Implant myopique de chambre postérieure en Collamer pliable

Sylvain Roy; Jean-Jacques Tritten

doi:10.1055/s-2002-30666

Klinische Monatsblätter für Augenheilkunde, Table of Contents

Klin Monbl Augenheilkd 2002; 219(4): 196-200
DOI: 10.1055/s-2002-30666

Klinische Studie

Implant myopique de chambre postérieure en Collamer pliable

Myopische Hinterkammerimplantate aus faltbarem CollamerSylvain Roy¹ , Jean-Jacques Tritten²

¹Hôpital ophtalmique Jules Gonin, Lausanne, Suisse (Direktor: Prof. L. Zografos)
²Hôpital de la Ville, 2300 La Chaux-de-Fonds, Suisse (Direktor: Dr. J.-J. Tritten)

Nous remercions le Dr Philippe Othenin-Girard et Monsieur Marc Curchod de l'Hôpital ophtalmique Jules Gonin, pour leur aide précieuse dans la documentation de l'imagerie numérique

Abstract

Zusammenfassung

Hintergrund: Wir berichten über Resultate, Wirkungen und Sicherheit der Hinterkammerlinse beim phaken Patienten mit mittlerer bzw. hochgradiger Kurzsichtigkeit. Material und Methoden: 23 Augen von 12 Patienten mit einem präoperativen mittleren refraktiven sphärischen Äquivalent von - 10,94 ± 5,97 D wurde eine Staar-ICL™-Hinterkammerlinse implantiert. Mittleres Follow-up war 12,9 ± 7,4 Monate (4 - 24 Monate). Die prä-und postoperative unkorrigierte und bestkorrigierte Sehschärfe, die subjektive Refraktion, der intraokulare Druck, die Keratometrie, die Zentrierung der Linse und die vorderen subkapsulären Verdichtungen wurden erfasst. Ergebnisse: Die postoperative unkorrigierte Sehschärfe verbesserte sich bei allen Augen. Die beste Korrektur erhöhte sich von 0,82 ± 0,39 auf 1,05 ± 0,24. Die Verbesserung war statistisch relevant (Student-t-Test, p = 0,0097). Das postoperative mittlere refraktive sphärische Äquivalent war - 0,82 ± 1,42 D (p < 0,0001), der intraokulare Druck war 15,65 ± 2,72 mm Hg. Die Linsen blieben befriedigend zentriert und keine vorderen subkapsularen Verdichtungen wurden beobachtet. Drei Patienten litten an postoperativen Komplikationen ohne Verminderung der Sehschärfe. Schlussfolgerung: Die Verwendung einer intraokularen Hinterkammerlinse beim phaken Patienten mit mittlerer bis hochgradiger Kurzsichtigkeit ist eine sichere Technik. Langzeitergebnisse stehen noch aus.

Implantation of a foldable Collamer lens as a posterior chamber phakic intraocular lens in myopia

Background: The purpose of this study was to report results, effectiveness and safety of implanting a negative collagen/HEMA copolymer posterior chamber phakic intraocular lens in moderate to highly myopic eyes. Material and methods: 23 eyes from 12 patients with a mean preoperative spherical equivalent refraction of - 10.94 ± 5.97 D underwent a refractive procedure with the Staar ICL™ posterior chamber phakic intraocular lens. The average follow-up was 12.9 ± 7.4 months (range 4 - 24 months). Preoperative and postoperative uncorrected and bestcorrected visual acuity, subjective refraction, intraocular pressure, keratometry, ICL™ centration and anterior subcapsular opacities were evaluated. Results: Postoperative uncorrected visual acuity improved in all eyes. The best corrected visual acuity increased from 0.82 ± 0.39 preoperatively to 1.05 ± 0.24 postoperatively. The gain in visual acuity was statistically significant (Student t-test, p = 0.0097). The mean postoperative spherical equivalent refraction was - 0.82 ± 1.42 D (p < 0,0001). The mean postoperative intraocular pressure was 15.65 ± 2.72 mm Hg. The intraocular contact lens remained well centred in all eyes and no anterior subcapsular opacities were observed. Three patients underwent transcient complication without affecting the visual outcome. Conclusion: The use of a posterior chamber phakic intraocular lens in myopic eyes is a safe procedure to correct moderate to high myopia. Long-term results are still unknown.

Schlüsselwörter

Kurzsichtigkeit - Intraokularlinsen - refraktive Eingriffe - faltbare Linsen - Collamer-Linse

