scholarly journals Complications and visual outcome of sutureless, scleral fixated intraocular lens in cases with traumatic aphakia

2021 ◽  
Vol 13 ◽  
pp. 251584142110090
Author(s):  
Amit Kumar Deb ◽  
Sandip Sarkar ◽  
Kaviyapriya Natarajan ◽  
Vignesh Elamurgan ◽  
Jagadeeswari Jayaseelan ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Intraocular Lens ◽  
Visual Outcome ◽  
Study Data ◽  
Posterior Segment ◽  
Cystoid Macular Oedema ◽  
Retrospective Data Analysis ◽  
The Difference ◽  
Scleral Fixated Intraocular Lens

Purpose: The aim of this study is to describe the complications and outcome of sutureless scleral fixated intraocular lens (SFIOL) implantation in traumatic aphakia. Setting: The study was conducted in a tertiary eye care centre in South India. Design: The study involved a retrospective data analysis. Methods: Medical records of cases with traumatic aphakia who had undergone sutureless SFIOL implantation in the last 2 years were included in the study. Data on intraoperative and postoperative complications and visual outcome were collected and analysed. Results: In total, 45 cases were recruited. Mean logarithm of the minimum angle of resolution (logMAR) best-corrected visual acuity (BCVA) improved from preoperative 1.64 ± 0.45 to 0.63 ± 0.36 at last follow-up visit, and the difference was statistically significant ( p < 0.0001). Final logMAR BCVA was worse than one in three patients who had associated posterior segment pathology. There was no incidence of intraoperative haptic rebound into the vitreous cavity or intraocular lens (IOL) drop. Four cases had hypotony, two cases had choroidal detachment, four cases had raised intraocular pressure (IOP), eight cases had transient corneal oedema and six patients had mild dispersed vitreous haemorrhage during immediate postoperative period. Six patients had postoperative cystoid macular oedema (CME). Two cases developed glaucoma. None of the patients had postoperative haptic exposure, retinal detachment (RD), iris capture of IOL or SFIOL dislocation till the last follow-up. Conclusion: Final visual outcome of sutureless SFIOL implantation in traumatic aphakia may be affected by concomitant posterior segment pathology. The immediate and late postoperative complications noted in our study were comparable with other similar studies. However, longer follow-up is needed to detect RD and angle recession glaucoma at the earliest and initiate therapy.

Refractive and Visual Outcomes after Scleral Fixated Intraocular Lens Implantation in Children with Ectopia Lentis

2020 ◽  
Vol 12 (1) ◽  
pp. 75-82
Author(s):  
Regina Lalramhluni ◽  
Soveeta Rath ◽  
Ankita Shrivastav ◽  
Prem Kumar Singh ◽  
Rahul Mayor ◽  
...  
Keyword(s):  
Intraocular Lens ◽  
Visual Outcome ◽  
Ectopia Lentis ◽  
Corrected Visual Acuity ◽  
Good Visual Outcome ◽  
Induced Astigmatism ◽  
The Mean ◽  
The Stability ◽  
Scleral Fixated Intraocular Lens

Introduction: This study was conducted to report the refractive and visual outcome after Scleral Fixated Intraocular Lens (SFIOL) implantation in children with nontraumatic ectopia lentis. Methods: Retrospective review of the medical records of 25 eyes of 15 patients who underwent SFIOL implantation in children with non-traumatic ectopia lentis. Results: The mean best corrected visual acuity (BCVA) before SFIOL implantation was 1.07 ± 0.9 logMar units [median: 0.9, Interquartile range (ΙQR): 0.415 to 1.555] which improved to 0.41 ± 0.33 logMar units (median: 0.22, ΙQR: 0.180 to 1.555) at two months postoperative follow up. In phakic group, the mean spherical refraction preoperatively was -12.04 ± 7.82 DS (dioptre sphere) (IQR: +16 to -5.875) and postoperatively was +0.93 ± 2.67DS (IQR: -0.375 to +2). In aphakic group, the mean spherical refraction preoperatively was +12.22 ± 2.05 DS and postoperatively was +1.2 ± 1.9 DS. The mean total astigmatism preoperatively was -6.44 ± 4.95 DC (dioptre cylinder) (median: 6, IQR: -10.50 to +2) and postoperatively was -1.47 ± 0.98 DC (median: -1.5, IQR: -2 to - 0.625 ). The mean IOL induced astigmatism was -1.01 ± 0.95 DC (median -0.75, IQR: -1.33 to - 0.25). The spherical refractive equivalent was within 2 Diopter (D) of the target refraction calculated preoperatively in 20 eyes and in five eyes it was more than 2 D. Conclusion: SFIOL implantation is associated with good visual outcome with a significant improvement in the refractive error. However, a longer follow up is required to assess the change of refraction and the stability of the SFIOL.

