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Du J, Zhou W, Zhao T, Qian T, Lu Y, Li H, Zhang Z, Lian J. Efficacy and Safety of Implantable Collamer Lens V4c Implantation in 1,834 Myopic Eyes for 1 Year of Follow-up. J Refract Surg 2023; 39:694-704. [PMID: 37824302 DOI: 10.3928/1081597x-20230908-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2023]
Abstract
PURPOSE To evaluate visual outcomes of patients with myopia after EVO Implantable Collamer Lens (ICL) (STAAR Surgical) implantation and predict risk factors of postoperative vault abnormalities. METHODS In this single-center, retrospective analysis, 1,834 eyes of 926 patients with myopia who underwent EVO ICL implantation were recruited between 2020 and 2021. Patients were followed up for 1 year, during which surgery outcomes were evaluated. In addition, 31 eyes with vault abnormalities who underwent secondary surgery were enrolled to form a generalized linear model, which aimed to predict risk factors contributing to vault abnormalities. RESULTS At the final follow-up visit, safety and efficacy indexes were 1.12 ± 0.17 and 1.10 ± 0.19, respectively, and there was no statistical significance between the low and high myopia groups. Furthermore, 79.18% of eyes achieved a residual spherical equivalent within ±0.50 diopters. Except for the temporary elevation of intraocular pressure at 1 week postoperatively, IOP and endothelial cell density remained stable during follow-up visits. The rate of postoperative adverse events was 21.97% and most adverse events were transient. Vault abnormalities accounted for the majority of complications (9.54%). Results of generalized linear model showed that age was a risk factor for postoperative vault abnormalities, and the anterior chamber depth served as a protective factor (P < .05). CONCLUSIONS Visual outcomes of EVO ICL implantation were satisfactory in safety and efficacy indexes in both the low and high myopia groups for 1 year of follow-up, with acceptable stability in postoperative spherical equivalent, intraocular pressure, and endothelial cell density. This study emphasized cautious ICL size selection for older patients and those with shallow anterior chamber depth. [J Refract Surg. 2023;39(10):694-704.].
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Sánchez Trancón A, Cerpa Manito S, Torrado Sierra O, Baptista AM, Serra PM. Vault differences in eyes implanted with spherical and toric implantable collamer lenses: an inter-eye analysis. BMC Ophthalmol 2022; 22:435. [PMCID: PMC9664806 DOI: 10.1186/s12886-022-02653-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 10/11/2022] [Indexed: 11/16/2022] Open
Abstract
Abstract
Purpose
To determine the influence of implantable collamer lenses (ICL) geometry, i.e. spherical and toric on the vault, and report the refractive and visual outcomes of patients bilaterally implanted with the two ICL geometries.
Methods
This retrospective case series analysed 41 patients implanted with a spherical ICL (sICL) in one eye and an equal sized toric ICL (tICL) in the fellow eye. The anatomical and ICL-related parameters were assessed using anterior-segment optical coherence tomography (AS-OCT Visante, Zeiss Meditec AG) and optical tomography (Pentacam, OCULUS). The influence of the anatomical and ICL-related parameters on the vault was determined using generalised estimating equations (GEE) to incorporate inter-eye correlations.
Results
Postoperative spherical equivalent was within ± 0.50D in 66% and 83% of the eyes, respectively implanted with sICL and tICL. The efficacy index in the sICL group was 1.06 and 1.14 in the tICL group. The mean inter-eye vault difference was -1.46 µm, anatomical and ICL-related parameters showed similar associations with the vault for sICL and tICL. The GEE identified the ICL size minus the anterior chamber width, the ICL spherical power and ICL central thickness as significant factors influencing the vault.
Conclusions
Spherical and toric ICL showed good efficacy for the correction of myopia and astigmatism. Patients implanted bilaterally with sICL and tICL tend to present similar vaults. The vault produced by both types of ICL was mainly regulated by the oversizing of the ICL. This suggests that the ICL geometry (spherical vs toric) is a factor with limited influence on the vault, thus the sizing method of a sICL and tICL should be similar.
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Prediction of the trabecular iris angle after posterior chamber phakic intraocular lens implantation. J Cataract Refract Surg 2021; 48:604-610. [PMID: 34486579 DOI: 10.1097/j.jcrs.0000000000000804] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Accepted: 08/22/2021] [Indexed: 11/25/2022]
Abstract
PURPOSE To create an equation for predicting the trabecular iris angle (TIA) and to verify its accuracy after implantable collamer lens (ICL) implantation. SETTING Nagoya Eye Clinic, Nagoya, Japan. DESIGN Retrospective evaluation of a screening approach. METHODS The subjects included 174 eyes (174 patients) that underwent ICL implantation. Patients were randomly assigned to the prediction equation group (116 eyes) or verification group (58 eyes). Anterior segment optical coherence tomography (AS-OCT; CASIA2 TOMEY) was performed before and 3 months after ICL surgery. For the prediction group, a prediction equation was created with the preoperative AS-OCT parameters and ICL size as independent variables and the postoperative anterior chamber depth (ACD) as dependent variables. Then, by applying the predicted post-ACD and preoperative AS-OCT parameters as independent variables and TIA after ICL surgery as the dependent variable, a prediction equation was created to predict the postoperative TIA (post-TIA) after ICL surgery. Each prediction equation was created using stepwise multiple regression analysis, and its accuracy was verified by a Bland-Altman plot in the verification group. RESULTS The explanatory variables (standardized partial regression coefficient) selected in the post-TIA prediction equation were post-ACD (0.629), TIA750 (0.563), iris curvature (0.353), pupil diameter (-0.281), iris area (-0.249), and trabecular iris space area 250 (-0.171) (R2 = 0.646). There were no clinically significant systematic errors between measured and predictive post-TIA values in the verification group. The average absolute prediction error was 3.43° ± 2.22°. CONCLUSIONS Post-TIA can be accurately predicted from the predicted post-ACD and other preoperative AS-OCT parameters.
