scholarly journals Ex-PRESS shunt implantation for intractable glaucoma with posterior chamber phakic intraocular lens: a case report

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Rongrong Hu ◽  
Wei Xu ◽  
Baishuang Huang ◽  
Xiaoyu Wang
Keyword(s):  
Anterior Chamber ◽  
Intraocular Lens ◽  
High Myopia ◽  
Posterior Chamber ◽  
Filtration Surgery ◽  
Phakic Intraocular Lens ◽  
Glaucoma Filtration Surgery ◽  
Shallow Anterior Chamber ◽  
The Right ◽  
Intractable Glaucoma

Abstract Background Implantation of the posterior chamber phakic intraocular lens has been widely performed to correct high and extreme myopia. Chronic intraocular pressure (IOP) elevation may occur in its late postoperative period. For medically uncontrolled cases, surgical treatment is necessary, and benefits should be weighed against risks when determining whether to remove the lens. Case presentation A 32-year-old man with extremely high myopia presented with progressive blurred vision and medically uncontrolled IOP in the right eye. His past ocular history was significant for bilateral implantable collamer lens (ICL) implantation ten years ago. On ophthalmic examination, the ICL was well placed with a vault height of 456 µm in the right eye. The anterior chamber angles were open but narrow, and mild to moderate trabecular pigmentation was noted. Ex-PRESS glaucoma filtration surgery without ICL removal was performed to control IOP. During surgery, an Ex-PRESS P50 shunt was inserted into the anterior chamber via the front edge of the blue-grey transition zone between the sclera and cornea. Transient hypotony and shallow anterior chamber occurred in the first week after surgery, along with an ICL tilt towards the cornea with reduced vault height. No other complications related to either the ICL or the Ex-PRESS shunt were noted. IOP remained stable at 12 ~ 14 mmHg at the first 3-month follow-up. Conclusions Ex-PRESS glaucoma filtration surgery might be a safe and effective alternative treatment for intractable glaucoma with high myopia and ICL implantation. Careful assessment of the ICL position and anterior chamber angle is necessary to plan the appropriate surgical procedure. A postoperative shallow anterior chamber may result in ICL dislocation.

Ultrasound biomicroscopy of ZSAL-4 anterior chamber phakic intraocular lens for high myopia

2001 ◽  
Vol 27 (10) ◽  
pp. 1567-1573 ◽  
Author(s):  
Ignacio Jiménez-Alfaro ◽  
Julián García-Feijoó ◽  
Juan J Pérez-Santonja ◽  
Ricardo Cuiña
Keyword(s):  
Anterior Chamber ◽  
Intraocular Lens ◽  
High Myopia ◽  
Ultrasound Biomicroscopy ◽  
Phakic Intraocular Lens

scholarly journals Early Results with a New Posterior Chamber Phakic Intraocular Lens in Patients with High Myopia

2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Dilek Yaşa ◽  
Ufuk Ürdem ◽  
Alper Ağca ◽  
Yusuf Yildirim ◽  
Burçin Kepez Yildiz ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Endothelial Cell ◽  
Intraocular Lens ◽  
High Myopia ◽  
Posterior Chamber ◽  
Phakic Intraocular Lens ◽  
Phakic Iol ◽  
Distance Visual Acuity ◽  
Early Results ◽  
Manifest Refraction

Purpose. To report clinical results of a foldable, hydrophilic acrylic, single-piece, injectable, posterior chamber phakic intraocular lens (pIOL).Material and Methods. Medical records of patients who underwent posterior chamber phakic IOL (Eyecryl Phakic IOL, Biotech Vision Care, Ahmedabad, India) implantation for surgical correction of myopia were retrospectively reviewed. Only patients with at least a one-year follow-up were included. Manifest refraction, uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), endothelial cell density (ECD), and pIOL vault were analyzed at 1, 3, 6, and 12 months after surgery. Complications observed during and after surgery were also recorded.Results. The study included 58 eyes of 29 patients. Mean patient age was 32 ± 7 years. Spherical equivalent of manifest refraction was −13.41 ± 3.23 D preoperatively and −0.44 ± 0.55 D postoperatively. Preoperative CDVA was 0.29 ± 0.71 logMAR. Postoperative UDVA and CDVA were 0.21 ± 0.66 and 0.15 ± 0.69 logMAR, respectively, at the 12-month visit. At the 12-month visit, the efficacy index was 1.20 and the safety index was 1.39. Mean ECD was 2713 ± 339 cells/mm2at the preoperative visit and 2608 ± 362 cells/mm2at the 12-month visit (3.9% loss,p<0.001). ECD loss from 3 months to 12 months was not statistically significant. No significant cataract formation, significant endothelial cell loss, glaucoma, uveitis, or any other vision-threatening complication was observed.Conclusion. Based on postoperative experience, we have found that Eyecryl Phakic IOL is safe and effective for treating high myopia.

