title: Viscocannula-assisted reinversion of implantable collamer lens: comparison of postoperative outcomes with the fellow eyes.
abstract: OBJECTIVE
  To analyze and compare the postoperative outcomes of eyes with accidental intraoperative inversion of implantable collamer lens (ICL) and viscocannula-assisted reinversion in high myopia.
  
  
  METHODS
  Retrospective observational case comparison.
  
  
  METHODS
  
  
  
  METHODS
  Institutional practice.
  
  
  METHODS
  Consecutive eyes with accidental intraoperative inversion of ICL and viscocannula-assisted reinversion from January 2007 to September 2010 were analyzed retrospectively. They were compared with the fellow eyes with normal ICL implantation at 1 month, 6 months, and 2 years.
  
  
  METHODS
  Uncorrected visual acuity (UCVA), best-corrected visual acuity (BCVA), corneal pachymetry, endothelial cell loss, intraocular pressure, lens transparency, anterior chamber depth, and postoperative uveitis.
  
  
  RESULTS
  A total of 206 myopic eyes had ICL implantation. Eight eyes (3.8%) of 8 patients had accidental intraoperative reinversion. Their fellow eyes had normal ICL implantation. There was no significant change (P = .611) in UCVA (reinverted and fellow eyes) at 2 years. There was no significant difference in postoperative UCVA (P = .611) and BCVA (P = .854) between the reinverted and the fellow eyes. The mean endothelial loss at 1 month, 6 months, and 2 years was 0.96% ± 0.5%, 0.92% ± 0.63%, and 0.89% ± 0.52% respectively in the reinverted eyes. There was no significant difference in the endothelial loss between the 2 groups at 1 month (P = .753), 6 months (P = .834), and 2 years (P = .916). One out of 8 eyes with reinversion had postoperative corneal edema, which resolved at 48 hours. None of the eyes reported uveitis or glaucoma. There was no loss of lens transparency.
  
  
  CONCLUSIONS
  Intraoperative inversion can occur during insertion of ICL and viscocannula-assisted reinversion can be performed without significant complications.
authors: Dr Agarwal's Eye Hospital and Eye Research Centre, Chennai, India.
authors: Dhivya Ashok
authors: DA
authors: Kumar
authors: Amar
authors: A
authors: Agarwal
authors: Gaurav
authors: G
authors: Prakash
authors: Soundari
authors: S
authors: Sivanganam
authors: Soosan
authors: S
authors: Jacob
authors: Athiya
authors: A
authors: Agarwal
mesh_terms: D000867:Anterior Chamber / Q000601:surgery; D002452:Cell Count; D055954:Corneal Endothelial Cell Loss / Q000175:diagnosis; D019781:Corneal Topography; D004728:Endothelium, Corneal / Q000473:pathology; D006801:Humans; D065347:Hypromellose Derivatives; D007049:Iatrogenic Disease; D007429:Intraocular Pressure / Q000502:physiology; D007431:Intraoperative Complications; D019654:Lens Implantation, Intraocular; D019300:Medical Errors; D008747:Methylcellulose / Q000031:analogs & derivatives* / Q000627:therapeutic use; D009216:Myopia / Q000503:physiopathology / Q000601:surgery*; D054120:Phakic Intraocular Lenses; D012029:Refraction, Ocular / Q000502:physiology; D012086:Reoperation; D012189:Retrospective Studies; D016896:Treatment Outcome; D055682:Viscoelastic Substances / Q000627:therapeutic use*; D014792:Visual Acuity / Q000502:physiology
chemical_list: D055682:Viscoelastic Substances; D065347:Hypromellose Derivatives; D008747:Methylcellulose