scholarly journals Intraoperative and Postoperative Intraocular Lens Opacifications: Analysis of 42545 Cases

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.

Detecting subclinical keratoconus by biomechanical analysis in tomographically regular keratoconus fellow eyes

2021 ◽  
pp. 112067212110637
Author(s):  
Victor A Augustin ◽  
Hyeck-Soo Son ◽  
Isabella Baur ◽  
Ling Zhao ◽  
Gerd U Auffarth ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Central Corneal Thickness ◽  
Corneal Thickness ◽  
Case Series ◽  
Biomechanical Analysis ◽  
Corvis St ◽  
Corrected Visual Acuity ◽  
The Mean ◽  
Best Corrected Visual Acuity ◽  
Fellow Eyes

Purpose To analyze the tomographically non-affected second eyes of keratoconus patients using the Corvis ST to detect any biomechanical abnormalities or subclinical keratoconus. Methods In this retrospective, single-center, consecutive case series 244 eyes of 122 keratoconus patients were analyzed between November 2020 and February 2021. Fourteen fellow eyes fulfilled the inclusion criteria and showed no clinical or tomographic signs of keratoconus. Main outcome measures included best-corrected visual acuity, tomographic and biomechanical analyses using Scheimpflug imaging: Pentacam and Corvis ST (Oculus, Wetzlar, Germany). Tomographic analyses included anterior and posterior simulated keratometry, K-Max, central corneal thickness, thinnest corneal thickness, Belin/Ambrosio Ectasia Display, and the ABCD grading system. For biomechanical analyses, the corneal biomechanical index (CBI) and tomographic biomechanical index were used. Results The mean best-corrected visual acuity was 0.01 ± 0.10 logMAR. Mean K-Max was 43.79 ± 1.12 D, mean central corneal thickness 529 ± 25 µm, mean thinnest corneal thickness 524 ± 23 µm, and mean Belin/Ambrosio Ectasia Display 1.0 ± 0.32. The mean CBI was 0.30 ± 0.21. Regular CBI values were found in six of 14 patients. The mean tomographic biomechanical index was 0.47 ± 0.22 with regular values observed in only two of 14 patients. No signs of tomographic or biomechanical abnormalities were shown in only one of 14 keratoconus fellow eyes, with regular ABCD, Belin/Ambrosio Ectasia Display, CBI and tomographic biomechanical index values. Conclusions Tomographically normal fellow eyes of keratoconus patients are rare. In these cases, a biomechanical analysis of the cornea may help detect a subclinical keratoconus. The tomographic biomechanical index was the most sensitive index to verify a mild ectasia.

scholarly journals Effect of phacoemulsification with intraocular lens implantation in eyes with cataract and functioning filtering blebs

2013 ◽  
Vol 13 (2) ◽  
pp. 33-41
Author(s):  
Devendra Maheshwari ◽  
Rengappa Ramakrishanan ◽  
Mohideen Abdul Kader ◽  
Neelam Pawar ◽  
Ankit Gupta
Keyword(s):  
Visual Acuity ◽  
Intraocular Pressure ◽  
Intraocular Lens ◽  
Intraocular Lens Implantation ◽  
Corrected Visual Acuity ◽  
Lens Implantation ◽  
The Mean ◽  
One Year ◽  
Best Corrected Visual Acuity

Aim: To evaluate the effect of phacoemulsification with intraocular lens implantation in eyes with pre-existing trabeculectomy.Methods: This prospective single-center clinical study evaluated intraocular pressure in 60 eyes of 60 patients who underwent phacoemulsification and implantation of a foldable intraocular lens after a previous successful trabeculectomy. Patients who had a trabeculectomy more than one year prior to the study were included. Intraocular pressure, number of antiglaucoma medications, bleb appearance, and visual acuity were recorded preoperatively, and at each follow-up examination and 12 months after phacoemulsification.Results: The mean intraocular pressure before phacoemulsification was 12.42 mmHg (SD, 4.60 mmHg), which increased to 14.98 mmHg (SD, 4.18 mmHg), 14.47 mmHg (SD, 3.58 mmHg), 15.44 mmHg (SD, 3.60 mmHg), and 15.71 mmHg (SD, 3.47 mmHg) after one, three, six, and 12 months, respectively. At each follow-up visit, the mean IOP was significantly higher than the preoperative value (p < 0.001, p = 0.015, p ≤ 0.001, and p = 0.001 at month one, three, six, and 12, respectively). The mean preoperative best-corrected visual acuity was 0.98 logMAR (SD, 0.44 logMAR) and the mean postoperative best-corrected visual acuity at 12 months was 0.20 logMAR (SD, 0.21 logMAR) [p = 0.0001]. The mean preoperative number of antiglaucoma medications used was 0.57 (SD, 0.63), which increased to 0.65 (SD, 0.63 ), 0.70 (SD, 0.72 ) 0.68, (SD, 0.70), and 0.67 (SD, 0.77 ) at one, three, six, and 12 months, respectively, but there were no statistically significant differences. Bleb size decreased clinically after phacoemulsification. Nineteen of 60 eyes (32%) developed fibrosis of bleb with decreased bleb size.Conclusion: Phacoemulsification with intraocular lens implantation significantly increased intraocular pressure and increased the number of antiglaucoma medications in eyes with pre-existing functioning filtering blebs.