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Gargallo-Martinez B, Garcia-Medina JJ, Rubio-Velazquez E, Fernandes P, Villa-Collar C, Gonzalez-Meijome JM, Gutierrez-Ortega R. Vault changes after cyclopentolate instillation in eyes with posterior chamber phakic intraocular lens. Sci Rep 2020; 10:9646. [PMID: 32541775 PMCID: PMC7296012 DOI: 10.1038/s41598-020-66146-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2020] [Accepted: 04/14/2020] [Indexed: 11/09/2022] Open
Abstract
Posterior chamber phakic intraocular lens (pIOL) implantation is a common option for correcting moderate-to-high ocular refractive defects. Because this pIOL is implanted on ciliary sulcus, the distance between the back surface of the pIOL and the anterior surface of the crystalline lens, that it is known as vault, should be measured in different conditions to ensure the technique's safety. Cyclopentolate is a drug that dilates the pupil and relaxes accommodation (cycloplegia). It is often used for different ocular examinations and for other medical purposes. However, there is no evidence of the effect of this drug on vault. This study quantified central vault changes associated with cyclopentolate instillation. We measured the vault under normal conditions (pre-cycloplegic instillation) and after instilling cyclopentolate on 39 eyes of 39 patients with implanted pIOL. Our results suggest that cyclopentolate instillation may induce changes to vault in eyes with implanted pIOL. These changes seem safe and are mainly associated with vault under normal conditions, but also with anterior chamber depth, pupillary diameter and pIOL size.
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Affiliation(s)
- Beatriz Gargallo-Martinez
- Department of Ophthalmology, Clínica Novovisión, Murcia, Spain. .,Departament of Condensed Matter Physics, University of Sevilla, Sevilla, Spain.
| | - Jose Javier Garcia-Medina
- Departament of Ophthalmology, General University Hospital Morales Meseguer, Murcia, Spain. .,Department of Ophthalmology and Optometry, University of Murcia, Murcia, Spain.
| | - Elena Rubio-Velazquez
- Department of Ophthalmology, Clínica Novovisión, Murcia, Spain.,Departament of Ophthalmology, General University Hospital Morales Meseguer, Murcia, Spain
| | - Paulo Fernandes
- Clinical & Experimental Optometry Research Lab, Center of Physics, University of Minho, Braga, Portugal
| | - César Villa-Collar
- Department of Ophthalmology, Clínica Novovisión, Murcia, Spain.,Faculty of Biomedicine and Health, European University of Madrid, Madrid, Spain
| | - José M Gonzalez-Meijome
- Clinical & Experimental Optometry Research Lab, Center of Physics, University of Minho, Braga, Portugal
| | - Ramón Gutierrez-Ortega
- Department of Ophthalmology, Clínica Novovisión, Murcia, Spain.,Department of Ophthalmology and Optometry, University of Murcia, Murcia, Spain
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Park K, Chung JK. Result of Central Vault Depending on Lens Diameters in Patients with Implantable Collamer Lens Implantation. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2019. [DOI: 10.3341/jkos.2019.60.12.1191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Kibum Park
- Department of Ophthalmology, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
| | - Jin Kwon Chung
- Department of Ophthalmology, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
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Zhang X, Chen X, Wang X, Yuan F, Zhou X. Analysis of intraocular positions of posterior implantable collamer lens by full-scale ultrasound biomicroscopy. BMC Ophthalmol 2018; 18:114. [PMID: 29743110 PMCID: PMC5944172 DOI: 10.1186/s12886-018-0783-5] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2017] [Accepted: 05/03/2018] [Indexed: 11/29/2022] Open
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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Affiliation(s)
- Xi Zhang
- Department of Ophthalmology, Zhongshan Hospital of Fudan University, Shanghai, People's Republic of China.,Department of Ophthalmology, Eye and ENT Hospital of Fudan University, Shanghai, People's Republic of China.,Department of Ophthalmology, Myopia Key Laboratory of the Health Ministry, Shanghai, People's Republic of China
| | - Xun Chen
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, Shanghai, People's Republic of China.,Department of Ophthalmology, Myopia Key Laboratory of the Health Ministry, Shanghai, People's Republic of China
| | - Xiaoying Wang
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, Shanghai, People's Republic of China. .,Department of Ophthalmology, Myopia Key Laboratory of the Health Ministry, Shanghai, People's Republic of China.
