Pupil Dilation with Intracameral Epinephrine Hydrochloride during Phacoemulsification and Intraocular Lens Implantation

Objective. To investigate mydriatic effect of intracamerally injected epinephrine hydrochloride during phacoemulsification and intraocular lens (IOL) implantation.Methods. Eighteen cataract patients for bilateral phacoemulsification were enrolled. To dilate pupil, one eye was randomly selected to receive intracamerally 1 mL epinephrine hydrochloride 0.001% for 1 minute after corneal incision (intracameral group), and the contralateral eye received 3 drops of compound tropicamide 0.5% and phenylephrine 0.5% at 5-minute intervals 30 minutes before surgery (topical group). Pupil diameters were measured before corneal incision, before ophthalmic viscoelastic device (OVD) injection, after OVD injection, before IOL implantation, and at the end of surgery.Results. At each time point, the mean pupil diameter in the intracameral group was2.20±0.08,5.09±0.20,6.76±0.19,6.48±0.18, and5.97±0.24 mm, respectively, and in the topical group it was7.98±0.15,7.98±0.15,8.53±0.14,8.27±0.16, and7.93±0.20 mm, respectively. The topical group consistently had larger mydriatic effects than the intracameral group (P<0.05). The onset of mydriatic effect was rapid in the intracameral group. There was no difference in surgical performance or other parameters between groups.Conclusions. Intracameral epinephrine hydrochloride appears to be an alternative to the mydriatic modalities for phacoemulsification and IOL implantation. In comparison with topical mydriatics, intracameral epinephrine hydrochloride offers easier preoperative preparation, more rapid pupil dilation, and comparable surgical performance.

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Congenital and developmental cataract surgery with undercorrected Intraocular lens (IOL) power implantation targeting emmetropia at 8 years of age and post-operative refractive status

Asian Journal of Medical Sciences ◽

10.3126/ajms.v12i9.36890 ◽

2021 ◽

Vol 12 (9) ◽

pp. 126-129

Author(s):

Kabindra Bajracharya ◽

Anjita Hirachan ◽

Kriti Joshi ◽

Bimala Bajracharya

Keyword(s):

Cataract Surgery ◽

Intraocular Lens ◽

Axial Length ◽

Iol Implantation ◽

Refractive Status ◽

Developmental Cataract ◽

Iol Power ◽

The Mean ◽

One Year

Background: In congenital and developmental cataract primary undercorrection of intraocular lens (IOL) power is a common practice. However, long-term refractive status of these children is largely unknown. Aims and Objective: To analyse refractive status after cataract surgery with undercorrected IOL power implantation in congenital and developmental cataract. Materials and Methods: This study was descriptive, retrospective conducted for three years from 1st January 2013 to 31st December 2015. The children (> 6 months to <=7 years of age) who underwent cataract surgery for congenital and developmental cataract with a primary IOL implantation and had reached the age of 8 years were studied. The data were collected in terms of demography, axial length, biometry, IOL implanted, hyperopic correction and postoperative refractive status at 8 years. Results: Total numbers of children operated were 181 with total eyes 288. Unilateral cases were 74 (40.88%) and bilateral 107 (59.12%). Male were 121 (66.85%) and female were 60 (33.15%) with male is to female ratio of 2:1. Right eye was involved in 152 (52.8%) and left eye 136 (47.2%). The mean axial length at the age of one year was 20.75 mm, and gradually increased as age increased which was 22.47 mm at 6 years. The mean biometry was 27.9 diopter (D) at the age of one year which gradually decreased as age increased. Of the total 288 congenital cataract operated, complete follow-up documents were available for 77 (26.74%) eyes up to 8 years which showed emmetropia achieved in 25.97%, myopia in 28.57% and hypermetropia in 45.45%. Conclusion: Primary IOL implantation with hyperopic correction is accepted practice in congenital and developmental cataract. Emmetropia can be achieved however some hyperopic or myopic refractive status at the age of 8 years is not a surprise. Myopic shift continues as the age increases. Parent awareness for early detection and surgery, optical correction and regular follow-up are essential for good outcome.

