scholarly journals Microperipheral Iridectomy for Troublesome Posterior Synechiolysis in Secondary Intraocular Lens Implantation

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
Wu Xiang ◽  
Jing Li ◽  
Wan Chen ◽  
Haotian Lin ◽  
Weirong Chen
Keyword(s):  
Intraocular Lens ◽  
Pediatric Patients ◽  
Posterior Chamber ◽  
Intraoperative Bleeding ◽  
Iol Implantation ◽  
Secondary Iol Implantation ◽  
Peripheral Iridectomy ◽  
Surgical Incisions ◽  
Posterior Synechiae ◽  
Secondary Intraocular Lens Implantation

Purpose. To introduce an effective method for separating extensive posterior synechiae and those located under or adjacent to surgical incisions. Methods. Pediatric patients who had been subjected to cataract surgery and developed troublesome posterior synechiae requiring secondary intraocular lens (IOL) implantation were recruited. All patients underwent microperipheral iridectomy at the 12 o’clock position. Then, an ophthalmic viscosurgical device was injected into the posterior chamber through the iris fistula to mechanically separate the posterior synechiae, using scissors to cut robust posterior synechiae if necessary. The results of posterior synechiolysis and the position of the implanted IOL were analyzed. Results. Sixteen patients (median age, 51.56 months; range, 28–80 months) were included. The scope of posterior synechia in clock was 4.42 (range, 1–10). All troublesome posterior synechiae were successfully separated using the microperipheral iridectomy method, and all patients underwent IOL implantation in the ciliary sulcus. There was one case of peripheral iridectomy-related early intraoperative bleeding; no bleeding was observed at the end of surgery. Conclusions. Microperipheral iridectomy is a useful method for the management of troublesome posterior synechiae during secondary IOL implantation in pediatric patients, which makes secondary IOL implantation an easier and safer method in some challenging cases.

scholarly journals Comparison of the Techniques of Secondary Intraocular Lens Implantation after Penetrating Keratoplasty

2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Katarzyna Krysik ◽  
Dariusz Dobrowolski ◽  
Ewa Wroblewska-Czajka ◽  
Anita Lyssek-Boron ◽  
Edward Wylegala
Keyword(s):  
Surgical Techniques ◽  
Vitreous Body ◽  
Iol Implantation ◽  
Scleral Fixation ◽  
Lens Extraction ◽  
Secondary Iol Implantation ◽  
Secondary Implantation ◽  
Significant Difference ◽  
Corrected Distance Visual Acuity ◽  
Secondary Intraocular Lens Implantation

Aim. To conduct a retrospective analysis of secondary IOL implantation in patients who underwent PK with no simultaneous IOL implantation. Materials and Methods. The retrospective study of the secondary implantation of IOLs was conducted in 46 eyes that underwent a primary operation with PK and cataract/lens extraction with no IOL implantation due to capsule rupture or combining corneal or intraocular complications. The minimum period from PK was 12 months. All secondary IOL implantations were performed from January 2011 to August 2017. Aphakic postkeratoplasty patients were treated using one of the surgical techniques for secondary IOL implantation. In-the-bag IOL implantation was possible if the posterior capsule was complete. If the lens capsule remnants were sufficient to provide secure IOL support, an in-the-sulcus IOL implantation was performed. Scleral fixation was offered in eyes with extensive capsular deficiency or the presence of the vitreous body in anterior chamber. BCVA and expected and achieved refraction were evaluated; we included using two biometry devices, and results were compared. Results. The corrected distance visual acuity (CDVA) before surgery ranged from 0.1 to 0.8 (mean 0.54 ± 0.17). After secondary IOL implantation, CDVA ranged from 0.2 to 0.8 (mean 0.43 ± 0.14) at postoperative 1 month and from 0.3 to 0.9 (mean 0.55 ± 0.15) at postoperative 6 months (p<0.05). Comparison of the final refraction using two methods of biometry showed no statistically significant difference in the group that underwent scleral fixation of the IOL, similar to the findings for the in-the-bag and in-the-sulcus IOL implantation groups. In the scleral-fixation group, p=0.55 for the USG biometry technique and p=0.22 for the OB technique. p values for the IOL-implantation group were p=0.49 and p=0.44, respectively. Conclusion. Both implantation methods are safe for the patients. Final refraction is depending on the technique and indication to keratoplasty. Both biometry techniques deliver precise data for IOL choice.

