Managing intraocular lens dislocation with one-port pars plana vitrectomy under direct vision with microscope illumination

2021 ◽  
Vol 2 (3) ◽  
pp. 127-130
Author(s):  
Jin Yang ◽  
◽  
Xiao-Di Qiu ◽  
Lei Cai ◽  
Yi Lu ◽  
...  
Keyword(s):  
Intraocular Lens ◽  
Pars Plana Vitrectomy ◽  
Glaucoma Surgery ◽  
Direct Vision ◽  
Intraocular Lens Dislocation ◽  
Secondary Iol Implantation ◽  
Study Results ◽  
Posterior Capsule Rupture ◽  
Pars Plana ◽  
Iol Dislocation

AIM: To describe a technique of managing intraocular lens (IOL) with deep dislocation in the vitreous cavity by performing pars plana vitrectomy (PPV) with only one pars plana incision under the direct illumination of the surgical microscope. METHODS: Patients who had in-the-bag or out-of-the-bag (spontaneous) IOL dislocation after uneventful phacoemulsification cataract extractions, with the dislocated IOL or IOL-capsular bag complex dropping completely into the vitreous since 2013 were included in our studies. The postoperative patients were followed up for 6mo. Detailed description of technique and retrospective description of eight typical cases were demonstrated in this study. RESULTS: A total of 40 surgeries were conducted using this technique. The main possible predisposing conditions included: post-vitrectomy, posterior capsule rupture or broken zonules, a history of ocular trauma, long axial length, secondary IOL implantation, chronic uveitis, retinitis pigmentosa and post-glaucoma surgery. In all eyes, the IOLs were successfully removed. No intraoperative or postoperative complications related to the procedures occurred. The preoperative corrected distance visual acuity (CDVA) ranged from 20/133 to 20/25, and at 6mo postoperatively, the CDVA was similar or the same. The intraocular pressure was all within the normal range. CONCLUSION: One-port PPV under direct vision with microscope illumination is a simple and safe surgical technique to managing IOL dislocation, which shortens the surgical time, and largely avoids surgical complications.

scholarly journals Long-term surgical outcomes of primary retropupillary iris claw intraocular lens implantation for the treatment of intraocular lens dislocation

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Eun Young Choi ◽  
Chul Hee Lee ◽  
Hyun Goo Kang ◽  
Jae Yong Han ◽  
Suk Ho Byeon ◽  
...  
Keyword(s):  
Intraocular Lens ◽  
Pars Plana Vitrectomy ◽  
Case Series ◽  
Retrospective Case ◽  
Iol Implantation ◽  
Intraocular Lens Dislocation ◽  
Post Surgery ◽  
Pars Plana ◽  
Iol Dislocation ◽  
Iris Claw

AbstractWe aimed to investigate the efficacy and safety of primary retropupillary iris claw intraocular lens (R-IOL) implantation in patients with complete intraocular lens (IOL) dislocation. In this single-center retrospective case series, we reviewed the medical records of patients who underwent R-IOL implantation surgery with pars plana vitrectomy for the treatment of IOL dislocation between September 2014 and July 2019. The primary outcome was change in visual acuity (VA) up to 24 months postoperatively. The secondary outcomes included changes in intraocular pressure (IOP), refractive errors, and endothelial cell count (ECC) over the same period. Data of 103 eyes (98 patients) were analyzed. The mean uncorrected VA was significantly improved at one month postoperatively (− 0.69 logMAR, P < 0.001), compared to the preoperative value. IOP (− 2.3 mmHg, P = 0.008) and ECC (− 333.4 cells/mm2, P = 0.027) significantly decreased one month post-surgery and remained stable thereafter. Postoperative mean spherical equivalents were similar to the prediction error throughout the follow-up period. IOP elevation (n = 8, 7.8%), cystoid macular edema (n = 4, 3.9%), and dislocation of the R-IOL (n = 10, 9.7%) were managed successfully. Overall, primary R-IOL implantation with pars plana vitrectomy is effective and safe for correcting IOL dislocation due to various causes.

scholarly journals Pars plana vitrectomy combined with penetrating keratoplasty  and transscleral-sutured intraocular lens implantation in complex eyes: a case series

2020 ◽  
Author(s):  
Takahiko Hayashi ◽  
Yasutsugu Ida ◽  
Toshiki Shimizu ◽  
Tsubasa Kuroki ◽  
Yuji Kobashigawa ◽  
...  
Keyword(s):  
Graft Survival ◽  
Intraocular Lens ◽  
Pars Plana Vitrectomy ◽  
Penetrating Keratoplasty ◽  
Case Series ◽  
Glaucoma Surgery ◽  
Bullous Keratopathy ◽  
Spherical Equivalent ◽  
Iol Implantation ◽  
Pars Plana