| | - Fei Yuan
- Department of Ophthalmology, Zhongshan Hospital of Fudan University, Shanghai, People's Republic of China
| | - Xingtao Zhou
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, Shanghai, People's Republic of China.,Department of Ophthalmology, Myopia Key Laboratory of the Health Ministry, Shanghai, People's Republic of China
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Gonzalez-Lopez F, Mompean B, Bilbao-Calabuig R, Vila-Arteaga J, Beltran J, Baviera J. Dynamic Assessment of Light-Induced Vaulting Changes of Implantable Collamer Lens With Central Port by Swept-Source OCT: Pilot Study. Transl Vis Sci Technol 2018; 7:4. [PMID: 29736325 PMCID: PMC5931257 DOI: 10.1167/tvst.7.3.4] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Accepted: 03/24/2018] [Indexed: 11/24/2022] Open
Abstract
Purpose To assess dynamic variations in vault induced by changes in brightness in eyes implanted with phakic collamer intraocular lens (pIOL) with central port for correction of myopia, defining new parameters of vaulting measurement. Methods We used a noninvasive Fourier-domain swept-source anterior-segment optical coherence tomography (AS-OCT) system to dynamically evaluate the shifts between the pIOL and anterior chamber structures under changing light conditions. For each eye assessed, we measured vault interval (VI), which we define based on central vault values in maximum mydriasis and in maximum miosis after light-induced changes in pupil diameter, and vault range (VR), which we define as the absolute difference between the VI values. Results The pilot study sample comprised 39 eyes (23 patients) previously implanted (mean 107 ± 156 days) with a pIOL. A significant difference in vault value was found when maximum and minimum pupil size was assessed under changing external light conditions (P < 0.001). The mean VR from scotopic (0.5 lux) to photopic (18,500 lux) light conditions was 167 ± 70 μm. Conclusions Vault is continuously affected during movements of the pupil induced by external luminance. Translational Relevance Quantifiable dynamic parameters VR and VI obtained with this AS-OCT device describe the position of the pIOL in the posterior chamber of the eye in a more accurate and real way than static vault measurements, and may contribute to improved understanding of the behavior of the pIOL in terms of safety.
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Affiliation(s)
| | - Blas Mompean
- Clínica Baviera, Instituto Oftalmológico Europeo, Madrid, Spain.,Department of Ophthalmology, Hospital Torrevieja, Alicante, Spain
| | | | | | - Jaime Beltran
- Clínica Baviera, Instituto Oftalmológico Europeo, Madrid, Spain
| | - Julio Baviera
- Clínica Baviera, Instituto Oftalmológico Europeo, Madrid, Spain
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8
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Changes in Objective Vault and Effect on Vision Outcomes after Implantable Collamer Lens Implantation: 1-Year Follow-up. Eur J Ophthalmol 2018; 22:153-60. [PMID: 21607932 DOI: 10.5301/ejo.2011.8359] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/11/2011] [Indexed: 11/20/2022]
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Lisa C, Baamonde B, Pérez-Vives C, Montés-Micó R, Alfonso JF. Five-year functional outcomes and vault of -20 diopter myopic phakic intraocular lens implantation. J Cataract Refract Surg 2016; 41:2724-30. [PMID: 26796453 DOI: 10.1016/j.jcrs.2015.07.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2015] [Revised: 07/09/2015] [Accepted: 07/15/2015] [Indexed: 11/27/2022]
Abstract
PURPOSE To evaluate refractive and visual outcomes and complications associated with phakic intraocular lens (pIOL) implantation to correct high myopia. SETTINGS Fernández-Vega Ophthalmological Institute, Oviedo, Spain. DESIGN Retrospective observational case series. METHODS Uncorrected distance visual acuity (UDVA) and corrected distance visual acuity (CDVA), refraction, vault, and adverse effects were evaluated after 5 years with Visian ICMV4 pIOL. RESULTS Mean spherical equivalent (SE) dropped from -18.32 ± 2.37 diopters (D) preoperatively to -0.88 ± 0.52D 5 years postoperatively; 61% of eyes were within ±0.75 D of the target. The mean Snellen decimal CDVA and UDVA were 0.73 ± 0.23 and 0.55 ± 0.26, respectively. More than 50% of eyes achieved 20/25 or better CDVA postoperatively. Four eyes had lost 2 or 1 lines of CDVA, 10 eyes had not lost any lines from preoperatively, and 46 eyes had gained 1 or more lines of CDVA 5 years postoperatively. The safety index was 1.26 ± 0.32. Forty eyes had UDVA of 20/40 or better postoperatively. The efficacy index was 0.99 ± 0.42. At 5-year follow-up, the mean central vault was 475.28 ± 216.38 μm. No eyes showed central contact between the pIOL and crystalline lens. Nevertheless, 10 eyes showed peripheral contact with a central vault between 150 and 260 μm. Two eyes developed anterior subcapsular cataract, although only 1 eye required cataract surgery. CONCLUSIONS Predictability, safety and effective outcomes of posterior pIOL of (- were good, as well as postoperative complications over the long term. A central vault of 260 μm was enough to prevent the peripheral contact between the pIOL and crystalline lens in eyes with high myopia. FINANCIAL DISCLOSURE The authors have no proprietary interest in any of the materials mentioned in this article.
