scholarly journals Standardized Flanged Intrascleral Intraocular Lens Fixation with the Double-Needle Technique for Cataract Luxation in the Vitreous Chamber during Phacoemulsification

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
Gianluca Besozzi ◽  
Chiara Posarelli ◽  
Maria Carmela Costa ◽  
Alessio Montericcio ◽  
Giuseppe Nitti ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Endothelial Cell ◽  
Cell Count ◽  
Intraocular Lens ◽  
Spherical Equivalent ◽  
Refractive Outcome ◽  
Endothelial Cell Count ◽  
Corrected Visual Acuity ◽  
Target Refraction ◽  
Best Corrected Visual Acuity

Purpose. To assess the visual and refractive outcome of immediate intraoperative vitrectomy and intrascleral intraocular lens implantation using a “standardized” sutureless Yamane technique during cataract luxation in the vitreous chamber as a complication of phacoemulsification. Design. A prospective, interventional, consecutive case series. Materials and Methods. Twelve patients underwent vitrectomy and intrascleral intraocular lens fixation using a standardized Yamane technique as the primary procedure during complicated phacoemulsification. Patients were evaluated preoperatively and 6 months postoperatively for best-corrected distance visual acuity, correspondence to the preoperative refractive target in the spherical equivalent, endothelial cell count, and complications. Results. Mean preoperative best-corrected visual acuity was 1.16 ± 0.3 logarithm of the minimum angle of resolution (logMAR), the endothelial cell count was 1910.5 ± 297.64, and target refraction at baseline was −0.197 ± 0.087. Postoperatively, best-corrected visual acuity was significantly improved; the mean value was 0.05 logMAR ± 0.06. Mean baseline target refraction in the spherical equivalent was −0.20 ± −0.09 (range: −0.08 to −0.37), and mean final refraction was −0.44 ± −0.14 (range: −0.25 to −0.75) with no significant difference p = 0.87 . No complication was registered intra- and postoperatively. Conclusion. Standardization of the Yamane technique seemed a valuable option for patients who had complicated phacoemulsification to achieve a predictable refractive outcome. Synopsis. The predictable refractive outcome could be achieved with the immediate standardized Yamane technique in patients with intraoperative cataract luxation in the vitreous chamber during phacoemulsification.

scholarly journals Visual Outcome of Descemet Membrane Endothelial Keratoplasty during the Learning Curve in Initial Fifty Cases

2019 ◽  
Vol 2019 ◽  
pp. 1-7
Author(s):  
Sanjay K. Singh ◽  
Sanjeeta Sitaula
Keyword(s):  
Visual Acuity ◽  
Endothelial Cell ◽  
Learning Curve ◽  
Cell Count ◽  
Endothelial Keratoplasty ◽  
Descemet Membrane Endothelial Keratoplasty ◽  
Descemet Membrane ◽  
Endothelial Cell Count ◽  
Corrected Visual Acuity

This study was performed to evaluate the clinical outcomes of the first fifty patients who underwent Descemet membrane endothelial keratoplasty (DMEK) during the 3-month postoperative period and to describe the challenges encountered during the learning curve. In this retrospective study, we reviewed the charts of patients who underwent DMEK. All information regarding patient demographics, indication for surgery, preoperative and postoperative visual acuity at 3 months, donor age, and complications encountered intraoperatively and postoperatively was recorded. Donor endothelial cell count at the time of surgery and during the 3-month follow-up was noted. Data were analyzed using SPSS version 17. Fifty eyes of 49 patients were included in the study with majority being female patients (male : female = 2 : 3). Mean age of patients was 56.8 ± 11.4 years with the age range of 22–78 years. The common indications for DMEK were pseudophakic bullous keratopathy –57.1%, Fuchs endothelial dystrophy-34.7%, failed grafts-6.1% (Descemet stripping endothelial keratoplasty (DSEK) and failed penetrating keratoplasty), and others. Preoperative best spectacle-corrected visual acuity was <20/400 in 88% cases. Postoperative best spectacle-corrected visual acuity at 3 months was >20/63 in 41.8% of the cases, and 93% had visual acuity of 20/200 or better. Donor size was 8 mm, and average donor endothelial cell count (ECC) was 2919 ± 253 cells/mm2. Average ECC at 3 months postoperatively was 1750 ± 664 cells/mm2, which showed a 40% decrease in ECC. The most common encountered complication was graft detachment, which occurred in 16% cases for which rebubbling was done. Regular follow-up and timely identification of graft detachment may prevent the need for retransplantation.

