scholarly journals Bilateral Toric Phakic Intraocular Lens Implantation for Correction of High Myopic Astigmatism in a Patient with Marfan Syndrome with Lens Coloboma: A Case Report

2021 ◽  
pp. 208-213
Author(s):  
Bhupesh Singh ◽  
Sourabh Sharma ◽  
Suchit Dadia ◽  
Neha Bharti ◽  
Sudhank Bharti
Keyword(s):  
Visual Acuity ◽  
Marfan Syndrome ◽  
Intraocular Lens ◽  
Refractive Error ◽  
Treatment Options ◽  
Complication Rates ◽  
Phakic Intraocular Lens ◽  
High Loss ◽  
Error Treatment ◽  
The Right

Marfan syndrome (MFS) is known to cause significant refractive error. Treatment options are limited in this condition for correcting refractive error. Clear lens exchange is done in these cases, but complication rates are high. Loss of accommodation is another concern in these young adults. We report toric phakic intraocular lens (pIOL) implantation in improving the uncorrected visual acuity (UCVA) in a known case of MFS with lens coloboma. A 22-year-old female patient with MFS with inferior lens coloboma underwent bilateral toric pIOL implantation in the same sitting. Pre- and post-operative UCVA and best-corrected visual acuity were assessed. Central and peripheral vaulting of the pIOL in relation to the natural lens was also assessed. UCVA improved from 20/500 to 20/20 in the right and 20/550–20/20 in the left eye. Marked central vaulting with partial peripheral vaulting was achieved. There were no post-operative complications. Phakic IOL implantation surgery could be an effective approach to achieve excellent uncorrected refractive outcome in patients with MFS to treat high myopia.

scholarly journals Postsurgical Cystoid Macular Edema following Posterior Chamber Toric Phakic Intraocular Lens Implantation Surgery: A Case Report

2015 ◽  
Vol 6 (2) ◽  
pp. 223-227 ◽  
Author(s):  
Julide Canan Umurhan Akkan ◽  
Kemal Tuncer ◽  
Ahmet Elbay
Keyword(s):  
Visual Acuity ◽  
Case Report ◽  
Macular Edema ◽  
Intraocular Lens ◽  
Cystoid Macular Edema ◽  
Posterior Chamber ◽  
Phakic Intraocular Lens ◽  
Distance Visual Acuity ◽  
Initial Surgery ◽  
The Right

Purpose: To describe a case of cystoid macular edema (CME) developing after posterior chamber toric phakic intraocular lens (PIOL) implantation. Methods: Case report. Results: A 33-year-old male underwent implantation of toric implantable collamer lenses (ICL), a new generation of PIOLs, for both eyes. Preoperative best spectacle-corrected distance visual acuity (BCVA) was 20/25 in the right eye and 20/32 in the left eye, with a manifest refraction of -9.25 -4.0 × 4° and -9.75 -4.25 × 171°, respectively. On day 1 postoperatively, the left eye had an uncorrected distance visual acuity (UDVA) of 20/60 with a refraction of +2.0 -3.5 × 11°. Despite the rotation of the PIOL, the cylindrical refractive component persisted in the left eye with a refraction of +2.0 -3.5 × 11°. Two weeks after the initial surgery, he presented with a decrease in his visual acuity in the left eye. The UDVA and BCVA were both 20/100 in the left eye with a refraction of +2.0 -4.25 × 3°. Dilated fundus examination and macular optical coherence tomography revealed a CME in the left eye. Following topical nepafenac therapy and explantation of the ICL, we observed a complete resolution of the CME at 3 months with an improvement in BCVA to 20/32 in the left eye. Conclusions: To our knowledge, this is the first reported case of postsurgical CME following toric ICL implantation. In cases of phakic eyes with an intact posterior capsule, postsurgical CME can develop, thus highlighting the purpose of this report.

scholarly journals Off-Label Use of Phakic Intraocular Lens with a “Piggyback” Technique

2018 ◽  
Vol 9 (3) ◽  
pp. 465-472 ◽  
Author(s):  
Tadgh Schempf ◽  
Hoon C. Jung
Keyword(s):  
Visual Acuity ◽  
Intraocular Lens ◽  
Posterior Chamber ◽  
Off Label Use ◽  
Phakic Intraocular Lens ◽  
Fellow Eye ◽  
Off Label ◽  
Label Placement ◽  
The Right ◽  
Label Use

