Tilt and decentration of an intraocular lens implanted in the ciliary sulcus after capsular bag defect during cataract surgery

2012 ◽  
Vol 251 (1) ◽  
pp. 89-93 ◽  
Author(s):  
Thomas Sauer ◽  
Ulrich Mester
Keyword(s):  
Cataract Surgery ◽  
Intraocular Lens ◽  
Capsular Bag

scholarly journals Anterior Capsule Opening Contraction and Late Intraocular Lens Dislocation after Cataract Surgery in Patients with Weak or Partially Absent Zonular Support

Medicina ◽  
2021 ◽  
Vol 57 (1) ◽  
pp. 35
Author(s):  
Juris Vanags ◽  
Renārs Erts ◽  
Guna Laganovska
Keyword(s):  
Cataract Surgery ◽  
Intraocular Lens ◽  
Yttrium Aluminum Garnet ◽  
Late Complications ◽  
High Rate ◽  
Anterior Capsule ◽  
Capsular Tension Ring ◽  
Hydrophobic Acrylic ◽  
Capsular Bag

Background and objectives: To evaluate anterior capsule opening (ACO) contraction and late intraocular lens (IOL) dislocation after cataract surgery in patients with weak or partially absent zonular support and assess methods of reducing these complications. Materials and methods: For this prospective study, we enlisted cataract surgery patients in our hospital with preoperative diagnoses of weak zonules. All patients received phacoemulsification surgery with implantation of a hydrophobic acrylic IOL and capsular tension ring (CTR). ACO reductions were measured for six months after enrolment. Data on late IOL dislocations were collected five years after enrolment of the last patient. Results: Fifty-three patients were enrolled from 2011 to 2015. Over the six-month active follow-up period, ACO area reduction was 23% in patients receiving CTRs of 11 mm diameter and 8% for patients with CTRs of 12 mm, with an overall mean of 15% reduction. Five years after the last patient was enrolled, seven patients (13%) had experienced late IOL-CTR-capsular bag dislocation. For these patients, the mean ACO reduction in the first six months of follow-up was 33%, including for those who had received neodymium-doped yttrium aluminum garnet (Nd: YAG) anterior capsulotomies. Conclusion: Use of hydrophobic acrylic lenses and CTR reduces ACO contraction, with rates comparable to those after cataract surgery without ocular comorbidity. Our patients experienced a relatively high rate of late IOL-CTR-capsular bag dislocation. However, dislocated complexes were easily repositioned and few patients required IOL exchange. Frequent visits are warranted to promptly detect late complications of cataract surgery in patients with weak zonular support.

scholarly journals Late within the Capsular Bag Intraocular Lens Dislocation (Ten – Year Experience)

2021 ◽  
Vol 37 (2) ◽  
Author(s):  
Munir Amjad Baig ◽  
Rabeeya Munir
Keyword(s):  
Cataract Surgery ◽  
Intraocular Lens ◽  
Inclusion Criteria ◽  
Lens Dislocation ◽  
Mature Cataract ◽  
Intraocular Lens Dislocation ◽  
Plate Design ◽  
Capsular Bag ◽  
Iol Dislocation

Purpose:  To find out the frequency and causes of within the bag intraocular lens dislocation. Study Design:  Descriptive, retrospective study. Place and Duration of Study:  Federal Government Services Hospital Islamabad, from 2008 to 2018. Methods:  Records of all the patients who underwent uneventful phacoemulsification were studied. Patients with Pseudoexfoliation and glaucoma were excluded. Out-of-the bag IOL dislocations and early dislocations that occurred within first three months after the cataract surgery were also not included. Percentage of patients with dislocated lens within the capsular bag after three months or more was calculated and the cause of dislocation was found. Results were presented in percentages. Results:  Three thousand patients underwent uneventful phacoemulsification. Two thousand nine hundred thirty two (2932) patients fulfilled the inclusion criteria while 68 patients did not return for follow up. Age ranged between 25 and 75 years. There were 1600 males and 1332 were females. One thousand seven hundred and sixty were right eyes and one thousand one hundred and seventy two were left eyes. Sixty one (2.08%) developed late IOL dislocations, 35 (57.3%) males and 26 (42.7%) females. Patients of age group 50 – 75 years had more IOL dislocations. Causes of dislocation included; advanced mature cataract 21.3%, 19.7% with postoperative trauma, uveitis 14.7%, Myopia 9.8%, Silicon plate design in 9.8%, eccentric capsulorhexis 8.1%, small capsulorhexis 6.5%, retinitis pigmentosa 3.2% and in 6.5% no cause was found. Conclusion:  Advanced mature cataract and postoperative trauma were the commonest causes of IOL dislocation. Key Words:  Cataract surgery, Phacoemulsification, Trauma, Capsulorhexis. Intra ocular lens dislocation.