Outcomes and Complications of Concurrent Pars Plana Vitrectomy and Scleral-Fixated Intraocular Lens Placement Using Gore-Tex Suture

2019 ◽  
Vol 4 (2) ◽  
pp. 119-124
Author(s):  
H. Russell Day ◽  
Alia K. Durrani ◽  
Stephen J. Kim ◽  
Shriji Patel
Keyword(s):  
Visual Acuity ◽  
Postoperative Complications ◽  
Intraocular Lens ◽  
Pars Plana Vitrectomy ◽  
Vitreous Hemorrhage ◽  
Posterior Chamber ◽  
Pars Plana ◽  
The Mean ◽  
Scleral Fixated Intraocular Lens

Purpose: The authors aim to describe the visual outcomes and postoperative complications of concurrent pars plana vitrectomy and scleral-fixated intraocular lens (IOL) placement using Gore-Tex suture. Methods: A retrospective review of medical records was performed on 27 eyes of 27 patients undergoing concurrent pars plana vitrectomy and scleral-fixated IOL with Gore-Tex suture. Outcome measures were change in preoperative and postoperative visual acuity, final manifest refraction, and incidence of intraoperative and postoperative complications. Results: The mean age was 69.2 ± 11.3 years; there were 16 male patients (59%). The duration of follow-up ranged from 33 to 576 days with a mean of 200 ± 143 days. All patients received Bausch + Lomb Akreos AO60 IOL. The overall mean best-corrected visual acuity in Snellen equivalent improved from 20/276 preoperatively to 20/44 postoperatively ( P < .001). The mean postoperative manifest spherical equivalent refraction was –0.35 ± 1.34 diopters (D). Seventy-five percent of eyes were ± 1.0 D of target refraction. Postoperative complications included corneal edema (26.0%), ocular hypertension (25.9%), hypotony (7.4%), cystoid macular edema (7.4%), vitreous hemorrhage (7.4%), and hyphema (3.7%). No cases of suture breakage, IOL dislocation, retinal detachment, or uveitis–glaucoma–hyphema syndrome were identified. Conclusions: The use of Gore-Tex suture for posterior chamber IOL fixation resulted in favorable outcomes. No suture-related complications occurred during the follow-up period. Final refraction in this setting is typically within ± 1.0 D of target.

scholarly journals The simply modified intrascleral fixation using round flange (SMURF) technique for intrascleral intraocular lens fixation

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Soa Kim ◽  
Jee Taek Kim
Keyword(s):  
Intraocular Lens ◽  
Invasive Procedure ◽  
Crystalline Lens ◽  
Early Postoperative Period ◽  
Cystoid Macular Oedema ◽  
Modified Technique ◽  
Intraocular Pressure Elevation ◽  
Wound Leakage ◽  
Iol Dislocation

AbstractWe describe a simply modified intrascleral fixation using round flange (SMURF) technique and report the clinical outcomes of the surgery. Forty-one eyes of 41 consecutive patients, with intraocular lens (IOL) dislocation, crystalline lens subluxation, and zonular weakness, who underwent surgery using the SMURF technique were included. The modified technique included the use of a conventional 27-gauge needle, a non-bent needle, oblique sclerotomy, direct threading of the leading haptic, and simple placement of the following haptic. IOLs were successfully placed and showed good centring. There were no cases of wound leakage or hypotony during the early postoperative period. Postoperative complications included vitreous haemorrhage in one eye (2.4%), intraocular pressure elevation in one eye (2.4%), and iris capture in six eyes (14.6%). There were no cases of postoperative retinal detachment, cystoid macular oedema, endophthalmitis, or IOL dislocation during the follow-up period. We proposed a few modifications in the intrascleral flanged technique for IOL fixation. The modified technique is a simple, easy, and minimally invasive procedure for successful IOL intrascleral fixation.

