Results of Cataract Extraction in Patients with Corneal Opacity

Purpose. To evaluate the effectiveness of cataract extraction in patients with varying degrees of corneal opacity.Patients and methods. We performed cataract extraction with implantation of the intraocular lenses of 14 eyes (9 patients) with varying degree of corneal opacity. The causes of corneal opacities were: keratitis in anamnesis — 6 cases, the result of wearing soft contact lenses — 2 eyes, eye injury — 2, the outcome of dermatitis of unspecified genesis with eye damage — 3, perforation of the corneal ulcer — 1 case. In 9 eyes, opacity of the cornea occupied the optic part of the cornea, in 5 cases, the opacity of the cornea was in the paraoptic zone. The middle uncorrected visual acuity of all cases is 0.05 ± 0.03, and the middle best corrected visual acuity is 0.14 ± 0.07. The phacoemulsification of the cataract with implantation of the intraocular lens was performed for all the patients.Results. There were no complications during the operation, in the early and late postoperative periods. As a result of cataract extraction, all patients, regardless of the degree of cornea opacity, noted vision improvement. On the first day after the operation, the middle best corrected visual acuity was 0.06 ± 0.02 in 4 eyes, in 10 cases the middle best corrected visual acuity was 0.09 ± 0.03. The middle best corrected visual acuity 7 days after the surgery was 0.31 ± 0.07. After 6 months of observation of patients with corneal opacity after phacoemulsification of the cataract with implantation of the intraocular lens, the most corrected visual acuity was 0.27 ± 0.19.Conclusions. All patients with corneal opacity of varying degrees of intensity after cataract extraction noted improved vision. The central location of the opacity of the cornea significantly reduced visual acuity, and paraoptic — influenced the vision to a lesser extent. The degree of cornea turbidity was also affected the initial visual acuity — the more clouding and the depth of the cornea, the lower the vision. The result of the lens extraction also depended on the maturity of the cataract — with a more turbid lens the result was higher in relation to preoperative indices.

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Analysis of the surgical treatment of posterior lenticonus associated with congenital cataract

Russian Pediatric Ophthalmology ◽

10.18821/1993-1859-2016-11-3-138-143 ◽

2016 ◽

Vol 11 (3) ◽

pp. 138-143

Author(s):

K. B Pershin ◽

N. F Pashinova ◽

Alina Vasil’evna Cherkashina ◽

A. Yu Tsygankov

Keyword(s):

Visual Acuity ◽

Surgical Treatment ◽

Intraocular Lens ◽

Congenital Cataract ◽

Intraocular Lenses ◽

Entire Group ◽

Intraocular Lens Implantation ◽

Corrected Visual Acuity ◽

Lens Implantation ◽

Best Corrected Visual Acuity

Aim. The objective of the present study was to analyze the results of the surgical treatment of the children presenting with posterior lenticonus associated with congenital cataract. Materials and methods. The total of 8 children (8 eyes) with posterior lenticonus enrolled in this study accounted for 6.5% of all cases of congenital cataract treated at the “Excimer” Eye Center during the period from 2003 to 2015. The age of the patients varied from 0.2 to 15 (mean 8.1±3.8) years. Preoperatively, the uncorrected visual acuity was estimated to be 0.11±0.1 (0.01 - 0.3), with the best corrected visual acuity being 0.15±0.13 (range: 0.01 - 0.4). Lensectomy was performed under general anesthesia by means of the incision technology (1.8 and 2.2 mm) with the use of the Millenium, Stellaris microsurgical system (Bausch and Lomb, USA) and the Infinity system (Alcon, USA). In all the cases, different IOL models (Alcon, USA) were implanted; in four cases, the toric intraocular lenses were used. Results. In all the patients with posterior lenticonus and congenital cataract, the “dry” aspiration of the lens was performed. The distinctive features of posterior capsulorhexis included the use of two viscoelastic materials, viz. heavy Healon GV applied over the intraocular lens and ProVisc applied under the intraocular lens in the form of a “layer cake”. Thereafter, posterior capsulorhexis and vitrectomy were done. The lens was implanted into the capsular bag (n = 6) and into the ciliary sulcus (n = 2) with the anterior and posterior “optic capture”; the edges of the optical hole were placed behind the capsulorhexis hole. In the cases of the initial posterior capsular defect (n = 3), we performed vitreorhexis and vitrectomy followed by intraocular lens implantation. The best corrected visual acuity increased from 0.15 before the operation to 0.72 after surgery, with astigmatism being reduced from 2.3±0.9 to 1.6±065 diopters (overall astigmatism for the entire group) and from 1.81±0.46 to 0.56±0.56 diopters for the subgroup treated by means of toric IOL implantation. The patients remained under the observation during the follow-up period of more than 36 months. Conclusion. Lensectomy followed by intraocular lens implantation used for the treatment of the children presenting with posterior lenticonus and congenital cataract is the efficient method for the management of this combined pathology. Such features of the surgical technique as “dry” aspiration of the lens mass, posterior capsulorhexis, anterior vitrectomy, and optical capture taken together make it possible to achieve the favourable and stable functional outcome of the treatment.