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The Predictability of Preoperative Pilocarpine-Induced Lens Shift on the Outcomes of Accommodating Intraocular Lenses Implanted in Senile Cataract Patients

Journal of Ophthalmology ◽

10.1155/2016/6127130 ◽

2016 ◽

Vol 2016 ◽

pp. 1-7 ◽

Cited By ~ 1

Author(s):

Jin Li ◽

Qi Chen ◽

Zhibo Lin ◽

Lin Leng ◽

Fang Huang ◽

...

Keyword(s):

Optical Coherence Tomography ◽

Intraocular Lens ◽

Anterior Segment ◽

Senile Cataract ◽

Intraocular Lenses ◽

Iol Implantation ◽

Accommodation Stimulus ◽

The Mean ◽

Preoperative Parameter ◽

Cataract Patients

Purpose. To evaluate the predictability of lens shift induced by pilocarpine (LSPilo) on the outcomes of accommodating intraocular lens (Acc-IOL) implantation.Methods. Twenty-four eyes of 24 senile cataract patients who underwent phacoemulsification and Acc-IOL implantation were enrolled.LSPilowas evaluated with anterior segment optical coherence tomography (AS-OCT). At 3 months postoperatively, the best corrected distance visual acuities (BCDVA), distance-corrected near visual acuities (DCNVA), and subjective and objective accommodations were measured. IOL shifts under accommodation stimulus (IOLSAcc) were evaluated with AS-OCT.Results. The meanLSPilowas 112.29 ± 30.72 µm.LSPilowas not associated with any preoperative parameters. The meanIOLSAccwas 130.46 ± 42.71 µm. The mean subjective and objective accommodation were 1.54 ± 0.39 D and 1.27 ± 0.41 D, respectively. The mean postoperative BCDVA and DCNVA (log MAR value) were 0.22 ± 0.11 and 0.24 ± 0.12, respectively.LSPilopositively correlated withIOLSAcc(r=0.541;P=0.006), subjective accommodation (r=0.412;P=0.022), and objective accommodation (r=0.466;P=0.045), respectively.Conclusion.LSPilois an independent preoperative parameter associated with the postoperative Acc-IOL mobility and pseudophakic accommodation. It may offer valuable information for ophthalmologists in determining the suitable candidates for Acc-IOL implantation.

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Rotational stability and clinical outcomes of a new one piece toric intraocular lens with anchor-wing haptics

BMC Ophthalmology ◽

10.1186/s12886-021-02240-7 ◽

2022 ◽

Vol 22 (1) ◽

Author(s):

Iichiro Sugita ◽

Tomoichiro Ogawa ◽

Kazuo Ichikawa ◽

Takahide Okita ◽

Kazuno Negishi ◽

...

Keyword(s):

Intraocular Lens ◽

University Hospital ◽

Rotational Stability ◽

Primary Analysis ◽

Toric Intraocular Lens ◽

Private Hospitals ◽

Safety And Efficacy ◽

Iol Implantation ◽

Age Related ◽

The Mean

Abstract Background To evaluate the safety and efficacy of a new toric intraocular lens (IOL) with anchor-wing haptics. Methods The new toric IOL with anchor-wing haptics (NS60YT, NIDEK Co., Ltd.) was implanted in eligible patients with age-related cataracts with preoperative corneal astigmatism of 1.0 D or greater at a university hospital and two private hospitals in Japan. The following IOL cylinder powers were evaluated: 1.50 D (NS60YT3), 2.25 D (NS60YT4), 3.00 D (NS60YT5) and 4.50 D (NS60YT7). All patients were assessed out to 12 months postoperatively. The primary endpoint was visual acuity (VA) with spherical addition at 6 months postoperatively, and the primary analysis calculated the proportion of eyes with VA with spherical addition of 0.1 logMAR or better. The magnitude of rotation was compared to the intended axis of IOL implantation at each postoperative examination. Adverse events were evaluated for the safety analysis. Results This study enrolled 64 eyes of 53 patients. At 6 months postoperatively, for all IOL powers, VA with spherical addition of 0.1 logMAR or better was achieved in 90% [95% confidence interval (CI): 80–96] of eyes. The mean IOL rotation was 5.3 ± 4.3° at 12 months postoperatively. The mean magnitude of rotation ranged from 1.9° to 2.5° between each postoperative examination from 1 day to 12 months. There were no vision-threatening intraoperative or postoperative complications for the duration of the study. Conclusions The NS60YT IOL remained stable after implantation and was efficacious for treating 1.00 D or greater astigmatism in patients with senile cataracts. Trial registration This study was registered at ClinicalTrials.gov (NCT03242486) on August 8, 2017 - Retrospectively registered.