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Affiliation(s)
- Carlos Lisa
- From the Fernández-Vega Ophthalmological Institute (Lisa, Baamonde, Alfonso), Oviedo, Spain; Surgery Department (Baamonde, Alfonso), School of Medicine, University of Oviedo, Spain; GIO (Pérez-Vives, Montés-Micó), Optics Department, Faculty of Physics, University of Valencia, Spain
| | - Begoña Baamonde
- From the Fernández-Vega Ophthalmological Institute (Lisa, Baamonde, Alfonso), Oviedo, Spain; Surgery Department (Baamonde, Alfonso), School of Medicine, University of Oviedo, Spain; GIO (Pérez-Vives, Montés-Micó), Optics Department, Faculty of Physics, University of Valencia, Spain
| | - Cari Pérez-Vives
- From the Fernández-Vega Ophthalmological Institute (Lisa, Baamonde, Alfonso), Oviedo, Spain; Surgery Department (Baamonde, Alfonso), School of Medicine, University of Oviedo, Spain; GIO (Pérez-Vives, Montés-Micó), Optics Department, Faculty of Physics, University of Valencia, Spain
| | - Robert Montés-Micó
- From the Fernández-Vega Ophthalmological Institute (Lisa, Baamonde, Alfonso), Oviedo, Spain; Surgery Department (Baamonde, Alfonso), School of Medicine, University of Oviedo, Spain; GIO (Pérez-Vives, Montés-Micó), Optics Department, Faculty of Physics, University of Valencia, Spain
| | - José F Alfonso
- From the Fernández-Vega Ophthalmological Institute (Lisa, Baamonde, Alfonso), Oviedo, Spain; Surgery Department (Baamonde, Alfonso), School of Medicine, University of Oviedo, Spain; GIO (Pérez-Vives, Montés-Micó), Optics Department, Faculty of Physics, University of Valencia, Spain.
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Igarashi A, Shimizu K, Kamiya K. Eight-year follow-up of posterior chamber phakic intraocular lens implantation for moderate to high myopia. Am J Ophthalmol 2014; 157:532-9.e1. [PMID: 24239774 DOI: 10.1016/j.ajo.2013.11.006] [Citation(s) in RCA: 158] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2013] [Revised: 11/04/2013] [Accepted: 11/06/2013] [Indexed: 11/17/2022]
Abstract
PURPOSE To assess the long-term clinical outcomes of Implantable Collamer Lens (Visian ICL; STAAR Surgical) implantation for moderate to high myopia. DESIGN Retrospective observational case series. METHODS This study evaluated 41 eyes of 41 patients with myopic refractive errors of -4.00 to -15.25 diopters (D) who underwent ICL implantation and routine postoperative examinations. Before surgery, and 1 and 6 months and 1, 4 and 8 years after surgery, we assessed the safety, efficacy, predictability, stability, and adverse events of the surgery. RESULTS The safety and efficacy indices were 1.13 ± 0.27 and 0.83 ± 0.36. At 8 years, 68.3% and 85.4% of the eyes were within 0.5 and 1.0 D, respectively, of the targeted correction. Manifest refraction changes of -0.32 ± 0.73 D occurred between 1 month and 8 years. The mean endothelial cell loss from preoperative levels was 6.2% at 8 years. Two eyes (4.9%) developed clinically significant symptomatic cataract during the follow-up period. Simultaneous lens extraction and phacoemulsification with IOL implantation was successfully performed in these 2 eyes. CONCLUSIONS According to our experience, ICL implantation was overall good in measures of safety, efficacy, predictability, and stability for the correction of moderate to high myopia during the 8-year observation period, suggesting its long-term viability as a surgical option for the treatment of such eyes.
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Affiliation(s)
- Akihito Igarashi
- Department of Ophthalmology, University of Kitasato School of Medicine, Kanagawa, Japan.
| | - Kimiya Shimizu
- Department of Ophthalmology, University of Kitasato School of Medicine, Kanagawa, Japan
| | - Kazutaka Kamiya
- Department of Ophthalmology, University of Kitasato School of Medicine, Kanagawa, Japan
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Kim WK, Cho EY, Kim HS, Kim DS, Kim JK. The Benefits of One Day, One Eye Surgery in Bilateral ICL Implantation. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2013. [DOI: 10.3341/jkos.2013.54.7.1019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Lindland A, Heger H, Kugelberg M, Zetterström C. Changes in vaulting of myopic and toric implantable collamer lenses in different lighting conditions. Acta Ophthalmol 2012; 90:788-91. [PMID: 21834924 DOI: 10.1111/j.1755-3768.2011.02224.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
PURPOSE To evaluate the changes in vaulting of myopic and toric Implantable Collamer Lenses (ICLs) in different lighting conditions. METHODS Thirty-seven eyes of 37 patients implanted with a myopic ICL and 26 eyes of 26 patients implanted with a toric ICL were examined using Visante optical coherence tomography (OCT) in photopic (257 lux) and mesopic (2 lux) conditions. Pupil diameter and distance changes between the ICL and adjacent intraocular structures were measured. RESULTS The mean horizontal pupillary diameters in mesopic conditions were 5.3 ± 0.9 (SD) mm. In photopic conditions, a mean decrease of -1.8 ± 0.6 mm [95% confidence interval (95% CI) -2.0 to -1.7; p < 0.0001] was observed. The mean distances between the ICL and the crystalline lens in mesopic conditions were 0.33 ± 0.17 mm. In photopic conditions, a mean decrease of -0.04 ± 0.06 mm (95% CI -0.05 to -0.02; p < 0.0001) in the ICL-crystalline lens distance was found. There was a -0.02 ± 0.04 mm (95% CI -0.03 to -0.01; p = 0.0022) decrease in the anterior chamber depth and a 0.02 ± 0.06 mm (95% CI 0.002 to 0.032; p = 0.0275) increase in the distance between the cornea and the ICL. We found no difference in the change in vaulting between the two ICLs in different lighting conditions. CONCLUSION There is a decrease in the central vaulting of myopic and toric ICLs in photopic conditions. This is due to both posterior movement of the ICL and anterior protrusion of the crystalline lens.
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Affiliation(s)
- Are Lindland
- Department of Ophthalmology, University of Oslo, Oslo, Norway.
