Literature Review Highlights January 2011 Spontaneous Rotation of a Toric Implantable Collamer LensBy Alejandro Navas et al. Case Rep Ophthalmol 2010;1:99-104 January 2011. TICL spontaneous rotation 3 months after uneventful surgery in which suc cessful repositioni ng lead to satisfac- tory outcomes in the left eye of a 23-year-old-female. Her medical and ophthalmological histories were unre- markable. Although the cause of this spontaneo us rotation has been not stablished the author suggests as possib le causes trauma or bad foot-plates position. Since vault was optimal reposition was decided resolving the issue. TICL rotation was 0.4% for t his surgeon (250 TICL implanted and only one rotation case) ICL repositioning is a safe, effective and easy procedure. • 6 months after repositioning neither ASCO nor re-rotation was observed. • General guidelines: • If optimal vault repositioning • If borderline or low vault consider exchange with longer lens vs repositioning.Take-home message Toric ICL to Correct Ametropia in Keratoconic Eyes After CXL By M.Shafik. Ophthalmology Times Europe. January/February 2011. Preliminary results Safety and efficacy of Toric ICL implantation after CXL treatment in eyes with STABLE keratoconus are evaluated. TICL was implanted at least 9 months after CXL procedure and inclusion criteria included KC eyes with central clear cornea at least 9 months after CXL and stable manifest refraction at least over the past 3 months. Preop Rx(D) -8.25 –5.25 x180° ACD 3.42mm, WTW 11.7mm, CT 514µ, Ks 40.3@87°x45.5@177° TICL impl -18.5 +6.0x93 TICM120V (Requiered rotati on3° CW) UCVA 1w post 20/30 (Rx –0.75 –0.75x178° ) Vault 1w post Around 700µ UCVA 3m post 20/100 (Rx +2.5 –4.5x178° ) TICL rotation 35°CCW off-axis UCVA after repositioning 20/25 stable during the rest of follow-up TICL in KC eyes after CXL: Preliminary results Spontaneous TICLrotation Bioptics after ICare: Interface fluid complication PB secondary to OVD remaning after AC- pIOL 6H216 eyes of 10 patients were assessed over 1 year follow-up after TICL implantation Mean age was 25.6±4.1 years (21 to 33) Mean preoperative SE was -7.61±4.10D (-2.25 to -15.75D) Mean preoperative Cylinder was -4.34±1.62D (-2.0 to -7.5D) Mean postoperative Sphere decreased to plano Mean postoperative Cylinder decreased to -0.05D Mean postoperative UCVA improved to 0.88±0.18 and efficacy index was 1.4 100% of eyes gained one or more lines of UCVA Mean vaulting was 509.75µ Excellent UCVA improvement in all eyes attributed to the merits of both modalities CXL improving corneal symmetry and TICL correcting residual sphere and cylinder as well was overcoming some aberrations induced by the corneal irregularity Great discrepancy between manifest and objective refraction values. TICL calculation chosen based on manifest refraction which is the key parameter to successful correction of the refractive error. TICL as very promising tool to correct high refractive error in STABLE keratoconus after stabilizing the condition by CXL. • Combining TICL and CXL is an excellent refractiv e option in eyes with STABLE keratoconus. CXL mini- mally invasive procedure to stabilize or slow the progression of keratoconus. • Stability of manifest refraction as well as an accurate determination of the refractive error prior to TICL calculation is key to ensure excellent visual performance. • We advice taking manifest refraction as basis for TICL calculation. 1 1 2 2 Inside this issue Take-home message For further information, please contact: [email protected]
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UCVA after repositioning 20/25 stable during the rest of follow-up
TICL in KC eyes after
CXL: Preliminary
results
Spontaneous TICL
rotation
Bioptics after ICare :Interface fluid
complication
PB secondary to OVD
remaning after AC-
pIOL 6H2
16 eyes of 10 patients were assessed over 1 year follow-up after TICL implantation
Mean age was 25.6±4.1 years (21 to 33)
Mean preoperative SE was -7.61±4.10D (-2.25 to -15.75D)
Mean preoperative Cylinder was -4.34±1.62D (-2.0 to -7.5D)
Mean postoperative Sphere decreased to plano
Mean postoperative Cylinder decreased to -0.05D
Mean postoperative UCVA improved to 0.88±0.18 and efficacy index was 1.4
100% of eyes gained one or more lines of UCVA
Mean vaulting was 509.75µ Excellent UCVA improvement in all eyes attributed to the merits of both modalities CXL improving corneal symmetryand TICL correcting residual sphere and cylinder as well was overcoming some aberrations induced by the corneal
irregularity
Great discrepancy between manifest and objective refraction values. TICL calculation chosen based on manifest
refraction which is the key parameter to successful correction of the refractive error.
TICL as very promising tool to correct high refractive error in STABLE keratoconus after stabilizing the condition by
CXL.
• Combining TICL and CXL is an excellent refractive option in eyes with STABLE keratoconus. CXL mini-
mally invasive procedure to stabilize or slow the progression of keratoconus.
• Stability of manifest refraction as well as an accurate determination of the refractive error prior to TICL
calculation is key to ensure excellent visual performance.
• We advice taking manifest refraction as basis for TICL calculation.