Intraocular Lens Repositioning With Polypropylene Suture to Reduce Optic Tilt

2017 ◽  
Vol 2 (1) ◽  
pp. 48-50
Author(s):  
Itsara Lertjirachai ◽  
Maxwell S. Stem ◽  
Bozho Todorich ◽  
Jeremy D. Wolfe ◽  
Antonio Capone
Keyword(s):  
Case Report ◽  
Surgical Technique ◽  
Intraocular Lens ◽  
Tilt Correction ◽  
Polypropylene Suture ◽  
Polypropylene Sutures ◽  
Iol Fixation ◽  
Iol Exchange

Purpose: To describe a technique to reduce intraocular lens (IOL) tilt after sutureless intrascleral (SIS) fixation. Methods: Case report with review of surgical technique. Results: We report a technique that can be used to correct IOL tilt that may rarely accompany SIS IOL fixation. The procedure involves placing pupil-spanning polypropylene sutures on either side of the IOL optic to keep the optic parallel to the plane of the iris. Conclusion: Sutureless intrascleral IOL tilt correction can be achieved using polypropylene suture, thus obviating the need for more invasive surgical maneuvers, such as IOL exchange.

Long-Term Stability of Sutured Scleral Fixation of a Posterior Chamber Intraocular Lens With 10-0 Polypropylene for More Than 30 Years

2021 ◽  
pp. 247412642097887
Author(s):  
Gregg T. Kokame ◽  
Tarin T. Tanji ◽  
Jase N. Omizo
Keyword(s):  
Intraocular Lens ◽  
Posterior Chamber ◽  
Scleral Flap ◽  
Scleral Fixation ◽  
Polypropylene Suture ◽  
Long Term Stability ◽  
Posterior Chamber Intraocular Lens ◽  
Polypropylene Sutures

Purpose: We report the longest follow-up to our knowledge of stable scleral fixation of a posterior chamber intraocular lens (PC IOL) with 10-0 polypropylene sutures. Methods: A retrospective review is presented of a case with more than 30 years’ follow-up after performing sutured scleral fixation with 10-0 polypropylene suture using 2 sutures tied together under a scleral flap. One suture was a cow-hitch looped around the haptic, and the other suture was passed through the sclera to create the scleral fixation. Results: The scleral fixation with 10-0 polypropylene suture knots for both haptics of the PC IOL allowed central optic positioning with excellent vision for more than 30 years without suture breakage. Conclusions: Polypropylene sutures for scleral fixation of PC IOLs remained stable for more than 30 years with central positioning of the PC IOL, without exposure of the fixation suture knots through the conjunctiva, and without suture breakage.

Dislocation of a Scleral-Fixated, Hydrophobic, Single-Piece Acrylic Intraocular Lens Secondary to Eyelet Fracture From Gore-Tex Suture

2019 ◽  
Vol 3 (5) ◽  
pp. 395-398 ◽  
Author(s):  
R. Rishi Gupta ◽  
Mark E. Seamone ◽  
André S. Pollmann ◽  
Daniel M. O’Brien ◽  
Darrell R. Lewis
Keyword(s):  
Case Report ◽  
Operating Room ◽  
Intraocular Lens ◽  
First Report ◽  
Single Piece ◽  
Iol Exchange

Purpose: This article reports a case of the dislocation of a scleral-fixated enVista MX60 (Bausch + Lomb) intraocular lens (IOL) secondary to eyelet fracture at the point of contact with a Gore-Tex (W.L. Gore & Associates) suture. Methods: A case report is discussed. Results: An 81-year-old woman presented with decreased vision secondary to a dislocated Gore-Tex scleral-sutured enVista MX60 IOL in the left eye 14 months after surgery. The patient returned to the operating room for IOL exchange, and intraoperatively it was confirmed that the eyelet of the lens had fractured secondary to tension from the Gore-Tex suture. Conclusions: To the best of the authors’ knowledge, this is the first report of eyelet fracture in an enVista MX60 scleral-sutured IOL secondary to tension from a Gore-Tex suture.

