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.

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.

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 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.

scholarly journals Cataract surgery in camp patients: a study on visual outcomes

1970 ◽  
Vol 3 (2) ◽  
pp. 159-164
Author(s):  
SG Pai ◽  
SJ Kamath ◽  
V Kedia ◽  
K Shruthi ◽  
A Pai
Keyword(s):  
Visual Acuity ◽  
Cataract Surgery ◽  
Visual Outcome ◽  
Posterior Chamber ◽  
Small Incision Cataract Surgery ◽  
Evaluation Team ◽  
Visual Outcomes ◽  
Corrected Visual Acuity ◽  
Operative Complications ◽  
Best Corrected Visual Acuity

Aim: To assess the complications and visual outcomes associated with cataract surgery in camp patients operated at a tertiary centre. Materials and methods: In a retrospective study, 206 outreach camp patients had undergone cataract surgeries with posterior chamber intraocular lens implantation under peribulbar anesthesia over a period of 6 months. Post-operative complications on Day 1 were graded as per Oxford Cataract Treatment and Evaluation Team (OCTET) definitions. One month postoperative complications, best corrected visual acuity and refractive errors were assessed. Results: 206 eyes underwent cataract extraction with PCIOL implantation. Small incision cataract surgery (SICS) was the commonest method (78.6%) used. The most common first post-operative day complication was mild iridocyclitis (26.2%). The complications were based on OCTET definitions, and showed that 33 % had Grade I and 3.4 % had Grade II complications. The major post-operative complication after 4 weeks of surgery was posterior capsular opacity. 89.8 % of the eyes had a 4 week-post-operative best corrected visual acuity of e” 6/24. The commonest refractive error was myopia with against the rule astigmatism, seen in 86 out of 150 cases. Conclusion: High quality cataract surgery with a low rate of intra-operative complications and good visual outcome can be attained in camp patients operated in the base hospitals, thus justifying more similar screening camps to clear the vast cataract backlog. Key words: cataract surgery, eye camp, visual outcomes DOI: http://dx.doi.org/10.3126/nepjoph.v3i2.5270 Nepal J Ophthalmol 2011; 3(2): 159-164

scholarly journals Refractive Aspect of Cataracts – Towards Customisation

2009 ◽  
Vol 03 (02) ◽  
pp. 80
Author(s):  
Pascal Rozot ◽  
Jean-Claude Rigal-Sastourne ◽  
◽  
Keyword(s):  
Visual Acuity ◽  
Cataract Surgery ◽  
Spherical Aberration ◽  
Intraocular Lenses ◽  
Posterior Chamber ◽  
Depth Of Focus ◽  
Prospective Multicentre Study ◽  
Corrected Visual Acuity ◽  
Visual Results ◽  
Best Corrected Visual Acuity

Currently, posterior chamber intraocular lenses (IOLs) correct totally or partially spherical aberrations. In this article we present the visual results of a prospective multicentre study evaluating the Micro AY IOL correcting 0.11μm of spherical aberration, which is a good compromise between optimal vision and a consistent depth of focus. We evaluated 124 eyes that were operated on using bi-manual micro-cataract surgery (BiMICS: 75%) or co-axial micro-cataract surgery (CoMICS: 25%) phacoemulsification with insertion of a Micro AY IOL through a 1.8–2.2mm incision. Mean post-operative best corrected visual acuity was 0.97±0.25; pre-operative spherical aberrations were +0.24±0.13μm, and reached +0.10±0.11μm post-operatively. There were no complications due to the lens, and photopic contrast sensitivity reached high levels.

scholarly journals Treatment of Stable Keratoconus by Cataract Surgery with Toric IOL Implantation