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Alfonso JF, Fernández-Vega L, Lisa C, Fernandes P, González-Meijome J, Montés-Micó R. Long-term evaluation of the central vault after phakic Collamer® lens (ICL) implantation using OCT. Graefes Arch Clin Exp Ophthalmol 2012; 250:1807-12. [PMID: 22371020 DOI: 10.1007/s00417-012-1957-0] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2011] [Revised: 01/07/2012] [Accepted: 01/30/2012] [Indexed: 10/28/2022] Open
Abstract
PURPOSE The aim of this work is to evaluate the changes in the central vault after using implantable Collamer® lenses (ICL) to correct myopia. METHODS This cohort study included 133 eyes; mean spherical equivalent -9.47 ± 3.71 diopters (D) (range: -2.75 to -22.25 D) who underwent ICL V4 implantation. Besides a complete ophthalmologic examination, the central vaulting was measured with Visante OCT and evaluated between different periods of follow-up (1 week, 1, 3, and 6 months, and yearly postoperatively). Post-operative time ranged from 6 to 73 months. RESULTS Within the first 6 months, the mean central vaulting dropped from 510 ± 238 μm (range 100 to 940 μm) to 439 ± 231 μm (range 90 to 910) a significant decrease by 71 ± 58 μm (range -170 to 30 μm) (p = 0.028) with a trend to a lower reduction after this period. After 36 month from ICL implantation, this variation tends to be smaller with the majority of the eyes having a mean decrease smaller than 2 μm per month. Initial vault (Spearman Rho = -0.237, p = 0.006) was the factor more significantly associated with decrease in vault; eyes presenting a reduction in vault >100 μm had an average initial vault that was 141 μm and 184 μm higher than eyes with no change or with increase in vault over time, respectively. CONCLUSIONS This study shows a continuous reduction of central vault over time. The reduction is highest during the first 6 months and tends to be lower and slow down over time. The decrease of vaulting was more pronounced in eyes with larger initial vaulting.
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Affiliation(s)
- Jose F Alfonso
- Fernández-Vega Ophthalmological Institute, Avda. Dres. Fernández-Vega 114, 33012, Oviedo, Spain.
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14
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Central vault after phakic intraocular lens implantation: correlation with anterior chamber depth, white-to-white distance, spherical equivalent, and patient age. J Cataract Refract Surg 2012; 38:46-53. [PMID: 22153092 DOI: 10.1016/j.jcrs.2011.07.035] [Citation(s) in RCA: 62] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2011] [Revised: 07/21/2011] [Accepted: 07/22/2011] [Indexed: 11/21/2022]
Abstract
PURPOSE To compare the central postoperative vault of a phakic intraocular lens (pIOL) to correct myopia, myopic astigmatism, and hyperopia and identify ocular and lens parameters that might predict the vault amount. SETTING Fernández-Vega Ophthalmological Institute, Oviedo, Spain. DESIGN Cohort study. METHODS Three months after implantation of Implantable Collamer Lens pIOLs to correct myopia, hyperopia, and myopic astigmatism, central vault was measured using optical coherence tomography. Patients were divided into groups according to the preoperative anterior chamber depth (ACD) to compare the effects of ACD, white-to-white (WTW) distance, and lens diameter on postoperative pIOL vault. RESULTS Hyperopic pIOLs had statistically significantly lower vault followed by myopic pIOLs and toric pIOLs, which had a higher mean value and narrower range (260 to 860 μm). Measured vaults had a positive correlation with preoperative ACD (r = .32, P<.001) and WTW (r = .29, P<.001) and a negative correlation with preoperative spherical equivalent (SE) (r = -0.21, P<.001) and patient age (r = -0.12, P=.025). Eyes with a vault of 250 μm or less had a shallower ACD than eyes with a vault between 250 μm and 750 μm (mean difference -0.11 mm; P=.012) and those with a vault greater than 750 μm (mean difference -0.25 mm; P<.001). CONCLUSIONS Central vaulting was lower in hyperopic eyes. Current nomograms for pIOL diameter selection based on ACD and WTW might yield ideal vault and may have to be adjusted for older patients, shallower ACD, lower WTW, and lower SE.
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Kim WK, Yang H, Cho EY, Kim HS, Kim JK. The Effect of Lens Thickness to Anterior Chamber Depth on the Vault after ICL Implantation. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2012. [DOI: 10.3341/jkos.2012.53.8.1081] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Fernandes P, González-Méijome JM, Madrid-Costa D, Ferrer-Blasco T, Jorge J, Montés-Micó R. Implantable collamer posterior chamber intraocular lenses: a review of potential complications. J Refract Surg 2011; 27:765-76. [PMID: 21710954 DOI: 10.3928/1081597x-20110617-01] [Citation(s) in RCA: 186] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2010] [Accepted: 05/27/2011] [Indexed: 01/31/2023]
Abstract
PURPOSE To review the peer-reviewed literature reporting postoperative complications of the most recent models of Visian Implantable Collamer posterior chamber intraocular lenses (ICL, STAAR Surgical Co). METHODS A literature search of the PubMed database was performed to identify all articles related to ICL complications. Articles were obtained and reviewed to identify those that reported complications using the latest ICL designs. RESULTS Cataract was the major postoperative complication reported: 136 (5.2%) in 2592 eyes. Of those, 43.4% (n=59) were reported within 1 year, 15.4% (n=21) between 1 and 3 years, and 35.3% (n=48) ≥ 3 years after ICL implantation. Twenty-one (15.4%) cataracts were reported as surgically induced, 46 (33.8%) eyes had poor vault (<200 μm), and cataract surgery was carried out in 27.9% (n=38) of eyes. Early acute intraocular pressure increase was also reported to be relatively frequent, whereas acute pupillary block was less frequent and mostly resolved with additional iridotomies. A total of 42 ICLs were explanted due to cataract and IOP. Reported endothelial cell loss varied from 9.9% at 2 years to 3.7% 4 years postoperatively. This loss was reported to be more pronounced within the first 1 to 2 years, with stability or lower progression after that time. CONCLUSIONS The majority of reported complications after ICL implantation are cataract formation. The improvements in lens geometry and more accurate nomograms applied to the selection of the lens to be implanted, in addition to the surgeon's learning curve, might be factors in the decreased occurrence of postoperative complications reported currently.