scholarly journals The effect of amblyopia on clinical outcomes of children with astigmatism

2021 ◽  
Vol 13 ◽  
pp. 251584142110408
Author(s):  
Burçin Çakır ◽  
Nilgün Özkan Aksoy ◽  
Sedat Özmen ◽  
Özlem Bursalı
Keyword(s):  
Visual Acuity ◽  
Clinical Outcomes ◽  
Medical Records ◽  
Convergence Insufficiency ◽  
Corrected Visual Acuity ◽  
Ocular Deviation ◽  
The Mean ◽  
The Difference ◽  
Best Corrected Visual Acuity

Background: Amblyopia is more common in children with high astigmatism, but factors contributing to development of amblyopia and visual outcomes are not fully understood. Objective: To evaluate the effect of amblyopia on the clinical outcomes in children with ⩾1.75 diopter (D) astigmatism. Methods: We reviewed the medical records of children with ⩾1.75 D astigmatism with and without amblyopia (amblyopes group and non-amblyopes group). The mean age, gender, amount and type of ocular deviation, presence of convergence insufficiency (CI), stereopsis, time of initial spectacle use and follow-up time, differences in best-corrected visual acuity (VoD) and spherical equivalent (SE) between eyes were assessed and compared between the groups. Best-corrected visual acuity (BCVA), mean SE, astigmatism measurements were assessed and compared between amblyopic, fellow, and non-amblyopic eyes. Results: The records included 68 eyes of 34 children with amblyopia and 56 eyes of 28 children without amblyopia. The mean age, gender, amount and type of ocular deviation, presence of CI, stereopsis, time of initial spectacle use, follow-up time, and the difference in SE did not differ between groups. In amblyopes, exodeviation was more common and statistically greater in near (33 cm) than at distance (6 m) (p = 0.005). The mean BCVA and astigmatism values were statistically different between amblyopic, fellow, and non-amblyopic eyes. Conclusion: A greater near than distance exodeviation and higher mean astigmatism value were found in amblyopic children with astigmatism.

scholarly journals Smoking and Stroke in Appalachian Kentucky

2018 ◽  
pp. 1-4
Author(s):  
Dignan Mark ◽  
Dignan Mark ◽  
Kitzman Patrick ◽  
S Gutti Subhash ◽  
N Gutti Swathi ◽  
...  
Keyword(s):  
Medical Records ◽  
Case Series ◽  
Eastern Region ◽  
Retrospective Case ◽  
Series Design ◽  
Stroke Prevalence ◽  
Appalachian Kentucky ◽  
The Mean ◽  
Stroke Type ◽  
Stroke Belt

This project used a retrospective case series design to investigate factors associated with stroke in a rural area in Appalachian Kentucky. The south-eastern region of the U.S. is often referred to as the ‘stroke belt,’ and includes the Appalachian region of the state of Kentucky. Data were collected from medical records of patients from a neurology practice and regional hospital with a diagnosis of stroke from March 2012 through November 2015. Data were collected without personal identifiers and included demographic characteristics, stroke type, treatments received, and referrals for additional care including rehabilitation. Data from a total of 84 stroke cases diagnosed between March 2012 and November 2015 were included. Of the 84 cases, 46 (54.8%) were female and all but one was Caucasian. The distribution by race is consistent with the population of the region. The stroke cases ranged in age from 41 to 92 (M=66.3) and the age at stroke diagnosis ranged from 40 to 90 (M=65.7). Fourteen (16.7%) had evidence of a previous stroke at diagnosis. For smokers, the mean age at diagnosis was 62.7 for smokers while for non-smokers it was 67.5. The study reported smoking rates that were nearly three-times the national average, and the smokers in this study were found to have stroke onset approximately five-years earlier than non-smokers. The results from this case series support the need for further investigation on stroke prevalence and factors contributing to continued risk for stroke in Appalachia.