scholarly journals Comparative Analysis of the Safety and Functional Outcomes of Anterior versus Retropupillary Iris-Claw IOL Fixation

2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Paolo Mora ◽  
Giacomo Calzetti ◽  
Stefania Favilla ◽  
Matteo Forlini ◽  
Salvatore Tedesco ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Refractive Error ◽  
Study Data ◽  
Posterior Chamber ◽  
Complicated Cataract ◽  
Corrected Distance Visual Acuity ◽  
Study Inclusion ◽  
Capsular Support ◽  
Iris Claw

Purpose. To compare the functional and clinical outcomes of the iris-claw intraocular lens (IOL) placed on the anterior versus posterior surface of the iris. Patients and Methods. A multicenter, retrospective study. Data on eyes that underwent anterior or retropupillary iris-claw IOL implantation because of inadequate capsular support secondary to complicated cataract surgery, trauma, and dislocated/opacified IOLs since January 2015 were analyzed. For study inclusion, evaluation results had to be available in the medical records both preoperatively and at 1 and 12 months after implantation. The following parameters were compared between the groups: best-corrected distance visual acuity (BCDVA), spherical and cylindrical refractive error, endothelial cell density (ECD), central macular thickness (CMT), and percentage and type of postoperative complications. Results. In total, 60 eyes of 60 patients aged 73 ± 13 years were included: 28 eyes (47%) involved anterior, and 32 eyes (53%) retropupillary, iris-claw IOL fixations. Preoperatively, the groups were similar in all parameters except for a significantly higher proportion of retropupillary fixations in patients who had previously experienced a closed-globe trauma (p=0.03). The groups showed comparable improvements in BCDVA after surgery (final BCDVA: 0.34 ± 0.45 vs. 0.37 ± 0.50 logMAR in the anterior and retropupillary placement groups, respectively). During follow-up, no group difference was observed in refractive error or CMT. Both groups experienced similarly marked ECD loss and showed similar incidence of postoperative complications, with cystoid macular edema being the most common complication. Multivariable linear regression showed that BCDVA at 1 month was the best predictor of the final BCDVA. Conclusions. Anterior chamber and posterior chamber iris-claw IOL fixations proved equally effective and safe for aphakic correction in eyes with inadequate capsular support.

scholarly journals Prechoroidal Cleft in Type 3 Neovascularization: Incidence, Timing, and Its Association with Visual Outcome

2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Jae Hui Kim ◽  
Young Suk Chang ◽  
Jong Woo Kim ◽  
Chul Gu Kim ◽  
Dong Won Lee
Keyword(s):  
Pigment Epithelium ◽  
Retinal Pigment ◽  
Visual Outcome ◽  
Subretinal Hemorrhage ◽  
Type 3 Neovascularization ◽  
The Difference ◽  
Type 3 ◽  
Endothelial Growth Factor ◽  
Rpe Tear

Purpose. To investigate the incidence and timing of prechoroidal cleft development and its association with visual prognosis in type 3 neovascularization. Methods. This retrospective study included 166 eyes that were diagnosed with type 3 neovascularization. All eyes were treated with antivascular endothelial growth factor therapy. The incidence and timing of prechoroidal cleft development were evaluated. Best-corrected visual acuity (BCVA) at diagnosis and at final follow-up was compared between eyes with (cleft group) and without (no-cleft group) prechoroidal cleft. The incidence of retinal pigment epithelium (RPE) tear and subretinal hemorrhage was also compared between the two groups. Results. During the mean 39.7 ± 18.5 months of follow-up, prechoroidal cleft developed in 37 eyes (22.3%) at an average of 14.6 ± 10.4 months. The BCVA at final follow-up was significantly worse in the cleft group than in the no-cleft group (P=0.024), whereas the difference was not significant at diagnosis (P=0.969). The incidence of RPE tear (P=0.002) and subretinal hemorrhage (P<0.001) was significantly higher in the cleft group. Conclusions. Prechoroidal cleft is a frequently observed finding during the treatment course of type 3 neovascularization. Eyes with prechoroidal cleft are at high risk of RPE tear or subretinal hemorrhage and subsequently associated with poor prognosis.