Key words

Myopia - intraocular lens - refractive surgery - foldable lens - Collamer lens

Full Text

References

Références

1 Neumann A C, McCarty G, Sanders D R. Delayed regression of effect in myopic epikeratophakia vs myopic keratomileusis for high myopia. Refract Corneal Surg. 1989; 5 161-166
2 American Academy of Ophthalmology . Keratophakia and keratomileusis: safety and effectiveness. Ophthalmology. 1992; 99 1332-1341
3 Kim W J, Lee J H. Long-term results of myopic epikeratoplasty. J Cataract Refract Surg. 1993; 19 352-355
4 American Academy of Ophthalmology . Radial keratotomy for myopia. Ophthalmology. 1993; 100 1103-1115
5 Güell J L, Muller A. Laser in situ keratomileusis (LASIK) for myopia from - 7 to - 18 diopters. J Refract Surg. 1996; 12 222-228
6 American Academy of Ophthalmology . Automated lamellar keratoplasty. Ophthalmology. 1996; 103 852-861
7 Condon P I, Mulhern M, Fulcher T. et al . Laser intrastromal keratomileusis for high myopia and myopic astigmatism. Br J Ophthalmol. 1997; 81 199-206
8 Esquenazi S. Comparison of laser in situ keratomileusis and automated lamellar keratoplasty for the treatment of myopia. J Refract Surg. 1997; 13 637-643
9 Mulhern M G, Foley-Nolan A, O'Keefe M, Condon P I. Topographical analysis of ablation centration after excimer laser photorefractive keratectomy and laser in situ keratomileusis for high myopia. J Cataract Refract Surg. 1997; 23 488-494
10 Maldonado-Bas A, Onnis R. Results of laser in situ keratomileusis in different degrees of myopia. Ophthalmology. 1998; 105 606-611
11 Knorz M C, Wiesinger B, Liermann A. et al . Laser in situ keratomileusis for moderate and high myopia and myopic astigmatism. Ophthalmology. 1998; 105 932-940
12 Davidorf J M, Zaldivar R, Oscherow S. Results and complications of laser in situ keratomileusis by experienced surgeons. J Refract Surg. 1998; 14 114-122
13 Allarakhia L, Knoll R L, Lindstrom R L. Soft intraocular lens. J Cataract Refract Surg. 1987; 13 607-620
14 Van der Heijde G L, Fechner P U, Worst J GF. Optische Konsequenzen der Implantation einer negatives Intrakularlinse bei myopen Patienten. Klin Monatsbl Augenheilkd. 1988; 193 99-102
15 Joly P, Baikoff G, Bonnet P. Mise en place d'un implant négatif de chambre antérieure chez des sujets phaques (in French). Bull Soc Ophtalmol Fr. 1989; 89 27-733
16 Fechner P, Worst J. A new concave intraocular lens for the correction of myopia. Eur J Implant Refract Surg. 1989; I 41-47
17 Fechner P U, van der Heijde G L, Worst J G. The correction of myopia by lens implantation into phakic eyes. Am J Ophthalmol. 1989; 107 659-663
18 Fyodorov S N, Zuyev V K, Aznabayer B M. Intraocular correction of high myopia with negative posterior chamber lens. Ophthalmosurgery. 1991; 3 57-58
19 Erturk H, Ozcetin H. Phakic posterior chamber intraocular lenses for the correction of high myopia. J Refract Surg. 1995; 11 388-391
20 Fechner P U, Haigis W, Wichmann W. Posterior chamber myopia lenses in phakic eyes. J Cataract Refract Surg. 1996; 22 178-182
21 Assetto V, Benedetti S, Pesando P. Collamer intraocular contact lens to correct high myopia. J Cataract Refract Surg. 1996; 22 551-556
22 Perez-Santonja J J, Bueno J L, Zato M A. Surgical correction of high myopia in phakic eyes with Worst-Fechner myopia intraocular lenses. J Refract Surg. 1997; 13 268-281; discussion 281 - 284
23 Marinho A, Neves M C, Pinto M C, Vaz F. Posterior chamber silicone phakic intraocular lens. J Refract Surg. 1997; 13 219-277
24 Pearce J L. Sixteen months' experience with 140 posterior chamber intraocular lens implants. Br J Ophthalmol. 1997; 61 310-315
25 Wiechens B, Winter M, Haigis W. et al . Bilateral cataract after phakic posterior chamber top hat-style silicone intraocular lens. J Refract Surg. 1997; 13 392-397
26 Baikoff G, Arne J L, Bokobza Y. et al . Angle-fixated anterior chamber phakic intraocular lens for myopia of - 7 to - 19 diopters. J Refract Surg. 1998; 14 282-293
27 Zaldivar R, Davidorf J M, Oscherow S. Posterior chamber phakic intraocular lens for myopia of - 8 to - 19 diopters. J Refract Surg. 1998; 14 294-305
28 Rosen E, Gore C. Staar Collamer posterior chamber phakic intraocular lens to correct myopia and hyperopia. J Cataract Refract Surg. 1998; 24 596-606
29 Brauweiler P H, Wehler T, Busin M. High incidence of cataract formation after implantation of a silicone posterior chamber lens in phakic, highly myopic eyes. Ophthalmol. 1999; 106 1651-1655
30 Menezo J L, Peris-Martinez C, Cisneros A, Martinez-Costa R. Posterior chamber phakic intraocular lenses to correct high myopia: a comparative study between Staar and Adatomed models. J Refract Surg. 2001; 17 32-42
31 McLeod S. Beyond Snellen acuity. The assessment of visual function after refractive surgery. Arch Ophthalmol. 2001; 119 1371-1373
32 Faucher A, Gregoire J, Blondeau P. Accuracy of Goldmann tonometry after refractive surgery. J Cataract Refract Surg. 1997; 23 832-838
33 Abbasoglu O E, Bowmann R W, Cavanagh H D, McCulley J P. Reliability of intraocular pressure measurements after myopic excimer photorefractive keratectomy. Ophthalmol. 1998; 105 2193-2196

Dr. Sylvain Roy

Hôpital ophtalmique Jules Gonin

Av de France 15

1004 Lausanne · Suisse