scholarly journals Descemet Membrane Endothelial Keratoplasty for Corneal Decompensation Secondary to Phakic Intraocular Lenses

2019 ◽  
Vol 2019 ◽  
pp. 1-7 ◽  
Author(s):  
Ester Fernández López ◽  
Cristina Peris Martínez
Keyword(s):  
Visual Acuity ◽  
Postoperative Complications ◽  
Intraocular Lenses ◽  
Bullous Keratopathy ◽  
Step Procedure ◽  
Uncorrected Visual Acuity ◽  
Primary Graft Failure ◽  
Phakic Intraocular Lenses ◽  
Corneal Decompensation ◽  
One Year

Purpose. To describe the surgical technique and clinical outcomes of bilensectomy (pIOL explant and phacoemulsification), followed by DMEK performed for bullous keratopathy secondary to pIOL. Methods. Seven eyes of seven patients, who developed corneal decompensation after pIOL implantation, underwent bilensectomy followed by DMEK in a two-step procedure. Main outcome measures included uncorrected visual acuity (UCVA) and best-corrected visual acuity (BCVA), refraction, endothelial cell density (ECD) at 1, 3, 6, and 12 months, and intraoperative and postoperative complications. Results. DMEK was performed at a mean time of 9.83 ± 8.23 months after bilensectomy. BCVA (log MAR) improved in all eyes, increasing from 1.11 ± 0.78 preoperatively to 0.54 ± 0.21, 0.28 ± 0.23, 0.21 ± 0.21, and 0.17 ± 0.17 at 1, 3, 6, and 12 months after DMEK. One year after surgery, mean spherical equivalent and cylinder were −0.70 ± 0.92 D and −1.50 ± 0.54 D, respectively. ECD decreased by 62 ± 4%, 69 ± 4%, 74 ± 4%, and 77 ± 3% at 1, 3, 6, and 12 months after DMEK. There was one case of primary graft failure and no other postoperative complications. Conclusions. The two-step technique bilensectomy followed by DMEK is a feasible technique for the management of bullous keratopathy secondary to pIOL, providing a fast visual recovery with good visual and refractive results.

scholarly journals First Experiences with Implantation of Phakic Lenses in Correction of Myopia in R. N. Macedonia

PRILOZI ◽  
2021 ◽  
Vol 42 (3) ◽  
pp. 37-46
Author(s):  
Biljana Kostovska ◽  
Jasmina Pluncevikj Gligoroska ◽  
Fanka Gilevska ◽  
Zlatko Arnaudovski ◽  
Nikica Gabric
Keyword(s):  
Visual Acuity ◽  
High Myopia ◽  
Postoperative Outcome ◽  
Intraocular Lenses ◽  
Implantable Collamer Lens ◽  
Corrected Visual Acuity ◽  
Uncorrected Distance Visual Acuity ◽  
Phakic Intraocular Lenses ◽  
One Year ◽  
Myopic Astigmatism

Abstract Objective: Analysis of visual acuity parameters in patients with moderate to high myopia and myopic astigmatism 1 year after treatment with phakic intraocular lenses. Material and methods: This was a retrospective study on 35 patients (52 eyes) with moderate to high myopia who were implanted with the Visian V4c phakic implantable Collamer lens (Staar Surgical, Nidau, Switzerland). Examined parameters were: uncorrected distance visual acuity (UDVA) and best corrected visual acuity (CDVA), manifest and cycloplegic refraction, intraocular pressure, and endothelial cell count. The investigated parameters were measured preoperatively, 1, 3, 6 and 12 months postoperatively. Results: In 17 patients, phakic lenses were implanted binocularly and in 18 patients monocularly. Preoperatively 34.62% of patients had CDVA from 0.9 to 1.0. One year after the surgery 48.08% of patients had UDVA from 0.9 to 1.0. Preoperatively 80.77% of patients had diopter range from -6.00 Dsph to -10.00 Dsph. At 1 year postoperatively 78.85% of patients were within 0.00 Dsph to -1.00 Dsph. Preoperatively, in patients with astigmatism -4 Dcyl to -2 Dcyl dominated, as opposed to significant improvement postoperatively when 94.23% had astigmatism ranging from -1.0 Dcyl to 0 Dcyl. Conclusion: The implantation of phakic lenses demonstrated a successful postoperative outcome in the treatment of myopia and myopic astigmatism. Visual acuity and refraction show a gradual and significant improvement in visual function parameters within 1 year of lens implantation.