scholarly journals Contralateral Posterior Chamber Phakic Intraocular Lens Implantation as Rehabilitation of Refractive Lens Exchange with a Monofocal Intraocular Lens in a Young, Nonpresbyopic, Bilateral Highly-Myopic Patient

2019 ◽  
Vol 2019 ◽  
pp. 1-5 ◽  
Author(s):  
Kepa Balparda ◽  
Claudia Marcela Vanegas-Ramírez ◽  
Laura Segura-Muñoz ◽  
Manuela Gómez-Londoño
Keyword(s):  
Intraocular Lens ◽  
Crystalline Lens ◽  
Posterior Chamber ◽  
Phakic Intraocular Lens ◽  
Short Term ◽  
Corneal Surgery ◽  
Iol Implantation ◽  
Refractive Lens Exchange ◽  
Patient’S Satisfaction ◽  
Refractive Lens

Background. Refractive errors are widespread in the human population; nowadays, numerous surgical options allow for efficient and safe correction them. One of the main elements to ensure success in this kind of intervention will depend on the careful patient and surgical approach selection. Excimer laser corneal surgery is considered by most for low to moderate ametropias. Another option, which has been suggested may be safer, is to cut a small corneal lenticule with femtosecond laser, and then extracting it through a small incision. Nevertheless, in some specific cases, such as patients with high refractive error or those with some corneal abnormality, laser corneal ablations are considered unsafe from either a biomechanical or refractive standpoint. In this kind of particular cases, Phakic Intraocular Lens (P-IOL) implantation constitutes attractive, highly predictable and safe option. Objective. The authors want to show the case of a young high-myopic woman, already pseudophakic in one eye, where the P-IOL implantation in the fellow eye yielded excellent short-term visual results, and high patient’s satisfaction, is presented. Materials. The authors present the case of a 32-years-old, highly myopic female patient underwent a Refractive Lens Exchange (RLE) with a monofocal Intraocular Lens (IOL) implantation in her left eye elsewhere, and developed severe visual issues, especially regarding near-work. Symptoms resolved through the implantation of a posterior chamber P-IOL in the contralateral eye. Results. The postoperative course was unremarkable, inflammation was mild, and visual recovery was quick. There was no need to perform any procedure on her left eye or to use any reading glasses, as unilateral effective near vision through her right eye was enough for all her daily tasks. Conclusions. RLE in young pre-presbyopic highly myopic patients may not be an advisable alternative in most cases, because of the high risks of retinal complications observed. In addition, eliminating accommodation will cause significant limitations, and multifocal IOLs currently available are far from the quality of vision that a young human crystalline lens yields. On the other hand, implantation of a P-IOL is a good option if eye conditions are optimal, as it preserves natural accommodation. In this case an EyeCryl Phakic Toric® IOL showed excellent short-term refractive predictability and safety.

scholarly journals Nucleus Drop or Intraocular Lens Drop Underwent Pars Plana Vitrectomy due to Complication of Cataract Surgery

2019 ◽  
Vol 2 (2) ◽  
Author(s):  
Noviana Kurniasari Vivin ◽  
Ari Djatikusumo ◽  
Elvioza Elvioza ◽  
Gitalisa Andayani ◽  
Anggun Rama Yudantha ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Cataract Surgery ◽  
Intraocular Lens ◽  
Pars Plana Vitrectomy ◽  
Iol Implantation ◽  
Secondary Iol Implantation ◽  
Choice Of Procedure ◽  
Department Of Ophthalmology ◽  
Pars Plana

