornhautendothel eine entscheidende Rolle beim Endothelzellverlust spielt. Allein deswegen werden bei den Vorderkammerlinsen tendenziell höhere Endothelzellverluste beobachtet als bei den Hinterkammerlinsen. Eine ausreichende präoperative Vorderkammertiefe ist essenziell, zumindest bei den irisfixierten pIOLs, um eine sichere Distanz zum Endothel zu gewährleisten. Die Vorderkammer wird jedoch mit zunehmendem Alter flacher und es kann deswegen sinnvoll sein, das Patientenalter bei den Sicherheitskriterien mitzuberücksichtigen. Obwohl der Endothelzellverlust bei den aktuellen pIOL-Modellen i. d. R. gering ist, sind regelmäßige Kontrollen mit Messung der Endothelzelldichte aufgrund großer interindividueller Unterschiede bei den Patienten mit pIOLs nach wie vor unverzichtbar. Falls ein höherer Endothelzellverlust beobachtet wird als erwartet und die nachfolgenden Kontrollen die Tendenz bestätigen, soll die pIOL rechtzeitig explantiert werden. Hierbei ist die Endothelreserve individuell zu betrachten, indem man das Patientenalter, den physiologischen Endothelzellverlust sowie den Verlust durch weitere Operationen berücksichtigen sollte. Bei einer sorgfältigen Indikationsstellung und einer langfristigen Patientenbetreuung stellen die pIOLs nach wie vor eine sichere Behandlungsoption dar.

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Lentes intraoculares fáquicas: recientes avances e innovaciones

Cited by 8 publications

References 45 publications

<p>Safety and Efficacy of a New Posterior Chamber Phakic Intraocular Lens in Cases of High Myopia: Early Results</p>

<p>Safety and Efficacy of a New Posterior Chamber Phakic Intraocular Lens in Cases of High Myopia: Early Results</p>

Comparison of Iris-Claw Phakic Lens Implant versus Corneal Laser Techniques in High Myopia: A Five-Year Follow-Up Study

Endothelzellverlust bei phaken Intraokularlinsen

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