New surgical approach for sutureless scleral fixation

2020 ◽  
Vol 30 (3) ◽  
pp. 612-615 ◽  
Author(s):  
Chiara Veronese ◽  
Chiara Maiolo ◽  
Grayson W Armstrong ◽  
Laura Primavera ◽  
Carlo Torrazza ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Surgical Technique ◽  
Intraocular Lens ◽  
Posterior Chamber ◽  
Scleral Fixation ◽  
Refractive Outcomes ◽  
Corrected Visual Acuity ◽  
Change In The Mean ◽  
Intraocular Lens Decentration ◽  
Best Corrected Visual Acuity

Purpose: The aim of this article is to describe a novel surgical technique for sutureless scleral fixation of an intraocular lens using the newly developed FIL SSF Carlevale IOL (Soleko, Italy). Methods: Four eyes of four patients with poor capsular support were recruited to our study, three resulting from intraocular lens subluxation and one case resulting from traumatic cataract. A novel sutureless sclera-fixated intraocular lens was implanted into the posterior chamber of each eye with sclerocorneal plugs fixating the lens to the wall of the eye. Results: Mean age of patients was 52 ± 16 years, ranging from 35 to 70 years. Mean follow-up was 6.50 ± 1.29 months (range: 5–7 months). Mean preoperative best-corrected visual acuity was 0.50 ± 0.33 logMAR (range: 1–0.3 logMAR). Postoperative best-corrected visual acuity improved to 0.08 ± 0.08 logMAR (range: 0.2–0 logMAR). There was no significant change in the mean intraocular pressure and there were no postoperative complications, such as iatrogenic distortion or breakage of the intraocular lens haptic, intraocular lens decentration, endophthalmitis, or retinal detachment. Discussion: To the best of our knowledge, this is the first report of outcomes using the novel sutureless sclera-fixated FIL SSF Carlevale IOL. This new surgical technique offers a simplified and effective approach for sutureless scleral intraocular lens fixation with good refractive outcomes.

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.

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 One-Haptic Fixation of Posterior Chamber Intraocular Lenses without Scleral Flaps

2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
Author(s):  
Ashraf I. Moawad ◽  
Asaad A. Ghanem
Keyword(s):  
Visual Acuity ◽  
Operation Time ◽  
Good Choice ◽  
Intraocular Lenses ◽  
Posterior Chamber ◽  
Modified Technique ◽  
Scleral Fixation ◽  
Corrected Visual Acuity ◽  
Aphakic Eyes ◽  
Best Corrected Visual Acuity

Purpose. To assess visual results and complications of a modified technique of posterior chamber intraocular lenses (PC IOLs) in aphakic eyes without scleral flaps.Methods. Modified one-haptic scleral fixation was performed in one eye each of 25 patients with aphakia and insufficient capsule support. Follow-up period was six months. Outcome measures included best-corrected visual acuity, intraocular pressure (IOP), and postoperative complications.Results. The study included 15 males and 10 females. The preoperative best-corrected visual acuity (BCVA) ranged from 5/60 to 6/9. The operation time ranged from 25 to 45 minutes (mean 35.25 ± 5.34 min). Anterior vitrectomy was performed in 12 cases (48%). There was no major IOL decentration. The final BCVA ranged from 6/36 to 6/9. Seven cases (28%) showed postoperative glaucoma, five cases (20%) had temporary hypotony, and hyphema in 2 eyes (8%). No cases of suture erosion, postoperative endophthalmitis, retinal detachment, or IOL dislocation were detected.Conclusion. This technique of one-haptic scleral fixation of posterior chamber IOLs is a good choice in presence of insufficient capsule support. It reduces the operation time, achieves the IOL stability, and minimizes postoperative suture-related complications.

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 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 Aphakia korrekciója irisklip műlencse retropupillaris beültetésével

2017 ◽  
Vol 158 (1) ◽  
pp. 20-24
Author(s):  
Antal Szabó ◽  
András Papp ◽  
Ágnes Borbándy ◽  
Zsuzsanna D. Géhl ◽  
Zoltán Zsolt Nagy ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Intraocular Lens ◽  
Secondary Procedure ◽  
Medical Optics ◽  
Corrected Visual Acuity ◽  
Time Period ◽  
The Mean ◽  
The Stability ◽  
Best Corrected Visual Acuity

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.

scholarly journals Features of Surgical Correction of Spontaneous Luxation of the Complex “IOL Posterior Chamber – Capsular Bag”

2019 ◽  
Vol 4 (4) ◽  
pp. 108-112
Author(s):  
O. P. Mishchenko ◽  
N. A. Senchenko ◽  
A. G. Shchuko
Keyword(s):  
Visual Acuity ◽  
Surgical Treatment ◽  
Posterior Chamber ◽  
Case Histories ◽  
Corrected Visual Acuity ◽  
Postoperative Astigmatism ◽  
Operation Results ◽  
Best Corrected Visual Acuity ◽  
Capsular Bag ◽  
Iol Dislocation