scholarly journals Descemet stripping endothelial keratoplasty: One-year follow-up

2010 ◽  
Vol 138 (11-12) ◽  
pp. 690-693
Author(s):  
Ljubisa Nikolic ◽  
Vesna Jovanovic
Keyword(s):  
Corneal Thickness ◽  
Long Term Results ◽  
Bullous Keratopathy ◽  
Endothelial Keratoplasty ◽  
Descemet Stripping Endothelial Keratoplasty ◽  
Air Bubble ◽  
Primary Graft Failure ◽  
Internal Side ◽  
One Year

Introduction. Sutureless transplantation of endothelium on a thin stromal carrier was introduced under the name of Descemet stripping endothelial keratoplasty (DSEK) in 2004. It has become the treatment of choice of corneal oedema due to endothelial dysfunction. Objective. To investigate posterior lamellar graft attachment, central corneal thickness (CCT), astigmatism, and best corrected visual acuity (BCVA) during one-year follow-up. Methods. Surgery was performed on one eye of 11 patients with pseudophakic bullous keratopathy and Fuchs? dystrophy. The graft thick 150-200 ?m and 8.0 mm in diameter was detached manually. The carrier of the recipient cornea was created by DSEK. The graft was folded in half, introduced into the anterior orbital chamber through a 5.0 mm cut on the limbus and attached by air bubble along the internal side of the recipient cornea. CCT and astigmatism were evaluated by corneal topography, and graft attachment by biomicroscopy. Results. One year after surgery, all grafts remained attached. Primary graft failure occurred in three eyes, probably due to the crushing effect of the forceps. BCVA was 20/30 (2 eyes), and 20/40 (6 eyes), CCT 643-728 ?m, and astigmatism 1.1 D to 2.9 D. The peak values were reached three months after surgery, and did not change much afterwards. Conclusion. This is the first report on the long-term results of DSEK in our literature. The results are similar to those obtained by more experienced DSEK surgeons, and suggest that this procedure is safe and successful.

scholarly journals Comparison of the Outcomes of Manual Small Incision Cataract Surgery (MSICS) and Phacoemulsification (PHACO) in Ghana

2021 ◽  
Vol 18 (3) ◽  
pp. 143-149
Author(s):  
Samuel Kyei ◽  
Ebenezer Zaabaar ◽  
Frank Assiamah ◽  
Michael Agyemang Kwarteng ◽  
Kofi Asiedu
Keyword(s):  
Visual Acuity ◽  
Postoperative Complications ◽  
Cataract Surgery ◽  
Medical Records ◽  
Cross Sectional Study ◽  
Small Incision Cataract Surgery ◽  
Cross Sectional ◽  
Small Incision ◽  
Uncorrected Visual Acuity

Background: The growing middle-class population of Ghana has seen more people being employed in visually demanding occupations  and hence there is an increased desire for quality post-cataract surgical visual outcomes. This study aimed at comparing the outcomes of manual small incision cataract surgery (MSICS) and phacoemulsification (PHACO) among Ghanaians. Methods: This was a retrospective cross-sectional study in which records of patients who underwent MSCIS or phacoemulsification by the same surgeon were reviewed. Results: Medical records of 248 eyes were reviewed, out of which 132 underwent PHACO and 116 had MSICS. A significant number of the  PHACO group had good (6/6–6/18) uncorrected visual acuity (UCVA) compared to the MSICS group at 1–2 weeks follow-up (p = 0.003) and 4–6 weeks follow-up (p = 0.002). MSICS resulted in a higher total astigmatic change compared to PHACO (p < 0.001). The PHACO grouphad a higher number of postoperative complications compared with the MSICS group (p <0.001). Postoperative borderline and poor  uncorrected visual acuity were associated with age, total astigmatic change, and postoperative complications. Conclusion: The postoperative UCVA outcomes at 4–6 weeks’ follow-up indicates that PHACO resulted in noticeably less spectacle dependency when compared to MSICS.

scholarly journals Correction of High Corneal Astigmatism during Cataract Surgery