Purpose: We report a case of a highly myopic pseudophakic patient who received off-label placement of a phakic intraocular lens (pIOL) via a “piggyback” technique, allowing the placement of an intraocular lens (IOL) in his fellow eye, resulting in improved visual acuity and emmetropia. Case Report: A 66-year-old, highly myopic, pseudophakic male with an IOL implant in his left eye was referred for second opinion for surgical options for his phakic right eye. Given the severe myopic status of both eyes, he received off-label placement of a posterior chamber pIOL with a piggyback technique for the pseudophakic left eye followed by standard cataract surgery and intraocular lens implantation in the right eye. For the left eye, uncorrected best visual acuity improved from 20/70 to 20/25. Conclusion: This case demonstrates the successful off-label use of a phakic IOL in a pseudophakic, highly myopic patient with a piggyback technique, resulting in improved visual acuity and ultimately allowing IOL placement in the fellow eye for emmetropia. This off-label use of pIOL can offer ophthalmologists an alternative option for pseudophakic patents with severe refractive error.

Clinical case of phakic intraocular lens rotation

2021 ◽  
pp. 50-53
Author(s):  
Y.V. Belonozhenko ◽  
◽  
T.K. Semenova ◽  
S.V. Krivko ◽  
A.E. Lugovskoy ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Intraocular Lens ◽  
Clinical Case ◽  
Clinical Signs ◽  
Vertical Position ◽  
Phakic Intraocular Lens ◽  
Ciliary Processes ◽  
Uncorrected Visual Acuity ◽  
The Right ◽  
Preoperative Examination

Purpose. To analyze causes of the emerged postoperative rotation of the phakic intraocular lens (PIOL) of the IPCLT V2.0 model, to assess the effectiveness of its elimination and the outcomes. Clinical case. Patient A., 42 years old. Clinical diagnosis: High myopia, chorioretinal form, direct corneal astigmatism in both eyes. The combination of thin cornea with limbal vascularization did not allow to perform for him photorefractive surgery. The implantation of PIOL IPCLT V2.0 model was performed according to the method recommended by the manufacturer. On the first day after the operation, the position of the PIOL was correct in both eyes. Indicators of uncorrected visual acuity significantly increased from initial 0.01–0.02 to 0.4–0.5. The best corrected visual acuity also increased, amounting to 0.7–0.9 for the right/left eye, respectively. 1.5 months after the operation, the patient complained of a decrease and the appearance of instability in visual acuity in both eyes. Biomicroscopic examination revealed the PIOL rotation along the plane from a horizontal to a vertical position. Conclusion. At the stage of preoperative examination, special attention should be paid to the presence of circular symmetry of the zonule of Zinn attachment to the ciliary processes and to the lens capsule. Such indirect clinical signs as prolapse of the iris, asymmetry of the distances «ciliary processes – the edge of the lens» may indicate the presence of individual unfavorable anatomical features of the shape of the eye, which with high probability can lead to displacement or rotation of the PIOL IPCLT V2.0 model. Key words: myopia, phakic intraocular lens (PIOL), PIOL IPCLT V2.0 model.

scholarly journals Early Results with a New Posterior Chamber Phakic Intraocular Lens in Patients with High Myopia

2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Dilek Yaşa ◽  
Ufuk Ürdem ◽  
Alper Ağca ◽  
Yusuf Yildirim ◽  
Burçin Kepez Yildiz ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Endothelial Cell ◽  
Intraocular Lens ◽  
High Myopia ◽  
Posterior Chamber ◽  
Phakic Intraocular Lens ◽  
Phakic Iol ◽  
Distance Visual Acuity ◽  
Early Results ◽  
Manifest Refraction