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Stability and clinical outcomes of a new one piece toric intraocular lens with anchor-wing haptics

10.21203/rs.3.rs-55494/v2 ◽

2020 ◽

Author(s):

Iichiro Sugita ◽

Tomoichiro Ogawa ◽

Kazuo Ichikawa ◽

Takahide Okita ◽

Kazuno Negishi ◽

...

Keyword(s):

Intraocular Lens ◽

University Hospital ◽

Primary Analysis ◽

Toric Intraocular Lens ◽

Private Hospitals ◽

Safety And Efficacy ◽

Iol Implantation ◽

Age Related ◽

Uncorrected Visual Acuity ◽

The Mean

Abstract Background: To evaluate the safety and efficacy of a new toric intraocular lens (IOL) with anchor-wing haptics.Methods: The new toric IOL with anchor-wing haptics (NS60YT, NIDEK Co., Ltd.) was implanted in eligible patients with age-related cataracts with preoperative corneal astigmatism of 1.0 D or greater at a university hospital and two private hospitals in Japan. The following IOL cylinder powers were evaluated: 1.50 D (NS60YT3), 2.25 D (NS60YT4), 3.00 D (NS60YT5) and 4.50 D (NS60YT7). All patients were assessed out to 12 months postoperatively. The primary endpoint was uncorrected visual acuity (UCVA) with spherical addition at 6 months postoperatively, and the primary analysis calculated the proportion of eyes with UCVA with spherical addition of 0.1 logMAR or better. The magnitude of rotation was compared to the intended axis of IOL implantation at each postoperative examination. Adverse events were evaluated for the safety analysis. Results: This study enrolled 64 eyes of 53 patients. At 6 months postoperatively, for all IOL powers, UCVA with spherical addition of 0.1 logMAR or better was achieved in 90% [95% confidence interval (CI): 80-96] of eyes. The mean IOL rotation was 5.3±4.3° at 12 months postoperatively. The mean magnitude of rotation ranged from 1.9° to 2.5° between each postoperative examination from 1 day to 12 months. There were no vision-threatening intraoperative or postoperative complications for the duration of the study.Conclusions: The NS60YT IOL remained stable after implantation and was efficacious for treating 1.00 D or greater astigmatism in patients with senile cataracts.Trial registration: This study was registered at ClinicalTrials.gov (NCT03242486) on August 8, 2017 - Retrospectively registered. (https://clinicaltrials.gov/ct2/show/NCT03242486)

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Stability and Clinical Outcomes of A New One Piece Toric Intraocular Lens with Anchor-wing Haptics

10.21203/rs.3.rs-55494/v1 ◽

2020 ◽

Author(s):

Iichiro Sugita ◽

Tomoichiro Ogawa ◽

Kazuo Ichikawa ◽

Takahide Okita ◽

Kazuno Negishi ◽

...

Keyword(s):