2019 ◽  
Vol 15 (4) ◽  
pp. 405-410 ◽  
Author(s):  
K. B. Pershin ◽  
N. F. Pashinova ◽  
M. E. Konovalov ◽  
E. P. Gurmizov ◽  
O. Yu. Zubenko ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Surgical Treatment ◽  
Clinical Experience ◽  
Intraocular Lens ◽  
Surgical Intervention ◽  
Corneal Astigmatism ◽  
Intraocular Lenses ◽  
Toric Intraocular Lens ◽  
Surgical Interventions ◽  
Uncorrected Visual Acuity

Patients, who need cataract surgical treatment, often fail to achieve a high uncorrected visual acuity after surgery due to the concomitant astigmatism involved. Currently, surgeons are increasingly performing combined surgical interventions, including relaxing limbal keratotomic incisions (manual keratotomy) or femtoarcuatous keratotomy, as well as implanting toric intraocular lenses. In recent years, additional toric intraocular lenses have been available. Purpose: to analyze our own clinical experience of implanting an additional toric intraocular lens to correct corneal astigmatism in three clinical cases. The article presents our clinical experience of successful correction of residual corneal astigmatism after previous cataract phacoemulsification with the implantation of a monofocal toric intraocular lens in three patients patients aged 70, 61 and 54 years. In all cases, an additional toric intraocular lens Add-on Torica-sPB pre-filled in the cartridge with a good refractive effect was implanted. The uncorrected visual acuity was 1.0 in all the investigated cases at the follow-upo period of 6 months after the surgical intervention. Calculation of the toric intraocular lens optical power was performed using an online calculator. A feature of surgical intervention was the repositioning of the additional toric intraocular lens into the ciliary sulcus. Changes in the data of keratotopography before and after surgery were absent. In none of the investigated cases, intra- and postoperative complications and dislocation of the implanted additional toric intraocular lens were determined. Based on these cases, high predictability, efficacy and safety of implantation of an additional toric intraocular lens are shown, in the case of residual middle-grade corneal astigmatism after the initial cataract phacoemulsification with the toric intraocular lens implantation. This approach can be successfully used in patients during one-stage surgical treatment of cataract and associated high-grade corneal astigmatism, expanding existing protocols for the treatment of this group of patients.

scholarly journals Evaluation of Distance-Specific Uncorrected Visual Acuity in Eyes Implanted with Extended Depth-of-Field Intraocular Lenses

2020 ◽  
Vol 49 (0) ◽  
pp. 97-103
Author(s):  
Yuka Sasaki ◽  
Hisae Nakamura ◽  
Ritsuko Miyata ◽  
Mutsumi Mitamura ◽  
Tsukasa Mabara ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Intraocular Lenses ◽  
Depth Of Field ◽  
Uncorrected Visual Acuity ◽  
Extended Depth Of Field

scholarly journals One Year Follow-Up After Veriflex Phakic Intraocular Lenses Implantation for Correction of Myopia

2016 ◽  
Vol 24 (3) ◽  
pp. 178
Author(s):  
Melisa Pjano ◽  
Alma Biscevic ◽  
Senad Grisevic ◽  
Ajla Pidro ◽  
Mirko Ratkovic ◽  
...  
Keyword(s):  
Intraocular Lenses ◽  
Phakic Intraocular Lenses ◽  
One Year

Enhancement of Refractive Results after Intraocular Lens Implantation

2011 ◽  
Vol 05 (01) ◽  
pp. 59
Author(s):  
Michael Amon ◽  
Guenal Kahraman ◽  
◽  
Keyword(s):  
Visual Acuity ◽  
Intraocular Lens ◽  
Convex Surface ◽  
Ultrasound Biomicroscopy ◽  
Rotational Stability ◽  
Convex Shape ◽  
Multifocal Iol ◽  
Primary Implant ◽  
Uncorrected Visual Acuity ◽  
One Year