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Khalifa YM, Goldsmith J, Moshirfar M. Bilateral Explantation of Visian Implantable Collamer Lenses Secondary to Bilateral Acute Angle Closure Resulting from a Non-Pupillary Block Mechanism. J Refract Surg 2010; 26:991-4. [DOI: 10.3928/1081597x-20100521-01] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2010] [Accepted: 04/21/2010] [Indexed: 11/20/2022]
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Kamiya K, Shimizu K, Aizawa D, Igarashi A, Komatsu M, Nakamura A. One-Year Follow-up of Posterior Chamber Toric Phakic Intraocular Lens Implantation for Moderate to High Myopic Astigmatism. Ophthalmology 2010; 117:2287-94. [DOI: 10.1016/j.ophtha.2010.03.054] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2009] [Revised: 02/07/2010] [Accepted: 03/24/2010] [Indexed: 10/19/2022] Open
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Schmidinger G, Lackner B, Pieh S, Skorpik C. Long-term changes in posterior chamber phakic intraocular collamer lens vaulting in myopic patients. Ophthalmology 2010; 117:1506-11. [PMID: 20363503 DOI: 10.1016/j.ophtha.2009.12.013] [Citation(s) in RCA: 125] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2009] [Revised: 12/08/2009] [Accepted: 12/08/2009] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE Evaluation of central and midperipheral vaulting of the posterior chamber phakic intraocular Collamer lens (ICL; Staar Surgical Inc., Monrovia, CA) in eyes with moderate to high myopia. DESIGN Retrospective analysis of prospectively collected data. PARTICIPANTS Eighty-four eyes treated with the latest ICL (V4 model) and 27 eyes treated with early ICL models were examined. METHODS After standardized ICL implantation, patients underwent complete ophthalmologic examinations before surgery and at 1 week, 1 month, 3 months, 6 months, and at yearly intervals thereafter. Central vaulting was measured using the Jaeger device (Haag-Streit, Bern, Switzerland). From 2006 onward, vaulting was measured additionally by optical coherence tomography (Visante OCT; Carl Zeiss Meditec, Jena, Germany). Using the Visante OCT, the crystalline lens rise and the midperipheral vaulting of the ICL were assessed. MAIN OUTCOME MEASURES Central vaulting after ICL implantation. RESULTS The mean duration of follow-up was 74.1+/-23.1 months and 96.3+/-50.2 months in eyes treated with V4 and early models, respectively. Postoperative central vaulting was 466+/-218 microm (range, 30-900 microm) in eyes treated with the V4 models and 321+/-200 microm (range, 150-900 microm) in those treated with early ICL models. From the 6-month follow-up onward, a continuous and nearly linear reduction of central vaulting was observed. At the 10-year follow-up, the mean central vaulting was reduced to 184+/-159 microm (range, 6-500 microm) and 138+/-218 microm (range, 0-820 microm) in eyes treated with V4 or early models, respectively. Eyes with total vaulting had a mean central vaulting of 407+/-202 microm (range, 180-730 microm), whereas those with midperipheral contact had a significantly lower central vaulting of 105+/-87 microm (range, 0-200 microm). CONCLUSIONS This study revealed consistent reduction of central vaulting over a 10-year period and provides further evidence that insufficient vaulting of the ICL is responsible for the development of anterior subcapsular cataract. A minimum central vaulting of 230 microm seems to be necessary to ensure total vaulting of the ICL. If an ICL is chosen for the correction of myopia, targeting for the greatest possible postoperative central vaulting is advised to achieve safe and complete vaulting for several years.
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Affiliation(s)
- Gerald Schmidinger
- Department of Ophthalmology, Medical University of Vienna, Vienna, Austria.
