scholarly journals One-Haptic Fixation of Posterior Chamber Intraocular Lenses without Scleral Flaps

2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
Author(s):  
Ashraf I. Moawad ◽  
Asaad A. Ghanem
Keyword(s):  
Visual Acuity ◽  
Operation Time ◽  
Good Choice ◽  
Intraocular Lenses ◽  
Posterior Chamber ◽  
Modified Technique ◽  
Scleral Fixation ◽  
Corrected Visual Acuity ◽  
Aphakic Eyes ◽  
Best Corrected Visual Acuity

Purpose. To assess visual results and complications of a modified technique of posterior chamber intraocular lenses (PC IOLs) in aphakic eyes without scleral flaps.Methods. Modified one-haptic scleral fixation was performed in one eye each of 25 patients with aphakia and insufficient capsule support. Follow-up period was six months. Outcome measures included best-corrected visual acuity, intraocular pressure (IOP), and postoperative complications.Results. The study included 15 males and 10 females. The preoperative best-corrected visual acuity (BCVA) ranged from 5/60 to 6/9. The operation time ranged from 25 to 45 minutes (mean 35.25 ± 5.34 min). Anterior vitrectomy was performed in 12 cases (48%). There was no major IOL decentration. The final BCVA ranged from 6/36 to 6/9. Seven cases (28%) showed postoperative glaucoma, five cases (20%) had temporary hypotony, and hyphema in 2 eyes (8%). No cases of suture erosion, postoperative endophthalmitis, retinal detachment, or IOL dislocation were detected.Conclusion. This technique of one-haptic scleral fixation of posterior chamber IOLs is a good choice in presence of insufficient capsule support. It reduces the operation time, achieves the IOL stability, and minimizes postoperative suture-related complications.

27-gauge trocar-assisted transconjunctival sutureless intraocular lens scleral fixation

2020 ◽  
pp. 112067212091906
Author(s):  
David Vladimir Diamint ◽  
Juan Martin Giambruni
Keyword(s):  
Visual Acuity ◽  
Cataract Surgery ◽  
Intraocular Lens ◽  
Posterior Chamber ◽  
Surgery Complications ◽  
Scleral Fixation ◽  
Sutureless Technique ◽  
Corrected Visual Acuity ◽  
Cataract Surgery Complications ◽  
Best Corrected Visual Acuity

Objective To present the surgical outcome of posterior chamber intraocular lens scleral fixation using a 27-gauge trocar-assisted transconjunctival sutureless technique in aphakic patients due to cataract surgery complications with inadequate capsular support. Methods Six consecutive patients with aphakia due to cataract surgery complications with inadequate capsular bag support were operated by two surgeons. Intraocular lens scleral fixation was performed with a 27-gauge trocar-assisted transconjunctival sutureless technique. Patients were followed-up for 12 months. Preoperative and postoperative best-corrected visual acuities were assessed with Early Treatment Diabetic Retinopathy Study charts and expressed in decimals. Results All patients showed statistically significant best-corrected visual acuity improvement and excellent anatomic results. Mean preoperative best-corrected visual acuity was 0.17 (range of 0.1–0.2). Mean postoperative best-corrected visual acuity was 0.84 (range of 0.63–1.00). Mean initial spherical equivalent refractive error was +11.85 (range of +9.00 to +15.00). Mean final spherical equivalent refractive error was –0.25 (range of –1.25 to +2.25). There were no postoperative complications during the whole follow-up. Conclusion Fixation of a posterior chamber intraocular lens using a 27-gauge trocar-assisted transconjunctival sutureless intrascleral technique is an excellent option for aphakic patients secondary to cataract surgery complications with inadequate capsular support.

