Focusing on preoperative evaluation for cataractous eyes after implantable collamer lens

Authors: Wang Xiaoying,  Zhou Xingtao,  Zhu Xiangjia,  Jiang Yongxiang,  Chen Xun
DOI: 10.3760/cma.j.cn115989-20230815-00070
Published 2024-03-10
Cite as Chin J Exp Ophthalmol, 2024, 42(3): 219-223.

Abstract                              [Download PDF] [Read Full Text]

With increasing age, more and more patients with posterior chamber intraocular lens (ICL) implantation are facing the threat of cataracts to their visual acuity.When examining the eyes of cataract patients after ICL surgery, attention should be paid to whether the density of corneal endothelial cells is greater than 2 000 cells/mm2, the state of the anterior chamber angle, and whether there are fundus abnormalities such as retinal detachment and choroidal neovascularization.When conducting eye biometry measurement, attention should be paid to the measurement starting and ending lines of anterior chamber depth and lens thickness.If patients undergo ICL combined with corneal refractive surgery, they should be examined with two or more devices to obtain corneal refractive power according to the examination requirements after corneal laser vision correction.When selecting the type of intraocular lens, consideration should be given to the histological characteristics of high myopia.Compared to C- and L- loops, plate-haptic is relatively more stable in patients with high myopia accompanied by large capsules and larger diameters of continuous curvilinear capsulorhexis.Kane, Barrett Universal Ⅱ, Olsen, Hill-RBF formulas for calculating the refractive power of intraocular lenses are more accurate in people with long axial length.It is recommended to perform ICL removal simultaneously with phacoemulsification and intraocular lens implantation, preferably with a surgical incision greater than 2.6 mm.Femtosecond laser assisted cataract extraction surgery, although superior to traditional phacoemulsification in reducing corneal endothelial cell loss, reducing corneal edema, and high-quality capsulorhexis, can cause incomplete capsulorhexis and fragmentation due to the cavitation bubbles, manual adjustment of location, and the impact of lower vault.It is recommended to use it with caution.Ophthalmologists should fully understand and pay attention to the characteristics and difficulties of cataract surgery after ICL surgery, communicate fully with patients, and make personalized surgery to achieve better visual outcomes.

Key words:

Implantable collamer lens; High myopia; Cataract; Intraocular lens; Key pearls of operation

Contributor Information

Wang Xiaoying

Department of Ophthalmology, Eye &

ENT Hospital, Fudan University, Shanghai 200031, China

Zhou Xingtao

Department of Ophthalmology, Eye &

ENT Hospital, Fudan University, Shanghai 200031, China

Zhu Xiangjia

Department of Ophthalmology, Eye &

ENT Hospital, Fudan University, Shanghai 200031, China

Jiang Yongxiang

Department of Ophthalmology, Eye &

ENT Hospital, Fudan University, Shanghai 200031, China

Chen Xun

Department of Ophthalmology, Eye &

ENT Hospital, Fudan University, Shanghai 200031, China

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