Intraocular lens explantation following cataract surgery: Indications, techniques, and video demonstrations

2021 ◽  
pp. 112067212110396
Author(s):  
Steven G Safran ◽  
Erica Darian-Smith ◽  
Minas T Coroneo
Keyword(s):  
Cataract Surgery ◽  
Intraocular Lens ◽  
Anterior Segment ◽  
Specific Area ◽  
Patient Expectations ◽  
Effective Strategy ◽  
Capsular Bag

As techniques for modern cataract surgery have expanded and premium intraocular lens (IOL) use is now widespread, patient expectations are high. The need for IOL explantation, whilst still low, remains an ongoing issue. Intraocular lens explantation can be challenging for a number of reasons and as such we have introduced an additional technique to add to the surgeon’s repertoire. Bimanual haptic stripping of fibrosis at the specific area where the haptic is adherent to the capsular bag is an effective strategy to aid in dissection of haptics without compromising the capsule or zonules. Given the challenges associated with IOL explantation, newly designed IOLs need to avoid these “sticking points” at which the IOLs interact with the fibrosed capsule. Techniques we have evolved and which are described below should assist anterior segment surgeons to facilitate IOL removal in an efficient and safe way.

Trans-iris fixation of dislocated in-the-bag intraocular lenses

2019 ◽  
Vol 30 (3) ◽  
pp. 538-542
Author(s):  
Amir Faramarzi ◽  
Sepehr Feizi ◽  
Shahin Yazdani
Keyword(s):  
Cataract Surgery ◽  
Intraocular Lens ◽  
Intraocular Lenses ◽  
Posterior Chamber ◽  
Lens Dislocation ◽  
Capsular Tension Ring ◽  
Intraocular Lens Dislocation ◽  
Late Dislocation ◽  
Iris Fixation ◽  
Capsular Bag

Purpose: The aim of this article is to describe the safety and efficacy of trans-iris suture fixation for the management of late dislocation of in-the-capsular-bag intraocular lenses following uncomplicated cataract surgery. Patients and methods: Eleven eyes of 11 patients with late in-the-capsular-bag intraocular lens dislocation following uneventful phacoemulsification cataract surgery were recruited in the study. The dislocated intraocular lens–capsular bag complex was sutured to the iris at two points 180° apart using 9-0 polypropylene sutures on long needles. Results: Mean patient age was 67 ± 6 years. Seven eyes had pseudoexfoliation syndrome, one eye had Marfan syndrome, and another eye had a traumatic cataract; no risk factor was identified for intraocular lens dislocation in two eyes. A capsular tension ring had been implanted during cataract surgery in four eyes. In six eyes, the posterior chamber intraocular lenses were one-piece foldable while the remaining were three-piece intraocular lenses. Compared to the preoperative value, corrected distance visual acuity was significantly improved postoperatively ( p < 0.005). Intraoperative hyphema occurred in two eyes. Pupil ovalization was observed in all eyes. Mean endothelial cell count decreased by 4 ± 1.7% after intraocular lens fixation. The capsular bag–intraocular lens complex was stable and well-centered in the pupillary area in all eyes at the final follow-up examination which was performed 16 ± 4 months postoperatively. Conclusion: Trans-iris fixation is a simple and effective procedure for management of late intraocular lenses–capsular bag complex dislocation, without major complications.

