scholarly journals Assessment of intraocular lens/capsular bag biomechanical interactions following cataract surgery in a human in vitro graded culture capsular bag model

2021 ◽  
Vol 205 ◽  
pp. 108487
Author(s):  
I. Michael Wormstone ◽  
Niklas B. Damm ◽  
Martin Kelp ◽  
Julie A. Eldred
2012 ◽  
Vol 53 (1) ◽  
pp. 23 ◽  
Author(s):  
Lucy J. Dawes ◽  
Christopher D. Illingworth ◽  
I. Michael Wormstone

Medicina ◽  
2021 ◽  
Vol 57 (1) ◽  
pp. 35
Author(s):  
Juris Vanags ◽  
Renārs Erts ◽  
Guna Laganovska

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.


2008 ◽  
Vol 34 (4) ◽  
pp. 687-695 ◽  
Author(s):  
Katrien De Keyzer ◽  
Inge Leysen ◽  
Jean-Pierre Timmermans ◽  
Marie-José Tassignon

2021 ◽  
Vol 37 (2) ◽  
Author(s):  
Munir Amjad Baig ◽  
Rabeeya Munir

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.


2021 ◽  
pp. 112067212110396
Author(s):  
Steven G Safran ◽  
Erica Darian-Smith ◽  
Minas T Coroneo

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.


2019 ◽  
Vol 30 (3) ◽  
pp. 538-542
Author(s):  
Amir Faramarzi ◽  
Sepehr Feizi ◽  
Shahin Yazdani

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.


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