scholarly journals Persistent troublesome floaters necessitating the explantation of XtraFocus Pinhole IOL (Morcher)

2019 ◽  
Vol 12 (4) ◽  
pp. e229057 ◽  
Author(s):  
Prateek Agarwal ◽  
Samuel Edward Navon

A 41-year-old patient presented with blurred vision and photophobia in the left eye with an uncorrected visual acuity of 20/150, improving to 20/30 with pinhole and diagnostic rigid gas permeable lens trial. He had a history of trauma with subsequent cataract extraction with residual irregular astigmatism and traumatic mydriasis. XtraFocus Pinhole intraocular lens (Morcher) was implanted in the left eye and the vision improved to 20/40. Postoperatively, the patient experienced significant floaters which persisted to the extent of necessitating explantation of implant.

2019 ◽  
Vol 12 (11) ◽  
pp. e232473 ◽  
Author(s):  
Prateek Agarwal ◽  
Samuel Edward Navon ◽  
Praveen Subudhi ◽  
Neha Mithal

A 21-year-old patient presents to us with complaints of blurred vision and photophobia in the left eye, with an uncorrected visual acuity of 20/100 improving to 20/30 with pinhole and diagnostic rigid gas permeable lens trial. He had a history of trauma with subsequent cataract extraction, with residual irregular astigmatism and traumatic mydriasis. XtraFocus Pinhole intraocular lens (Morcher) was implanted in the left eye. One week postoperatively, the left eye uncorrected visual acuity improved to 20/30, uncorrected intermediate visual acuity improved to 20/40, and uncorrected near visual acuity improved to J4. The glare and photophobia resolved completely. Surprisingly, the patient complained of severely poor vision in dim illumination. His vision was limited to bare perception of objects and hand movements close to the face. He started facing difficulties in major activities such as driving at night and in dark ambient surroundings such as movie theatres, which persisted to the extent of necessitating explantation of the implant.


2019 ◽  
Vol 12 (12) ◽  
pp. e233128
Author(s):  
Prateek Agarwal ◽  
Samuel Edward Navon ◽  
Neha Mithal

A 38-year-old patient presented to us with complaints of blurred vision and photophobia in the left eye with an uncorrected visual acuity of 20/400, improving to 20/60 with pinhole. The patient underwent phakic iris-claw lens surgery 15 years ago for high myopia. On examination, there was anterior chamber rigid phakic iris-claw lens along with complicated cataract. We planned for sutureless self-sealing 6.5 mm sclerocorneal tunnel for explantation of rigid phakic iris-claw lens along with cataract extraction with irrigating vectis. There was postoperative reduction in astigmatism due to incision planned on steep axis, and visual acuity improved to 20/30 uncorrected. This technique provides significant advantages from the previously described techniques in terms of decreased postop astigmatism, no need for sutures, no issues of chamber instability and iris trauma and without the need for phacoemulsification.


2019 ◽  
Vol 12 (4) ◽  
pp. e228902 ◽  
Author(s):  
Prateek Agarwal ◽  
Samuel Edward Navon

A 69-year-old patient presented to us with traumatic mydriasis with irregular pupil measuring 7 mm, with superior loss of iris tissue and large inferior peripheral iridotomy and pseudophakia. The patient had history of blunt trauma 3 years ago in a fire cracker injury. He was operated elsewhere primarily after the trauma for cataract surgery with intraocular lens implantation and had suboptimal visual outcome with glare and photophobia. He presented to us with irregular pupil and inferior iridectomy with pseudophakia. The uncorrected visual acuity was 20/150 improving to 20/50 with glasses. He had a history of cataract surgery with intraocular lens (IOL) implantation done elsewhere several years back. The patient was not a diabetic or hypertensive. There was a para central corneal scar causing irregular corneal astigmatism. Extra focus pinhole IOL was implanted in sulcus having a pinhole aperture 1.36 mm. Preoperative total corneal higher-order aberrations were 3.3 µ and total corneal coma was 0.97 µ. Postoperatively uncorrected distance visual acuity improved to 20/40 intermediate uncorrected visual acuity improved to 20/30 and uncorrected near visual acuity was J3.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Anvesh Annadanam ◽  
Timothy Soeken ◽  
Manjool Shah ◽  
Nambi Nallasamy

Abstract Background Anterior segment surgeries such as cataract surgery, intraocular lens (IOL) repositioning, and radial keratotomy (RK) may hasten endothelial dysfunction, particularly in the context of pre-existing Fuchs dystrophy, necessitating future corneal transplantation. Case presentation A 68-year-old woman with a history of RK with associated irregular astigmatism in both eyes and iris-fixated intraocular lens (IF-IOL) in the left eye presented with six months of decreased vision in the left eye. She was found to have Fuchs dystrophy and underwent DMEK surgery. She had an uncomplicated postoperative course, with uncorrected visual acuity improving to 20/20 three months after surgery. Conclusion To our knowledge, this is the first reported case of a highly successful DMEK surgery in a patient with prior RK and IF-IOL.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ahmed A. Zein El-Dein ◽  
Ahmed Elmassry ◽  
Hazem M. El-Hennawi ◽  
Ehab F. Mossallam