Abstract Background The aim of this study was to evaluate the clinical outcomes of pars plana vitrectomy (PPV) combined with penetrating keratoplasty (PKP) and transscleral-sutured intraocular lens (IOL) implantation (IOL-suture) in complex eyes.Methods In this prospective, consecutive interventional case series, patients who underwent PKP combined with PPV and IOL implantation from July 2014 to March 2018 at Yokohama Minami Kyosai Hospital were enrolled. The postoperative best corrected visual acuity (BCVA) (converted to logarithm of the minimal angle of resolution [logMAR] units), intraocular pressure (IOP, mmHg), endothelial cell density (ECD, cells/mm2), graft survival, complications, astigmatism, and spherical equivalent (dioptres [D]) were evaluated. Results This study included 11 eyes of 11 patients (three females and eight males; mean age, 61.8 ± 13.9 years) with an injury (n = 6) or bullous keratopathy (n = 5). The BCVA significantly improved from 1.50 ± 0.66 logMAR preoperatively to 0.78 ± 0.59 logMAR (p < 0.001) postoperatively. The baseline ECD significantly decreased from 2396 ± 238 cells/mm2 preoperatively to 1132 ± 323 cells/mm2 (p < 0.001) postoperatively. Despite two rejection episodes, graft survival rates were 100%. The mean follow-up period was 38.0 ± 20.5 months. Two patients required combined glaucoma surgery, and three patients underwent subsequent glaucoma surgery. Postoperative astigmatism and spherical equivalent were 3.9 ± 3.2 D and 0.29 ± 2.18 D, respectively.Conclusion The combination of PKP, PPV, and IOL-suture implantation could be a safe and effective approach for eyes requiring anterior segment surgery; however, these eyes are associated with a higher incidence of glaucoma surgery.

scholarly journals Nucleus Drop or Intraocular Lens Drop Underwent Pars Plana Vitrectomy due to Complication of Cataract Surgery

2019 ◽  
Vol 2 (2) ◽  
Author(s):  
Noviana Kurniasari Vivin ◽  
Ari Djatikusumo ◽  
Elvioza Elvioza ◽  
Gitalisa Andayani ◽  
Anggun Rama Yudantha ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Cataract Surgery ◽  
Intraocular Lens ◽  
Pars Plana Vitrectomy ◽  
Iol Implantation ◽  
Secondary Iol Implantation ◽  
Choice Of Procedure ◽  
Department Of Ophthalmology ◽  
Pars Plana

Abstract Background: The incidence of nucleus drop or intraocular lens (IOL) drop as the complication of phacoemulsification increases due to the increased frequency of phacoemulsification. Pars plana vitrectomy (PPV) followed by endofragmentation and secondary IOL implantation is the choice of procedure for management. This study aims to determine the frequency, outcomes, and complication of PPV in the case of nucleus drop or IOL drop in the Department of Ophthalmology, Fakultas Kedokteran Universitas Indonesia – Rumah Sakit Cipto Mangunkusumo (FKUI-RSCM) Methods: This study is a retrospective descriptive study conducted in the Vitreoretinal Division of the Department of Ophthalmology, FKUI - RSCM. Research data was taken from the medical records of all nucleus drop or IOL drop patients underwent PPV in January 2017-December 2017. Results: There were 19 cases studied. The incidence of nucleus drop occurred in phacoemulsification surgery techniques (94.7%) and ECCE techniques (5.3%). Vitrectomy surgery was performed ≤2 weeks in 31.6% and >2 weeks in 68.4% after the patient first arrived at the vitreoretinal clinic. Most pre-PPV visual acuity was 1/60-6/60 (47.1%). In the final follow-up, visual acuity improved from 6/45 to 6/6 occurred in 42.2% of cases. Complication after PPV and secondary IOL implantation include elevated IOP (10.5%), IOL decentration (5.3%), corneal decompensation (5.3%), macular edema (5.3%), and retinal detachment (5.3%). Conclusion: Nucleus drop or IOL drop generally occurs in phacoemulsification cataract surgery techniques. Improved visual acuity was achieved after PPV and secondary IOL implantation at the end of the follow-up period. Most common post-PPV complication is elevated IOP.  

scholarly journals Possible Predisposing Factors for Late Intraocular Lens Dislocation After Routine Cataract Surgery

Medicina ◽  
2013 ◽  
Vol 49 (5) ◽  
pp. 37 ◽  
Author(s):  
Lina Krėpštė ◽  
Loreta Kuzmienė ◽  
Arūnas Miliauskas ◽  
Ingrida Janulevičienė
Keyword(s):  
Cataract Surgery ◽  
Intraocular Lens ◽  
Odds Ratio ◽  
University Hospital ◽  
Intraocular Lens Dislocation ◽  
Complicated Cataract ◽  
Study Results ◽  
The University ◽  
Iol Dislocation