Abstract Background: The incidence of nucleus drop or intraocular lens (IOL) drop as the complication of phacoemulsification increases due to the increased frequency of phacoemulsification. Pars plana vitrectomy (PPV) followed by endofragmentation and secondary IOL implantation is the choice of procedure for management. This study aims to determine the frequency, outcomes, and complication of PPV in the case of nucleus drop or IOL drop in the Department of Ophthalmology, Fakultas Kedokteran Universitas Indonesia – Rumah Sakit Cipto Mangunkusumo (FKUI-RSCM) Methods: This study is a retrospective descriptive study conducted in the Vitreoretinal Division of the Department of Ophthalmology, FKUI - RSCM. Research data was taken from the medical records of all nucleus drop or IOL drop patients underwent PPV in January 2017-December 2017. Results: There were 19 cases studied. The incidence of nucleus drop occurred in phacoemulsification surgery techniques (94.7%) and ECCE techniques (5.3%). Vitrectomy surgery was performed ≤2 weeks in 31.6% and >2 weeks in 68.4% after the patient first arrived at the vitreoretinal clinic. Most pre-PPV visual acuity was 1/60-6/60 (47.1%). In the final follow-up, visual acuity improved from 6/45 to 6/6 occurred in 42.2% of cases. Complication after PPV and secondary IOL implantation include elevated IOP (10.5%), IOL decentration (5.3%), corneal decompensation (5.3%), macular edema (5.3%), and retinal detachment (5.3%). Conclusion: Nucleus drop or IOL drop generally occurs in phacoemulsification cataract surgery techniques. Improved visual acuity was achieved after PPV and secondary IOL implantation at the end of the follow-up period. Most common post-PPV complication is elevated IOP.  

scholarly journals Prognostic Factors for Low Visual Acuity after Cataract Surgery with Vitreous Loss

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Michael Mimouni ◽  
Michal Schaap-Fogler ◽  
Philip Polkinghorne ◽  
Gilad Rabina ◽  
Rita Ehrlich
Keyword(s):  
Visual Acuity ◽  
Prognostic Factors ◽  
Cataract Surgery ◽  
Intraocular Lens ◽  
Axial Length ◽  
Visual Outcome ◽  
Multivariable Logistic Regression Analysis ◽  
Iol Implantation ◽  
Secondary Iol Implantation ◽  
Vitreous Loss

Purpose. The purpose of this study is to find prognostic factors associated with low visual acuity in patients experiencing vitreous loss during cataract surgery. Methods. A retrospective, noncomparative, interventional, case study of patients experiencing vitreous loss during cataract surgery. Data collected included demographics, best corrected visual acuity (BCVA), axial length (AL), presence of ocular comorbidity affecting central vision, timing of intraocular lens (IOL) implantation, position of the implanted lens, and the presence of corneal sutures. Low visual outcome was defined as BCVA < 20/40. Results. Overall, 179 patients (60.3% males) with a mean age of 73 ± 12 years and axial length of 23.5 ± 1.3 mm with a mean follow-up of 12 ± 13 months were included. In multivariable logistic regression analysis, low visual outcome was independently associated with persisting postoperative complications (OR 6.25, 95% CI 1.378–30.9), preexisting ocular comorbidities (OR 4.45, 95% CI 1.1–18.00), and secondary intraocular lens (IOL) implant (OR 10.36, 95% CI 1.8–60.00). Conversely, pars plana vitrectomy (PPV) for dislocated fragments of lens material, age > 70 years, gender, axial length, degree of surgeon, corneal suturing, and anterior chamber lens implantation were not found to have significant associations with low visual outcomes ( P > 0.05 ). Conclusions. Low visual outcome after vitreous loss during cataract surgery was associated with ocular comorbidities, secondary IOL implantation, development of cystoid macular edema, and additional surgical complications.

scholarly journals Primary and Secondary Intraocular Lens Implantation in Congenital Cataract Surgery: A Retrospective Comparative Study of the Visual Outcomes

