Skip to main content

Advertisement

SpringerLink
Log in

The effect of irrigation and aspiration on the corneal endothelial cell density in patients undergoing Implantable Collamer Lens with a central hole implantation for myopia correction

  • Original Paper
  • Published:
International Ophthalmology Aims and scope Submit manuscript

Abstract

Purpose

In the conventional technique, viscoelastic agents are typically rinsed away with balanced salt solution (BSS), but it may lead to a series of complications such as viscoelastic residue, anterior chamber instability and intraoperative TICL rotation. The utilization of irrigation and aspiration (I/A) has been shown to be effective in maintaining anterior chamber stability, reducing the incidence of postoperative high intraocular pressure, and minimizing postoperative fundus complications. However, there is a lack of previous studies investigating the impact of I/A on corneal endothelial cells during ICL implantation. The objective of this study was to examine the effect of I/A on corneal endothelial cells in patients undergoing myopia correction through implantation of Implantable Collamer Lens with a central hole (V4c ICL).

Methods

A retrospective selection was made of 344 eyes from 172 patients who underwent V4c ICL implantation and I/A to remove viscoelastic agent from the anterior chamber between 2021 and 2022. The intraocular pressure (IOP) was measured at 1 h, 2 h and 3 h after surgery. Corneal endothelial cell density (ECD), coefficient of variation in cell size (CV), standard deviation of cell area (SD), and percentage of hexagonal cells (HEX) were evaluated at 1 week postoperatively to assess corneal endothelial cells. The first two represent polymegethism or morphological variation, while the third parameter represents the degree of polymorphism of the corneal endothelial cells. Electronic medical records were utilized for data collection purpose.

Results

All surgeries proceeded without complications. The IOP was 16.50 ± 3.42 mmHg (range: 11.5–22.3 mmHg) prior to surgery and increased to 21.25 ± 5.61 mmHg (range: 9.5–34.8 mmHg), 19.85 ± 5.18 mmHg (range: 11.4–36.2 mmHg) and finally settled at an average of 18.81 ± 4.57 mmHg (range: 10.1–38.8 mmHg) at the respective time points of 1 h, 2 h and 3 h after surgery. The preoperative ECD was recorded as being approximately 3004 ± 295 cell/mm2, which exhibited a marginal decreased of 1.17% postoperatively, resulting in an average ECD value of 2969 ± 303 cell/mm2 one week after surgery (P = 0.12). Similarly, the preoperative CV was determined as 31.10 ± 3.78%, and it experienced a slight reduction with an average CV value of 30.74 ± 3.77% at week after surgery (P = 0.21). And, the preoperative SD was reported as 104.76 ± 17.26, and it remained virtually unchanged with an average SD value of 104.85 ± 18.75 at one week after surgery (P = 0.95). The preoperative HEX was calculated as 55.38 ± 8.94%, and it remained its stability with an average HEX value of 55.45 ± 8.73% one week after surgery (P = 0.92).

Conclusion

The utilization of I/A led to a slight decrease in postoperative ECD when compared to conventional surgical techniques. Nevertheless, the reduction in ECD remained within acceptable limits, taking into accout the avervantaged it offered, such as stabilization of the anterior chamber and decreased occurrence of viscoelastic residue after surgery. It is challenging to anticipate the long-term safety of corneal endothelial cells based on current short-term studies. However, this study provides a valuable reference indicating that neither anterior chamber irrigation nor I/A aspiration have an adverse impact on the safety of corneal endothelial cells in the short term. Further research is imperative to enhance our understanding of their effects over an extended period.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

Data availability

Not applicable.

References

  1. Repplinger B, Kohnen T (2018) Intraocular pressure after implantation of an ICL with aquaport : Development of intraocular pressure after implantation of an ICL (model V4c) with aquaport without iridotomy. Der Ophthalmol: Zeitschrift der Deutschen Ophthalmol Gesellschaft 115(1):29–33. https://doi.org/10.1007/s00347-017-0556-1

    Article  CAS  Google Scholar 

  2. Packer M (2016) Meta-analysis and review: effectiveness, safety, and central port design of the intraocular collamer lens. Clin Ophthalmol 10:1059–1077. https://doi.org/10.2147/opth.S111620

    Article  PubMed  PubMed Central  Google Scholar 

  3. Miao HM, Zhao F, Niu LL, Zhao J, Wang XY, Zhou XT (2021) One-step viscoelastic agent technique for ICL V4c implantation for myopia. Int J Ophthalmol 14(9):1359–1364. https://doi.org/10.18240/ijo.2021.09.10

    Article  PubMed  PubMed Central  Google Scholar 

  4. Packer M (2018) The implantable collamer lens with a central port: review of the literature. Clin Ophthalmol 12:2427–2438. https://doi.org/10.2147/opth.S188785