Abstract Background This study aimed to assess visual outcomes, quality of vision and patients’ satisfaction of a trifocal diffractive intraocular lens after cataract surgery with phacoemulsification. Results The study included 36 eyes that underwent implantation of trifocal diffractive intraocular lens (IOL). The residual mean postoperative spherical equivalent was − 0.40 ± 0.29 diopters. Mean Uncorrected distance visual acuity was 0.80 ± 0.16 decimal (snellen equivalent 25 ft) while mean Uncorrected intermediate visual acuity was 0.82 ± 0.31 decimal (snellen equivalent 25 ft) and mean Uncorrected near visual acuity (UCNVA) was 0.87 ± 0.20 decimal (snellen equivalent 23 ft). In defocus curve, there was infinitesimal gradual change between the three foci. Contrast sensitivity was just below the inferior limit of normal. Conclusion Trifocal diffractive IOL created a true intermediate focus proved by VA and defocus curve and better quality of vision assessed by contrast sensitivity and high order aberration. Moreover, it was safe and effective for correcting distance and near vision in these patients. Most of the patients were very satisfied and achieved spectacle independence. Trial registration Registration number and date: NCT04465279 on July 10, 2020.


2018 ◽  
Vol 2018 ◽  
pp. 1-6 ◽  
Author(s):  
Kannan NB ◽  
Piyush Kohli ◽  
Bhanu Pratap Singh Pangtey ◽  
Kim Ramasamy

Aim. This paper aims at evaluating refractive outcome and complication profile of sutureless, glueless, flapless, intrascleral fixation of intraocular lens (SFIOL) in pediatric population. Methods. This retrospective study included patients ≤18 years of age who underwent SFIOL for ectopia lentis. Details obtained included preoperative uncorrected visual acuity (UCVA), cycloplegic refraction, and best-corrected visual acuity (BCVA); intraoperative complications; and postoperative UCVA, cycloplegic refraction, and BCVA and complications. Results. Median pre- and postoperative UCVA was logMAR 1.78 (Snellen 20/1200) and logMAR 0.30 (Snellen 20/40), respectively, (p<0.001). Median pre- and postoperative BCVA was logMAR 0.24 (Snellen 20/34) and logMAR 0.18 (Snellen 20/30), respectively. UCVA ≥20/60 was attained in 90% of eyes. BCVA ≥20/30 was attained in 85.0% of eyes. Most common early postoperative complications were hyphaema (10%), transient vitreous hemorrhage (2.5%), and ocular hypotony (2.5%). None of these developed any long-term sequelae. Only one case of subluxation of IOL was seen. No case of late endophthalmitis or retinal detachment was seen. Conclusion. Since refractive error induced is minimal, the procedure is suitable for IOL implantation in children, who are noncompliant with spectacles. The complication profile is similar to that reported in adults.


2020 ◽  
Vol 13 (1) ◽  
pp. e233312
Author(s):  
Prateek Agarwal ◽  
Praveen Subudhi ◽  
Neha Mithal

A 38-year-old patient with a history of non-progressive keratoconus in the left eye presented to us with an uncorrected visual acuity of 20/400, which improved to 20/60 with pinhole. We planned for intracorneal rings segment in the left eye. Postoperatively uncorrected visual acuity improved to 20/30. The patient presented 2 weeks later with severely decreased vision to 20/100 and migration of intracorneal rings were noted with both the rings riding side by side. The patient gave history of vigorous eye rubbing. The rings were repositioned with the help of Sinskey hooks and superior ring was anchored with 10-nylon suture passed through the ring hole to the corneal stroma. Two more sutures were placed radial to the circumference of inferior ring to prevent its migration. The sutures were removed after 1 month and the patient was followed up with stable position of the rings for the next 6 months . The uncorrected visual acuity improved to 20/40.


2017 ◽  
Vol 8 (3) ◽  
pp. 539-544 ◽  
Author(s):  
Guy Sallet

We report the case of an emmetropic 32-year-old female with decreased uncorrected visual acuity and diplopia due to intermittent episodes of spasm of the near reflex. Neurologic, general, and ophthalmic examination could not find an organic cause. Attempts at spontaneous recovery, psychogenic therapy, and cycloplegic therapy were unsuccessful and the symptoms persisted for almost 5 years, leading to psychogenic distress. Final treatment with refractive lens exchange and implantation of a toric trifocal intraocular lens resolved the spasm of the near reflex, resulting in an uncorrected distance and near visual acuity of 20/20.


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