scholarly journals Suturing technique for scleral fixation of toric intraocular lens in the traumatic aphakic eye with corneal astigmatism

2018 ◽  
Vol 29 (1) ◽  
pp. 100-105 ◽  
Author(s):  
Qintuo Pan ◽  
Zhengwei Yang ◽  
Xiaomeng Chen ◽  
Wenlong Wei ◽  
Zhisheng Ke ◽  
...  

Purpose: To describe the clinical outcomes of traumatic aphakic eyes with corneal astigmatism after using a novel technique for toric intraocular lens suture fixation. Methods: In total, 12 eyes of 12 patients who underwent a new scleral suture fixation technique of one-piece toric intraocular lens (SN6AT series, Alcon Inc., TX, USA) were included in our retrospective study. Preoperative patient status, postoperative visual acuity and refractive outcomes, postoperative intraocular lens rotation, tilt, decentration, and complications were analyzed. Results: The mean follow-up was 11.6 ± 1.0 months. The mean preoperative best-corrected visual acuity was 0.55 ± 0.32 in the logarithm of minimum angle of resolution equivalent; the postoperative best-corrected visual acuity was 0.45 ± 0.34. The mean preoperative total corneal astigmatism was 2.51 ± 1.67 D. The mean postoperative residual astigmatism was 0.77 ± 0.54 D. The mean intraocular lens rotation was 3.33° ± 1.37° (range, 1°–6°). The mean intraocular lens tilt in horizontal direction was 3.64° ± 1.02° (range, 2.6°–6.3°) and in vertical direction it was 3.19° ± 1.07 ° (range, 1.6°–5.2°). The mean intraocular lens decentration in horizontal direction was 0.14 ± 0.03 mm (range, 0.089–0.192 mm) and in vertical direction it was 0.15 ± 0.02 mm (range, 0.113–0.181 mm). One patient had mild vitreous hemorrhage and two other patients had high postoperative residual sphere and astigmatism, respectively. But no other serious complications were observed. Conclusion: Scleral suture fixation of foldable toric intraocular lens to correct corneal astigmatism can be a safe and effective alternative technique to manage traumatic aphakic eyes that lack adequate capsular support.

2020 ◽  
Vol 1 (2) ◽  
pp. 83-88
Author(s):  
Irene Simo ◽  
◽  
Laura Remón ◽  

AIM: To evaluate the efficacy of Bi-Flex toric intraocular lens (T-IOL; Medicontur, Medical Engineering, Ltd., Inc.) implantation to correct preexisting astigmatism in patients having cataract surgery. METHODS: This retrospective consecutive study included 22 eyes of 16 patients with more than 2.50 diopters (D) of corneal preexisting astigmatism having cataract. Preoperative and postoperative uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), objective and subjective refraction and keratometric and topographic cylinder were measured. Postoperative the toric IOL axis was evaluated using vector analysis. RESULTS: Postoperatively, subjective refractive cylinder was reduced significant (P<0.05) from 4.05±1.53 D to 1.35±0.86 D. The component J0 reduced in magnitude from -0.81±2.02 D to -0.12±0.62 D (P<0.05). Both, UCVA and BCVA improved significantly at 1mo after surgery (P<0.05 in both cases). After the surgery, the UCVA and BCVA were 0.24±0.19 and 0.06±0.08, respectively. The mean toric IOL axis rotation was 2.95±5.25 degree, with rotation less than 10 degrees in 86.36% of eyes. No differences in mean keratometric values obtained before and after surgery were found (P>0.05 for J0 and J45). CONCLUSION: Implantation of the Bi-Flex toric IOL is a safe and effective method to correct the preexisting regular astigmatism (greater than 2.50D).


2020 ◽  
Author(s):  
Yinan Liu ◽  
Qianru Wu ◽  
Hongyuan Cai ◽  
Xiaoyong Chen

Abstract Background This study aimed to compare the clinical effects of two brands of toric intraocular lens used in surgical correction of cataract with corneal astigmatism. Methods 35 patients (50 eyes) with corneal astigmatism who underwent ophthalmic surgery from April 2019 to July 2019 were retrospectively analyzed. Among them, 25 eyes of 20 patients were implanted with Rayner 623T, while 25 eyes of 15 patients with Alcon AcrySof Toric intraocular lens (IOL). Three months after surgery, the uncorrected distance visual acuity (UCDVA), best corrected distance visual acuity (BCDVA), residual astigmatism, rotational degree of intraocular lens, contrast sensitivity, objective visual quality and the National Eye Institute 25-Item Visual Function Questionnaire (NEI VFQ-25) scale score were compared. Results The mean postoperative UCDVA (logMAR) and BCDVA (logMAR) in the Rayner group were 0.17 ± 0.20 and 0.08 ± 0.15, respectively (P > 0.05), while those in the Alcon group were 0.21 ± 0.16 and 0.10 ± 0.11, respectively (P > 0.05). The mean residual astigmatism in the Rayner group was (0.69±0.40) while that in the Alcon group was (0.62±0.49), (P >0.05). There was no statistically significant difference between the two groups in IOL rotational stability, contrast sensitivity and objective visual quality (P > 0.05). The NEI VFQ-25 scale score was 85.16±5.91 in the Rayner group while that was 82.08±6.16 in the Alcon group, (P > 0.05). Conclusions The two brands of toric intraocular lens- Rayner 623T and Alcon AcrySof Toric showed no significant difference in their clinical effects.