    Article  PubMed  PubMed Central  Google Scholar 

  5. Kamiya K, Ando W, Hayakawa H, Gotoda S, Shoji N (2022) Vertically fixated posterior chamber phakic intraocular lens implantation through a superior corneal incision. Ophthalmol Ther 11(2):701–710. https://doi.org/10.1007/s40123-022-00470-6

    Article  PubMed  PubMed Central  Google Scholar 

  6. Schumann RG, Schaumberger MM, Rohleder M, Haritoglou C, Kampik A, Gandorfer A (2006) Ultrastructure of the vitreomacular interface in full-thickness idiopathic macular holes: a consecutive analysis of 100 cases. Am J Ophthalmol 141(6):1112–1119. https://doi.org/10.1016/j.ajo.2006.01.074

    Article  PubMed  Google Scholar 

  7. Almalki S, Abubaker A, Alsabaani NA, Edward DP (2016) Causes of elevated intraocular pressure following implantation of phakic intraocular lenses for myopia. Int Ophthalmol 36(2):259–265. https://doi.org/10.1007/s10792-015-0112-4

    Article  PubMed  Google Scholar 

  8. Bayatpour D, Abouali O, Ghaffarieh A, Ahmadi G (2017) In silico investigation of cornea deformation during irrigation/aspiration in phacoemulsification in cataract surgery. Med Eng Phys 43:77–85. https://doi.org/10.1016/j.medengphy.2017.02.010

    Article  PubMed  Google Scholar 

  9. Wang Y, Shi X, Wei S, Yue C, Wang Z, Li X (2022) Evaluation of flow field in the anterior segment during irrigation and aspiration in cataract surgery with three-dimensional computational simulation. Med Eng Phys 99:103741. https://doi.org/10.1016/j.medengphy.2021.103741

    Article  PubMed  Google Scholar 

  10. Schulze SD, Bertelmann T, Manojlovic I, Bodanowitz S, Irle S, Sekundo W (2015) Changes in corneal endothelium cell characteristics after cataract surgery with and without use of viscoelastic substances during intraocular lens implantation. Clin ophthalmol 9:2073–2080. https://doi.org/10.2147/opth.S90628

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  11. Wang Y, Yang R, Huang Y et al (2022) Clinical observations of EVO-ICL implantation and changes in corneal astigmatism using a modified technique. BMC ophthalmol 22(1):381. https://doi.org/10.1186/s12886-022-02603-8

    Article  PubMed  PubMed Central  Google Scholar 

  12. Qin Q, Bao L, He Z et al (2021) Pure ICL implantation: a novel ophthalmic viscosurgical device-free method. J Ophthalmol. https://doi.org/10.1155/2021/7363267

    Article  PubMed  PubMed Central  Google Scholar 

  13. Vaiciuliene R, Rylskyte N, Baguzyte G, Jasinskas V (2022) Risk factors for fluctuations in corneal endothelial cell density. Exp Ther Med 23(2):129. https://doi.org/10.3892/etm.2021.11052

    Article  PubMed  Google Scholar 

Download references

Funding

This work was supported by the Science & Technology Department of Sichuan Province (China) funding project (No. 2021YFS0221) and 1.3.5 project for disciplines of excellence, West China Hospital, Sichuan University(No.2022HXFH032, ZYJC21058, 2021-023,2022-014).

Author information

Authors and Affiliations

  1. Department of Ophthalmology, West China Hospital, Sichuan University, No.37, Guoxue Xiang, Chengdu, 610041, Sichuan, China

    Hao Zhang, Yingping Deng, Ke Ma, Hongbo Yin & Jing Tang

  2. Harbin Medical University, No.157, Baojian Road, Harbin, 150000, Heilongjiang, China

    Zhaoyuan Xu

Authors
  1. Hao Zhang
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Zhaoyuan Xu
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Yingping Deng
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Ke Ma
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Hongbo Yin
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Jing Tang
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

JT interpreted the patient data and provided the patient material. HZ wrote the first draft of the manuscript. ZX made a statistical analysis of the data. YD, HY and KM supplemented, perfected and revised the first draft of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Jing Tang.

Ethics declarations

Conflict of interest

All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript.

Ethical approval and consent to participate

Our study was submitted to and approved by the Biomedical Ethics Sub-Committee of the West China Hospital of Sichuan University.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Zhang, H., Xu, Z., Deng, Y. et al. The effect of irrigation and aspiration on the corneal endothelial cell density in patients undergoing Implantable Collamer Lens with a central hole implantation for myopia correction. Int Ophthalmol 44, 94 (2024). https://doi.org/10.1007/s10792-024-02968-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1007/s10792-024-02968-3

Keywords

Search

Navigation