Summary:An overview on polypseudophakia (‘piggyback’ intraocular lens [IOLs]) is given. Requirements on a sulcus-supported supplementary IOL are defined. Two-year results of a new IOL (Sulcoflex®) are presented and indications for this IOL are defined.Methods:The IOL is especially designed for implantation into the ciliary sulcus in pseudophakic eyes (piggyback). It is a single-piece implant made of hydrophilic acrylic. Optic- and haptic-edges are round. The optic has a diameter of 6.5mm and a concave/convex shape for perfect fit on the anterior convex surface of the primary IOL. The haptic is angulated, and has an undulated design to preclude IOL rotation. A monofocal, a multifocal or a toric version of the sulcoflex IOL were implanted into the ciliary sulcus of pseudophakic eyes. All IOLs were implanted by injector through a 3mm clear cornea incision. After surgery near and far uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA) and eye pressure were assessed. Inflammation was measured by laser flare/cell meter. Position and rotational stability of the IOL were documented regularly at all control visits. Furthermore, Scheimpflug photography and ultrasound biomicroscopy were performed.Results:Surgery was performed without any complication in all cases. Two years after surgery there were no severe intra- or post-operative complications detected. Emmetropia was achieved in all cases (±0.25dpt) and the refraction was stable. Flare values were lower than the values measured after standard cataract procedures. Rotational stability and centration were excellent. Intraocular pressure was within the normal range at all visits. After one year of follow-up no iris-chafing was documented. In all cases, a good distance was found between iris and the Sulcoflex-IOL and primary implant and the Sulcoflex-IOL. In those cases with the multifocal IOL-version all patient achieved independency from glasses.Conclusion:Surgery with implantation of a sulcus-IOL is safe and less traumatic than IOL-exchange. The material and design of the Sulcoflex IOL ensure that the implants are well tolerated within the eye. The implant can be used at the same time with the primary implant or as secondary implant. Indications for implantation of this IOL are the correction of ‘post-surgical’ ametropia, of astigmatism (toric IOL) of higher order aberrations (aspherical IOL) and of ‘pseudophakic presbyopia’ (multifocal IOL). In the future, other potential indications will be established.

Phacolytic glaucoma: visual outcome

2017 ◽  
Vol 5 (6) ◽  
pp. 2636
Author(s):  
Venkataratnam Peram ◽  
Srihari Atti ◽  
Superna Mahendra
Keyword(s):  
Visual Acuity ◽  
Intraocular Pressure ◽  
Postoperative Complications ◽  
Tertiary Care ◽  
Visual Outcome ◽  
Posterior Chamber ◽  
Bullous Keratopathy ◽  
Care Hospital ◽  
Presenting Symptoms ◽  
Phacolytic Glaucoma

Background: This study was conducted to evaluate the visual outcome of phacolytic glaucoma, a common cause of ocular morbidity.Methods: Participants were 30 patients in a tertiary care hospital for both urban and rural population. 30 eyes of patients clinically diagnosed as phacolytic glaucoma were treated. Demographic data and duration of the symptoms of the patients before presenting to the hospital were noted. Intraocular pressure (IOP) and visual acuity were recorded preoperatively and postoperatively. Small Incision cataract surgery with posterior chamber intraocular lens implantation (IOL) was done after the control of intraocular pressure and inflammation. Postoperative complications were noted. The data was analyzed by simple statistical methods.Results: Age group distribution was 19 (63.3%) in >50-60 yrs, 9 (30.0%) in >60-70 yrs and 2(6.4%) in >70 yrs. Sex distribution was 21 (70.0%) of males and 9 (30.0%) of females. Mean age of the all the patients was 60.7 yrs (males 59.95 yrs and females 62.6 yrs). Laterality was RE in 16 (70.9%) and LE in 9 (30.0%). Duration of the presenting symptoms before reporting to the hospital was <1 week in 17 (56.6% and >1 week in 13 (43.3%). Mean IOP was 45.8 mmHg preoperatively. Visual Acuity was PL doubtful in 2 (6.6%), PL +ve in 15 (50.0%) and HM<3/60 in 13 (43.4%) preoperatively. Postoperative visual acuity at 6-8 weeks was <6/60 in 8 (26.7%) and >6/60 in 22 (73.3%). Postoperative complications were bullous keratopathy in 5 (16.6%), anterior uveitis with membrane on IOL in 7 (23.3%), posterior capsular tear in 3 (10.0%) and Zonular dialysis in 2 (6.6%). Fellow eye showed pseudophakia in 22 (73.4%), immature cataract in 6 (20.0%) and Aphakia in 2 (6.6%).Conclusions: This study concludes that a better Visual outcome in phacolytic glaucoma depends on the effective Preoperative control of intraocular pressure and inflammation.

scholarly journals Verisyse versus Veriflex Phakic Intraocular Lenses: Refractive Outcomes and Endothelial Cell Density 5 Years after Surgery