Outcomes of corneal neurotisation using processed nerve allografts: a multicentre case series

2020 ◽  
pp. bjophthalmol-2020-317361
Author(s):  
Adam R Sweeney ◽  
Margaret Wang ◽  
Christopher L Weller ◽  
Cat Burkat ◽  
Andrea L. Kossler ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Ocular Trauma ◽  
Surgical Techniques ◽  
Case Series ◽  
Retrospective Case ◽  
Corneal Sensation ◽  
Corrected Visual Acuity ◽  
The Mean ◽  
Maximal Gain ◽  
Prior Infection

BackgroundCorneal neurotisation is a rapidly evolving procedure treating neurotrophic keratopathy. The variety of surgical techniques used and corresponding outcomes after corneal neurotisation are not well understood. This study describes the techniques and outcomes in the largest case series of corneal neurotisation using processed nerve allografts to date.MethodsThis is a retrospective case series of patients who underwent corneal neurotisation with human cadaveric processed nerve allografts. All patients had preoperative and postoperative description of best corrected visual acuity and measurement of corneal sensation. Comparative studies after stratification of techniques were performed.ResultsA total of 17 patients were identified. The cause of corneal anaesthesia was prior infection in eight cases, trigeminal nerve palsy in eight cases and ocular trauma in one case. There were no intraoperative or postoperative complications. Following neurotisation surgery, the time to first gain of corneal sensation and maximal gain of sensation occurred at a mean of 3.7 months (range 1–8 months) and 6.6 months (range 3–15 months), respectively. The mean preoperative and postoperative corneal sensation as measured by Cochet-Bonnet aesthesiometry was 0.36 cm (range 0–3.2 cm) and 4.42 cm (range 0–6 cm), respectively (p<0.01). Visual acuity was unchanged after neurotisation. There were no statistical differences in outcomes based on end-to-end versus end-to-side coaptations, donor nerve selection or laterality of donor nerve.ConclusionCorneal neurotisation with processed nerve allografts is a safe and effective procedure. This study provides further evidence for the use of processed nerve allografts for corneal neurotisation.

scholarly journals Aphakia korrekciója irisklip műlencse retropupillaris beültetésével

2017 ◽  
Vol 158 (1) ◽  
pp. 20-24
Author(s):  
Antal Szabó ◽  
András Papp ◽  
Ágnes Borbándy ◽  
Zsuzsanna D. Géhl ◽  
Zoltán Zsolt Nagy ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Intraocular Lens ◽  
Secondary Procedure ◽  
Medical Optics ◽  
Corrected Visual Acuity ◽  
Time Period ◽  
The Mean ◽  
The Stability ◽  
Best Corrected Visual Acuity

Abstract: Introduction and aim: The correction of aphakia might be a challenge for the surgeon. The aim of this study is to describe the authors’ experience with the implantation of the retropupillary iris clip intraocular lens. Method: Patients between January 2014 and December 2015 were included in the retrospective study. Retropupillary implantation of iris clip intraocular lens VRSA 54 (AMO Advanced Medical Optics, USA) was performed in all cases. The minimum follow up period was three months. The stability of the intraocular lens and the intraoperative and postoperative complications and the visual acuity were evaluated. Results: During this time period 11 cases (1 female, 10 males) were included in the study. The mean age at the time of the implantation was 57.7 years (between 25–74 years). In 4 cases the iris clip lens was implanted during the first intervention, in 7 cases during the secondary procedure. In all cases the lens was fixated onto the iris posteriorly. The best corrected visual acuity before the iris clip implantation was 0.43 (0.1–1.0) and postoperatively at the time of the follow up 0.49 (0.04–1.0). Conclusions: With the use of the retropupillary implanted iris clip intraocular lens all of the patients could have been rehabilitated without major complications. Orv. Hetil., 2017, 158(1), 20–24.