2013 ◽  
Vol 13 (2) ◽  
pp. 33-41
Author(s):  
Devendra Maheshwari ◽  
Rengappa Ramakrishanan ◽  
Mohideen Abdul Kader ◽  
Neelam Pawar ◽  
Ankit Gupta

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.


2020 ◽  
Author(s):  
Da young Shin ◽  
Ho Sik Hwang ◽  
Hyun Seung Kim ◽  
Man Soo Kim ◽  
Eun Chul Kim

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.


2019 ◽  
Vol 15 (4) ◽  
pp. 405-410 ◽  
Author(s):  
K. B. Pershin ◽  
N. F. Pashinova ◽  
M. E. Konovalov ◽  
E. P. Gurmizov ◽  
O. Yu. Zubenko ◽  
...  

Patients, who need cataract surgical treatment, often fail to achieve a high uncorrected visual acuity after surgery due to the concomitant astigmatism involved. Currently, surgeons are increasingly performing combined surgical interventions, including relaxing limbal keratotomic incisions (manual keratotomy) or femtoarcuatous keratotomy, as well as implanting toric intraocular lenses. In recent years, additional toric intraocular lenses have been available. Purpose: to analyze our own clinical experience of implanting an additional toric intraocular lens to correct corneal astigmatism in three clinical cases. The article presents our clinical experience of successful correction of residual corneal astigmatism after previous cataract phacoemulsification with the implantation of a monofocal toric intraocular lens in three patients patients aged 70, 61 and 54 years. In all cases, an additional toric intraocular lens Add-on Torica-sPB pre-filled in the cartridge with a good refractive effect was implanted. The uncorrected visual acuity was 1.0 in all the investigated cases at the follow-upo period of 6 months after the surgical intervention. Calculation of the toric intraocular lens optical power was performed using an online calculator. A feature of surgical intervention was the repositioning of the additional toric intraocular lens into the ciliary sulcus. Changes in the data of keratotopography before and after surgery were absent. In none of the investigated cases, intra- and postoperative complications and dislocation of the implanted additional toric intraocular lens were determined. Based on these cases, high predictability, efficacy and safety of implantation of an additional toric intraocular lens are shown, in the case of residual middle-grade corneal astigmatism after the initial cataract phacoemulsification with the toric intraocular lens implantation. This approach can be successfully used in patients during one-stage surgical treatment of cataract and associated high-grade corneal astigmatism, expanding existing protocols for the treatment of this group of patients.


2020 ◽  
Author(s):  
Ho Ra ◽  
Ho Sik Hwang ◽  
Hyun Seung Kim ◽  
Man Soo Kim ◽  
Eun Chul Kim

Abstract Background: To evaluate the effect of toric intraocular lens implantation in cataract patient with corneal opacity and high astigmatism. Methods: 31 eyes of 31 patients who underwent cataract surgery with toric intraocular lens implantation were included. All patients had corneal opacity with astigmatism. Preoperative total corneal astigmatism was determined considering posterior astigmatism using a rotating Scheimpflug camera (Pentacam®: Oculus, Wetzlar, Germany). At 2 months after toric intraocular lens implantation, we evaluated residual astigmatism, uncorrected visual acuity (UCVA) and best corrected visual acuity (BCVA).Results: Postoperative UCVA and BCVA (0.30 ± 0.17, 0.22 ± 0.16LogMAR) were statistically improved compared to preoperative UCVA and BCVA (1.2 ± 0.34, 1.1 ± 0.30LogMAR, respectively) (P<0.01). Postoperative residual refractive astigmatism (1.2 ± 0.35D) was statistically reduced compared to preoperative refractive astigmatism (2.4 ± 0.65D) (P<0.05). Preoperative and postoperative total corneal astigmatism values were not statistically different. All eyes achieved postoperative visual acuity as good as or better than preoperative one. The size of corneal opacity covering pupil had significant negative correlation with postoperative UCVA and BCVA (logMAR) (R=0.91 P<0.05 and R=0.92 P<0.05, respectively)Conclusion: Toric intraocular lens implantation can improve UCVA, BCVA, and refractive astigmatism in cataract patient with corneal opacity. The size of corneal opacity covering pupil is the major prognostic factor for postoperative visual improvement. Therefore, toric intraocular lens implantation should be considered for cataract patients who have corneal opacity with high astigmatism.