New surgical approach for sutureless scleral fixation

2020 ◽  
Vol 30 (3) ◽  
pp. 612-615 ◽  
Author(s):  
Chiara Veronese ◽  
Chiara Maiolo ◽  
Grayson W Armstrong ◽  
Laura Primavera ◽  
Carlo Torrazza ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Surgical Technique ◽  
Intraocular Lens ◽  
Posterior Chamber ◽  
Scleral Fixation ◽  
Refractive Outcomes ◽  
Corrected Visual Acuity ◽  
Change In The Mean ◽  
Intraocular Lens Decentration ◽  
Best Corrected Visual Acuity

Purpose: The aim of this article is to describe a novel surgical technique for sutureless scleral fixation of an intraocular lens using the newly developed FIL SSF Carlevale IOL (Soleko, Italy). Methods: Four eyes of four patients with poor capsular support were recruited to our study, three resulting from intraocular lens subluxation and one case resulting from traumatic cataract. A novel sutureless sclera-fixated intraocular lens was implanted into the posterior chamber of each eye with sclerocorneal plugs fixating the lens to the wall of the eye. Results: Mean age of patients was 52 ± 16 years, ranging from 35 to 70 years. Mean follow-up was 6.50 ± 1.29 months (range: 5–7 months). Mean preoperative best-corrected visual acuity was 0.50 ± 0.33 logMAR (range: 1–0.3 logMAR). Postoperative best-corrected visual acuity improved to 0.08 ± 0.08 logMAR (range: 0.2–0 logMAR). There was no significant change in the mean intraocular pressure and there were no postoperative complications, such as iatrogenic distortion or breakage of the intraocular lens haptic, intraocular lens decentration, endophthalmitis, or retinal detachment. Discussion: To the best of our knowledge, this is the first report of outcomes using the novel sutureless sclera-fixated FIL SSF Carlevale IOL. This new surgical technique offers a simplified and effective approach for sutureless scleral intraocular lens fixation with good refractive outcomes.

scholarly journals Refractive Aspect of Cataracts – Towards Customisation

2009 ◽  
Vol 03 (02) ◽  
pp. 80
Author(s):  
Pascal Rozot ◽  
Jean-Claude Rigal-Sastourne ◽  
◽  
Keyword(s):  
Visual Acuity ◽  
Cataract Surgery ◽  
Spherical Aberration ◽  
Intraocular Lenses ◽  
Posterior Chamber ◽  
Depth Of Focus ◽  
Prospective Multicentre Study ◽  
Corrected Visual Acuity ◽  
Visual Results ◽  
Best Corrected Visual Acuity

Currently, posterior chamber intraocular lenses (IOLs) correct totally or partially spherical aberrations. In this article we present the visual results of a prospective multicentre study evaluating the Micro AY IOL correcting 0.11μm of spherical aberration, which is a good compromise between optimal vision and a consistent depth of focus. We evaluated 124 eyes that were operated on using bi-manual micro-cataract surgery (BiMICS: 75%) or co-axial micro-cataract surgery (CoMICS: 25%) phacoemulsification with insertion of a Micro AY IOL through a 1.8–2.2mm incision. Mean post-operative best corrected visual acuity was 0.97±0.25; pre-operative spherical aberrations were +0.24±0.13μm, and reached +0.10±0.11μm post-operatively. There were no complications due to the lens, and photopic contrast sensitivity reached high levels.

scholarly journals Visual outcome following scleral fixated intraocular lens implantation

2017 ◽  
Vol 16 (2) ◽  
pp. 63-68
Author(s):  
Chunu Shrestha ◽  
Sabina Shrestha ◽  
Aparajita Manoranjan
Keyword(s):  
Visual Acuity ◽  
Intraocular Lens ◽  
Visual Outcome ◽  
Posterior Chamber ◽  
Visual Rehabilitation ◽  
Post Surgery ◽  
Corrected Visual Acuity ◽  
The Common ◽  
Best Corrected Visual Acuity ◽  
Scleral Fixated Intraocular Lens