scholarly journals Management of Corneal Ectasia after LASIK with Phototherapeutic Keratectomy Combined with Photorefractive Keratectomy and Collagen Cross-Linking

2019 ◽  
Vol 2019 ◽  
pp. 1-7
Author(s):  
Weiyan Zhou ◽  
Hongya Wang ◽  
Xiao Zhang ◽  
Mingxia Tian ◽  
Changxia Cui ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Endothelial Cell ◽  
Cell Count ◽  
Cross Linking ◽  
Spherical Equivalent ◽  
Corneal Ectasia ◽  
Corneal Haze ◽  
Endothelial Cell Count ◽  
Spherical Equivalent Refraction ◽  
Collagen Cross Linking

Background. To evaluate the efficacy of phototherapeutic keratectomy (PTK) combined with photorefractive keratectomy (PRK) and riboflavin with ultraviolet-A collagen cross-linking (CXL), performed sequentially on the same day, in the management of corneal ectasia after LASIK. Methods. This retrospective review comprised consecutive patients with corneal ectasia after LASIK. The patients were administered PTK and PRK on the previous corneal flap, and CXL was given on the same day by the same surgeon. The main outcome measures included age, sex, uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), spherical equivalent refraction, cylinder equivalent refraction, steep and flat keratometries (K), central corneal thickness (CCT), endothelial cell count, corneal haze, and ectasia stability. Mean follow-up period was 6, 12, and 24 months. Results. Sixteen eyes of twelve patients were included in the study. Twenty-four months after administration of PTK combined with PRK and CXL, a significant improvement in UDVA was observed. Mean cylinder equivalent refraction was significantly reduced at 6, 12, and 24 months postoperatively. However, no significant reduction was observed in spherical equivalent refraction. A significant reduction in the flat K and steep K values was observed. No significant change in mean CCT value was observed. Mean endothelial cell count and morphology were unchanged between preoperative and postoperative patients. In addition, no obvious corneal haze was observed. Conclusions. PTK combined with PRK and CXL on the same day is a safe and effective treatment in improving visual acuity in selected patients with corneal ectasia after LASIK.

scholarly journals Outcomes of Re-fixation after the First Intraocular Lens Scleral Fixation

2021 ◽  
Vol 62 (9) ◽  
pp. 1189-1197
Author(s):  
Seung Kwan Nah ◽  
Jong Woo Kim ◽  
Chul Gu Kim ◽  
Jae Hui Kim
Keyword(s):  
Visual Acuity ◽  
Intraocular Pressure ◽  
Intraocular Lens ◽  
Spherical Equivalent ◽  
Scleral Fixation ◽  
Corrected Visual Acuity ◽  
Second Surgery ◽  
Iol Fixation ◽  
Best Corrected Visual Acuity ◽  
Iol Exchange

Purpose: To investigate the outcomes of re-fixation after the first intraocular lens (IOL) scleral fixation. Methods: We retrospectively reviewed the charts of patients who underwent second IOL scleral fixation and vitrectomy for dislocation of IOL after the first IOL scleral fixation. We compared the best-corrected visual acuity (BCVA) and spherical equivalent (SE) after 1 month of the first and second surgery, and noted the complications. Results: We included 21 eyes that underwent second IOL scleral fixation: 13 eyes (61.9%) with IOL exchange and eight (38.1%) with one-haptic fixation. Mean BCVAs (LogMAR) were 0.17 ± 0.25 and 0.11 ± 0.23 after the first and second surgery, respectively (<i>p</i> = 0.073); mean SEs were -0.94 ± 1.69 and -0.58 ± 1.46 diopters after the first and second surgery, respectively (<i>p</i> = 0.076). Postoperative complications occurred in eight eyes (38.1%), including temporarily increased intraocular pressure and suture knots exposure. However, none of the complications required re-operation. Conclusions: The outcomes of primary and secondary IOL fixation were similar, and there were no serious complications of the second surgery.