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 Repairing Cyclodialysis by Riveting: A Flanged Polypropylene Suture

2021 ◽  
pp. 784-790
Author(s):  
Ryosuke Tamiya ◽  
Masayuki Akimoto
Keyword(s):  
Intraocular Lens ◽  
Surgical Repair ◽  
Polypropylene Suture ◽  
Pars Plana ◽  
Polypropylene Sutures

Cyclodialysis causes intraocular lens (IOL) pupillary capture. It requires surgical repair to prevent this risk of IOL pupillary capture. However, since repairing cyclodialysis is often technically difficult, other methods such as barricading by suturing, pupilloplasty, and pars plana fixation of the IOL were preferred. We applied a double-flanged (riveting) technique for repairing cyclodialysis to prevent IOL pupillary capture following intrascleral fixation of the IOL. Cyclodialysis was surgically repaired by riveting with double-flanged 6-0 polypropylene sutures in 3 cases with no recurrence of pupillary capture during at least 12 months of follow-up. When pupillary capture is related to cyclodialysis, repairing cyclodialysis may help prevent pupillary capture after intrascleral fixation of the IOL. Riveting using a double-flanged 6-0 polypropylene suture could possibly make the procedure simpler and more efficient.

Towards the calculation of the optical power of an intraocular lens after thermokeratoplasty (a case report).

2018 ◽  
pp. 107-109
Author(s):  
O.I. Orenburkina ◽  
◽  
I.F. Nuriyev ◽  
A.E. Babushkin ◽  
N.A Nikitin ◽  
...  
Keyword(s):  
Case Report ◽  
Intraocular Lens ◽  
Optical Power

scholarly journals 27-gauge trocar-assisted sutureless intraocular lens fixation

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Tatsuya Jujo ◽  
Jiro Kogo ◽  
Hiroki Sasaki ◽  
Reio Sekine ◽  
Keiji Sato ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Endothelial Cell ◽  
Cell Density ◽  
Intraocular Lens ◽  
Vitreous Hemorrhage ◽  
Corneal Endothelial Cell ◽  
Endothelial Cell Density ◽  
Corneal Endothelial Cell Density ◽  
The Mean ◽  
Iol Fixation

Abstract Backgrounds However there have been numerous investigations of intrascleral intraocular lens (IOL) fixation techniques, there is room for improvement in terms of simplifying complicated techniques and reducing the high levels of skill required. This study aimed to report a novel technique for sutureless intrascleral fixation of the IOL using retinal forceps with a 27-gauge trocar. Methods Nineteen eyes of 18 patients underwent intrascleral fixation of the IOL from July 2018 to September 2019 were enrolled in this study. A 27-gauge trocar formed 3-mm scleral tunnels positioned at 4 and 10 o’clock, 2 mm from the corneal limbus. We used a 3-piece IOL haptic grasped by a 27-gauge retinal forceps and pulled from the 27-gauge trocar. The IOL was fixed by making a flange. Main outcome measures were visual acuity, corneal endothelial cell density, IOL tilt, decentration, predicted error of refraction and complications. Results The 19 eyes were followed up for 1 month. The mean pre- and postoperative logMAR uncorrected visual acuity (UCVA) was 1.06 ± 0.63 and 0.40 ± 0.26, respectively (p < 0.01), while the mean pre- and postoperative logMAR best corrected visual acuity (BCVA) was 0.27 ± 0.51 and 0.06 ± 0.15, respectively (p = 0.09). The mean corneal endothelial cell density was 2406 ± 625 to 2004 ± 759 cells/mm2 at 1 month (p = 0.13). The mean IOL tilt was 3.52 ± 3.00°, and the mean IOL decentration was 0.39 ± 0.39 mm. There was no correlation among IOL tilt, decentration and BCVA (p > 0.05). The mean prediction error of the target refraction was − 0.03 ± 0.93 D. The complications were vitreous hemorrhage (3 eyes), hyphema (1 eye), IOP elevation (1 eye), iris capture of the IOL (1 eye) and hypotony (2 eyes). No IOL dislocation occurred. Conclusions IOL intrascleral fixation with a flange achieved good IOL fixation and visual outcome in the scleral tunnels created with the 27-gauge trocar.

