PURPOSE: To evaluate the vault change after implantable collamer lens (ICL) size exchange according to the preoperative vault. METHODS: In 14 eyes of 13 patients, the vault change after ICL exchange operation due to unideal vault was compared in 2 groups, the smaller ICL exchanged group and larger ICL exchanged group. RESULTS: In 6 out of 14 eyes, the ICL was exchanged to a 0.5 mm smaller size and the vault was changed from 1.38 mm (1.18-1.70) to 0.71 mm (0.51-0.92) (p = 0.03). In 8 eyes, the ICL was exchanged to a 0.5 mm bigger size and the vault was changed from 0.07 mm (0.03-0.13) to 0.50 mm (0.12-1.01) (p < 0.01). The exchange operation was performed at 3.5 postoperative days (1-6) if the ICL was exchanged to 1 step smaller size, but the exchange operation was performed at 135 postoperative days (90-660) if the ICL was exchanged to 1 step bigger size (p < 0.01). CONCLUSIONS: ICL exchange to 1 step smaller or bigger size is an effective method to correct unideal postoperative vault to a more ideal vault size. The exchange to 1 step smaller size ICL tended to be performed sooner.
Humans ; Phakic Intraocular Lenses*

No abstract available.
Dislocations* ; Phakic Intraocular Lenses*

PURPOSE: The present study is a case report of 2 patients (4 eyes) whose symptoms subsided after corneal tattooing over the iridotomy site for persistent and excessive glare, which developed after iridotomy for phakic intraocular lens implantation. CASE SUMMARY: Two patients developed excessive glare symptoms after receiving iridotomy as a pre-procedure for phakic intraocular lens implantation. Case 1 and Case 2 showed persistent glare symptoms over a period of 6 months. Corneal tattooing was performed on the patients by applying tissue dye to the corneal stroma over the iridotomy site. The symptom was evaluated by comparison of glare scores from 0 to 10 after the procedure with a score of 10 prior to the procedure. After corneal tattooing, patient 1 reported a score of 4 and patient 2 reported a score of 3, showing significant symptom improvements without additional complications. CONCLUSIONS: Corneal tattooing at the peripheral cornea in front of the iridotomy site for patients with persistent glare symptoms after prophylactic iridotomy was shown to be effective.
Cornea ; Corneal Stroma ; Glare ; Humans ; Phakic Intraocular Lenses ; Tattooing

PURPOSE: To evaluate the benefits of one day, one eye ICL implantation which allows the ICL size of the later-operated eye to be adjusted after evaluating the postoperative vault of the first-operated eye in order to reduce the postoperative ICL size exchange rates of both eyes. METHODS: A total of 426 eyes of 213 patients who received one day, one eye bilateral ICL implantation were included in the present study. The cases where a different ICL size was implanted in the later-operated eye because of high or low postoperative vault of the first-operated eye were analyzed as well as the ICL exchange rates. RESULTS: Among 213 patients, same size ICLs were implanted in both eyes in 188 patients (88%) as planned. However, a different ICL size was implanted in the later-operated eye in 25 patients (12%). Eight eyes of 8 patients out of 25 patients needed their ICL size exchanged during the follow-up period and all 8 eyes were first-operated eyes. This occurred in 8 patients (3.8%) out of 213 patients. CONCLUSIONS: One day, one eye ICL implantation, which can help the size adjustment of the later-operated eye according to the postoperative 1 day vault of the first-operated eye, can reduce the risk of bilateral ICL size exchange operation.
Eye ; Follow-Up Studies ; Humans ; Phakic Intraocular Lenses

PURPOSE: To evaluate the crystalline lens thickness/anterior chamber depth (CLT/ACD) ratio as a preoperative factor that affects the vault after implantable contact lens (ICL) implantation. METHODS: A total of 130 eyes of 130 patients who received bilateral ICL implantation were included in the present study. The preoperative CLT/ACD ratio was analyzed to determine if the patients had any correlation with postoperative vault by Visante optical coherence tomography (OCT). RESULTS: The mean vault was 0.58 mm +/- 0.23 at postoperative 2 months. Eight eyes (6.15%) had low vault, 93 eyes (71.53%) had ideal vault and 29 eyes (29.31%) had high vault. The CLT/ACD ratios were 1.04 mm +/- 0.11, 0.96 mm +/- 0.09 and 0.90 mm +/- 0.09 in the low vault group, ideal vault group and high vault group, respectively (p < 0.01). The CLT/ACD ratio showed statistically significant correlations with postoperative vault in univariate analysis (r = -0.4718; p < 0.01) and in multivariate analysis (p < 0.01). CONCLUSIONS: Vaults after ICL implantation have a negative correlation with the preoperative CLT/ACD ratio. The results from the present study may improve the prediction of postoperative vault after ICL implantation.
Anterior Chamber ; Eye ; Humans ; Lens, Crystalline ; Lenses, Intraocular ; Multivariate Analysis ; Phakic Intraocular Lenses ; Tomography, Optical Coherence