Purpose. To report clinical results of a foldable, hydrophilic acrylic, single-piece, injectable, posterior chamber phakic intraocular lens (pIOL).Material and Methods. Medical records of patients who underwent posterior chamber phakic IOL (Eyecryl Phakic IOL, Biotech Vision Care, Ahmedabad, India) implantation for surgical correction of myopia were retrospectively reviewed. Only patients with at least a one-year follow-up were included. Manifest refraction, uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), endothelial cell density (ECD), and pIOL vault were analyzed at 1, 3, 6, and 12 months after surgery. Complications observed during and after surgery were also recorded.Results. The study included 58 eyes of 29 patients. Mean patient age was 32 ± 7 years. Spherical equivalent of manifest refraction was −13.41 ± 3.23 D preoperatively and −0.44 ± 0.55 D postoperatively. Preoperative CDVA was 0.29 ± 0.71 logMAR. Postoperative UDVA and CDVA were 0.21 ± 0.66 and 0.15 ± 0.69 logMAR, respectively, at the 12-month visit. At the 12-month visit, the efficacy index was 1.20 and the safety index was 1.39. Mean ECD was 2713 ± 339 cells/mm2at the preoperative visit and 2608 ± 362 cells/mm2at the 12-month visit (3.9% loss,p<0.001). ECD loss from 3 months to 12 months was not statistically significant. No significant cataract formation, significant endothelial cell loss, glaucoma, uveitis, or any other vision-threatening complication was observed.Conclusion. Based on postoperative experience, we have found that Eyecryl Phakic IOL is safe and effective for treating high myopia.

Visual Acuity, Intraocular Pressure, and Macular Thickness in Patients Undergoing Dialysis

2021 ◽  
Vol 19 (6) ◽  
pp. 98-106
Author(s):  
Monawar Muhsin Jabr ◽  
Hussain S. Hasan ◽  
Hind Ahmed Mahdi
Keyword(s):  
Chronic Kidney Disease ◽  
Visual Acuity ◽  
Intraocular Pressure ◽  
Standard Deviation ◽  
Kidney Disease ◽  
Refractive Error ◽  
Average Thickness ◽  
Foveal Thickness ◽  
Central Foveal Thickness ◽  
The Right

Background: Chronic kidney disease (CKD) is a public health problem over all the world. CKD may also be defined by the presence of kidney damage or a reduced glomerular filtration rate (GFR), which is the best overall indicator or index of kidney function. CKD patients are usually treated using kidney dialysis (hemodialysis) that uses a blood filtration mechanism (HD). Several metabolic parameters, such as blood urea, sodium, potassium, and glucose levels, can alter during HD. Osmotic alterations in blood, aqueous and vitreous humor, and other extracellular fluids arise from these fluctuations. That also can affect visual acuity, intraocular pressure (IOP), and retinal thickness. Aim of the Study: To evaluate some of the ocular findings undergoing HD to keep prevent the loss of patient vision such as visual acuity (VA), intraocular pressure (IOP), central corneal thickness (CCT), central Foveal Thickness (CFT), retinal nerve fiber layer (RNFL). Patient& Methods: This is a cohort (prospective) design study. This study including Seventy nine patients divided into two groups the first group from one week to six month (9 femal & 18 males) another group over than six month (36 female & 16 male) the average age between (12 to 70 years). This research performed in the three places department of the eye in Al-Hussein hospital in Samawah city, Al-Haboby hospital, Al-Hussein hospital in Dhi Qar city finally in Al-Shaheed Gazy hospital and Baghdad teaching hospital in Baghdad. Examining Visual Acuity by Snellen chart & auto refractometer, IOP& CCT by (CT.1 Computerized Tonometer TOPCON), RNLF and Central Foveal Thickness by OCT (Carl ZEISS, TOPCON). The inclusion criteria were as follows: all the patients undergoing dialysis from one week to over six months. Exclusion criteria were as follows: the patients have diabetic, any patients have a hereditary disease or glaucoma history or laser therapy, or intraocular injection in the eye before dialysis, the patients have a problem in the eye before dialysis such as cataracts or opacity leads to does surgery, the patients who have a refractive error or wear glass had been also excluded. Result: Includes the results of seventy-nine patients (45 females and 34 males) with chronic kidney disease examined ocular findings before a session of dialysis divided into two groups based on their duration of dialysis. Group one with twenty-seven patients (9 female & 18 male) under dialysis from one week to six months with mean & standard deviation (3.2037, ± 1.89259), group tow with fifty tow patients (36 female & 16 male) under dialysis from the duration over than six months with mean & standard deviation (44.2308, ± 26.24367) respectively. Patients aged (12 to 70 years) had mean age & ± standard deviation (35.1481, ± 12.88918), (44.4038, ± 15.42249) for two groups respectively. Patients in two groups had IOP (Right eye), its mean & standard deviation (15, ± 2.34), (15.69, ± 2.56) for group one & group tow respectively. Also, patients had CCT (Right eye) with mean & standard deviation (5.3467E2, ± 39.00296), (5.2312E2, ± 30.44162) for group one & group tow respectively. Patients had CCT (Left) with mean & standard deviation (5.2878E2, ± 37.55748), (5.2179E2, ± 29.58957) for group one & group tow respectively. Patients in two groups had average thickness RNFL (Right eye) with mean & standard deviation (1.0604E2, ± 25.17551), (95.6154, ± 21.27150) for group one & group tow respectively. Also, patients had average thickness RNFL (left eye) with mean & standard deviation (1.0930E2, ±23.80177), (98.7500, ± 23.77334) for group one & group tow respectively. Conclusions: This study found CCT effective with dialysis tend to be thin (53 patient,18 patient in group one &35 in group two) and that will be had a threefold higher risk of developing glaucoma when compared with thick average because of the IOP value affected by it. Refractive error effective with dialysis & become was more prominent that can be shown in the group two have (40 patient from 52) while (15 patient from27) in the group one although a lot of them corrected to the BCVA. In conclusion high value of the C/D ratio formed about (45.57%, 53.16%) to the right &left eye respectively this value will be form important sign of risk factor to progressive of glaucomatous need to be alert in the future. Also our research reveals CFT effective undergoing dialysis the thick value was (56 in the right eye, 55 in the left eye) high compared with the thin (9 in the right&9 in the left eye) & normal (14 in the right eye, 15 in the left eye). All the two groups of patients will be effected by the duration of dialysis with a time.