2012 ◽  
Vol 1 (2) ◽  
pp. 128-130
Author(s):  
Tova Lifshitz ◽  
Jaime Levy ◽  
Anry Pitchkhadze
Keyword(s):  
Visual Acuity ◽  
Cataract Surgery ◽  
Intraocular Lens ◽  
Toric Intraocular Lens ◽  
Toric Iol ◽  
Iol Implantation ◽  
Corrected Visual Acuity ◽  
Uncorrected Visual Acuity ◽  
Cylinder Power ◽  
Best Corrected Visual Acuity

ABSTRACT We present the case of a 73-year-old patient who underwent successful phacoemulsification and toric intraocular lens (IOL) implantation to correct high stable astigmatism due to keratoconus and cataract. Preoperative refraction was −3.25 −4.0 × 98°. A toric IOL (Acrysof SN60T6) with a spherical power of 16.5 D and a cylinder power of 3.75 D at the IOL plane and 2.57 D at the corneal plane was implanted and aligned at an axis of 0°. Uncorrected visual acuity improved from 6/60 to 6/10. Postoperative best corrected visual acuity was 6/6, 6 months after the operation. In conclusion, phacoemulsification with toric IOL implantation can be performed in eyes with keratoconus and cataract. How to cite this article Levy J, Pitchkhadze A, Lifshitz T. Treatment of Stable Keratoconus by Cataract Surgery with Toric IOL Implantation. Int J Kerat Ect Cor Dis 2012;1(2):128-130.

scholarly journals Study of patients with Pseudoexfoliation syndrome undergoing cataract surgery

2021 ◽  
Vol 7 (2) ◽  
pp. 184-189
Author(s):  
G Srinivasan ◽  
Deepa R
Keyword(s):  
Visual Acuity ◽  
Cataract Surgery ◽  
Intraocular Lens ◽  
Visual Outcome ◽  
Pseudoexfoliation Syndrome ◽  
Posterior Capsular Opacification ◽  
Pupillary Dilatation ◽  
Corrected Visual Acuity ◽  
Best Corrected Visual Acuity

To analyze the visual outcome in patients with pseudoexfoliation and to know the surgical parameters to cogitate in patients with pseudoexfoliation syndrome. An Observational study which was conducted in the Ophthalmology department in a tertiary care hospital in a rural area from June 2019 to December 2019. A total of 52 eyes of 52 patients aged 40 years and above, of either sex, clinically diagnosed with senile cataract and associated with pseudoexfoliation were enrolled in the study. After assessing best corrected visual acuity (BCVA), a detailed anterior and posterior segment examination was performed along with lacrimal sac syringing, manual keratometry, contact A-scan biometry and intraocular lens (IOL) power was calculated. All patients underwent manual small incision cataract surgery under peribulbar anaesthesia and intraocular lens was implanted. Intraoperative complications were noted during the surgery and was reported .Best corrected visual acuity was recorded on day 1, at 1week and at 1 month of follow up. Out of 52eyes of 52 patients, 29 were females (55.76%) and 38 eyes (73.07%) exhibited bilateral involvement. Distribution of the PXF material in various ocular structures was observed and majority of them (36.53%) had PXF material equally in iris, pupillary margin and lens. Based on the morphology of cataract associated with psudoexfoliation, nuclear cataract was the most commonly observed in 16 eyes (30.76%) and 42 eyes (80.76%) had moderate pupillary dilatation. The intraoperative difficulties observed during cataract surgery was poor pupillary dilatation which was managed by controlled sphincterotomy during the surgery in 3 eyes (5.76%), Iridiodialysis, rhexis extension, zonular dialysis each in 1 eye and posterior capsular rent in 2 eyes. Around 92.30% of the total study population achieved post-operative BCVA of 6/12 or better at 1month of follow up. Decreased visual acuity was noted in 2 (3.84%) eyes due to persistent corneal edema, one eye (1.92%) had posterior capsular opacification and one eye (1.92%) had cystoid macular edema. This study concludes that with careful preoperative assessment and necessary intraoperative precautions, good visual outcome can be achieved in patients with cataract with pseudoexfoliation.

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.

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