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 Corneal Neovascularization and Lipid Keratopathy after Intacs SK in Keratoconus

2013 ◽  
Vol 2 (3) ◽  
pp. 133-138
Author(s):  
Ramez Barbara ◽  
David Zadok ◽  
Adel Barbara ◽  
Shay Gutfreund
Keyword(s):  
Visual Acuity ◽  
Penetrating Keratoplasty ◽  
Corneal Neovascularization ◽  
Young Female ◽  
Spherical Equivalent ◽  
Corrected Visual Acuity ◽  
Optical Zone ◽  
Positive Results ◽  
Oval Shape ◽  
Best Corrected Visual Acuity

ABSTRACT Intacs have yielded positive results for the treatment of keratoconus in terms of reducing the keratometry readings astigmatism and spherical equivalent and consequently improving the uncorrected and best corrected visual acuity. Intacs severe keratoconus (SK) are new design of Intacs with a smaller optical zone (6 mm) and oval shape, they are indicated for severe keratocnus. Pannus is one of the complications of Intacs, as it has never been reported after Intacs SK. We report on corneal neovascularization in the corneal periphery which developed few months after Intacs SK implantation in the cornea of a young female who suffered from advanced keratoconus. The uncorrected visual (UCVA) acuity was satisfactory and the Intacs SK where not removed. Four years after the implantation she presented to our clinic complaining about eye irritation and photophobia, lipid keratopathy was observed. We gave here the choice of explanting the Intacs SK or to try to treat the neovascularization by subconjunctival Avastin, she preferred the second option because of a satisfactory UCVA (0.9). Avastin was injected in the subconjunctival, 10 weeks later Avastin and Kenelog were injected in the subconjunctival, few days after the second injection perforation and melting developed in the cornea, the patient underwent a tectonic graft and few months later penetrating keratoplasty with no intraoperative or postoperative complications. How to cite this article Barbara A, Zadok D, Gutfreund S, Barbara R. Corneal Neovascularization and Lipid Keratopathy after Intacs SK in Keratoconus. J Kerat Ect Cor Dis 2013;2(3):133-138.

scholarly journals Clinical differences between toric intraocular lens (IOL) and monofocal intraocular lens (IOL) implantation when myopia is determined as target refraction

2020 ◽  
Author(s):  
Da young Shin ◽  
Ho Sik Hwang ◽  
Hyun Seung Kim ◽  
Man Soo Kim ◽  
Eun Chul Kim
Keyword(s):  
Visual Acuity ◽  
Intraocular Lens ◽  
Corneal Astigmatism ◽  
Spherical Equivalent ◽  
Toric Intraocular Lens ◽  
Toric Iol ◽  
Iol Implantation ◽  
Monofocal Iol ◽  
Target Refraction ◽  
Better Than

Abstract Background: To analyze and compare the clinical results of toric intraocular lens (IOL) and monofocal IOL implantation when the target refraction value is determined -3 diopter (D) in cataract patients with corneal astigmatism >1.5 diopters (D).Methods: We performed a retrospective chart review for patients with corneal astigmatism >1.5D who underwent cataract surgery and their target refraction is determined -3D. 100 eyes (100 patients; monofocal IOL, 60; toric IOL, 40) were enrolled in the current study. Near and distant uncorrected visual acuity (UCVA), corrected VA, spherical equivalent and refractive, corneal astigmatism were evaluated before and after surgery.Results: The near UCVA of the toric IOL group (0.26±0.33) after cataract surgery was significantly better than that of the monofocal IOL group (0.48±0.32) (p=0.030). The distant UCVA of the toric IOL group (0.38 ± 0.14) was also significantly better than that of the monofocal IOL group (0.55 ± 0.22) (p = 0.026). There were no significant intergroup differences in postoperative best-corrected visual acuity (p = 0.710) and mean spherical equivalent (p = 0.465). In the toric IOL group, postoperative refractive astigmatism was -0.80 ± 0.46D and postoperative corneal astigmatism was -1.50 ± 0.62D, whereas the corresponding values in the monofocal IOL group were -1.65 ± 0.77D and -1.45 ± 0.64D; residual refractive astigmatism was significantly lower with toric IOL implantation compared with monofocal IOL implantation (p = 0.001). Conclusions: When myopic refraction such as -3D was determined as the target power in patients with corneal astigmatism, toric IOL implantation led to excellent improvement in both near and distant UCVA.

scholarly journals Retro-pupillary iris fixated intraocular lens: A boon to aphakia

2021 ◽  
Vol 7 (2) ◽  
pp. 415-418
Author(s):  
Subramanya K Giliyar ◽  
Ravi Bypareddy ◽  
Kamakshi N Moger ◽  
Vinutha Moger ◽  
Deeksha Bekal
Keyword(s):  
Visual Acuity ◽  
Intraocular Pressure ◽  
Intraocular Lens ◽  
Simple Procedure ◽  
Visual Outcome ◽  
Secondary Outcome ◽  
Corrected Visual Acuity ◽  
Corneal Decompensation ◽  
Best Corrected Visual Acuity ◽  
Capsular Support