scholarly journals Comparisons of Visual and Surgical Outcomes after Reuse or Replacement of Dislocated in-the-Bag Intraocular Lens

2018 ◽  
Vol 2018 ◽  
pp. 1-4 ◽  
Author(s):  
Takayuki Baba ◽  
Tomohiro Nizawa ◽  
Toshiyuki Oshitari ◽  
Shuichi Yamamoto
Keyword(s):  
Visual Acuity ◽  
Endothelial Cell ◽  
Intraocular Lens ◽  
Refractive Error ◽  
Surgical Outcomes ◽  
Case Series ◽  
Cell Loss ◽  
Significant Difference ◽  
Group A ◽  
Group B

Purpose. To compare the visual and surgical outcomes after a reuse or a replacement of a dislocated in-the-bag intraocular lens (IOL). Methods. This was a retrospective, nonrandomized case series at a single ophthalmological institution. Cases with an in-the-bag dislocation of an IOL were treated by pars plana vitrectomy and the reuse or the replacement of the IOL. The lens was held by intrascleral fixation of the haptics of the IOL under both conditions. The same dislocated IOL was reused in 6 eyes (group A) or it was replaced with another IOL in the other 9 eyes (group B). The pre- and postoperative parameters analyzed included the visual acuity, refractive error, corneal endothelial cell density, and intraocular pressure (IOP). Results. There was no significant difference between the two groups in the postoperative visual acuity (P=0.388), refractive error (P=0.955), IOP (P=0.529), and endothelial cell loss (P=0.940). A breakage or a tilting of the IOL was observed and required replacement in three eyes in the reuse group (P=0.044). Conclusions. Half of the cases with reused in-the-bag dislocated IOL had a breakage or a tilting of the IOL. The replacement of the in-the-bag dislocated IOL is better than the reuse of the IOL with intrascleral haptics fixation.