Visual improvement in amblyopic eye following treatment-induced vision loss in dominant eye with uveal melanoma

2019 ◽  
Vol 104 (2) ◽  
pp. 202-207
Author(s):  
Aldo Vagge ◽  
Carol L Shields ◽  
Jerry A Shields ◽  
Renelle Pointdujour-Lim ◽  
Bruce Schnall
Keyword(s):  
Visual Acuity ◽  
Uveal Melanoma ◽  
Visual Loss ◽  
Vision Loss ◽  
Case Series ◽  
Retrospective Case ◽  
Corrected Visual Acuity ◽  
Visual Improvement ◽  
Dominant Eye ◽  
The Mean

ObjectiveTo determine the frequency and amount of visual improvement in amblyopic eyes of adults following visual loss in the dominant eye resulting from treatment of uveal melanoma.Methods and analysisRetrospective case series of adult patients with amblyopia and dominant eye visual loss resulting from treatment of uveal melanoma. Review of best-corrected visual acuity (BCVA) in each eye (amblyopia eye vs melanoma eye) at date first seen and over time following treatment of uveal melanoma. BCVA in each eye was graded as improved (>2 logarithm of minimal angle of resolution (logMAR) lines) or unimproved (<2 logMAR lines).ResultsTwenty-one patients that met the inclusion criteria. Mean age at presentation was 56 years (range 39–73 years). Following treatment of the uveal melanoma and decline of BCVA in the dominant, the BCVA in the amblyopic eye improved in 11/21 (52%; 95% CI 30% to 74 %) patients. The degree of visual loss in the melanoma eye was to the level of the amblyopic eye or worse in 14 patients. In this group, BCVA improved in the amblyopic eye in 9/14 (64%; 95% CI 35% to 87 %) patients. Of these nine with improved eyes, the mean starting visual acuity was logMAR 0.6 (20/80) with mean improvement of logMAR 0.4 (4 lines±0.13 (range 0.2–0.6). Eight of nine eyes achieved a BCVA of 20/25 (n=3) or 20/20 (n=5).ConclusionVisual acuity in the amblyopic eye of adults can improve following visual loss in the contralateral dominant eye associated with treatment for uveal melanoma.

scholarly journals Long-term surgical outcomes of primary retropupillary iris claw intraocular lens implantation for the treatment of intraocular lens dislocation

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Eun Young Choi ◽  
Chul Hee Lee ◽  
Hyun Goo Kang ◽  
Jae Yong Han ◽  
Suk Ho Byeon ◽  
...  
Keyword(s):  
Intraocular Lens ◽  
Pars Plana Vitrectomy ◽  
Case Series ◽  
Retrospective Case ◽  
Iol Implantation ◽  
Intraocular Lens Dislocation ◽  
Post Surgery ◽  
Pars Plana ◽  
Iol Dislocation ◽  
Iris Claw

AbstractWe aimed to investigate the efficacy and safety of primary retropupillary iris claw intraocular lens (R-IOL) implantation in patients with complete intraocular lens (IOL) dislocation. In this single-center retrospective case series, we reviewed the medical records of patients who underwent R-IOL implantation surgery with pars plana vitrectomy for the treatment of IOL dislocation between September 2014 and July 2019. The primary outcome was change in visual acuity (VA) up to 24 months postoperatively. The secondary outcomes included changes in intraocular pressure (IOP), refractive errors, and endothelial cell count (ECC) over the same period. Data of 103 eyes (98 patients) were analyzed. The mean uncorrected VA was significantly improved at one month postoperatively (− 0.69 logMAR, P < 0.001), compared to the preoperative value. IOP (− 2.3 mmHg, P = 0.008) and ECC (− 333.4 cells/mm2, P = 0.027) significantly decreased one month post-surgery and remained stable thereafter. Postoperative mean spherical equivalents were similar to the prediction error throughout the follow-up period. IOP elevation (n = 8, 7.8%), cystoid macular edema (n = 4, 3.9%), and dislocation of the R-IOL (n = 10, 9.7%) were managed successfully. Overall, primary R-IOL implantation with pars plana vitrectomy is effective and safe for correcting IOL dislocation due to various causes.

scholarly journals Scleral buckle surgery for pseudophakic and aphakic retinal detachment in western Nepal

