The Benefits of One Day, One Eye Surgery in Bilateral ICL Implantation

Kyum Kim Wook; Young Cho Eun; Sun Kim Hee; Su Kim Deok; Kuk Kim Jin

doi:10.3341/jkos.2013.54.7.1019

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Wook, Eun, Hee, Deok, and Jin: The Benefits of One Day, One Eye Surgery in Bilateral ICL Implantation

Original Article

J Korean Ophthalmol Soc 2013;54(7):1019-1024.

Published online: 7 September 2013

DOI: https://doi.org/10.3341/jkos.2013.54.7.1019

The Benefits of One Day, One Eye Surgery in Bilateral ICL Implantation

Kyum Kim Wook, MD, Young Cho Eun, MD, Sun Kim Hee, MD, Su Kim Deok, MD, Kuk Kim Jin, MD

¹B&VIIT Eye Center, Seoul, Korea

Address reprint requests to Jin Kuk Kim, MD B&VIIT Eye Center, 14F Aratower #3 Seocho-daero 77-gil, Seocho-gu, Seoul 137-856, Korea Tel: 82-2-501-6800, Fax: 82-2-501-6435 E-mail: bestjinkuk@bseye.com

* This study was presented as a poster at the 108th Annual Meeting of the Korean Ophthalmology Society 2012.

Received 26 October 20121 February 2013 Accepted 22 April 2013

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To evaluate the benefits of one day, one eye ICL implantation which allows the ICL size of the later-operated eye to be adjusted after evaluating the postoperative vault of the first-operated eye in order to reduce the postoperative ICL size exchange rates of both eyes.

Methods

A total of 426 eyes of 213 patients who received one day, one eye bilateral ICL implantation were included in the present study. The cases where a different ICL size was implanted in the later-operated eye because of high or low post-operative vault of the first-operated eye were analyzed as well as the ICL exchange rates.

Results

Among 213 patients, same size ICLs were implanted in both eyes in 188 patients (88%) as planned. However, a different ICL size was implanted in the later-operated eye in 25 patients (12%). Eight eyes of 8 patients out of 25 patients needed their ICL size exchanged during the follow-up period and all 8 eyes were first-operated eyes. This occurred in 8 pa-tients (3.8%) out of 213 patients.

Conclusions

One day, one eye ICL implantation, which can help the size adjustment of the later-operated eye according to the postoperative 1 day vault of the first-operated eye, can reduce the risk of bilateral ICL size exchange operation.

Keywords: Exchange, Implantable collamer lens, Phakic intraocular lens, Vault

References

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Figure 1.

Visante OCT image of patient who received ICL implantation. The postoperative vault of this patient is 0.39 mm.

Table 1.

Basic characteristics of 426 eyes of 213 patients wh received bilateral ICL implantation

Characteristics	Values
Sex (M : F)	54 : 159
Age (years)	26.3 ± 4.6
Dominant eye (right: left)	154 : 59
Preoperative spherical equivalent (diopters)	-9.13 ± 2.44
Preoperative BCVA (log MAR)	-0.02 ± 0.04
Preoperative IOP (mm Hg)	14.3 ± 2.9
Scotopic pupil size (mm)	6.8 ± 0.7
Preoperative central corneal thickness (um)	520 ± 23
White to white with topography (mm)	11.7 ± 0.3
Implanted ICL size (mm)	11.9 ± 0.3
Postoperative spherical equivalent (diopters)	-0.31 ± 0.49
Postoperative UCVA (log MAR)	-0.08 ± 0.05
Postoperative IOP (mm Hg)	13.8 ± 2.6

Values are presented as mean ± SD. BCVA = best corrected visual acuity; IOP = intraocular pressure UCVA = uncorrected visual acuity.

Table 2.

The change of ICL sizes from first-operated eye to later-operated eye in 25 patients in which different size ICLs were implanted

ICL size (mm) (first-operated eye ? later-operated eye)	Number of patients
115 ? 120	7
120 ? 125	4
125 ? 130	0
130 ? 125	0
125 ? 120	8
120 ? 115	6
Total	25

Table 3.

The postoperative results of two groups which are first-operated eyes and later-operated eyes in 213 patients (426 eyes)

	First-opearted eyes	Later-operated eyes	p-value
Implanted ICL size (mm)	11.9 ± 0.33	11.9 ± 0.32	0.83^*
Postoperative vault (mm)	0.47 ± 0.24	0.46 ± 0.21	0.65^*
Low vault (eyes)	35 (16%)	36 (17%)	1.00^†
Ideal vault (eyes)	159 (75%)	158 (74%)	1.00^†
High vault (eyes)	19 (9%)	19 (9%)	1.00^†
ICL size exchanged (eyes)	10 (4.7%)	4 (1.9%)	0.17^†

^* Student’s t-test was done

^† Chi square test was done.

Table 4.

The analysis of ICL size in 14 eyes in which ICL size exchange was done

ICL size change (mm)	Total (eyes)	Groups (implanted ICL size of both eyes)
ICL size change (mm)	Total (eyes)	Same size (376 eyes)	Different size (50 eyes)
115 ? 120	5	2	3
120 ? 125	3	0	3
125 ? 130	0	0	0
130 ? 125	0	0	0
125 ? 120	5	3	2
120 ? 115	1	1	0
Total	14	6 (1.6%)	8 (16%)

Table 5.

The ICL exchange rate according to the size of implanted ICL

Implanted ICL size (mm)	Total (eyes)	ICL size of	bilateral eyes	Total
Implanted ICL size (mm)	Total (eyes)	Same size (378 eyes)	Different size (50 eyes)	Total
(mm)		Same size (378 eyes)	Different size (50 eyes)
115	143	2 (1.5%)	3 (23.1%)	5 (3.5%)
120	233	1 (0.5%)	3 (12%)	4 (1.7%)
125	48	3 (8.3%)	2 (16.7%)	5 (10.4%)
130	2	0 (0%)	0 (0%)	0 (0%)
Total	428	6 (1.6%)	8 (16%)	14 (3.3%)

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