|
|
|
Comparing the Clinical Application Outcomes between the NGENUITY Three-Dimensional and Binocular Microscope Visualization Systems in Posterior Chamber Implantable Collamer Lens Implantation |
| Kangjun Li1, Shanshan Wang2, Qinyun Li2, Xiaocui Song2, Yaxin Li2, Meng Ni2 |
1The Aier Eye Institute of Central South University, Changsha 410083, China;
2The Xi’an Aier Eye Hospital, Xi’an 710000, China |
|
|
|
| Guide |
|
|
Abstract Objective: To evaluate the operation and clinical applications of the NGENUITY® 3D-guided system
and the binocular microscope visualization system for posterior chamber implantable collamer lens
implantation (ICL). Methods: This was a randomized controlled study. A total of 60 patients (60 eyes) who
underwent ICL or Toric ICL (TICL) surgery in the Xi’an Aier Eye Hospital from October to November
2020 were enrolled and randomly divided into two groups that included 30 patients (30 eyes) in the 3D
group and 30 patients (30 eyes) in the microscope group. The following observation indexes were obtained
during this study: the operation indicators included the minimum light illuminance, ICL implant time, TICL
posit time and total operation time and the clinical outcome indicators that included changes in the patients’
intraocular pressure, visual acuity, manifest refraction spherical equivalent (MRSE), the average off-axis
rotation axial deviation and the rate of subconjunctival hemorrhage. The t test and Chi square test were used
for statistical analysis. Results: There were no significant differences between two groups in age, MRSE
or TICL proportion at baseline. There was a statistically significant difference between the microscope
group and the 3D group in the minimum light illuminance (10 800±1 300 lux, 5 000±1 500 lux),
the ICL implant time (12.6±3.7 s, 8.7±2.4 s), the TICL posit time (32.4±5.4 s, 16.3±2.4 s), and the
total operation time (415.4±43.3 s, 331.0±33.7 s). All differences were statistically significant (t=7.31,
P=0.003; t=6.32, P=0.001; t=8.34, P=0.001; t=5.83, P=0.002). The differences in intraocular pressure
changes 3 hours after surgery (5.24±3.42 mmHg, 3.12±2.15 mmHg) and the average off-axis rotation axial
deviation (5.68±0.18°, 3.23±0.13°). Comparisons were both statistically significant (t=2.82, P=0.002;
t=3.22, P=0.002). There were no significant differences between groups after the operation in the rate of
subconjunctival hemorrhage, uncorrected visual acuity, best corrected visual acuity or residual refractive
error. Conclusions: Compared with the binocular microscopy system ICL, the intraoperative light
illuminance, operative time and the average off-axis rotation axial deviation can be reduced more by the
NGENUITY® 3D-guided system ICL.
|
|
Received: 24 August 2021
|
|
|
| Fund: Natural Science Foundation of Hunan Province (2021JJ30048); Aier Eye Group Research Project Fund (AF1909D4, AF2009D8) |
|
Corresponding Authors:
Kangjun Li, the Aier Eye Institute of Central South University, Changsha 410000,China (Email: kj4907630@foxmail.com)
|
|
|
|
| [1] |
李康寯, 张凌子, 宋小翠, 等. SMILE和ICL矫正中低度近视术后角膜前后表面和总角膜高阶像差的变化. 国际眼科杂志,2018, 18(12): 2289-2292. DOI: 10.3980/j.issn.1672-5123.2018.12.42.
|
| [2] |
Li K, Wang Z, Zhang D, et al. Visual outcomes and corneal biomechanics after V4c implantable collamer lens implantation in subclinical keratoconus. J Cataract Refract Surg, 2020,46(10): 1339-1345. DOI: 10.1097/j.jcrs.0000000000000262.
|
| [3] |
Berquet F, Henry A, Barbe C, et al. Comparing heads-up versus binocular microscope visualization systems in anterior and
|
|
posterior segment surgeries: a retrospective study. Ophthalmol,2020, 243(5): 347-354. DOI: 10.1159/000507088.
|
| [4] |
Nariai Y, Horiguchi M, Mizuguchi T, et al. Comparison of microscopic illumination between a three-dimensional headsup system and eyepiece in cataract surgery. Eur J Ophthalmol,2021, 31(4): 1817-1821. DOI: 10.1177/1120672120929962.
