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Anterior Segment OCT Angle and Vault Analysis After Implantable Collamer Lens  Implantation in Patients With High Myopia Arturo Ramirez-Miranda M.D. Alejandro.

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Presentation on theme: "Anterior Segment OCT Angle and Vault Analysis After Implantable Collamer Lens  Implantation in Patients With High Myopia Arturo Ramirez-Miranda M.D. Alejandro."— Presentation transcript:

1 Anterior Segment OCT Angle and Vault Analysis After Implantable Collamer Lens  Implantation in Patients With High Myopia Arturo Ramirez-Miranda M.D. Alejandro Navas M.D., M.Sc. Arturo Gómez-Bastar M.D. Enrique O. Graue-Hernandez M.D., M.Sc. Department of Cornea and Refractive Surgery Instituto de Oftalmologia “Fundacion Conde de Valenciana” Mexico City, Mexico Dr. Ramirez-Miranda and Dr. Navas are consultants for Carl Zeiss Meditec. Dr. Ramirez-Miranda is a speaker of Thea Laboratoires. The remaining authors have no financial or proprietary interest in the materials presented herein.

2 PURPOSE To compare angle measurements before and after ICL V4c Implantation and vault changes during progress and under different light conditions, in patients with high myopia. The purpose of this study was to compare angle measurements before and after ICL V4c Implantation and vault changes during progress and under different light conditions, in patients with high myopia, using the Visante Optical coherence tomography. Visante optical coherence tomography (OCT SA/ Carl Zeiss Meditec)

3 METHODS Prospective, longitudinal, case series. Implantation of ICL4c.
High myopia. 75 eyes (52 patients). AS-OCT VISANTE (photopic, mesopic and escotopic light conditions)

4 METHODS Main Outcome Measures
Uncorrected visual acuity (UCVA) Best corrected visual acuity (BCVA) Slit lamp examination Optical coherence tomography (OCT) Angle and Vault were evaluated using an OCT Visante.

5 Preoperative Angle (°) Postoperative Angle (°)
RESULTS 75 eyes, 52 patients 32 females (69.5 %) Follow-up 13 +/- 3 months Mean age /- 4.8 years Light Conditions Preoperative Angle (°) Postoperative Angle (°) Angle Change(°) p Mesopic 54.2 37.7 -16.5 <0.05 Photopic 53.5 34.6 -18.6 Escotopic 58.4 39.7 -18.7

6 RESULTS

7 RESULTS Posible eliminacion
La del astigmatismo refractivo no por que no diferencio si son toricos o esfericos La del seguimiento por que son

8 RESULTS Posible eliminacion
La del astigmatismo refractivo no por que no diferencio si son toricos o esfericos La del seguimiento por que son

9 Achieved Vault (microns)
Light conditions Preoperative ACD Postoperative ACD p Mesopic 3.26 3.24 p>0.05 Photopic 3.22 2.85 p<0.05 Escotopic 2.90 . The mean White-to-white distance measured using OCT-Visante was / mm and Sulcus-to-Sulcus diameter was /- 0.5 mm. Light conditions Postoperative Angle Achieved Vault (microns) Mesopic 37.7 552 Photopic 34.6 507 Escotopic 39.7 374

10 DISCUSSION ICL V4c implantation is secure, stable, predictible and effective for correction of high myopia in a 6 month follow up. Greater influence on the vault: ICL size, the anterior chamber depth and a positive correlation with the keratometric mean power Nevertheless, we have to consider the risk of complications including cataract, endotelial cell lost, pigment dispersion syndrome, pigmentary glaucoma and pupillary block. The ideal achieved vault is recommended to be equal or greater than 1.0 to 1.5 mm. Previous studies demonstrated that the ICL V4c vault is comparable with ICL previous models. Schmidinger et al Minimum of 230 microns for long term safety Cronologic dinamic changes in vault and during accomodation, Vault of at least 500 microns to avoid complications in a 25 year period. Dong-Hoon et al determined that the most important factor to estimate the vault is the difference between the ICL and the sulcus-to-sulcus diameter Kamiya et al observed that the achieved vault diminished 10 mm aproximately per year of age. Greater influence on the vault: ICL size, the anterior chamber depth and a positive correlation with the keratometric mean power.

11 DISCUSSION Few studies report the changes presented in iridocorneal angle and vault after ICL V4 implantation measured by OCT-SA Visante and during its follow up. There are no studies that analyzed these changes with ICL V4c model.

12 CONCLUSION ICL V4c is a secure, efficient, predictable and stable procedure. There is a significant reduction in the iridocorneal angle after implantation. Inverse relationship between the iridocorneal angle and the achieved vault, accentuated under different light conditions.


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