I C L Implantation Of Old R D

 Discussing the feasibility and safety of ICL implantation in patients with old retinal detachment.

The majority of patients undergoing ICL implantation are hypermyopic, and their retinal conditions are oftenly not well,frequently accompanied by retinal  degeneration, holes, and even limited retinal detachment. For retinal degeneration or hole,   ICL implantationcan be performed after retinal photocoagulation. For  limited and old retinal detachment, whether ICL implantation can be performed and whether it is safe after the operation remain to be observed.

A 34-year-old female with a history of myopia for more than 20 years and occlusion sensation in the inferior temporal part of her left eye in the past 3 years.  Examination revealed limited RD in the superior nosal quadrant of the left eye and mild retinal degeneration of her right eye.  Laser photocoagulation was performed on left eye.  2023.04.15 Re-examination before ICL implantation showed that the area of limited RD in her left eye had not expanded, but a dry hole and subretinal proliferating cord can been seen, so photocoagulation around limited RD was performed again, and the changes of RD were observed continuously. After 2 months of following, we found the RD was still stable and limited. So ICL implantation in both eyes was performed on 2023.06.07. 2023/06/08. The  first day result after ICL procedure: OD: visual acuity 1.2; optometry: +0.50-0.50×38°;vault height: 1CT  (slit-lamp), : 270um(anterior segment OCT examination); OS: vision 1.0; optometry: -0.00-1.00×164°; vault: 1CT, 350um. There was no change in her left fundus. 2024.02.18, 8 months after surgery, the visual acuity OD1.2, OS1.0, the limited RD area is same as preoperation.

The preoperation examination result are as follow:

OD: 0.01，-8.00/-0.75×5°=1.0;W­-to-W(mm):11.4;ACD:(mm)2.70;Axis (mm):26.10;fundus:normal;ICLsize(mm):12.6Horizontal

OSO0.01，-8.00/-1.00×170°=1.2;W­-to-W(mm):11.3;ACD:(mm)2.70 ;Axis (mm):26.22;fundus:Limited retinal detachment superionosal;ICLsize(mm):oirep12.6Horizontal

1. Small area peripheral retinal degeneration , ICL procedure is safe  after retinal photocoagulation 1 week later. The large area(more than one quadrant), multiple degeneration areas, retinal dry hole without limited retinal detachment, ICL procedure can be performed  after retinal photocoagulation 2 weeks later.

2. With complex fundus conditions, such as patients with a samll or relatively large area of shallow retinal detachment, if the detached area was stable after mydriasis view more than 4 weeks after retinal photocoagulation,ICL implantation also can be  performed.

3. Make sure to closely mornitor the postoperation fundus, 1 day , 1 month, 3 months, 6 months, 1 year by mydriasis examination after surgery.