Introduction: Scleral fixated intraocular lens(SFIOL) implantation to correct aphakia offers superior visual rehabilitation in comparison to aphakic spectacles or contact lens. This study was done to evaluate a simplified technique of scleral fixation of posterior chamber intra-ocular lens (IOL) in terms of visual outcome and complications.Methods: This was a prospective study enrolling 23 eyes of 23 patients who underwent anterior vitrectomy followed by ab-externo sclera fixation of posterior chamber IOL using 10.0 polypropylene sutures from January 2016 to February 2017 in Nepal Eye Hospital.Scleral flap was made at 3 and 9'o clock meridian to cover the knots which prevent erosion of the knots through conjunctiva.  Main outcome measures were post-operative best corrected visual acuity and post-operative complications.Result: Best corrected visual acuity were 6/6 - 6/18 in 86.9% (n=20), 6/24 - 6/60 in 8.7% (n=2) and worse than 6/60 in 4.3% (n=1)at six months followup. The mean spherical equivalent before surgery was +10.60 diopter and -1.14 diopter post-surgery. The common indicationsfor scleral fixated intraocular lens weretrauma in 60.86% (n=14), surgical aphakia in21.73% (n=5), spontaneous posterior dislocation of lens in 13.0% (n=3) and subluxated intraocular lens in 4.34% (n=1). The common complications were astigmatism in 91.30% (n=21), decentered IOL in 4.34% (n=1) and uveitis in 4.35% (n=1).Conclusion: Ab-externosclerated fixated intraocular lens is a safe and effective method for visual rehabilitation with low post-operative risk.

scholarly journals Features of Surgical Correction of Spontaneous Luxation of the Complex “IOL Posterior Chamber – Capsular Bag”

2019 ◽  
Vol 4 (4) ◽  
pp. 108-112
Author(s):  
O. P. Mishchenko ◽  
N. A. Senchenko ◽  
A. G. Shchuko
Keyword(s):  
Visual Acuity ◽  
Surgical Treatment ◽  
Posterior Chamber ◽  
Case Histories ◽  
Corrected Visual Acuity ◽  
Postoperative Astigmatism ◽  
Operation Results ◽  
Best Corrected Visual Acuity ◽  
Capsular Bag ◽  
Iol Dislocation

Luxation of intraocular lens in capsular bag several years after cataract surgery leads to a decrease in visual function and requires surgical treatment.Aim: to determine effectiveness of various types of surgical treatment of late spontaneous dislocations of IOL in capsular bag.Methods. Analysis of 123 case histories of patients with late IOL dislocation, operated in 2013–2015, was made. First group included patients with replaced IOLs dislocated into pupillary lens. Second group consisted of patients who underwent reposition and suture of IOL to iris. Examination was made before operation and 6–12 months after operation. Results. The average term from moment of IOL implantation to its luxation was 8.78 ± 4.85 years. II degree of dislocation was detected in 74 % of patients, III degree of dislocation – in 10 %, and IV degree – in 16 % of patients.Uncorrected visual acuity was reduced to 0.15 ± 0.16; best corrected visual acuity to 0.31 ± 0.26. In 83.7 % of patients a pseudoexfoliation syndrome was detected. In 62.6 % of patients IOL luxation was accompanied byhydrodynamic disturbances. Best corrected visual acuity in period from 6 to 12 months after surgery was 0.40 ± 0.24, and after IOL reposition – 0.49 ± 0.22. In addition, after IOL replacement a significant increase in postoperative astigmatism was noted from –0.44 ± 0.84 to –1.96 ± 1.60 D (p < 0.001).Conclusion. As a result of surgical treatment of late spontaneous IOL dislocations in both groups increase in distance uncorrected and best corrected visual acuity was noted. Insufficient visual functions after surgical treatment were caused by concomitant pathology as well as increased postoperative astigmatism.

scholarly journals Changes in macular thickness post uncomplicated MSICS & phacoemulsification surgery