Secondary intraocular lens implantation: Complication rates, visual acuity, and refractive outcomes

2017 ◽  
Vol 43 (3) ◽  
pp. 369-376 ◽  
Author(s):  
Greg Brunin ◽  
Ahmar Sajjad ◽  
Eric J. Kim ◽  
Ildamaris Montes de Oca ◽  
Mitchell P. Weikert ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Intraocular Lens ◽  
Complication Rates ◽  
Intraocular Lens Implantation ◽  
Refractive Outcomes ◽  
Lens Implantation ◽  
Secondary Intraocular Lens Implantation

scholarly journals Cataract Surgery with or without Intraocular Lens Implantation in Pediatric Uveitis: A Systematic Review with Meta-Analyses

2021 ◽  
Vol 2021 ◽  
pp. 1-12
Author(s):  
Diana Chabané Schmidt ◽  
Moug Al-Bakri ◽  
Asrin Rasul ◽  
Regitze Bangsgaard ◽  
Yousif Subhi ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Cataract Surgery ◽  
Intraocular Lens ◽  
Complication Rates ◽  
Visual Axis ◽  
Iol Implantation ◽  
Pediatric Uveitis ◽  
Aphakic Eyes ◽  
Meta Analyses ◽  
Modern Era

Purpose. To systematically review the results of comparative studies of modern cataract surgery in pediatric uveitis with or without intraocular lens (IOL) implantation and to perform comparative meta-analyses to compare visual acuity outcomes and complication rates. Methods. On 12 November 2020, we systematically searched the Cochrane Central, PubMed/MEDLINE, EMBASE, ClinicalTrials.gov, and all affiliated databases of the Web of Science. Two authors independently reviewed studies and extracted data. Studies were reviewed qualitatively in text and quantitatively with meta-analyses. Outcome measures were preoperative and postoperative best-corrected visual acuity (BCVA), inflammation control, and rates of postoperative complications. Results. Ten studies of 288 eyes were eligible for review of which the majority were eyes with juvenile idiopathic arthritis-associated uveitis. Summary estimates revealed that the BCVA was better in pseudophakic eyes vs. aphakic eyes (1-year postoperative: −0.23 logMAR, 95% CI: −0.43 to −0.03 logMAR, P = 0.027 ; 5-year postoperative: −0.35 logMAR, 95% CI: −0.51 to −0.18 logMAR, P = 0.000036 ). Pseudophakic eyes had more visual axis opacification (OR 6.76, 95% CI: 2.73 to 16.8, P = 0.000036 ) and less hypotony (OR 0.19, 95% CI: 0.04 to 0.95, P = 0.044 ). Conclusions. In modern era cataract surgery on eyes with pediatric uveitis with IOL implantation leads to satisfactory and superior visual outcomes and no differences in complication rates apart from an increased prevalence of visual axis opacification and a decreased prevalence of hypotony when compared to aphakia. However, limitations of the retrospective design and the presence of selection bias necessitate a careful interpretation.

scholarly journals Exophiala Endophthalmitis after Cataract Surgery

2021 ◽  
Vol 62 (10) ◽  
pp. 1435-1439
Author(s):  
Tae Hwan Kim ◽  
Moon Kyung Shin ◽  
Yoon Hyung Kwon
Keyword(s):  
Visual Acuity ◽  
Cataract Surgery ◽  
Anterior Chamber ◽  
Intraocular Lens ◽  
Early Stage ◽  
Vitreous Body ◽  
Complete Removal ◽  
Eye Drops ◽  
Second Surgery ◽  
The Right

Purpose: To report a case of Exophiala endophthalmitis after cataract surgery, which has not been reported previously in Korea.Case summary: A 70-year-old woman visited the hospital 7 days after cataract surgery in her right eye with unilateral vision impairment. At the time of the visit, visual acuity of the right eye was hand motion, and the fundus was not clearly observed due to numerous inflammatory cells with hypopyon in the anterior chamber. With an initial diagnosis of suspected bacterial endophthalmitis, vitrectomy was performed immediately with intravitreal injection of antibiotics and steroid. On day 14 after vitrectomy, inflammation in the anterior chamber and vitreous opacity worsened, and complete vitrectomy, including of the vitreous base, and removal of the intraocular lens and capsule was performed. Exophiala was detected in the biopsy specimen on day 6 after the second surgery, and the patient was discharged with a prescription for voriconazole eye drops. On day 23 after the second surgery, the best-corrected visual acuity in the right eye had improved to 1.0, and there was no evidence of endophthalmitis recurrence and no observed additional abnormal findings of the fundus until 6 months after second surgery.Conclusions: In a case of fungal endophthalmitis that occurred after cataract surgery, good results were obtained by vitrectomy involving complete removal of the peripheral vitreous body, including the intraocular lens and lens capsule, which was the basis for growth of the fungus in the early stage of endophthalmitis.

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