Luxation of intraocular lens in capsular bag several years after cataract surgery leads to a decrease in visual function and requires surgical treatment.Aim: to determine effectiveness of various types of surgical treatment of late spontaneous dislocations of IOL in capsular bag.Methods. Analysis of 123 case histories of patients with late IOL dislocation, operated in 2013–2015, was made. First group included patients with replaced IOLs dislocated into pupillary lens. Second group consisted of patients who underwent reposition and suture of IOL to iris. Examination was made before operation and 6–12 months after operation. Results. The average term from moment of IOL implantation to its luxation was 8.78 ± 4.85 years. II degree of dislocation was detected in 74 % of patients, III degree of dislocation – in 10 %, and IV degree – in 16 % of patients.Uncorrected visual acuity was reduced to 0.15 ± 0.16; best corrected visual acuity to 0.31 ± 0.26. In 83.7 % of patients a pseudoexfoliation syndrome was detected. In 62.6 % of patients IOL luxation was accompanied byhydrodynamic disturbances. Best corrected visual acuity in period from 6 to 12 months after surgery was 0.40 ± 0.24, and after IOL reposition – 0.49 ± 0.22. In addition, after IOL replacement a significant increase in postoperative astigmatism was noted from –0.44 ± 0.84 to –1.96 ± 1.60 D (p < 0.001).Conclusion. As a result of surgical treatment of late spontaneous IOL dislocations in both groups increase in distance uncorrected and best corrected visual acuity was noted. Insufficient visual functions after surgical treatment were caused by concomitant pathology as well as increased postoperative astigmatism.

scholarly journals Small Incision Cataract Surgery (SICS) with Posterior Chamber Intraocular Lens (PCIOL) Implantation is the Preferred Method of Community-Based Cataract Surgery: Study of 100 Cases

1970 ◽  
Vol 22 (1) ◽  
pp. 132-135
Author(s):  
AKM Shahidur Rahman Tarafder ◽  
M Anwarul Kader ◽  
SM Rezaul Karim
Keyword(s):  
Visual Acuity ◽  
Cataract Surgery ◽  
Intraocular Lens ◽  
Posterior Chamber ◽  
Extracapsular Cataract Extraction ◽  
Small Incision Cataract Surgery ◽  
Small Incision ◽  
Corrected Visual Acuity ◽  
Department Of Ophthalmology ◽  
Posterior Chamber Intraocular Lens

To study "small incision cataract surgery (SICS)" for the rehabilitation of cataract visually impaired and blind patients, a retrospective study of 100 cases of cataract patients with small incision cataract surgery (SICS) with posterior chamber intraocular lens (PCIOL) implantation were done at Rajshahi Medical College Hospital. All cases were selected having corrected visual acuity less than 6/60 who were admitted at the Department of Ophthalmology for cataract surgery from March, 2006 to February, 2008. Age group of the patient range from 40 to 85 years. Age related senile cataract were selected any complicated cataract was excluded from the study. All these patients underwent SICS with 5.5 mm optic polymethylmethacrylate (PMMA) non-foldable posterior chamber intraocular lens (PCIOL) were implanted by irrigation vectis. Intra operative complication were present in 8% cases among them 3 cases (3%) required to conversion to Conventional Extracapsular Cataract Extraction (ECCE). 2 cases (2%) had small posterior capsular rent (PCR), 1 case (1%) irido dialysis & 2 cases (2%) hyphaema occurred. Postoperative complications were found in 38 cases (38%) among them transient corneal oedema occurred in 18 cases (18%) iritis occurred in 13 cases (13%), decentering of intraocular lens (IOL) occurred in 2 cases, corrected visual acuity after 6 weeks of operation were 6/12 or better in 97 cases (97% cases achieved functional vision). Induced astigmatism ± 0.50 D to ± 1.00 D occurred in 94 cases (94%) and ± 1.500 to 2.50D in 6 cases (6%). So, SICS may be the choice of surgery in respect of visual outcome with the limited facilities and surgeons. DOI: 10.3329/taj.v22i1.5037 TAJ 2009; 22(1): 132-135

scholarly journals Changes in macular thickness post uncomplicated MSICS & phacoemulsification surgery

2022 ◽  
Vol 7 (4) ◽  
pp. 619-623
Author(s):  
Kartika Anand ◽  
Ashutosh Dokania
Keyword(s):  
Visual Acuity ◽  
Cataract Surgery ◽  
Macular Thickness ◽  
Posterior Chamber ◽  
Prospective Clinical Study ◽  
Small Incision Cataract Surgery ◽  
Corrected Visual Acuity ◽  
Clinically Significant ◽  
Clinically Significant Macular Oedema ◽  
Best Corrected Visual Acuity

To evaluate changes in macular thickness via-a-vis visual acuity post uncomplicated manual small incision cataract surgery (MSICS) & phacoemulsification surgery Prospective clinical study on 160 patients of uncomplicated immature senile cataract, aged 40-70yrs, patients were randomised into two groups, MSICS & phacoemulsification, by simple 1:1 randomization, who underwent uncomplicated cataract surgery with posterior chamber intraocular lens (PCIOL). Post-operatively, the patients were evaluated for best corrected visual acuity (BCVA) and changes in macular thickness by optical coherence tomography (OCT) at post-op Day 1, 7, 21, 48, and 12 weeks. Paired t-test was used for comparison across follow up. : At 12 weeks post-operative, mean logMAR BCVA was 0.01±0.02 for MSICS group and 0±0.02 for Phacoemulsification group. Macular thickness was not statistically significant (p=0.342) between MSICS group (219.19±17.88µm) and Phacoemlusification group (215.61±16.21µm), at the end of 12 weeks post-operative. Clinically significant macular oedema was not diagnosed in any of the patients at the follow-ups.: Both procedures achieved good post-operative Best Corrected visual acuity without significant differences in BCVA between both the groups at the end of 12 weeks.

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