Kocová H, Vlková E, Michalcová L, Motyka O
Department of Ophthalmology, University Hospital Brno, Faculty of Medicine of Masaryk University, Jihlavská 20, 62500 Brno, Czech Republic.
Department of Ophthalmology, University Hospital Brno, Faculty of Medicine of Masaryk University, Jihlavská 20, 62500 Brno, Czech Republic.
J Fr Ophtalmol. 2017 Mar;40(3):215-223. doi: 10.1016/j.jfo.2016.10.009. Epub 2017 Mar 11.
To evaluate long-term refractive outcomes of implantable collamer lens (ICL) implantation and late postoperative complications.
We assessed outcomes of patients who underwent ICL implantation (type ICM V4 for myopia, ICH V3 for hyperopia, TICM V4 for astigmatism) in our department between 1998 and 2013. It comprised 62 eyes (40 myopic and 22 hyperopic). The average follow-up period was 10.5 years. We evaluated: uncorrected and best-corrected visual acuity (UCVA and BCVA), spherical equivalent (SE), ICL vault, endothelial cell density and late postoperative complications.
In myopes, the average UCVA was 1.0±0.37 and BCVA 1.18±0.38, in hyperopes 0.78±0.19 and 1.14±0.18, respectively. The average SE in myopes, whose target refraction was emmetropia, was -0.6±0.83 Dsf, in hyperopes +0.73±0.93. Central ICL vault was 206.16μm±105.94, (range 10-427) in myopes, 195.5μm±109.09, (range 20-404) in hyperopes. The most common late postoperative complication was cataract formation. Three myopic eyes (7.5%) developed symptomatic anterior subcapsular opacities with loss of at least two lines of BCVA. Cataract significantly affecting visual acuity occurred in 5 myopic eyes (12.5%) and 2 hyperopic eyes (9.09%). In these eyes, ICL removal and cataract surgery was performed.
In our experience, ICL implantation in moderate and high ametropia was effective and relatively safe. The most common late complication was cataract formation. This complication can be managed effectively surgically with good refractive outcomes without loss of BCVA.
评估可植入式角膜接触镜（ICL）植入术的长期屈光效果及术后晚期并发症。
我们评估了1998年至2013年间在我科接受ICL植入术（近视用ICM V4型，远视用ICH V3型，散光用TICM V4型）的患者的手术效果。共有62只眼（40只近视和22只远视）。平均随访期为10.5年。我们评估了：未矫正和最佳矫正视力（UCVA和BCVA）、等效球镜度（SE）、ICL拱高、内皮细胞密度及术后晚期并发症。
近视患者中，平均UCVA为1.0±0.37，BCVA为1.18±0.38；远视患者中，平均UCVA为0.78±0.19，BCVA为1.14±0.18。目标屈光度为正视的近视患者平均SE为-0.6±0.83 Dsf，远视患者为+0.73±0.93。近视患者中央ICL拱高为206.16μm±105.94（范围10 - 427），远视患者为195.5μm±109.09（范围20 - 404）。最常见的术后晚期并发症是白内障形成。3只近视眼（7.5%）出现有症状的前囊下混浊，BCVA至少下降两行。5只近视眼（12.5%）和2只远视眼（9.09%）发生了明显影响视力的白内障。对这些眼睛进行了ICL取出及白内障手术。
根据我们的经验，中高度屈光不正患者行ICL植入术有效且相对安全。最常见的晚期并发症是白内障形成。这种并发症可通过手术有效处理，屈光效果良好，且不会导致BCVA下降。