PURPOSE: To evaluate changes in the ciliary sulcus size, anterior chamber depth (ACD) and anterior chamber angle (ACA) during accommodation using an ultrasound biomicroscope (UBM). METHODS: Twenty-seven eyes of 27 healthy subjects were studied. We examined refractive error and intraocular pressure, measured the horizontal distance of the ciliary sulcus, ACD, and ACA at distant fixation and near fixation using a UBM (50 MHz transducer, model P45 UBM plus, Paradigm(R), Kent, U. K.). RESULTS: The subjects included 16 males and 6 females. The mean age of the subjects was 20.5 years (age range, 19-22 years), and mean spherical equivalent was -2.86+/-1.67 diopters. At distant fixation, horizontal ciliary sulcus size was 11.75+/-0.56 mm, ACD was 3.15+/-0.17 mm, and ACA was 38.5+/-4.2 . At near fixation, horizontal ciliary sulcus size was 11.34+/-0.65 mm, ACD was 2.92+/-0.15 mm, and ACA was 44.5+/-5.7 . CONCLUSIONS: During accommodation, horizontal ciliary sulcus size and ACD significantly decreased and ACA increased in the patients.
Anterior Chamber* ; Female ; Humans ; Intraocular Pressure ; Male ; Microscopy, Acoustic* ; Phakic Intraocular Lenses ; Refractive Errors ; Transducers ; Ultrasonography*

PURPOSE: To evaluate the efficacy, safety, stability and complications of the foldable iris-fixated phakic intraocular lens (Artiflex(R), Ophtec BV, Groningen, Netherlands) implantation for the correction of myopia with astigmatism. METHODS: The present study included 40 eyes of 20 patients who underwent Artiflex lens implantation, and 20 eyes of 10 patients who underwent Toric Artiflex lens implantation and were followed up for 1 year. We retrospectively examined visual acuity, refraction, any changes in astigmatism, efficacy, safety and corneal endothelial cell density. A correlation coefficient analysis of the factors that affected the changes was performed. RESULTS: The mean preoperative refractive spherical equivalent was -9.18 +/- 2.27 D and reached -0.45 +/- 0.45 D at 1 year after surgery. Postoperatively, 99.9% of the eyes showed improved visual acuity of more than 0.8. In patients with Toric Artiflex lens implantation, the preoperative mean astigmatism was -2.67 +/- 0.87 D, and at 1 year postoperatively -0.76 +/- 0.40 D, showing a statistically significant decrease (p < 0.001). The preoperative mean endothelial cell density was 2,850 +/- 230 cells/mm2 and decreased 1.3% on the final follow-up (2,812 +/- 261 cells/mm2) but without statistical significance (p = 0.456). Statistically significant correlation was not observed between endothelial cell loss and anterior chamber depth (r2 = -0.146, p = 0.267). CONCLUSIONS: Implantation of the iris-fixed intraocular lenses, Artiflex and Toric Artiflex, was safe and effective for correcting high myopia and astigmatism.
Anterior Chamber ; Astigmatism ; Endothelial Cells* ; Follow-Up Studies ; Humans ; Lenses, Intraocular ; Myopia ; Phakic Intraocular Lenses* ; Retrospective Studies ; Visual Acuity