Factors Influencing Visual Outcome after Penetrating Keratoplasty Combined with Intraocular Lens Implantation

2003 ◽  
Vol 13 (2) ◽  
pp. 134-138 ◽  
Author(s):  
J.B. Jonas ◽  
R.M. Rank ◽  
W.M. Budde ◽  
G. Sauder
Keyword(s):  
Visual Acuity ◽  
Intraocular Lens ◽  
Penetrating Keratoplasty ◽  
Visual Outcome ◽  
Intraocular Lens Implantation ◽  
Postoperative Visual Acuity ◽  
Factors Influencing ◽  
Lens Implantation ◽  
Preoperative Visual Acuity

Purpose To establish which factors influence visual outcome after penetrating keratoplasty combined with intraocular lens implantation. Methods This retrospective noncomparative clinical interventional case series study included 135 consecutive patients (mean age 70.2 ± 13.6 years) who underwent central penetrating allogenic keratoplasty combined with intraocular lens (IOL) implantation, all operated by the same surgeon. There were 79 triple procedures, 33 keratoplasties combined with an exchange of IOL, and 23 penetrating keratoplasties combined with a secondary implantation of a posterior chamber lens. Mean follow-up was 28.3 ± 18.7 months (range 3.3–112 months). Reasons for keratoplasty were herpetic or traumatic corneal scars or defects (46), Fuchs corneal endothelial dystrophy (22), pseudophakic or aphakic bullous keratopathy (49), corneal endothelial decompensation due to other reasons (15), and keratoconus (3). Main outcome measures were postoperative visual acuity and gain in visual acuity. Results Mean postoperative visual acuity and mean gain in visual acuity were 0.33 ± 0.21 (median 0.30) and 0.25 ± 0.20 (median 0.20), respectively. Compared with the preoperative measurements, mean visual acuity increased in 129 patients (129/135, 95.6%). Factors influencing postoperative visual outcome and gain in visual acuity were preoperative visual acuity (p<0.005), reason for keratoplasty (p<0.005), and diameter of the graft (p = 0.046). Postoperative visual outcome was independent of age, sex, right or left eye, presence of diabetes mellitus, preoperative refractive error, length of follow-up, duration of surgery, and preoperative intraocular pressure. Conclusions The most important factors influencing visual outcome after central penetrating allogenic keratoplasty combined with IOL surgery are preoperative visual acuity, graft size, and reason for keratoplasty. Other factors such as age, sex, diabetes mellitus, and preoperative refractive error do not substantially influence postoperative visual outcome.

scholarly journals Clinical Effect of Open-wedge High Tibial Osteotomy in Treatment of Kellgren-lawrence IV Knee Osteoarthritis Associated with Varus Tibial Deformity

2020 ◽  
Vol 8 (9_suppl7) ◽  
pp. 2325967120S0054
Author(s):  
Yu Sha ◽  
Lei Yan
Keyword(s):  
Postoperative Complications ◽  
Knee Osteoarthritis ◽  
High Tibial Osteotomy ◽  
Tertiary Hospital ◽  
Knee Function ◽  
Tibial Osteotomy ◽  
Open Wedge ◽  
Wedge High Tibial Osteotomy ◽  
The Difference

Objectives: The purpose of this study is to evaluate the clinical efficacy of open-wedge high tibial osteotomy (HTO) in treatment of kellgren- lawrence IV anterior medial knee osteoarthritis with varus tibia. Methods: Between 2016 and 2018, 56 patients with kellgren -lawrence IV knee osteoarthritis associated with varus tibial deformity who underwent a medial open-wedge high tibial osteotomy at a tertiary hospital were prospectively followed up. The surgical effect and postoperative complications were observed and analyzed. Meanwhile, the hospital for special surgery (HSS) scores of knee function before operation and at the last follow-up after operation was compared. Results: The median follow up was 19.8 months (range, 18 to 24 months). At the last follow-up, there was 40 excellent cases, 14 good cases, 2 fair case and 0 poor case. There were no complications such as vascular and nerve injury, internal fixation fracture and infection. The HSS score of knee function (89.6±3.9) at the last follow-up after operation was higher than (63.2±6.4) points before operation, and the difference was statistically significant ( P ＜0.05). Conclusion: Medial opening high tibial osteotomy shows remarkable therapeutic effect for patients with knee osteoarthritis associated with varus tibial deformity, and it can effectively relief the pain of knee joint with less postoperative complications.