To evaluate post operative visual outcome and complications of retro-pupillary iris fixated Intracoular lens (IOL) in aphakia. This is a prospective interventional case study conducted at our tertiary eye care centre from March 2018 to February 2019 All monocular aphakias secondary to any cause with no capsular support, good iris diaphragm support and BCVA of better than 6/60 were included. Patients who required combined procedures like trabeculectomy and retinal procedure were excluded. Patients with poor endothelial count/ corneal decompensation, any posterior segment pathologies, pre existing glaucoma and any form of uveitis were also excluded from the study. Pre operative visual acuity, slit lamp examination and fundus examination were carried out. Anterior vitrectomy and retropupillary fixation of iris claw lens were done. The primary outcome was to assess the post operative visual acuity and secondary outcome was to analyse post operative complications at various intervals up to 6 months after surgery. Our study comprised of thirty eyes of 30 aphakic patients. RPIFIOL was inserted as primary intraocular lens in 18 patients (%) and secondary intraocular lens in 12 patients(%). Baseline best corrected visual acuity was 0.831±0.66 logMAR. Four patients had light perception at baseline. The mean best corrected visual acuity was 0.77±0.35 logMAR at month 1, 0.64±0.36logmAR at month 3 and 0.53±0.33logmAR at month 6 respectively. Mean intraocular pressure at baseline was 16mmHg. Mean intraocular pressure at month 1, 3 and 6 were 17mmHg, 16mmHg, and 16mmHg. Among the complications, twelve eyes (40%) had significant ovalisation of pupil at post operative month 1 which persisted at month 6, two eyes(6.66%) had transient ocular hypertension (OHT), and none of the eyes progressed to glaucoma. Choroidal detachment was noted in 2 eyes (6.66%), CME in 3 eyes (9.99%), 1 eye (3.33%) had retinal detachment and 2 eyes (6.66%) had one haptic disenclavation. Among the complications, ovalisation of pupil was the most common observed one. Retro-pupillary Iris fixated IOL is an effective, safe and simple procedure for management of aphakia in eyes with no posterior capsular support.

scholarly journals Clinical differences between toric intraocular lens (IOL) and monofocal intraocular lens (IOL) implantation when myopia is determined as target refraction

2020 ◽  
Author(s):  
Da young Shin ◽  
Ho Sik Hwang ◽  
Hyun Seung Kim ◽  
Man Soo Kim ◽  
Eun Chul Kim
Keyword(s):  
Visual Acuity ◽  
Intraocular Lens ◽  
Corneal Astigmatism ◽  
Spherical Equivalent ◽  
Toric Intraocular Lens ◽  
Toric Iol ◽  
Iol Implantation ◽  
Monofocal Iol ◽  
Target Refraction ◽  
Better Than

Abstract Background: The aim of this study is to analyze and compare the clinical results of toric intraocular lens (IOL) and monofocal IOL implantation when the target refraction value is determined -3 diopter (D) in cataract patients with corneal astigmatism >1.5 diopters (D).Methods: We performed a retrospective chart review for patients with corneal astigmatism >1.5D who underwent cataract surgery and their target refraction is determined -3D. 100 eyes (100 patients; monofocal IOL, 60; toric IOL, 40) were enrolled in the current study. Near and distant uncorrected visual acuity (UCVA), corrected VA, spherical equivalent and refractive, corneal astigmatism were evaluated before and after surgery.Results: The near UCVA of the toric IOL group (0.26±0.33) after cataract surgery was significantly better than that of the monofocal IOL group (0.48±0.32) (p=0.030). The distant UCVA of the toric IOL group (0.38 ± 0.14) was also significantly better than that of the monofocal IOL group (0.55 ± 0.22) (p = 0.026). There were no significant intergroup differences in postoperative best-corrected visual acuity (p = 0.710) and mean spherical equivalent (p = 0.465). In the toric IOL group, postoperative refractive astigmatism was -0.80 ± 0.46D and postoperative corneal astigmatism was -1.50 ± 0.62D, whereas the corresponding values in the monofocal IOL group were -1.65 ± 0.77D and -1.45 ± 0.64D; residual refractive astigmatism was significantly lower with toric IOL implantation compared with monofocal IOL implantation (p = 0.001). There were no postoperative complications and no adverse events were reported.Conclusions: When myopic refraction such as -3D was determined as the target power in patients with corneal astigmatism, toric IOL implantation led to excellent improvement in both near and distant UCVA.