Objective. The aim of this study was to evaluate possible risk factors for late intraocular lens (IOL) dislocation after routine cataract surgery. Material and Methods. A retrospective analysis of medical records of all the patients who were treated in the university hospital between 2011 and 2012 for late IOL dislocation requiring surgical management after routine cataract surgery was performed. In total, 58 patients (58 eyes) were included into the study. Results. The mean time between cataract surgery and late IOL dislocation was 67.8 months (SD, 34.9). A negative correlation was found between the patient age at cataract surgery and the time between cataract surgery and IOL dislocation (r=–0.29; P=0.042). Late in-the-bag dislocation occurred in 87.9% and late out-of-the-bag dislocation in 12.1% of the cases. Pseudoexfoliation was present in 56.9% and 42.9% of the eyes with in-the-bag and out-of-the-bag dislocation, respectively. The odds ratio for IOL dislocation within 43 months after complicated cataract surgery was 24.0 (95% confidence interval [95% CI] 4.5–127.4; P<0.001) and for in-the-bag IOL dislocation 24.9 (95% CI, 4.2–148.0; P<0.001). The odds ratio for in-the-bag IOL dislocation within 43 months after advanced cataract surgery was 18.8 (95% CI, 2.0–180.0; P=0.011). Moreover, in-the-bag IOL dislocation occurred earlier in the patients with past uveitis (P=0.020) or zonule laxity (P=0.037). Conclusions. Complicated cataract surgery increased the risk of both late in-the-bag and out-ofthe- bag IOL dislocation, and advanced cataract increased the risk of late in-the-bag IOL dislocation. The time to in-the-bag IOL dislocation shortens with pseudoexfoliation syndrome, advanced age, or past uveitis. These factors must be taken into account while planning a postoperative follow-up.

scholarly journals Pars plana vitrectomy combined with penetrating keratoplasty and transscleral-sutured intraocular lens implantation in complex eyes: a case series

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Takahiko Hayashi ◽  
Ida Yasutsugu ◽  
Toshiki Shimizu ◽  
Tsubasa Kuroki ◽  
Yuji Kobashigawa ◽  
...  
Keyword(s):  
Graft Survival ◽  
Intraocular Lens ◽  
Pars Plana Vitrectomy ◽  
Penetrating Keratoplasty ◽  
Case Series ◽  
Glaucoma Surgery ◽  
Bullous Keratopathy ◽  
Spherical Equivalent ◽  
Iol Implantation ◽  
Pars Plana

Abstract Background The aim of this study was to evaluate the clinical outcomes of pars plana vitrectomy (PPV) combined with penetrating keratoplasty (PKP) and transscleral-sutured intraocular lens (IOL) implantation (IOL-suture) in complex eyes. Methods In this prospective, consecutive interventional case series, patients who underwent PKP combined with PPV and IOL implantation from July 2014 to March 2018 at Yokohama Minami Kyosai Hospital were enrolled. The postoperative best corrected visual acuity (BCVA) (converted to logarithm of the minimal angle of resolution [logMAR] units), intraocular pressure (IOP, mmHg), endothelial cell density (ECD, cells/mm2), graft survival, complications, astigmatism, and spherical equivalent (dioptres [D]) were evaluated. Results This study included 11 eyes of 11 patients (three females and eight males; mean age, 61.8 ± 13.9 years) with an injury (n = 6) or bullous keratopathy (n = 5). The BCVA significantly improved from 1.50 ± 0.66 logMAR preoperatively to 0.78 ± 0.59 logMAR (p < 0.001) postoperatively. The baseline ECD significantly decreased from 2396 ± 238 cells/mm2 preoperatively to 1132 ± 323 cells/mm2 (p < 0.001) postoperatively. Despite two rejection episodes, graft survival rates were 100%. The mean follow-up period was 38.0 ± 20.5 months. Two patients required combined glaucoma surgery, and three patients underwent subsequent glaucoma surgery. Postoperative astigmatism and spherical equivalent were 3.9 ± 3.2 D and 0.29 ± 2.18 D, respectively. Conclusion The combination of PKP, PPV, and IOL-suture implantation could be a safe and effective approach for eyes requiring anterior segment surgery; however, these eyes are associated with a higher incidence of glaucoma surgery.

