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Inicio Archivos de la Sociedad Española de Oftalmología (English Edition) Intraocular pressure fluctuations in patients implanted with an implantable coll...
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Vol. 94. Issue 8.
Pages 367-376 (August 2019)
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Vol. 94. Issue 8.
Pages 367-376 (August 2019)
Original article
Intraocular pressure fluctuations in patients implanted with an implantable collamer lens (ICL V4c). Three-month follow-up
Fluctuaciones de presión intraocular en pacientes operados con implante de implantable collamer lens (ICL V4c). Seguimiento a 3 meses
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J. Navarrete Argüello
Corresponding author
, H. Bello López Portillo, M.A. Cantero Vergara, G.A. Sierra Acevedo, K. Ruiz Salgado, M.V. Nieto Aguilar, M.A. Aguilar Pérez, S.Y. Ramos Hernández, A. Zaragoza Herrera, J.D. de la Torre Tovar
Hospital Central Militar, Mexico City, Mexico
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Tables (7)
Table 1. Comparison of maximum and minimum IOP descriptive statistics and mean pre- and post-op fluctuations.
Table 2. T for Student test of pre- and post-op angle, divided by vault value.
Table 3. Summary of McNemar test for difference between pre- and post-op IOP fluctuation alterations as per sample subdivisions.
Table 4. Summary of pre- and post-op descriptive statistics for VA, VC and SE.
Table 5. Results of the T for student test for VA, VC and SE between both measurements.
Table 6. T for student test for VA, VC and SE para type of surgeon.
Table 7. Chi square test results for relationship between postoperative complications and grouping variables.
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Abstract
Introduction

Fluctuating elevated intraocular pressure (IOP) is one of the complications of an implanted collamer lens (ICL), and its alteration is a predictive factor for the development of glaucoma.

Material and methods

A prospective, cross-sectional analytic study was conducted on patients suitable for ICL implantation. Complete clinical and biometric work-ups were performed, as well as night-time IOP curve, in supine position, with 4 determinations, in order to assess fluctuation, considering abnormal with a value higher than 5 mmHg being considered abnormal. Three months after the patients underwent surgery, the work-ups were repeated, including a night-time IOP curve to assess any changes in IOP fluctuations.

Results

A total of 31 eyes of 16 patients were studied. Mean IOP fluctuation in the preoperative assessment was 3.35 ± 2 mmHg, whereas the postoperative mean was 3.0 ± 2.2 mmHg, with the difference not being statistically significant. Visual acuity and capacity, as well as spheric equivalent did show a statistically significant improvement. There were 6 cases of complications, which were related to a higher vault and a greater ICL size. There was no relationship between these findings and the angle grade, pigment, and the level of training of the surgeon.

Conclusions

The effect of an ICL on IOP fluctuations, has been studied for the first time, which was not statistically significant. As in previous publications, the procedure was safe and reproducible, adding the fact that the level of training of the surgeon is not a determining factor in these findings.

Keywords:
Intraocular pressure fluctuations
Phakic intraocular lens
Implantable collamer lens
Glaucoma
Resumen
Introducción

una de las complicaciones del implante de ICL es la elevación de la presión intraocular (PIO), la cual es fluctuante y su alteración es un factor predictivo para el desarrollo de glaucoma.

Material y métodos

estudio prospectivo, transversal y analítico, en pacientes candidatos a implante de ICL. Previa valoración clínica completa, biometría y curva de PIO nocturna, posición supina, con 4 tomas, determinando la fluctuación, considerándose anormal arriba de 5 mmHg. Se les sometió a cirugía mediante técnica convencional. A los 3 meses se repitió valoración clínica completa, biometría y curva de PIO, para determinar si había cambios en las fluctuaciones de PIO.

Resultados

se estudiaron 31 ojos de 16 pacientes. El promedio de fluctuación preoperatorio fue de 3.35 ± 2 mmHg, mientras en el postoperatorio fue de 3.0 ± 2.2 mmHg, sin que esta diferencia fuera estadísticamente significativa. La agudeza, capacidad visual y equivalente esférico mostraron una mejoría estadísticamente significativa. Hubo 6 ojos con complicaciones, las cuales se relacionaron con un vault alto y un ICL de mayor tamaño. No hubo relación de complicaciones o fluctuaciones con el grado del ángulo camerular, el grado de pigmento o el nivel de entrenamiento del cirujano.

Conclusión

se exploró por primera vez el efecto del implante de ICL en las fluctuaciones de PIO, encontrando que no es estadísticamente significativo. Se mostró la seguridad y reproducibilidad del procedimiento, como en publicaciones previas, agregando que el nivel de entrenamiento del cirujano, no es un factor determinante en ninguno de dichos factores.

Palabras clave:
Fluctuaciones de presión intraocular
Lentes fáquicos
Implantable collamer lens
Glaucoma

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