|
| [5] |
Palácios RM, de Carvalho ACM, Maia M, et al. An experimental and clinical study on the initial experiences of Brazilian vitreoretinal surgeons with heads-up surgery. Graefes Arch ClinExp Ophthalmol, 2019, 257(3): 473-483. DOI: 10.1007/s00417-019-04246-w.
|
| [6] |
Agranat JS, Miller JB, Douglas VD, et al. The scope of threedimensional digital visualization systems in vitreoretinal surgery. Clin Ophthalmol, 2019(13): 2093-2096. DOI: 10.2147/OPTH.S213834.
|
| [7] |
Asani B, Siedlecki J, Schworm B, et al. 3D heads-up display vs.standard operating microscope vitrectomy for rhegmatogenous
|
|
retinal detachment.Front Med, 2020, 12(7): 1010-1017. DOI:10.3389/fmed. 2020.615515.
|
| [8] |
Eckardt C, Paulo E. Heads-up surgery for vitreoretinal procedures: an experimental and clinical study. Retina, 2016,36(1): 137-147. DOI: 10.1097/IAE.0000000000000689.
|
| [9] |
Postel Eric A. Long-term Follow-up of Iatrogenic Phototoxicity. Arch Ophthalmol, 1998, 116(6): 753-757. DOI: 10.1001/archopht.116.6.753.
|
| [10] |
Liu J, Wu D, Ren X, et al. Clinical experience of using the NGENUITY three-dimensional surgery system in ophthalmic surgical procedures. Acta Ophthalmol, 2020, 99(1): e101-e108.DOI: 10.1111 /aos.14518.
|
| [11] |
Shaaban Y, Badran T. Three-year effect of phakic intraocular lenses on the corneal endothelial cell density. Clin Ophthalmol,2020, 14(1): 149-155. DOI: 10.2147/OPTH.S236041.
|
| [12] |
张可, 王姗姗, 宋小翠, 等. 有晶状体眼后房型人工晶状体水平或垂直植入术后前房角与拱高的变化. 国际眼科杂志,2021, 21(6): 1091-1095. DOI: 10.3980/j.issn.1672-5123.2021.6.31.
|
| [13] |
任雁琳, 史春生, 姜波. FS-LASIK矫正不同程度近视术后角膜高阶像差的早期变化. 国际眼科杂志, 2021, 21(5): 796-799.DOI: 10.3980/j.issn.1672-5123.2021.5.09.
|
| [14] |
Shin JY, Ahn H, Seo KY, et al . Comparison of higher order aberrations after implantable collamer lens implantation and wavefront-guided LASEK in high myopia. J Refract Surg, 2012,28(2): 106-111. DOI: 10.3928/1081597X-20111018-02.
|
| [15] |
Kamiya K, Igarashi A, Shimizu K, et al. Visual performance after posterior chamber phakic intraocular lens implantation and wavefront-guided laser in situ keratomileusis for low to moderate myopia. Am J Ophthalmol, 2012, 153(6): 1178-1186.DOI: 10.1016/j.ajo.2011.12.005.
|
| [16] |
Rez-vives CP, Dominguez-Vicent A, Ferrer-Blasco T, et al.Optical quality of hyperopic and myopic phakic intraocular lenses. Indian J Ophthalmol, 2014, 62(4): 437-441. DOI: 10.4103/0301-4738.119423.
|
| [17] |
Kayhan B. The effects of implantable collamer lens implantation on higher order aberrations. Int J Ophthalmol, 2019, 12(12):1848-1852. DOI: 10.18240/ijo.2019.12.05.
|
| [18] |
Siedlecki J, Schmelter V, Mayer WJ, et al. SMILE versus implantable collamer lens implantation for high myopia: a matched comparative study. J Refract Surg, 2020, 36(3): 150-159. DOI: 10.3928 /1081597X-20200210-02.
|
| [19] |
Siedlecki j, Schmelter V, Schworm B, et al. Corneal wavefront aberrations and subjective quality of vision after small incision lenticule extraction. Acta ophthalmologica, 2020, 98(7):e907-e913. DOI: 10. 1111/aos.14420.
|
| [20] |
Sun WK, Yang H, Yoon G, et al. Higher-order aberration changes after implantable collamer lens implantation for myopia. Am J Ophthalmol, 2011, 151(4): 653-662. DOI: 10.1016/j.ajo.2010.10.031
|
|
|
|
