scholarly journals Surgical Management of Paediatric Aphakia in the Absence of Sufficient Capsular Support

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Evdoxia-Maria Karasavvidou ◽  
Craig Wilde ◽  
Anwar Zaman ◽  
Gavin Orr ◽  
Dharmalingam Kumudhan ◽  
...  
Keyword(s):  
Intraocular Lens ◽  
Vitreous Hemorrhage ◽  
Cell Loss ◽  
Surgical Approaches ◽  
Posterior Chamber ◽  
Advantages And Disadvantages ◽  
Posterior Chamber Intraocular Lens ◽  
Capsular Support ◽  
Iol Dislocation ◽  
Iris Claw

There are several available options for the demanding surgical correction of paediatric aphakia without sufficient capsular support. The literature suggests the implantation of a transscleral fixated posterior chamber-intraocular lens (PCIOL), an intrascleral fixated PCIOL, an iris-sutured intraocular lens (IOL), or an anterior chamber iris-claw IOL. We searched for reports on the management of paediatric aphakia in case of inadequate capsular support that delineated the diverse surgical approaches and their postoperative results. Analysis demonstrated that different complications can be encountered depending on IOL placement technique, such as suture rupture, IOL dislocation, secondary glaucoma, endophthalmitis, vitreous hemorrhage, and endothelial cell loss. However, it was shown that various IOL designs have similar visual outcomes. Taking into consideration the advantages and disadvantages of each surgical technique, ophthalmic surgeons can determine the safest and most efficient approach for paediatric aphakic patients.

scholarly journals Evaluation of Sutureless, Glueless, Flapless, Intrascleral Fixated Posterior Chamber Intraocular Lens in Children with Ectopia Lentis

2018 ◽  
Vol 2018 ◽  
pp. 1-6 ◽  
Author(s):  
Kannan NB ◽  
Piyush Kohli ◽  
Bhanu Pratap Singh Pangtey ◽  
Kim Ramasamy
Keyword(s):  
Visual Acuity ◽  
Intraocular Lens ◽  
Pediatric Population ◽  
Intraoperative Complications ◽  
Vitreous Hemorrhage ◽  
Posterior Chamber ◽  
Ectopia Lentis ◽  
Uncorrected Visual Acuity ◽  
Posterior Chamber Intraocular Lens

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.

scholarly journals Novel Technique to Overcome the Nonavailability of a Long Needle 9-0 Polypropylene Suture for Sutured Scleral Fixation of the Posterior Chamber Intraocular Lens Using a Single Fisherman’s Knot

2017 ◽  
Vol 2017 ◽  
pp. 1-4
Author(s):  
Yong Un Shin ◽  
Mincheol Seong ◽  
Hee Yoon Cho ◽  
Min Ho Kang
Keyword(s):  
Intraocular Lens ◽  
Posterior Chamber ◽  
Intraoperative Complication ◽  
Scleral Fixation ◽  
Polypropylene Suture ◽  
Endothelial Cell Count ◽  
Intraocular Hemorrhage ◽  
Posterior Chamber Intraocular Lens ◽  
Iol Dislocation

Purpose. To describe a method to overcome the nonavailability of a long needle 9-0 polypropylene suture for sutured scleral fixation of the posterior chamber intraocular lens (PC-IOL) using a single fisherman’s knot (SFK). Methods. First, a 10-0 polypropylene suture was passed from the sclera to the ciliary sulcus using a long needle. A 9-0 suture was tied to the unpassed portion of the 10-0 suture with an SFK. We pulled the 10-0 suture to pass the SFK through the sclera, and then we cut the knot and removed the 10-0 suture. IOL fixation with 9-0 sutures used the conventional techniques used for sutured scleral-fixated IOL. Preoperative and postoperative visual acuity, corneal astigmatism, and endothelial cell count and intraoperative/postoperative complications were evaluated. Results. An SFK joining the two sutures was passed through the sclera without breakage or slippage. A total of 35 eyes from 35 patients who underwent sutured scleral fixation of the IOL. An intraoperative complication (minor intraocular hemorrhage) was recorded in four cases. Knot exposure, IOL dislocation, subluxation, and retinal detachment were not observed. Conclusions. The SFK offers the opportunity to use 9-0 sutures for the long-term safety and may not require the surgeon to learn any new technique.

scholarly journals Anterior Chamber Iris Claw Lens for the Treatment of Aphakia in a Patient with Megalocornea

2015 ◽  
Vol 6 (2) ◽  
pp. 164-169 ◽  
Author(s):  
Norman Saffra ◽  
Aleksandr Rakhamimov ◽  
Robert Masini ◽  
Kenneth J. Rosenthal
Keyword(s):  
Anterior Chamber ◽  
Intraocular Lens ◽  
Crystalline Lens ◽  
Posterior Chamber ◽  
Cataract Formation ◽  
Posterior Chamber Intraocular Lens ◽  
Effective Option ◽  
Iris Claw Lens ◽  
Capsular Bag ◽  
Iris Claw

Megalocornea in isolation is a rare congenital enlargement of the cornea greater than 13 mm in diameter. Patients with megalocornea are prone to cataract formation, crystalline lens subluxation, zonular deficiencies and dislocation of the posterior chamber intraocular lens (PCIOL) within the capsular bag. A 55-year-old male with megalocornea in isolation developed subluxation of the capsular bag and PCIOL. The PCIOL and capsular bag were explanted, and the patient was subsequently implanted with an anterior chamber iris claw lens. An anterior chamber iris claw lens is an effective option for the correction of aphakia in patients with megalocornea.

scholarly journals Implantation of foldable posterior chamber intraocular lens in aphakic vitrectomized eyes without capsular support

2016 ◽  
Vol 79 (3) ◽  
pp. 159-162 ◽  
Author(s):  
Gurkan Erdogan ◽  
Cihan Unlu ◽  
Betul Onal Gunay ◽  
Esra Kardes ◽  
Ahmet Ergin
Keyword(s):  
Intraocular Lens ◽  
Posterior Chamber ◽  
Posterior Chamber Intraocular Lens ◽  
Capsular Support

scholarly journals Malik`s Technique of Single Loop Fixation of Posterior Chamber Intraocular Lens in Presence of Partial Capsular Support

2015 ◽  
Vol 9 (1) ◽  
pp. 169-171
Author(s):  
Krishan Pal Singh Malik ◽  
Ruchi Goel ◽  
Divya Kishore ◽  
Smriti Nagpal
Keyword(s):  
Intraocular Lens ◽  
Posterior Chamber ◽  
Scleral Flap ◽  
Single Loop ◽  
External Communication ◽  
Reproducible Technique ◽  
Scleral Tunnel ◽  
Posterior Chamber Intraocular Lens ◽  
Capsular Support

Single loop fixation of posterior chamber intraocular lens in the presence of partial capsular support is usually performed by creation of additional scleral flap or tunnel. This extra port may expose the suture holding the intraocular lens or the tucked-in lens haptics to the outside environment thereby increasing the risk of endophthalmitis. We describe a technique of single loop fixation where the scleral tunnel is created adjacent to the site with the absent capsule, the leading haptic is placed on the capsular scaffold, the trailing haptic is tied to 9-0 polypropylene, and the suture is then secured to the inner edge of the scleral lip with enough tension to center the optics and the wound is then closed. The suture knot gets buried within the scleral tunnel with no external communication and does not require a separate port. It is an easy, safe, fast and reproducible technique with a lens tilt of less than 2°.

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