scholarly journals Open-Globe Injury With Intraocular Foreign Body

2020 ◽  
pp. 247412642096503
Author(s):  
Filippos Vingopoulos ◽  
Yvonne Wang ◽  
Seanna Grob ◽  
Chloe Yang Ling Li ◽  
Dean Eliott ◽  
...  
Keyword(s):  
Foreign Body ◽  
Primary Repair ◽  
Anterior Segment ◽  
Case Series ◽  
Visual Outcome ◽  
Posterior Segment ◽  
Open Globe ◽  
Time From Injury

Purpose: To investigate characteristics of Open Globe Injuries (OGI) that presented with Intra-Ocular Foreign Body (IOFB), along with their long-term visual outcomes and complications. Methods: Retrospective interventional consecutive case series of OGIs with IOFBs that presented at Massachusetts Eye and Ear from 2010 to 2015. Data collected included time from injury to OGI repair, location of IOFB, retinal detachment (RD) rate, presenting and final visual acuity and subsequent surgeries. Results: Fifty-seven consecutive cases of OGIs with IOFBs were included. Mean follow-up was 28 months and median time from injury to OGI repair was 0 days. Overall, 38/57 (66.7%) eyes achieved final vision of 20/40 or better and 43/57 (75.4%) 20/150 or better. Thirty-three cases had IOFBs in the anterior segment only, 24 cases had posterior segment involvement. Thirty percent of cases (17/57) were complicated by an RD, 58.3% (14/24) in the posterior versus 9.1% (3/33) in the anterior IOFB group ( P = .01). There were no cases of endophthalmitis. Posterior IOFB and higher zone of injury were risk factors for RD both at presentation (both P < .001) and post-primary repair (both P < .001). Posterior IOFB was associated with higher vitrectomy rates both at presentation ( P < .001) and post-primary repair ( P = .002) and worse long-term visual outcome ( P = .01). Conclusions: OGIs with IOFB involving the posterior segment are associated with higher complication and re-operation rates and worse visual prognosis compared to those involving the anterior segment only.

scholarly journals An Ex-Press implant versus trabeculectomy in a fibrotic bleb with late failure after previous trabeculectomy

2021 ◽  
Vol 14 (3) ◽  
pp. 383-387
Author(s):  
Faried Wagdy ◽  
◽  
Hisham Elsorogy ◽  
Ahmed Alnagdy ◽  
Dina Abd Elfattah ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Open Angle Glaucoma ◽  
Implant Surgery ◽  
Late Failure ◽  
Group I ◽  
The Mean ◽  
The Difference ◽  
One Year ◽  
Age Range

AIM: To compare the outcome of an Ex-Press implant and subscleral trabeculectomy (SST) in the management of glaucoma after previous trabeculectomy on a fibrotic bleb. METHODS: This randomized prospective study included 28 eyes from 28 patients (age range: 42-55y) with primary open angle glaucoma (POAG) presented with elevated intraocular pressure (IOP) with fibrotic bleb despite previous SST for more than 4mo. The eyes enrolled in the study were divided into two groups: group I (subjected to Ex-Press implant surgery) and group II [subjected to SST with mitomycin C (MMC)]. The follow-up continued one year after surgery to evaluate IOP, visual acuity (VA), visual field (VF), and postoperative complications. RESULTS: A significant decrease in IOP was found in both groups with a higher reduction in Ex-Press implant surgery with the mean IOP of 14.50 mm Hg (P=0.001), while the SST group recorded the mean IOP of 16.50 mm Hg (P=0.001) after one year. However, the difference between the two groups in terms of the decrease in IOP was insignificant. Fewer postoperative complications were recorded in the Ex-Press implant surgery and more cases requiring further anti-glaucomatous medications were seen in the SST group. Both groups showed stability in terms of VA and VF. CONCLUSION: Ex-Press implant surgery and SST with MMC are two surgical alternatives for controlling IOP in late failure that occurs more than 4mo after previous SST with a fibrotic bleb. However, Ex-Press shunt is a safer surgery with fewer complications.

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