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Alfonso JF, Lisa C, Abdelhamid A, Fernandes P, Jorge J, Montés-Micó R. Three-year follow-up of subjective vault following myopic implantable collamer lens implantation. Graefes Arch Clin Exp Ophthalmol 2010; 248:1827-35. [PMID: 20333528 DOI: 10.1007/s00417-010-1322-0] [Citation(s) in RCA: 79] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2009] [Revised: 01/18/2010] [Accepted: 02/04/2010] [Indexed: 11/24/2022] Open
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Lindland A, Heger H, Kugelberg M, Zetterström C. Vaulting of myopic and toric Implantable Collamer Lenses during accommodation measured with Visante optical coherence tomography. Ophthalmology 2010; 117:1245-50. [PMID: 20163862 DOI: 10.1016/j.ophtha.2009.10.033] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2009] [Revised: 09/08/2009] [Accepted: 10/14/2009] [Indexed: 10/19/2022] Open
Abstract
PURPOSE To study changes in vaulting of myopic and toric Implantable Collamer Lenses (ICLs) version 4 during accommodation with Visante optical coherence tomography (OCT), and analyze the relationship between vaulting and anterior subcapsular opacification. DESIGN Cross-sectional study. PARTICIPANTS Seventy-seven eyes of 77 myopic patients were examined after implantation with an ICL (48 myopic, 29 toric). The median follow-up time was 63 months (range, 10-84). METHODS The distance between the posterior ICL surface and the anterior surface of the crystalline lens was measured in the nonaccommodative state and during accommodation with Visante OCT. The lenses were examined for opacification using slit-lamp microscopy. MAIN OUTCOME MEASURES The distance between the ICL and the anterior surface of the crystalline lens. RESULTS At baseline, the mean distance between the ICL and the crystalline lens was 0.31+/-0.19 mm and during accommodation 0.31+/-0.26 mm; the difference did not reach significance (P = 0.77). The distance at baseline was significantly (P = 0.01) less in older patients and significantly (P = 0.04) greater in patients with a toric ICL. Contact was observed at baseline or during accommodation in 12 eyes; there was a significantly lower incidence of contact in eyes implanted with a toric ICL (P = 0.03). Anterior subcapsular opacification developed in 10 eyes, in 5 of these the ICL touched the crystalline lens. CONCLUSIONS Anterior subcapsular opacification developed in 13.0% of eyes. We found no difference in vaulting of the ICL at baseline and during accommodation. There was contact between the ICL and the crystalline lens in 15.6% of the eyes. The association between anterior subcapsular opacification and contact was significant (P = 0.004).
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Affiliation(s)
- Are Lindland
- Department of Ophthalmology, University of Oslo, Norway.
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Kojima T, Maeda M, Yoshida Y, Ito M, Nakamura T, Hara S, Ichikawa K. Posterior Chamber Phakic Implantable Collamer Lens: Changes in Vault During 1 Year. J Refract Surg 2010; 26:327-32. [DOI: 10.3928/1081597x-20090617-11] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2009] [Accepted: 05/06/2009] [Indexed: 11/20/2022]
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Han SY, Moon SJ, Kim HS, Lee TH, Lee KH. Intraindividual Comparison of ICL and Toric ICL Implantation in the Correction of High Myopia With Astigmatism. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2010. [DOI: 10.3341/jkos.2010.51.6.802] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Kamiya K, Shimizu K, Kawamorita T. Changes in vaulting and the effect on refraction after phakic posterior chamber intraocular lens implantation. J Cataract Refract Surg 2009; 35:1582-6. [DOI: 10.1016/j.jcrs.2009.03.052] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2009] [Revised: 03/21/2009] [Accepted: 03/24/2009] [Indexed: 10/20/2022]
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Alfonso JF, Lisa C, Palacios A, Fernandes P, González-Méijome JM, Montés-Micó R. Objective vs subjective vault measurement after myopic implantable collamer lens implantation. Am J Ophthalmol 2009; 147:978-983.e1. [PMID: 19285654 DOI: 10.1016/j.ajo.2009.01.006] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2008] [Revised: 01/11/2009] [Accepted: 01/12/2009] [Indexed: 11/17/2022]
Abstract
PURPOSE To evaluate the relationship between subjective measurements of vault and objective values measured with Visante optical coherence tomography (OCT) in eyes receiving an implantable contact lens (ICL) for myopia correction. DESIGN Observational cross-sectional study. METHODS SETTING Fernández-Vega Ophthalmological Institute, Oviedo, Spain. PATIENTS Four hundred and fifty-two eyes from 246 patients were elected to be implanted with a Visian ICL V4 (STAAR Surgical Inc, Monrovia, California, USA). OBSERVATION PROCEDURES Subjective and objective measurements of vault after implantation of ICL. MAIN OUTCOME MEASURES Subjective vault classified in 5 levels assessed using an optical section during slit-lamp examination. Objective vault was measured with Visante OCT (Carl Zeiss Meditec Inc, Dublin, California, USA). RESULTS Average values of objective and subjective vault were 414 +/- 228 microm and 2.1 +/- 1.0, respectively and both parameters were highly correlated (r = 0.82; P < .001). Differences in average objective vault were statistically significant among the 5 groups of subjective vault (P < .001). Subjective vault 0 corresponded to a mean OCT value of 62 +/- 49 microm with 99% confidence interval (CI) [38; 86] microm; eyes with vault 1 to 203 +/- 93 microm with 99% CI [176; 230] microm; eyes with vault 2 to 402 +/- 131 microm with 99% CI [378; 425] microm; eyes with vault 3 to 594 +/- 146 microm, 99% CI [554; 633] microm; and vault 4 to 794 +/- 182 microm with 99% CI [713; 875] microm. CONCLUSIONS Subjective and objective values of vault are highly correlated. In 99% of cases within the CI, objective values for eyes subjectively classified within a certain level vary within a narrow interval (+/-25 to 80 microm) around the mean value, and this interval is characteristic of each subjective level.
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Affiliation(s)
- José F Alfonso
- Fernández-Vega Ophthalmological Institute, University of Oviedo, Oviedo, Spain.