SURGICAL OUTCOME OF LATE IN-THE-BAG INTRAOCULAR LENS DISLOCATION TREATED WITH PARS PLANA VITRECTOMY

Retina ◽  
2016 ◽  
Vol 36 (3) ◽  
pp. 576-581 ◽  
Author(s):  
Amanda Rey ◽  
Ignasi Jürgens ◽  
Agnieszka Dyrda ◽  
Xavier Maseras ◽  
Antonio Morilla
Keyword(s):  
Intraocular Lens ◽  
Surgical Outcome ◽  
Pars Plana Vitrectomy ◽  
Lens Dislocation ◽  
Intraocular Lens Dislocation ◽  
Pars Plana

scholarly journals Advantage of pars plana vitrectomy combined with penetrating keratoplasty  and transscleral-sutured intraocular lens implantation in complex eyes: a case series

2020 ◽  
Author(s):  
Takahiko Hayashi ◽  
Yasutsugu Ida ◽  
Toshiki Shimizu ◽  
Tsubasa Kuroki ◽  
Yuji Kobashigawa ◽  
...  
Keyword(s):  
Graft Survival ◽  
Intraocular Lens ◽  
Pars Plana Vitrectomy ◽  
Penetrating Keratoplasty ◽  
Case Series ◽  
Glaucoma Surgery ◽  
Bullous Keratopathy ◽  
Spherical Equivalent ◽  
Iol Implantation ◽  
Pars Plana

Abstract Background The aim of this study was to evaluate the clinical outcomes of pars plana vitrectomy (PPV) combined with penetrating keratoplasty (PKP) and transscleral-sutured intraocular lens (IOL) implantation (IOL-suture) in complex eyes. Methods In this prospective, consecutive interventional case series, patients who underwent PKP combined with PPV and IOL implantation from July 2014 to Mar 2017 at Yokohama Minami Kyosai Hospital were enrolled. The postoperative best corrected visual acuity (BCVA) (converted to logarithm of the minimal angle of resolution [logMAR] units), intraocular pressure (IOP, mmHg), endothelial cell density (ECD, cells/mm2), graft survival, complications, astigmatism, and spherical equivalent (dioptres [D]) were evaluated. Results This study included 11 eyes of 11 patients (three females and eight males; mean age, 61.8 ± 13.9 years) with an injury (n = 6) or bullous keratopathy (n = 5). The BCVA significantly improved from 1.50 ± 0.66 logMAR preoperatively to 0.78 ± 0.59 logMAR (p < 0.001) postoperatively. The baseline ECD significantly decreased from 2396 ± 238 cells/mm2 preoperatively to 1132 ± 323 cells/mm2 (p < 0.001) postoperatively. Despite two rejection episodes, graft survival rates were 100%. The mean follow-up period was 38.0 ± 20.5 months. Two patients required combined glaucoma surgery, and three patients underwent subsequent glaucoma surgery. Postoperative astigmatism and the spherical equivalent were 3.9 ± 3.2 D and 0.29 ± 2.18 D, respectively. Conclusion The combination of PKP, PPV, and IOL-suture implantation could be a safe and effective approach for eyes requiring anterior segment surgery; however, these eyes are associated with a higher incidence of glaucoma surgery.

scholarly journals Rapid Capsular Contraction with Secondary Intraocular Lens Dislocation Associated with Unspecified Rod-Cone Dystrophy: A Case Report

2018 ◽  
Vol 9 (1) ◽  
pp. 155-159 ◽  
Author(s):  
Jocelyn Lam ◽  
Bradley Sifrig ◽  
Hoon Jung
Keyword(s):  
Case Report ◽  
Cataract Surgery ◽  
Intraocular Lens ◽  
Cone Dystrophy ◽  
Capsular Contraction ◽  
Intraocular Lens Dislocation ◽  
History Of ◽  
Blurry Vision ◽  
Pars Plana ◽  
Iol Dislocation

Purpose: We report an unusual case of rapid and severe anterior capsular contraction associated with secondary intraocular lens (IOL) dislocation following cataract surgery in a patient with unspecified rod-cone dystrophy. Case Report: A 68-year-old woman with a history of uncharacterized bilateral rod-cone dystrophy presented with blurry vision 1 month after cataract surgery. Best corrected visual acuity was 20/40 in the operative eye. Slit-lamp exam showed severe anterior capsular phimosis limiting view of the fundus. Our patient underwent 2 sessions of Nd:YAG anterior capsulotomy with limited success. Limited anterior vitrectomy was then performed without success due to densely adherent capsular tissue to the anterior surface of the IOL and additional secondary IOL dislocation. She ultimately underwent pars plana vitrectomy, removal of the capsular bag, and IOL exchange with a scleral fixated IOL. Conclusion: Rapid and severe anterior capsular contraction following cataract surgery is rare but appears to be associated with rod-cone dystrophy.

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