2017 ◽  
Vol 1 (1) ◽  
Keyword(s):  
Visual Acuity ◽  
Intraocular Pressure ◽  
Cataract Surgery ◽  
Intraocular Lens ◽  
Congenital Cataract ◽  
Iol Implantation ◽  
Visual Outcomes ◽  
Secondary Iol Implantation ◽  
Myopic Shift ◽  
Congenital Cataract Surgery

Objectives: To compare visual outcomes, principally myopic shift, visual acuity, intraocular pressure and strabismus between primary and secondary intraocular lens (IOL) implantation following congenital cataract surgery. Methods: A retrospective study of the long-term ocular outcomes in primary versus secondary IOL implantation (IOL-I) following congenital cataract surgery was conducted. We analyzed the files of all children with congenital cataract who underwent unilateral or bilateral lensectomy, posterior capsulotomy and anterior vitrectomy followed by primary or secondary IOL-I between 2000 to 2012, at King Abdulaziz University Hospital, Jeddah. Preoperative and postoperative assessment of each operated eye in terms of axial length, refractive errors, strabismus as well as (post IOL-I) intraocular pressure (IOP) and best corrected visual acuity (BC-VA) were collected and analyzed. Results: Data of 26 eyes of 14 patients (9 males, 6 females) was analyzed: 16 (61.5%) eyes underwent lensectomty and anterior vasectomy with primary IOL-I and 10 (38.5%) eyes underwent lumpectomy and anterior vasectomy with secondary IOL-I. Mean age at cataract surgery was 67.53 (± 48.70) months in the group of primary IOL-I versus 5.90 (± 3.72) months in the group of secondary IOL-I; and patients were followed up for 49.33 (± 26.23) versus 86.50 (± 23.36) months, respectively (p=.051). In the secondary IOL-I group, the mean of time from primary lensectomy to IOL-I was 50.44 (± 18.41) months. Last BC-VA showed better outcomes in primary IOL-I group as 10 eyes (83.3%) with good VA versus only 2 eyes (20%) in the secondary IOL-I, (p=0.009). Myopic shift was greater in secondary IOL group 10.86 (± 11.62) versus 0.19 (± 2.38) diopters (D) in primary IOL (p=0.046*); while no significant difference was observed in IOP (p=0.697). No case of isotropic was detected in primary versus 6 cases in the secondary IOL group. Conclusion: Visual outcomes, including visual acuity, strabismus and myopic shift were better in the group of children who underwent primary IOL implantation at age of >2 years, when compared to those with secondary IOL implantation at the age of <2 years, following congenital cataract surgery. However, poor visual acuity in the secondary IOL group was mainly explained by the relatively higher prevalence of eye complications in this group.

scholarly journals Complication of foldable single-piece intraocular lens sulcus implantation in a child under two years old

2020 ◽  
Vol 1 (4) ◽  
pp. 295-300
Author(s):  
Julie Dewi Barliana
Keyword(s):  
Anterior Chamber ◽  
Intraocular Lens ◽  
Corneal Endothelium ◽  
Inflammatory Process ◽  
Posterior Chamber ◽  
Iol Implantation ◽  
Single Piece ◽  
Shallow Anterior Chamber ◽  
One Year ◽  
Corneal Diameter

A two-and-a-half-year-old boy presented to Cipto Mangunkusumo Hospital, Jakarta, Indonesia with a white spot on his left eye. He had cataract surgery one year prior at another hospital. On examination, corectopia, anterior synechiae, white plaque between the iris and corneal endothelium, a shallow anterior chamber, and an intraocular lens (IOL) in the posterior chamber were found. As a result, anterior chamber reformation and IOL explantation was performed. Intraoperatively, a foldable single-piece IOL was found in the ciliary sulcus. Hence, extreme inflammatory process after the operation was unavoidable. One month after the procedure, the cornea was opaque without an increase in intraocular pressure. It is recommended to perform IOL implantation only in children over two years of age with a corneal diameter more than 9 mm. A three-piece IOL might be implanted in the area of the ciliary sulcus only if the child needs an immediate IOL implant.

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