Department of Refractive Surgery Center, Weifang Eye Hospital, Weifang, Shandong, China.
Medicine (Baltimore). 2021 Mar 12;100(10):e24986. doi: 10.1097/MD.0000000000024986.
Implantable collamer lens have been used widely worldwide, and have been accepted by more and more doctors and patients due to good safety, stability, and effectiveness. However, there is still a problem of crystal rotation. The large angle rotation (over 10°) would weaken the original astigmatism correction effect and even induce irregular astigmatism, seriously affecting the visual quality of patients. Herein, we reported a case who had 2 times of crystal rotations after toric implantable collamer lens (TICL) implantation.
The patient was a 38-year-old man who underwent TICL implantation for the correction of high myopic astigmatism in eyes. He presented a sudden decrease in the visual acuity (VA) of the left eye 4 months after the TICL implantation. The uncorrected visual acuity (UCVA) was 8/20 (refraction, +2.25 -5.25 × 68).
Rotation of TICL was diagnosed. The toric marks with a rotation of 75° counter-clockwise from the original position were observed.
The TICL was re-set to the original position, leading to the UCVA of 12/20 in the left eye (refraction, -0.00 -0.75 × 131), with the vaulting of 589 μm. Ten months after the TICL relocation, the patient again presented a sudden decrease in the VA of the left eye, with the UCVA of 2/20 (refraction, +2.25 -5.00 × 66). Again, the toric marks with a rotation of 75° counter-clockwise from the original position was observed, just at the same position as the last rotation. This time, the TICL was removed. The axis and power were recalculated, and a new TICL was implanted, with the rotation of 73° counter-clockwise from the horizontal line of the temporal side.
The patient obtained a final UCVA of 12/20 in the left eye (refraction, +0.50 -0.50 × 26), which remained stable in the 6-month follow-up period, with the vaulting of 602 μm.
Rotation is a common complication after TICL surgery. Relocation or replacement of TICL are safe and efficient ways to recover VA due to TICL rotation.
可折叠式 Collamer 人工晶状体已在全球范围内广泛使用，由于其良好的安全性、稳定性和有效性，越来越多的医生和患者开始接受它。然而，它仍然存在晶体旋转的问题。如果旋转角度过大（超过 10°），会减弱原有的散光矫正效果，甚至导致不规则散光，严重影响患者的视觉质量。本文报告了 1 例 TICL 植入术后发生 2 次晶体旋转的病例。
患者男性，38 岁，双眼高度近视伴散光，于我院行 TICL 植入术矫正近视及散光。术后 4 个月，患者左眼突然出现视力下降，视力检查示裸眼视力（UCVA）为 8/20（矫正视力，+2.25～-5.25×68）。
TICL 发生旋转。观察到 TICL 的散光轴位标记逆时针旋转 75°，偏离原位置。
将 TICL 复位至原始位置，左眼 UCVA 提高至 12/20（矫正视力，-0.00～-0.75×131），拱高为 589μm。TICL 复位后 10 个月，患者左眼再次出现视力下降，UCVA 为 2/20（矫正视力，+2.25～-5.00×66）。同样观察到 TICL 的散光轴位标记逆时针旋转 75°，与上次旋转位置相同。这次，将 TICL 取出。重新计算轴位和屈光度，并植入新的 TICL，TICL 从颞侧水平线逆时针旋转 73°。
患者左眼最终获得 UCVA 为 12/20（矫正视力，+0.50～-0.50×26），在 6 个月的随访中保持稳定，拱高为 602μm。
旋转是 TICL 术后常见的并发症。TICL 旋转时，通过 TICL 复位或更换可以安全有效地恢复视力。