An Alternative Approach Using Circummandibular Wiring for Treatment of Dentoalveolar Fractures in Children: A Case Report

2021 ◽  
pp. 194338752199028
Author(s):  
José Henrique Santana Quinto ◽  
Andressa Bolognesi Bachesk ◽  
Lucas Costa Nogueira ◽  
Liogi Iwaki Filho
Keyword(s):  
Case Report ◽  
Surgical Technique ◽  
Bone Fracture ◽  
Closed Reduction ◽  
Alternative Methods ◽  
Alveolar Process ◽  
Fractures In Children ◽  
Alternative Approach ◽  
Open Treatment ◽  
Segmental Fractures

The prevalence of dentoalveolar injuries in children is approximately 25%, with falls from own height being one of the main etiologies. Diagnosis is based on the clinical evaluation associated with complementary imaging tests. The treatment of choice depends on the type of damage and structure affected. For alveolar process fractures, closed reduction and semi-rigid dental splinting for 4 to 6 weeks is generally satisfactory. However, some cases, such as severe segmental fractures, require open treatment to ensure adequate reduction and stabilization of the displaced alveolar segment, which is usually achieved by titanium miniplates and screws. Nevertheless, there are situations where this type of fixation is not possible, requiring alternative methods. Therefore, this article describes a surgical technique performed by open reduction, associating semi-rigid dental splint and circummandibular wiring in pediatric patient diagnosed with dentoalveolar fracture through clinical examination (with bone fracture displacement) and tomography. The technique promoted a good prognostic to the patient, proving to be a viable alternative for treating dentoalveolar fractures.

Avulsion of the anterior medial meniscus root: case report and surgical technique

2013 ◽  
Vol 23 (1) ◽  
pp. 146-151 ◽  
Author(s):  
Matthias J. Feucht ◽  
Philipp Minzlaff ◽  
Tim Saier ◽  
Andreas Lenich ◽  
Andreas B. Imhoff ◽  
...  
Keyword(s):  
Case Report ◽  
Surgical Technique ◽  
Medial Meniscus ◽  
Meniscus Root

scholarly journals Intraocular Lens Dislocation after Cataract Surgery in Tambolaka, Southwest Sumba, Indonesia: A Case Report

2018 ◽  
Vol 9 (1) ◽  
pp. 179-184
Author(s):  
Ratna Sitompul
Keyword(s):  
Case Report ◽  
Intraocular Lens ◽  
Rural Areas ◽  
Rare Complication ◽  
Cataract Extraction ◽  
Factors Affecting ◽  
Intraocular Lens Dislocation ◽  
Post Surgery ◽  
The Right ◽  
Iol Dislocation

Intraocular lens (IOL) dislocation is a rare complication of cataract extraction requiring prompt surgery. This case report aims to raise awareness of such cases and the importance of post-surgery follow-up. A 58-year-old female patient was found with anterior IOL dislocation a week after phacoemulsification surgery in her right eye. Visual acuity of the right eye was 1/60 with ciliary injection and IOL dislocation to the anterior chamber of the right eye. The patient underwent surgery of the right eye and the IOL haptic was found to be broken. In this case report, the factors affecting IOL dislocation are axis length, broken IOL haptic, and patient activity that increased intraocular pressure. Cataract extraction surgery, although common, needs to be conducted carefully, and it is important for ophthalmologists and general practitioners to detect this condition, especially in rural areas where facilities are limited, as IOL dislocation could occur and requires immediate treatment to achieve a better result.

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