PURPOSE: To evaluate the efficacy, safety, stability and complications of the foldable iris-fixated phakic intraocular lens (Artiflex(R), Ophtec BV, Groningen, Netherlands) implantation for the correction of myopia with astigmatism. METHODS: The present study included 40 eyes of 20 patients who underwent Artiflex lens implantation, and 20 eyes of 10 patients who underwent Toric Artiflex lens implantation and were followed up for 1 year. We retrospectively examined visual acuity, refraction, any changes in astigmatism, efficacy, safety and corneal endothelial cell density. A correlation coefficient analysis of the factors that affected the changes was performed. RESULTS: The mean preoperative refractive spherical equivalent was -9.18 +/- 2.27 D and reached -0.45 +/- 0.45 D at 1 year after surgery. Postoperatively, 99.9% of the eyes showed improved visual acuity of more than 0.8. In patients with Toric Artiflex lens implantation, the preoperative mean astigmatism was -2.67 +/- 0.87 D, and at 1 year postoperatively -0.76 +/- 0.40 D, showing a statistically significant decrease (p < 0.001). The preoperative mean endothelial cell density was 2,850 +/- 230 cells/mm2 and decreased 1.3% on the final follow-up (2,812 +/- 261 cells/mm2) but without statistical significance (p = 0.456). Statistically significant correlation was not observed between endothelial cell loss and anterior chamber depth (r2 = -0.146, p = 0.267). CONCLUSIONS: Implantation of the iris-fixed intraocular lenses, Artiflex and Toric Artiflex, was safe and effective for correcting high myopia and astigmatism.
Anterior Chamber ; Astigmatism ; Endothelial Cells* ; Follow-Up Studies ; Humans ; Lenses, Intraocular ; Myopia ; Phakic Intraocular Lenses* ; Retrospective Studies ; Visual Acuity

PURPOSE: To investigate endothelial change in phakic eyes implanted with Artisan phakic IOL inserts and to identify the associated factors. METHODS: We prospectively examined the endothelial change in 11 phakic eyes implanted with Artisan phakic IOL inserts. Noncontact specular microscopy was performed preoperatively, and at 1 week and 1 month postoperatively. RESULTS: The mean endothelial cell loss was 3.57% at 1 week, and 4.69% at 1 month. There was a statistically significant decrease in endothelial cell density and an increase in pleomorphism and polymegathism of the cells after the surgery which indicate cellular damage (p<0.05). There were no statistically significant changes in endothelial cell density, shape, or size between 1 week and 1 month postoperatively (p>0.05). No correlation was observed between cell loss and corneal curvature, critical distance, IOL optic size, IOL diopter, or serial order of the operation. However, there was significant negative correlation (R=-7.600; p>0.05) between cell loss and anterior chamber depth. CONCLUSIONS: Endothelial damage occurred primarily during the surgical procedure and special attention should be given to patients with shallow anterior chamber depth for iris-fixed phakic IOL inserts to avoid unintended endothelial damage.
Anterior Chamber ; Endothelial Cells ; Endothelium, Corneal* ; Humans ; Microscopy ; Myopia ; Phakic Intraocular Lenses* ; Prospective Studies

PURPOSE: To compare the effectiveness of toric foldable iris-fixated phakic intraocular lens (pIOL) implantation and non-toric foldable iris-fixated pIOL implantation with limbal relaxing incisions (LRIs) for correcting moderate-to-high astigmatism in myopic eyes. MATERIALS AND METHODS: The medical records of 146 patients (195 eyes) with myopic astigmatism who underwent toric foldable iris-fixated pIOL implantation (toric group; 94 eyes) or non-toric foldable iris-fixated pIOL implantation with concurrent LRIs (LRI group; 101 eyes) were retrospectively reviewed. For subgroup analysis, the two groups were subdivided according to preoperative astigmatic severity [moderate, 2.00 to <3.00 diopters (D); high, 3.00–4.00 D]. Visual and astigmatic outcomes were compared 6 months postoperatively. RESULTS: The uncorrected distance visual acuity was at least 20/25 in 100% and 98% of the toric and LRI group eyes, respectively. The toric group had lower mean residual cylindrical error (-0.67±0.39 D vs. -1.14±0.56 D; p<0.001) and greater mean cylindrical error change (2.17±0.56 D vs. 1.63±0.72 D; p<0.001) than the LRI group, regardless of the preoperative astigmatic severity. The mean correction index (1.10±0.16 vs. 0.72±0.24; p<0.001) and success index (0.24±0.14 vs. 0.42±0.21; p<0.001) also differed significantly between the groups. CONCLUSION: Both surgical techniques considerably reduced astigmatism and had comparable visual outcomes. However, toric foldable iris-fixated pIOL implantation was more reliable for correcting moderate-to-high astigmatism in myopic eyes.
Astigmatism* ; Humans ; Limbus Corneae ; Medical Records ; Phakic Intraocular Lenses* ; Retrospective Studies ; Visual Acuity