2019 ◽  
Author(s):  
Ho Ra ◽  
Ho Sik Hwang ◽  
Hyun Seung Kim ◽  
Man Soo Kim ◽  
Eun Chul Kim

Abstract Purpose: To evaluate the effect of toric intraocular lens implantation in cataract patient with corneal opacity and high astigmatism. Methods: 31 eyes of 31 patients who underwent cataract surgery with toric intraocular lens implantation were included. All patients had corneal opacity with astigmatism. Preoperative total corneal astigmatism was determined considering posterior astigmatism using a rotating Scheimpflug camera (Pentacam®: Oculus, Wetzlar, Germany). At 2 months after toric intraocular lens implantation, we evaluated residual astigmatism, uncorrected visual acuity (UCVA) and best corrected visual acuity (BCVA). Results: Postoperative UCVA and BCVA (0.30 ± 0.17, 0.22 ± 0.16LogMAR) statistically improved compared to preoperative UCVA and BCVA (1.2 ± 0.34, 1.1 ± 0.30LogMAR, respectively) (P<0.01). Postoperative residual refractive astigmatism (1.2 ± 0.35D) was statistically reduced compared to preoperative refractive astigmatism (2.4 ± 0.65D) (P<0.05). Preoperative and postoperative total corneal astigmatism values were not statistically different. All eyes achieved postoperative visual acuity as good as or better than preoperative one. The size of corneal opacity covering pupil had significant negative correlation with postoperative UCVA and BCVA (logMAR) (R=0.91 P<0.05 and R=0.92 P<0.05, respectively). Conclusion: Toric intraocular lens implantation can improve UCVA, BCVA, and refractive astigmatism in cataract patient with corneal opacity. The size of corneal opacity covering pupil is the major prognostic factor for postoperative visual improvement. Therefore, toric intraocular lens implantation should be considered for cataract patients who have corneal opacity with high astigmatism.


2020 ◽  
Author(s):  
Da young Shin ◽  
Ho Sik Hwang ◽  
Hyun Seung Kim ◽  
Man Soo Kim ◽  
Eun Chul Kim

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.


2019 ◽  
Author(s):  
Ho Ra ◽  
Ho Sik Hwang ◽  
Hyun Seung Kim ◽  
Man Soo Kim ◽  
Eun Chul Kim

Abstract Purpose: To evaluate the effect of toric intraocular lens implantation in cataract patient with corneal opacity and high astigmatism. Methods: 31 eyes of 31 patients who underwent cataract surgery with toric intraocular lens implantation were included. All patients had corneal opacity with astigmatism. Preoperative total corneal astigmatism was determined considering posterior astigmatism using a rotating Scheimpflug camera (Pentacam®: Oculus, Wetzlar, Germany). At 2 months after toric intraocular lens implantation, we evaluated residual astigmatism, uncorrected visual acuity (UCVA) and best corrected visual acuity (BCVA). Results: Postoperative UCVA and BCVA (0.30 ± 0.17, 0.22 ± 0.16LogMAR) statistically improved compared to preoperative UCVA and BCVA (1.2 ± 0.34, 1.1 ± 0.30LogMAR, respectively) (P<0.01). Postoperative residual refractive astigmatism (1.2 ± 0.35D) was statistically reduced compared to preoperative refractive astigmatism (2.4 ± 0.65D) (P<0.05). Preoperative and postoperative total corneal astigmatism values were not statistically different. All cases achieved visual acuity were as good as or better than that preoperatively. The percentage of corneal opacity covering pupillary area had significant negative correlation with postoperative UCVA and BCVA (logMAR) (R=-0.88 P<0.00001 and R=-0.87 P<0.00001, respectively) Conclusion: Toric intraocular lens implantation can improve UCVA, BCVA, and refractive astigmatism in cataract patient with corneal opacity. The percentage of central corneal opacity covering pupillary area is the major prognostic factor for postoperative visual improvement. Therefore, toric intraocular lens implantation should be considered for cataract patients who have corneal opacity with high astigmatism.


2017 ◽  
Vol 158 (1) ◽  
pp. 20-24
Author(s):  
Antal Szabó ◽  
András Papp ◽  
Ágnes Borbándy ◽  
Zsuzsanna D. Géhl ◽  
Zoltán Zsolt Nagy ◽  
...  

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.


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