2018 ◽  
Vol 2018 ◽  
pp. 1-8
Author(s):  
Dilek Yaşa ◽  
Alper Ağca
Keyword(s):  
Visual Acuity ◽  
Endothelial Cell ◽  
Cell Density ◽  
Endothelial Cell Density ◽  
Intraocular Lenses ◽  
Distance Visual Acuity ◽  
Medical Optics ◽  
Significant Difference ◽  
Phakic Intraocular Lenses

Purpose. To compare refractive stability, central endothelial cell density (ECD), and complications between Verisyse (Abbott Medical Optics, Netherlands) and Veriflex (Abbott Medical Optics, Netherlands) phakic intraocular lenses (pIOL) over five years.Methods. We retrospectively reviewed the medical records of patients who underwent Verisyse or Veriflex pIOL implantation for surgical correction of myopia. Patients with a 5-year follow-up period were included in the study. Uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), spherical equivalent of manifest refraction (SE), and ECD were compared between the groups preoperatively and 1, 3, and 5 years postoperatively.Results. The study included 47 eyes in the Verisyse group and 50 eyes in the Veriflex group. There was no significant difference in mean SE, UDVA, CDVA, and ECD preoperatively or postoperatively. In both groups, there was a statistically significant myopic shift between 1-year and 5-year visits (−0.25 ± 0.30 D and −0.23 ± 0.48 D in the Verisyse and Veriflex groups, respectively). There was no significant difference between the groups in terms of efficacy and safety indexes at 5 years. ECD loss was highest during the first year (3.9% loss in the Verisyse group and 3.9% loss in the Veriflex group,p=0.670). At 5 years, the mean cumulative ECD losses in the Verisyse and Veriflex groups were 7.42% and 7.64%, respectively (p=0.709). Cataracts developed in 2.1% of the eyes in the Verisyse group and in 2.0% of those in the Veriflex group. No sight-threatening complications were observed.Conclusion. Verisyse and Veriflex pIOLs are highly effective for treating high myopia up to 5 years after surgery. Longitudinal studies with longer follow-up periods are necessary to determine the endothelial safety profile.

scholarly journals Implantable Collamer Lens for Correction of Refractive Errors in Patients with Keratoconus following Collagen Cross-Linking: One Year Follow-up

2014 ◽  
Vol 3 (1) ◽  
pp. 29-35 ◽  
Author(s):  
Hassenien Safa Shuber
Keyword(s):  
Visual Acuity ◽  
Cross Linking ◽  
Refractive Errors ◽  
Implantable Collamer Lens ◽  
Uncorrected Visual Acuity ◽  
Efficacy Index ◽  
The Mean ◽  
One Year ◽  
Collagen Cross Linking

ABSTRACT Objective The purpose of this study is to assess the predictability, safety, efficacy and stability of correction of refractive errors in patients with keratoconus using Visian implantable collamer lens (ICL) following collagen cross-linking. Materials and methods This prospective, non-comparative study evaluated 20 eyes of 14 patients with keratoconus subjected to implantation of intraocular collamer lens at least 1 year following collagen cross-linking and stable refraction. Mean preoperative myopia was −8.43 ± 5.13 Diopters (D) (–3.5 to −20.0D and mean cylinder was −2.19 ± 1.28D (0.0 to −4.5D). The preoperative spherical equivalent (SE) was −9.52 ± 5.33D (–3.75 to −21.25D). During the 12 months follow-up, uncorrected visual acuity, best corrected visual acuity, refraction, intraocular pressure and vaulting are measured. Results At 12 months postoperatively, 90% of eye had refractive cylinder of <1.0D with (p = 0.003) and 20 (100%) eyes was within ±0.75D of sphere at 1 year (r2 = 0.99) and (p = 0.0085). The mean postoperative BCVA in decimal was 0.498 ± 0.232, while the mean preoperative BCVA was 0.484 ± 0.285. The safety index at 12 months was 1.02. The mean postoperative UCVA in decimal was 0.498 ± 0.232 and the mean preoperative BCVA is 0.484 ± 0.29 and the efficacy index at 12 months was 1.01. Conclusion Implantation of Visian Intraocular collamer lens is predictable, safe and effective way to correct refractive error in patients with keratoconus following collagen cross-linking. How to cite this article Shuber HS. Implantable Collamer Lens for Correction of Refractive Errors in Patients with Keratoconus following Collagen Cross-Linking: One Year Follow-up. Int J Kerat Ect Cor Dis 2014;3(1):29-35.

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