Intraocular Lens ◽

University Hospital ◽

Primary Analysis ◽

Toric Intraocular Lens ◽

Private Hospitals ◽

Safety And Efficacy ◽

Iol Implantation ◽

Age Related ◽

Uncorrected Visual Acuity ◽

The Mean

Abstract Background: To evaluate the safety and efficacy of a new toric intraocular lens (IOL) with anchor-wing haptics.Methods: The new toric IOL with anchor-wing haptics (NS60YT, NIDEK Co., Ltd.) was implanted in eligible patients with age-related cataracts with preoperative corneal astigmatism of 1.0 D or greater at one university hospital and two private hospitals in Japan. Four cylinder powers of the IOL were evaluated as follows: 1.50 D (NS60YT3), 2.25 D (NS60YT4), 3.00 D (NS60YT5) and 4.50 D (NS60YT7). All patients were assessed out to 12 months postoperatively. The primary endpoint was uncorrected visual acuity (UCVA) with spherical addition 6 months postoperatively, and the primary analysis calculated the proportion of UCVA with spherical addition of 0.8 or better. The magnitude of rotation was compared to the intended axis of IOL implantation at each postoperative examination. Adverse events were evaluated for the safety analysis. Results: The study enrolled 64 eyes of 53 patients. At 6 months postoperatively, for all models, mean UCVA with spherical addition of 0.8 or better was achieved in 90% [95% confidence interval (CI): 80-96] of eyes. The mean IOL rotation was 5.3±4.3° 12 months after surgery. Between each postoperative examination from 1 day to 12 months, the mean magnitude of rotation ranged between 1.9° to 2.5°.There were no vision threatening intraoperative or postoperative complications for the duration of the study.Conclusions: The NS60YT IOL remained stable after implantation and was efficacious for treating 1.00 D or greater astigmatism in patients with senile cataracts.Trial registration: This study was registered at ClinicalTrials.gov (NCT03242486) on August 8, 2017 - Retrospectively registered. (https://clinicaltrials.gov/ct2/show/NCT03242486)

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Secondary Sulcus-Fixed Foldable IOL Implantation with 25-G Infusion in Patients with Previous PPV after Open-Globe Injury

European Journal of Ophthalmology ◽

10.5301/ejo.5000963 ◽

2017 ◽

Vol 27 (6) ◽

pp. 786-790

Author(s):

Tiangeng He ◽

Caiyun You ◽

Song Chen ◽

Xiangda Meng ◽

Yuanyuan Liu ◽

...

Keyword(s):

Visual Acuity ◽

Open Globe Injury ◽

Corneal Incision ◽

Iol Implantation ◽

Clear Corneal Incision ◽

Secondary Iol Implantation ◽

Open Globe ◽

Uncorrected Visual Acuity ◽

Pars Plana ◽

The Mean

Purpose To evaluate the safety and efficacy of secondary sulcus-fixed foldable intraocular lens (IOL) implantation through a clear corneal incision with 25-G infusion in patients with previous pars plana vitrectomy (PPV) after open-globe injury, and to analyze postoperative outcomes and prognostic factors of treatment. Methods Clinical data of 89 eyes of 89 patients with open-globe injury who underwent secondary sulcus-fixed foldable IOL implantation through a clear corneal incision with 25-G infusion after vitrectomy in our hospital between January 2008 and June 2015 were retrospectively analyzed. The examinations before IOL implantation mainly included visual acuity, slit-lamp examination, direct and indirect ophthalmoscope, visual electrophysiology, corneal endothelium, B scan, ultrasound biomicroscope, and intraocular pressure. Five eyes underwent suturing of peripheral iris and 7 eyes underwent suturing of iris laceration simultaneously. The mean follow-up was 18 months with a range from 6 months to 8 years. Results The mean interval between secondary sulcus-fixed foldable IOL implantation and vitrectomy was 2.8 months with a range from 2 to 6 months. The uncorrected visual acuity improved in all patients with a well-centered IOL ranging from 0.1 to 0.8 with the best-corrected visual acuity from 0.1 to 1.0 after secondary IOL implantation. The postoperative complications mainly included mild anterior chamber exudates in 10 eyes (11%), temporary IOP elevation in 12 eyes (13%), and recurrent retinal detachment in 5 eyes (6%), which were subsequently managed by surgery. Conclusions The interval of 2.8 months between vitrectomy and secondary IOL implantation is an appropriate and safe option to correct aphakia in patients receiving vitrectomy for open-globe injury.

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Changes in Anterior Chamber Angle and Pupillary Diameter after Implantation of a New Posterior Chamber Phakic Intraocular Lens

10.21203/rs.3.rs-178396/v1 ◽

2021 ◽

Author(s):

Mehmet Emin Sucu ◽

Yusuf Berk Akbaş ◽

Alper Agca ◽

Gökhan Demir

Keyword(s):