2022 ◽  
Vol 7 (4) ◽  
pp. 619-623
Author(s):  
Kartika Anand ◽  
Ashutosh Dokania
Keyword(s):  
Visual Acuity ◽  
Cataract Surgery ◽  
Macular Thickness ◽  
Posterior Chamber ◽  
Prospective Clinical Study ◽  
Small Incision Cataract Surgery ◽  
Corrected Visual Acuity ◽  
Clinically Significant ◽  
Clinically Significant Macular Oedema ◽  
Best Corrected Visual Acuity

To evaluate changes in macular thickness via-a-vis visual acuity post uncomplicated manual small incision cataract surgery (MSICS) & phacoemulsification surgery Prospective clinical study on 160 patients of uncomplicated immature senile cataract, aged 40-70yrs, patients were randomised into two groups, MSICS & phacoemulsification, by simple 1:1 randomization, who underwent uncomplicated cataract surgery with posterior chamber intraocular lens (PCIOL). Post-operatively, the patients were evaluated for best corrected visual acuity (BCVA) and changes in macular thickness by optical coherence tomography (OCT) at post-op Day 1, 7, 21, 48, and 12 weeks. Paired t-test was used for comparison across follow up. : At 12 weeks post-operative, mean logMAR BCVA was 0.01±0.02 for MSICS group and 0±0.02 for Phacoemulsification group. Macular thickness was not statistically significant (p=0.342) between MSICS group (219.19±17.88µm) and Phacoemlusification group (215.61±16.21µm), at the end of 12 weeks post-operative. Clinically significant macular oedema was not diagnosed in any of the patients at the follow-ups.: Both procedures achieved good post-operative Best Corrected visual acuity without significant differences in BCVA between both the groups at the end of 12 weeks.

scholarly journals Results of Cataract Extraction in Patients with Corneal Opacity

2019 ◽  
Vol 16 (2) ◽  
pp. 179-184
Author(s):  
E. A. Ivachev ◽  
E. V. Anisimova ◽  
I. P. Denisova
Keyword(s):  
Visual Acuity ◽  
Intraocular Lens ◽  
Contact Lenses ◽  
Cataract Extraction ◽  
Corneal Opacity ◽  
Intraocular Lenses ◽  
Lens Extraction ◽  
Soft Contact Lenses ◽  
Corrected Visual Acuity ◽  
Best Corrected Visual Acuity

Purpose. To evaluate the effectiveness of cataract extraction in patients with varying degrees of corneal opacity.Patients and methods. We performed cataract extraction with implantation of the intraocular lenses of 14 eyes (9 patients) with varying degree of corneal opacity. The causes of corneal opacities were: keratitis in anamnesis — 6 cases, the result of wearing soft contact lenses — 2 eyes, eye injury — 2, the outcome of dermatitis of unspecified genesis with eye damage — 3, perforation of the corneal ulcer — 1 case. In 9 eyes, opacity of the cornea occupied the optic part of the cornea, in 5 cases, the opacity of the cornea was in the paraoptic zone. The middle uncorrected visual acuity of all cases is 0.05 ± 0.03, and the middle best corrected visual acuity is 0.14 ± 0.07. The phacoemulsification of the cataract with implantation of the intraocular lens was performed for all the patients.Results. There were no complications during the operation, in the early and late postoperative periods. As a result of cataract extraction, all patients, regardless of the degree of cornea opacity, noted vision improvement. On the first day after the operation, the middle best corrected visual acuity was 0.06 ± 0.02 in 4 eyes, in 10 cases the middle best corrected visual acuity was 0.09 ± 0.03. The middle best corrected visual acuity 7 days after the surgery was 0.31 ± 0.07. After 6 months of observation of patients with corneal opacity after phacoemulsification of the cataract with implantation of the intraocular lens, the most corrected visual acuity was 0.27 ± 0.19.Conclusions. All patients with corneal opacity of varying degrees of intensity after cataract extraction noted improved vision. The central location of the opacity of the cornea significantly reduced visual acuity, and paraoptic — influenced the vision to a lesser extent. The degree of cornea turbidity was also affected the initial visual acuity — the more clouding and the depth of the cornea, the lower the vision. The result of the lens extraction also depended on the maturity of the cataract — with a more turbid lens the result was higher in relation to preoperative indices. 