scholarly journals Effect of peripheral iridectomy on VEGF-A and TGF-β levels in rabbit aqueous humour

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Annabel C. Y. Chew ◽  
Li-Fong Seet ◽  
Stephanie W. L. Chu ◽  
Nyein C. Lwin ◽  
Tina T. Wong
Keyword(s):  
Anterior Chamber ◽  
Aqueous Humour ◽  
Glaucoma Surgery ◽  
Filtration Surgery ◽  
Glaucoma Filtration Surgery ◽  
Peripheral Iridectomy ◽  
New Zealand White Rabbits ◽  
The Right ◽  
Tgf Β1 ◽  
Time Point

Abstract Background Peripheral iridectomy (PI), routinely performed during glaucoma filtration surgery, may contribute to scarring. This study aims to determine whether PI alters the concentrations of VEGF-A and TGF-β isoforms in the rabbit aqueous humour. Methods Anterior chamber paracentesis (ACP) was performed in both eyes of six New Zealand white rabbits, with additional surgical PI performed in the right eyes. Eyes were examined on postoperative days (PODs) 1, 7, 30 and 60 by means of the tonopen, slit-lamp biomicroscopy, and bead-based cytokine assays for TGF-β and VEGF-A concentrations in the aqueous humor. Results ACP caused a significant reduction in intraocular pressure (IOP) from mean preoperative 11.47 ± 1.01 mmHg to 5.67 ± 1.63 mmHg on POD 1 while PI did not cause further IOP reduction. Limbal conjunctival vasculature appeared slightly increased on POD 1 in both ACP and PI eyes with PI also causing mild bleeding from damaged iris vessels. Two PI eyes developed fibrinous anterior chamber reaction and/ or peripheral anterior synechiae. Aqueous VEGF-A levels were not significantly different between eyes treated with ACP and PI. Aqueous TGF-β concentrations distributed in the ratio of 4:800:1 for TGF-β1:TGF-β2:TGF-β3 respectively. While aqueous TGF-β2 was not significantly induced by either procedure at any time point, TGF-β1 and TGF-β3 were significantly induced above baseline levels by PI on POD 1. Conclusion PI increases the risk of inflammation. The combined induction of aqueous TGF-β1 and TGF-β3 by PI in glaucoma surgery may impact surgery success in glaucoma subtypes sensitive to these isoforms.

Bilateral Isolated Spherophakia with Lens Subluxation, High Myopia and Secondary Angle Closure: A Case Report

2018 ◽  
Author(s):  
Ye Zhang ◽  
Ravi Thomas ◽  
Cong Wang ◽  
Xiangyu Shi
Keyword(s):  
Anterior Chamber ◽  
High Myopia ◽  
Rare Condition ◽  
Spherical Shape ◽  
Angle Closure ◽  
Lens Subluxation ◽  
Pars Plana Lensectomy ◽  
Shallow Anterior Chamber ◽  
One Year ◽  
The Right

Abstract Background: Spherophakia is a rare condition and compared to its occurrence with familial and systemic disorders, isolated spherophakia is even more uncommon. This rare case of isolated spherophakia will raise the alertness of physicians when dealing with a high myopia patient with shallow anterior chamber and relatively normal fundus. Case presentation: We report a case of a 17-year-old male who experienced painless decrease of vision in both eyes (OU) for 11 years, with progression of visual impairment and occasional ocular pain for one year. Examination revealed high myopia, increased intraocular pressures (IOP, 28 mmHg in the right eye (OD) and 33 mmHg in the left (OS)), shallow central anterior chambers, lenses of a spherical shape with superior subluxation, occludable angles without peripheral anterior synechiae, and healthy optic discs OU. A diagnosis of bilateral isolated spherophakia, lens subluxation, high myopia and secondary angle closure (AC) was made. Pars plana lensectomy with anterior vitrectomy and scleral suturing of an intraocular lens was performed. On postoperative follow-up at 19 days OD and 63 days OS, the visual acuity was 6/6 and the IOP was normal without any medication OU. Conclusions: A presentation with high myopia, shallow anterior chamber with a normal retina should alert the clinician to the possibility of spherophakia, as compared to high myopia caused by elongated axial length. Surgery should be considered in cases of spherophakia with AC where the IOP cannot be controlled by noninvasive means.

scholarly journals Posterior chamber collagen copolymer phakic intraocular lens with a central hole for moderate-to-high myopia

Medicine ◽  
2016 ◽  
Vol 95 (36) ◽  
pp. e4641 ◽  
Author(s):  
Xinfang Cao ◽  
Weiliang Wu ◽  
Yang Wang ◽  
Chen Xie ◽  
Jianping Tong ◽  
...  
Keyword(s):  
Intraocular Lens ◽  
High Myopia ◽  
Central Hole ◽  
Posterior Chamber ◽  
Phakic Intraocular Lens
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