Anterior Chamber ◽

Intraocular Lens ◽

Pupil Diameter ◽

Anterior Chamber Depth ◽

Posterior Chamber ◽

Pupillary Diameter ◽

Phakic Intraocular Lens ◽

Iridocorneal Angle ◽

The Mean ◽

Pupillary Size

Abstract Purpose: To evaluate the effect of the Eyecryl posterior chamber phakic intraocular lens (pIOL) on iridocorneal angle (ICA) parameters, anterior chamber depth (ACD), and pupillary size.Methods: The medical files of myopic patients who had implantation of the Eyecryl posterior chamber pIOL were reviewed retrospectively. Trabecular-iris space area at 500 and 750μm (TISA500, TISA750), angle opening distances at 500 and 750μm (AOD500, AOD750), anterior chamber depth (ACD), iridocorneal angle (ICA), and pupil diameter under different illumination conditions were analyzed preoperatively, and at 1 and 3 months postoperatively.Results: Ninety-three eyes of 48 patients were included in the study. The mean age of patients was 31.63 ±4.95 years (range, 21-54). The mean ICA decreased from 49.97° ± 6.33 before surgery to 30.75° ± 5.86 and 30.79° ± 5.74 at 1 and 3 months after surgery, respectively. The mean ACD was reduced from 3.23 ± 0.22 mm before surgery to 2.55 ± 0.34 mm and 2.46 ± 0.28 mm at 1 and 3 months after surgery, respectively. TISA500, TISA750, AOD500, and AOD750 were also reduced significantly after surgery. The mean pupil size under photopic, mesopic and scotopic illuminations decreased insignificantly by 1 month and continued to decrease significantly by 3 months after surgery.Conclusion: The implantation of the Eyecryl posterior chamber pIOL in myopic patients caused significant changes in anterior chamber parameters including ICA, ACD, TISA 500, TISA 750, AOD 500, AOD 750, and the pupil diameter under different illumination conditions.

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Intraoperative and Postoperative Intraocular Lens Opacifications: Analysis of 42545 Cases

Journal of Ophthalmology ◽

10.1155/2021/1285947 ◽

2021 ◽

Vol 2021 ◽

pp. 1-6

Author(s):

Xiaochen Wang ◽

Xiaoming Wu ◽

Yunhai Dai ◽

Yusen Huang

Keyword(s):

Intraocular Lens ◽

Medical Records ◽

Case Series ◽

Retrospective Case ◽

Iol Implantation ◽

Corrected Visual Acuity ◽

The Mean ◽

Medical University ◽

Hydrophobic Acrylic ◽

Best Corrected Visual Acuity

Purpose. To assess the types and causes of intraocular lens (IOL) turbidity in a tertiary eye center. Setting. Qingdao Eye Hospital of Shandong First Medical University, Qingdao, China. Design. Retrospective case series. Methods. Patients who underwent uncomplicated phacoemulsification and IOL implantation for cataract between January 2015 and December 2019 were included. Medical records were reviewed of participants with intraoperative or postoperative IOL opacification for clinical data, artificial crystal materials, and causes of the opacification. Results. A total of 42545 IOLs were implanted in the five years, comprising 25471 (66.0%) hydrophilic IOLs, 11881 (27.9%) hydrophobic IOLs, and 2601 (6.1%) hydrophilic-hydrophobic acrylic IOLs. Among the operated eyes, 14 eyes (13 patients) experienced IOL opacification, which was permanent for 10 IOLs, including 7 (0.6%) hydrophilic IOLs (860UV) and 3 (0.2%) hydrophilic-hydrophobic acrylic IOLs (L-312). The mean interval between surgery and diagnosis of permanent opacification was 34.4 ± 18.4 (SD) months (range, 12 to 59 months). Permanent IOL clouding led to a statistically significant reduction in best corrected visual acuity (mean, 0.64 ± 0.4 logMAR; P < 0 .004 ). Acute IOL clouding occurred in four eyes during the implantation of a hydrophilic-hydrophobic acrylic IOL of L-312, 809M, or 839M and returned to transparency several hours later. All four procedures were performed in winter, with the mean outside temperature being −5.75°C. Conclusions. The rate of IOL opacification was 0.03%. Both delayed postoperative and acute intraoperative opacifications occurred with various characteristics in IOLs made of different materials and designs. Clinicians should be aware of this risk for cataract surgery.

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Outcomes and Complications of Sutured Scleral-Fixated Foldable Intraocular Lens Implantation: A Retrospective Study of 5-Year Follow-Up

Journal of Ophthalmology ◽

10.1155/2021/5525064 ◽

2021 ◽

Vol 2021 ◽

pp. 1-8

Author(s):

Ting Yu ◽

Mengting Yu ◽

Wenjie Wu ◽

Xinna Wu ◽

Suzhen Xiao ◽

...