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Factors influencing myopic shift in children after intraocular lens implantation

European Journal of Ophthalmology ◽

10.1177/1120672119845228 ◽

2019 ◽

Vol 30 (5) ◽

pp. 933-940 ◽

Cited By ~ 1

Author(s):

Sandra Valeina ◽

Santa Heede ◽

Renars Erts ◽

Svetlana Sepetiene ◽

Elina Skaistkalne ◽

...

Keyword(s):

Visual Acuity ◽

Intraocular Lens ◽

Intraocular Lenses ◽

Intraocular Lens Implantation ◽

Corrected Visual Acuity ◽

Intraocular Lens Power ◽

Lens Implantation ◽

Myopic Shift ◽

Lens Power ◽

Best Corrected Visual Acuity

Introduction: Intraocular lenses have always been a controversial topic in pediatric cataract surgery. In the early 1990s in the post-Soviet states of Eastern Europe, intraocular lenses promised an easier full-time correction and amblyopia treatment. Since 1991, ophthalmologists in Latvia have been implanting intraocular lenses in infants. Amount of the postoperative myopic shift and its influencing factors, analyzed in this article, are important indicators of congenital cataract treatment. Materials and methods: A retrospective chart review off 85 children (137 eyes) who underwent foldable posterior chamber intraocular lens implantation at the Clinical University Hospital in Riga, Latvia, from 1 January 2006 until 31 December 2016, was performed. Depending on the age at surgery, patients were divided into six groups: 1–6, 7–12, 13–24, 25–48, 49–84, and 85–216 months. Results: The largest and more variable myopic shift was found in a group of diffuse/total and nuclear cataract with surgery before the age of 6 months. There was a statistically significant correlation between the acquired best-corrected visual acuity and the amount of myopic shift (rs = 0.33; p < 0.001). Comparing the amount of myopic shift in two groups of different intraocular lens implantation target refraction tactics, we did not find statistically significant differences. Comparing the amount of myopic shift and implanted intraocular lens power, a negative, statistically significant correlation was found. Conclusion: The earlier the cataract extraction surgery and intraocular lens implantation is performed, the larger the myopic shift. The morphological type of cataract, best-corrected visual acuity, secondary glaucoma, and intraocular lens power influence the amount of myopic shift.

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Effect of phacoemulsification with intraocular lens implantation in eyes with cataract and functioning filtering blebs

Asian Journal of Ophthalmology ◽

10.35119/asjoo.v13i2.44 ◽

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.

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Cataract Surgery and Uveitis

Annals of King Edward Medical University ◽

10.21649/akemu.v9i3.1332 ◽

2016 ◽

Vol 9 (3) ◽

Author(s):

Mumtaz Hussain ◽

Muhammad Moin ◽

Nazir Ahmad Aasi ◽

Muhammad Waqas ◽

Jawaid Mughal

Keyword(s):

Visual Acuity ◽

Cataract Surgery ◽

General Hospital ◽

Cataract Extraction ◽

Extracapsular Cataract Extraction ◽

Iol Implantation ◽

Corrected Visual Acuity ◽

Best Corrected Visual Acuity

The study of 30 patients was performed at Lahore General Hospital, and Institute Of Ophthalmology Mayo Hospital, Lahore from June 1989 to June 2003 for 14 years. Total number of eyes were 34 where 2 patients had both eyes. Age ranged from 12-65 years. Males were 11 and females were 19. all the patients had planned extracapsular cataract extraction with IOL implantation. Total follow up period ranged from 1-5 years and best corrected visual acuity in these patients after surgery was 6/12 to 6/6. Post operatively, eyes had vitreous membranes and glaucomatous reaction.