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Kamiya K, Shimizu K, Komatsu M. Factors affecting vaulting after implantable collamer lens implantation. J Refract Surg 2009; 25:259-64. [PMID: 19370820 DOI: 10.3928/1081597x-20090301-04] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
PURPOSE To evaluate the vaulting of the STAAR Implantable Collamer Lens (ICL) over the crystalline lens after implantation. METHODS One hundred twenty-three eyes of 68 patients with myopic refractive errors of -3.25 to -22.75 diopters undergoing ICL implantation were examined retrospectively. The magnitude of the central vaulting of the ICL was assessed quantitatively using slit-lamp microscopy at 3 months after surgery. Multiple regression analysis was used to assess the factors affecting the amount of vaulting. RESULTS The mean central vaulting 3 months after surgery was 603.6 +/- 259.6 microm. Explanatory variables relevant to the vaulting were, in order of influence, the horizontal white-to-white distance (partial regression coefficient B = 0.268, P = .0002) and patient age (B = -0.007, P = .011). CONCLUSIONS Although the majority of the variance remains unexplained, younger patients' eyes and eyes with greater white-to-white distances are more predisposed to have higher ICL vaulting over the crystalline lens.
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Affiliation(s)
- Kazutaka Kamiya
- Department of Ophthalmology, University of Kitasato School of Medicine, Kanagawa, Japan.
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Comparison of Collamer toric implantable [corrected] contact lens implantation and wavefront-guided laser in situ keratomileusis for high myopic astigmatism. J Cataract Refract Surg 2008; 34:1687-93. [PMID: 18812119 DOI: 10.1016/j.jcrs.2008.06.030] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2008] [Accepted: 06/14/2008] [Indexed: 11/22/2022]
Abstract
PURPOSE To compare the postoperative visual outcomes after implantation of a Collamer toric implantable contact lens (ICL) and after wavefront-guided laser in situ keratomileusis in high myopic astigmatism. SETTING Department of Ophthalmology, Kitasato University, Kanagawa, Japan. METHODS This study comprised 30 eyes (18 patients) having toric ICL implantation and 24 eyes (17 patients) having wavefront-guided LASIK (Technolas 217z) to correct high myopic astigmatism (manifest spherical equivalent [SE] <or=-6.0 diopters [D]; manifest refractive cylinder >or=1.0 D). The safety, efficacy, predictability, stability, and adverse events were assessed preoperatively and 1 week and 1, 3, and 6 months postoperatively. RESULTS At 6 months, the mean safety index was 1.28+/-0.25 (SD) in the ICL group and 1.01+/-0.16 in the LASIK group and the mean efficacy index, 0.87+/-0.15 and 0.83+/-0.23, respectively. All eyes in the ICL group and 71% of eyes in the LASIK group were within +/-1.00 D of the targeted SE correction at 6 months. The mean change in manifest refraction from 1 week to 6 months was -0.04+/-0.24 D in the ICL group and -0.60+/-0.49 D in the LASIK group. There were no significant complications in the ICL group; 2 eyes (8.3%) in the LASIK group required enhancement ablations. CONCLUSION Toric ICL implantation was better than wavefront-guided LASIK in eyes with high myopic astigmatism in almost all measures of safety, efficacy, predictability, and stability, suggesting that toric ICL implantation may become a viable surgical option to treat high myopic astigmatism.
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Tsorbatzoglou A, Németh G, Széll N, Biró Z, Berta A. Anterior segment changes with age and during accommodation measured with partial coherence interferometry. J Cataract Refract Surg 2007; 33:1597-601. [PMID: 17720076 DOI: 10.1016/j.jcrs.2007.05.021] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2007] [Accepted: 05/25/2007] [Indexed: 11/24/2022]
Abstract
PURPOSE To evaluate anterior segment alterations with age and during accommodation in different age groups. SETTING Department of Ophthalmology, Medical and Health Science Center, University of Debrecen, Debrecen, Hungary. METHODS Fifty-three subjects (101 normal eyes) were enrolled in this study and divided into 3 age groups: younger than 30 years (Group 1), between 31 years and 44 years (Group 2), and older than 45 years (Group 3). The total amplitude of accommodation was determined with a defocusing technique, and anterior segment measurements were performed by partial coherence interferometry. RESULTS Group 1 comprised 32 eyes; Group 2, 37 eyes; and Group 3, 32 eyes. The total amplitude of accommodation decreased with age (P<.0001). With the target position at infinity, the lens thickness (LT) and anterior segment length (ASL) increased and the anterior chamber depth (ACD) decreased significantly with age (P<.0001). During accommodation in the youngest group, the mean change in LT was 36.3 mum/diopter (D) and in ACD, -26.7 mum/D. The mean accommodation-induced ACD change was -0.08 mm +/- 0.06 (SD) in Group 1, -0.064 +/- 0.087 mm in Group 2, and -0.03 +/- 0.06 mm in Group 3 (P = .0004). The mean LT change during near fixation was 0.109 +/- 0.063 mm in Group 1, 0.103 +/- 0.136 mm in Group 2, and 0.006 +/- 0.05 mm in Group 3 (P<.0001). The mean ASL change during accommodation was 0.029 +/- 0.037 mm, 0.039 +/- 0.114 mm, and -0.023 +/- 0.051, respectively (P<.0001). CONCLUSIONS In addition to forward movement of the anterior lens surface with age, the posterior surface moved backward. Alterations in LT and ACD sufficient for a unit of refractive power change during accommodation might be smaller than previously thought. Anterior shifting of the lens may also participate in the accommodative response.
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Affiliation(s)
- Alexis Tsorbatzoglou
- Department of Ophthalmology, Medical and Health Science Center, University of Debrecen, Debrecen, Hungary.
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