Keyword(s):

Retrospective Study ◽

Intraocular Lens ◽

Tertiary Hospital ◽

Long Term Outcomes ◽

Iol Implantation ◽

Minimum Angle ◽

The Mean ◽

Iol Dislocation

Purpose. To evaluate long-term outcomes and complications of sutured scleral-fixated foldable intraocular lens (IOL) implantation. Design. Retrospective study. Methods. Patients who underwent sutured scleral-fixated foldable IOL implantation using 10-0 polypropylene suture were followed up for at least 5 years at one Chinese tertiary hospital and two primary hospitals. Results. 52 eyes among 48 patients (35 male and 13 female) were evaluated. The mean age (years) was 50.27 ± 20.08 (range: 6 to 81). The mean postoperative follow-up time (months) was 79.70 ± 18.84 (range: 60 to 121). The mean best-corrected visual acuity (BCVA) improved from 0.83 ± 0.69 logarithm of the minimum angle of resolution (logMAR) at baseline to 0.50 ± 0.45 logMAR at the last follow-up visit. There was improved or unchanged BCVA in 44 eyes (84.62%) and reduced BCVA in 8 eyes (15.38%). Mild intraoperative intravitreal hemorrhage was observed in 3 eyes (5.77%). Early postoperative complications included transient elevated intraocular pressure (IOP) in 5 eyes (9.62%) and hypotony in 1 eye (1.92%). Secondary epimacular membrane occurred in 5 eyes (9.62%) and retinal detachment (RD; 3 years postsurgery), subconjunctival suture knot exposure (5 years postsurgery), and persistent elevated IOP (in a GRAVES patient) occurred in 1 eye (1.92%) each. No suture erosion or breakage nor IOL dislocation was observed. No visually threatening IOL tilt or decentration was reported in any patient. Conclusion. Sutured scleral-fixated foldable IOL implantation demonstrated satisfactory long-term outcomes and rare suture-related complications. This technology was safe and did not require complicated equipment and is of considerable interest in the setting of aphakia without adequate capsule support.

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Experimental Study on Delivery Performance of an Automated Preloaded Intraocular Lens Injector System for Corneal and Sclerocorneal Incisions

Journal of Ophthalmology ◽

10.1155/2021/5548493 ◽

2021 ◽

Vol 2021 ◽

pp. 1-8

Author(s):

Tetsuro Oshika ◽

Noriyuki Sasaki

Keyword(s):

Experimental Study ◽

Intraocular Lens ◽

Corneal Incision ◽

Iol Implantation ◽

Delivery Performance ◽

Incision Size ◽

Study Results ◽

Injector System ◽

Porcine Eyes ◽

Corneal Incisions

Purpose. To evaluate delivery performance of an automated preloaded intraocular lens (IOL) injector systems (AutonoMe) in the porcine eyes. Methods. In the freshly excised porcine eyes, lens removal and IOL implantation were performed. There were 4 groups (10 eyes per group) with different incision site and size: 2.2-mm and 2.4-mm corneal incisions and 2.2-mm and 2.4-mm sclerocorneal incisions. Delivery performance and wound enlargement of AutonoMe were analyzed and compared with those of iTec and iSert from a previous study. Results. There were a few minor troubles associated with AutonoMe, such as overriding plunger within cartridge and trapped trailing haptic during IOL insertion, but the incidence was low. Other interactions were not observed, such as IOL adherence to plunger, sudden ejection of IOL, intrawound lens manipulation, IOL behavior, and gross damage to IOL. AutonoMe caused significantly less wound enlargement for both corneal and sclerocorneal incisions than other injector devices. Wound enlargement by using AutonoMe was significantly smaller with 2.4-mm corneal incision than with 2.2-mm corneal incision, but the final incision size was still smaller with 2.2-mm corneal incision. For sclerocorneal incisions, the amount of wound stretch was not different between 2.2 and 2.4 mm incisions. Conclusion. The wound enlargement caused by the automated preloaded insertion system, AutonoMe, was smaller than that of other preloaded injectors for both corneal and sclerocorneal incisions. There were a few minor technical events during IOL insertion, but the overall incidence was low.

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