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Clinical Performance of Toris K Contact Lens in Patients with Moderate to Advanced Keratoconus: A Real Life Retrospective Analysis

Journal of Ophthalmology ◽

10.1155/2016/2358901 ◽

2016 ◽

Vol 2016 ◽

pp. 1-6 ◽

Cited By ~ 2

Author(s):

Ihsan Yilmaz ◽

Ferah Ozcelik ◽

Berna Basarir ◽

Gokhan Demir ◽

Gonul Durusoy ◽

...

Keyword(s):

Visual Acuity ◽

Contact Lens ◽

Contact Lenses ◽

Clinical Performance ◽

Real Life ◽

Soft Contact Lenses ◽

Corrected Visual Acuity ◽

Uncorrected Visual Acuity ◽

Central Cone ◽

The Mean

Objectives.To evaluate the visual performance of Toris K soft contact lenses in patients with moderate-to-advanced keratoconus and also to compare the results according to cone types, cone location, and severity of keratoconus.Materials and Methods.Sixty eyes of 40 participants were included in this retrospective study. Uncorrected visual acuity (UCVA), best-spectacle corrected visual acuity (BCVA), best-contact lens corrected visual acuity (BCLCVA), and comfort rating via visual analogue scales (VAS) were measured.Results.The mean age was 27.3 ± 8.6 years (range: 18 to 54). The mean logMAR UCVA, BCVA, and BCLCVA were 0.85 ± 0.38 (range: 0.30–1.30), 0.47 ± 0.27 (range: 0.10–1.30), and 0.16 ± 0.20 (range: 0–1.00). There were significant increases in visual acuities with contact lenses (p<.05). BCLCVA was significantly better in oval type than globus type (p=.022). UCVA and BCLCVA were significantly better in moderate keratoconus group (p=.015,p=.018). The mean line gain in Snellen was 3.6 ± 1.8 lines (range: 0–7 lines). The mean line gain was higher in central cone group than paracentral cone group and oval group than globus group (p=.014,p=.045). The mean VAS score was 8.14 ± 1.88 (range: 6–10).Conclusions.Toris K can improve visual acuity of patients with keratoconus. Toris K is successful even in the moderate and advanced form of the disease.

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Retro-pupillary iris fixated intraocular lens: A boon to aphakia

Indian Journal of Clinical and Experimental Ophthalmology ◽

10.18231/j.ijceo.2021.082 ◽

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.

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27-gauge trocar-assisted transconjunctival sutureless intraocular lens scleral fixation

European Journal of Ophthalmology ◽

10.1177/1120672120919068 ◽

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.

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Visual outcome following scleral fixated intraocular lens implantation

Medical Journal of Shree Birendra Hospital ◽

10.3126/mjsbh.v16i2.18478 ◽

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.

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Aphakia korrekciója irisklip műlencse retropupillaris beültetésével

Orvosi Hetilap ◽

10.1556/650.2017.30607 ◽

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.

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Visual outcome of extracapsular cataract extraction and intraocular lens replacement in leprosy patients

Eastern Mediterranean Health Journal ◽

10.26719/2004.10.1-2.187 ◽

2004 ◽

Vol 10 (1-2) ◽

pp. 187-191

Author(s):

A. Derakhshan

Keyword(s):

Visual Acuity ◽

Intraocular Lens ◽

Visual Outcome ◽

Cataract Extraction ◽

Corneal Opacity ◽

Extracapsular Cataract Extraction ◽

Keratic Precipitates ◽

Posterior Synechia ◽

Leprosy Patients ◽

Islamic Republic Of Iran

The study was carried out in Meshed, Islamic Republic of Iran, from 1998 to 2000 to explore the visual outcome of eye surgery with extracapsular cataract extraction and intraocular lens replacement on 18 leprosy patients [20 eyes]. The most common complications of leprosy were madarosis [90%] and partial or total corneal opacity [90%]. Visual acuity before surgery ranged from ‘light perception’ to 1/10, and this improved after surgery to 5/10-8/10 for 55% of patients. Postoperative infection leading to endophthalmitis occurred in only 1 patient and was treated with drugs; this patient’s visual acuity remained at 10 cm finger count. Posterior synechia due to chronic uveitis in leprosy was diagnosed in 70% of eyes, obstructed iris in 25%, keratic precipitates in 25% and moderate iris atrophia in 10%

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