27-gauge trocar-assisted transconjunctival sutureless intraocular lens scleral fixation

2020 ◽  
pp. 112067212091906
Author(s):  
David Vladimir Diamint ◽  
Juan Martin Giambruni
Keyword(s):  
Visual Acuity ◽  
Cataract Surgery ◽  
Intraocular Lens ◽  
Posterior Chamber ◽  
Surgery Complications ◽  
Scleral Fixation ◽  
Sutureless Technique ◽  
Corrected Visual Acuity ◽  
Cataract Surgery Complications ◽  
Best Corrected Visual Acuity

Objective To present the surgical outcome of posterior chamber intraocular lens scleral fixation using a 27-gauge trocar-assisted transconjunctival sutureless technique in aphakic patients due to cataract surgery complications with inadequate capsular support. Methods Six consecutive patients with aphakia due to cataract surgery complications with inadequate capsular bag support were operated by two surgeons. Intraocular lens scleral fixation was performed with a 27-gauge trocar-assisted transconjunctival sutureless technique. Patients were followed-up for 12 months. Preoperative and postoperative best-corrected visual acuities were assessed with Early Treatment Diabetic Retinopathy Study charts and expressed in decimals. Results All patients showed statistically significant best-corrected visual acuity improvement and excellent anatomic results. Mean preoperative best-corrected visual acuity was 0.17 (range of 0.1–0.2). Mean postoperative best-corrected visual acuity was 0.84 (range of 0.63–1.00). Mean initial spherical equivalent refractive error was +11.85 (range of +9.00 to +15.00). Mean final spherical equivalent refractive error was –0.25 (range of –1.25 to +2.25). There were no postoperative complications during the whole follow-up. Conclusion Fixation of a posterior chamber intraocular lens using a 27-gauge trocar-assisted transconjunctival sutureless intrascleral technique is an excellent option for aphakic patients secondary to cataract surgery complications with inadequate capsular support.

scholarly journals Visual outcome following scleral fixated intraocular lens implantation

2017 ◽  
Vol 16 (2) ◽  
pp. 63-68
Author(s):  
Chunu Shrestha ◽  
Sabina Shrestha ◽  
Aparajita Manoranjan
Keyword(s):  
Visual Acuity ◽  
Intraocular Lens ◽  
Visual Outcome ◽  
Posterior Chamber ◽  
Visual Rehabilitation ◽  
Post Surgery ◽  
Corrected Visual Acuity ◽  
The Common ◽  
Best Corrected Visual Acuity ◽  
Scleral Fixated Intraocular Lens

Introduction: Scleral fixated intraocular lens(SFIOL) implantation to correct aphakia offers superior visual rehabilitation in comparison to aphakic spectacles or contact lens. This study was done to evaluate a simplified technique of scleral fixation of posterior chamber intra-ocular lens (IOL) in terms of visual outcome and complications.Methods: This was a prospective study enrolling 23 eyes of 23 patients who underwent anterior vitrectomy followed by ab-externo sclera fixation of posterior chamber IOL using 10.0 polypropylene sutures from January 2016 to February 2017 in Nepal Eye Hospital.Scleral flap was made at 3 and 9'o clock meridian to cover the knots which prevent erosion of the knots through conjunctiva.  Main outcome measures were post-operative best corrected visual acuity and post-operative complications.Result: Best corrected visual acuity were 6/6 - 6/18 in 86.9% (n=20), 6/24 - 6/60 in 8.7% (n=2) and worse than 6/60 in 4.3% (n=1)at six months followup. The mean spherical equivalent before surgery was +10.60 diopter and -1.14 diopter post-surgery. The common indicationsfor scleral fixated intraocular lens weretrauma in 60.86% (n=14), surgical aphakia in21.73% (n=5), spontaneous posterior dislocation of lens in 13.0% (n=3) and subluxated intraocular lens in 4.34% (n=1). The common complications were astigmatism in 91.30% (n=21), decentered IOL in 4.34% (n=1) and uveitis in 4.35% (n=1).Conclusion: Ab-externosclerated fixated intraocular lens is a safe and effective method for visual rehabilitation with low post-operative risk.

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