scholarly journals Special Cases in Cataract Surgery

2021 ◽  
Author(s):  
Minghui Deng ◽  
Song Chen ◽  
Xiaogang Wang
Keyword(s):  
Clinical Practice ◽  
Retinitis Pigmentosa ◽  
Cataract Surgery ◽  
Intraocular Lens ◽  
Refractive Surgery ◽  
Special Cases ◽  
Corneal Refractive Surgery ◽  
Capsular Bag ◽  
Posterior Polar Cataract ◽  
Clinical Cases

During phacoemulsification for cataracts, the surgeon may encounter various challenges and should therefore be trained to handle them. This chapter will share an example of clinical cases encountered by the author in clinical practice, which mainly includes the successful implantation of a trifocal intraocular lens in the capsular bag after posterior capsular tear during posterior polar cataract surgery as well as cataract surgery design after corneal refractive surgery, shrinkage, and treatment of capsular opening in patients with retinitis pigmentosa after cataract surgery to provide a reference for clinicians.

scholarly journals Curious Case of a Foldable Intraocular Lens that did not Unfold

2020 ◽  
Author(s):  
Nimisha Nagpa ◽  
Pawan Prasher
Keyword(s):  
Cataract Surgery ◽  
Intraocular Lens ◽  
Visual Outcome ◽  
Elderly Male ◽  
Current Case ◽  
Visual Symptoms ◽  
Cataractous Lens ◽  
Good Visual Outcome ◽  
One Year ◽  
Capsular Bag

Phacoemulsification is a modern technique of cataract surgery that allows the removal of cataractous lens and implantation of a foldable Intraocular Lens (IOL) through a small sub 3 mm incision. For a good visual outcome, it is imperative that the IOL is well centered and its haptics unfold properly inside the capsular bag and keep it distended. However, at times the IOL haptics may not unfold properly leading to adverse visual symptoms. Herein, Authors present an unusual case of a 61-year-old elderly male with no other associated ocular or systemic illness, who presented nine months after cataract surgery in his left eye, with both haptics of the IOL unusually folded and the edge of one haptic encroaching into the pupillary area leading to visual symptoms. As multiple attempts to dial the haptics into the capsular bag were unsuccessful, likely due to strong capsular adhesions, the unfolded haptics were placed in the sulcus with attempted optic capture. The postoperative period was uneventful with BCVA of 20/20 at one year. The current case highlights the need to be vigilant about the proper positioning of the haptics at the end of routine cataract surgery and the need for early intervention in the event of any complication.

scholarly journals Three Cases of Intraoperative Acute Fluid Misdirection Syndrome during Cataract Surgery

2021 ◽  
Vol 62 (8) ◽  
pp. 1141-1147
Author(s):  
Hyun Young Park ◽  
Ji Hyun Kim
Keyword(s):  
Cataract Surgery ◽  
Intraocular Lens ◽  
Intraoperative Complications ◽  
Pseudoexfoliation Syndrome ◽  
Normal Limits ◽  
Osmotic Agent ◽  
Pars Plana ◽  
The Right ◽  
End Stage ◽  
Capsular Bag

Purpose: We report the management of three cases of intraoperative acute fluid misdirection syndrome during cataract surgery.Case summary: Cataract surgery was performed in one eye of an 82-year-old woman with pseudoexfoliation syndrome, one eye of an 80-year-old man with end-stage glaucoma, and both eyes of a 72-year-old man with pseudoexfoliation syndrome. In the first two cases, the capsular bag space decreased during cortex aspiration and after removal of the cortex, respectively. After intravenous mannitol and intake of oral acetazolamide, the intraocular lens was successfully inserted in the first two cases on the same day. In the third case, after first removing the nucleus and cortex of the right eye, the capsular bag space decreased and an intraocular lens was carefully inserted. No intraoperative complications were seen during the left eye operation. One month after the operation, the best-corrected visual acuity had improved and the intraocular pressure was within normal limits for all three cases.Conclusions: A relatively shallow chamber, pseudoexfoliation, zonular laxity, and use of high molecular weight ophthalmic viscosurgical devices may cause acute fluid misdirection syndrome during cataract surgery. Pars plana vitrectomy may be required. However, intravenous high osmotic agent treatment should be attempted first, followed by intraocular lens insertion on the same day.

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