1970 ◽  
Vol 3 (2) ◽  
pp. 109-117
Author(s):  
RN Byanju ◽  
S Bajimaya ◽  
I Kansakar ◽  
A Melamud
Keyword(s):  
Visual Acuity ◽  
Retinal Detachment ◽  
Case Series ◽  
Scleral Buckle ◽  
Retrospective Case ◽  
Repeat Surgery ◽  
Corrected Visual Acuity ◽  
Best Corrected Visual Acuity ◽  
Aphakic Retinal Detachment

Introduction: Retinal detachment remains one of the most serious complications of cataract surgery. Treatment of this condition has represented a challenge for vitreoretinal surgeons. Scleral buckle (SB) surgery is one of the treatment options in pseudophakic and aphakic retinal detachment (RD). Aims: To find out the anatomical and visual outcome of SB in pseudophakic and aphakic RD. Subjects and methods: Retrospective case series of 46 consecutive eyes of 46 patients with RD (38 pseudophakic and 8 aphakic eyes) that had undergone conventional SB surgery were reviewed from patient files. Postoperative retinal status at 3 weeks, 6 weeks and 3 months were recorded to see the anatomical success rate after retinal reattachment surgery. Best corrected visual acuity (BCVA) at 3 months follow-up was noted. Results: The mean age of the patients was 54.28 ± 13.49 years. Forty eyes (86.9 %) had primary attachment by 6 weeks duration. Five eyes had undergone repeat surgery within a six-week duration (pars plana vitrectomy). Forty patients had follow-up visit to 12 weeks, achieving retinal attachment in 37 eyes (80.5 %). Best corrected visual acuity (BCVA) at 3 months was better than 6/60 in 18 eyes (39.1%), BCVA better or equal to 1/60 but less than 6/60 in 18 eyes (39.1%) and BCVA less than 1/60 in 4 eyes (8.7 %). Conclusion: Conventional scleral buckling has good outcome for pseudophakic and aphakic RD and can be useful for patients in peripheral eye hospitals where patients cannot afford high cost surgeries. Keywords: scleral buckle, pseudophakia, retinal detachment DOI: http://dx.doi.org/10.3126/nepjoph.v3i2.5261 Nepal J Ophthalmol 2011; 3(2): 109-117

scholarly journals Multifocal IOL Explantation in Patients with Opaque Lentis after Refractive Lens Exchange

2021 ◽  
Author(s):  
Maria Phylactou ◽  
Nizar Din ◽  
Francesco Matarazzo ◽  
Vincenzo Maurino
Keyword(s):  
Intraoperative Complications ◽  
Case Series ◽  
Retrospective Case ◽  
Yag Laser ◽  
Refractive Lens Exchange ◽  
Multifocal Iol ◽  
Refractive Lens ◽  
The Mean ◽  
Hydrophobic Acrylic ◽  
Iol Exchange

Abstract Purpose We describe the outcomes of intraocular lens (IOL) explantation in a cluster of opaque multifocal Lentis LS-313 following refractive lens exchange (RLE). Methods Single-centre, single-surgeon, retrospective case series. Results The study enrolled 10 eyes of 10 patients, 6 male and 4 female. All patients had uneventful RLE with multifocal IOL implantation. The mean patient age at the time of RLE was 53 years ± 2.52 (SD). Two eyes had YAG laser capsulotomy prior explantation. The mean interval between the initial RLE and IOL explantation was 5.4 years ± 1.4 (SD). IOL exchange was performed in all eyes in one procedure. Five eyes had in the bag hydrophobic acrylic IOL (3 multifocal and 2 monofocal) three eyes had 3-piece hydrophobic acrylic IOL in the ciliary sulcus and two had an anterior chamber IOL. Intraoperatively one patient had weak zonules and two patients had zonular dehiscence and required anterior vitrectomy. The mean preoperative CDVA was 0.25 ± 0.15 (SD) logMAR and at the final follow-up, improved to 0.00 ± 0.07 (SD) logMAR (p < 0.01). Light microscopy with von Kossa stain confirmed IOL calcification. No postoperative complications were recorded. Conclusions IOL exchange appears to be a feasible and safe surgical option for multifocal IOL opacification. However, patients must be warned of additional intraoperative risks including zonular dialysis, vitreous loss, retinal detachment and need for potential ACIOL with its associated sequel of complications. Moreover, YAG laser capsulotomy should be considered carefully as increases the chances of intraoperative complications and restricts the surgical options of secondary IOL insertion, including in-the-bag IOL exchange with MFIOL.

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