Successful surgical management of interlenticular membrane by vitreoretinal interlenticular membranectomy (VIM)

2021 ◽  
Vol 14 (7) ◽  
pp. e242201
Author(s):  
Cheng Fei Kong ◽  
Brendon Lee ◽  
John Downie ◽  
Ian C Francis
Keyword(s):  
Visual Acuity ◽  
Nd:Yag Laser ◽  
Unusual Case ◽  
Treatment Options ◽  
Intraocular Lenses ◽  
Management Option ◽  
Novel Technique ◽  
Corrected Visual Acuity ◽  
Best Corrected Visual Acuity

The formation of a light scattering interlenticular membrane (ILM) is a known complication of polypseudophakia and has been particularly noted with the use of dual intracapsular Alcon AcrylSof intraocular lenses (IOLs). The treatment options for this condition have largely been restricted to either Nd:YAG laser membranotomy or explantation of the dual IOL complex. In this case report, we describe an unusual case of ILM in a 76-year-old woman whose ILM had formed between her primary intracapsular IOL and her piggyback sulcal IOL. Furthermore, we describe vitreoretinal interlenticular membranectomy (VIM), a novel technique involving a translimbal anterior interlenticular membranectomy using vitreoretinal instrumentation. There were no intraoperative or postoperative complications. Postoperative best-corrected visual acuity was 6/4, maintained for 3 years of follow-up. VIM is offered as a management option for surgeons to address ILM when Nd:YAG laser therapy fails, and the IOLs cannot be safely explanted.

Unilateral spontaneous filtering bleb dissecting into the cornea in a patient with high myopia

2019 ◽  
pp. 112067211987715
Author(s):  
Pablo Sanjuán ◽  
Borja Salvador-Culla ◽  
Maria Isabel Canut ◽  
Rafael I Barraquer
Keyword(s):  
Visual Acuity ◽  
Intraocular Pressure ◽  
High Myopia ◽  
Anterior Segment ◽  
Cataract Extraction ◽  
Posterior Chamber ◽  
Visual Axis ◽  
Filtering Bleb ◽  
Corrected Visual Acuity ◽  
Best Corrected Visual Acuity

Purpose: To report a case of a unilateral spontaneous filtering bleb dissecting into the cornea in a patient with high myopia. Clinical case: A 33-year-old woman with high myopia (–18 D) presented with discomfort in the left eye. Ocular history included pars plana vitrectomy and cataract extraction and posterior chamber intraocular lens implantation in the left eye. Best-corrected visual acuity was 0.65 and intraocular pressure was 20 mmHg. Slit-lamp examination showed a filtering bleb in the upper-temporal quadrant, which extended and dissected the proximal cornea without affecting the visual axis. The morphology and content of the bleb was studied with anterior segment optical coherence tomography, which ruled out a corneal-scleral fistulization into the subconjunctival space. The spontaneous filtering bleb was resected surgically. Due to her high myopia, two strips of fascia lata were used to strengthen the area. In the postoperative period, a complete resection of the bleb was confirmed, without apparent leaking points and with a well-vascularized conjunctiva. No complications were noted. The patient maintained the same best-corrected visual acuity and intraocular pressure than before surgery. Conclusion: The formation of a spontaneous filtering bleb is a rare entity in patients with high myopia, whose risk increases due to their thinned sclerae. The risk is even greater if they have undergone ocular surgeries. Resection of the filtering bleb in our case halted the progression of the corneal dissection, therefore respecting the transparency of the visual axis and preserving visual acuity.

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