Secondary Piggyback Intraocular Lens for Management of Residual Ametropia after Cataract Surgery

Purpose: To investigate the indications, clinical outcomes, and complications of secondary piggyback intraocular lens (IOL) implantation for correcting residual refractive error after cataract surgery. Methods: In this prospective interventional case series, patients who had residual refractive error after cataract surgery and were candidates for secondary piggyback IOL implantation between June 2015 and September 2018 were included. All eyes underwent secondary IOL implantation with the piggyback technique in the ciliary sulcus. The types of IOLs included Sulcoflex and three-piece foldable acrylic lenses. Patients were followed-up for at least one year. Results: Eleven patients were included. Seven patients had hyperopic ametropia, and four patients had residual myopia after cataract surgery. The preoperative mean of absolute residual refractive error was 7.20 ± 7.92, which reached 0.42 ± 1.26 postoperatively (P < 0.001). The postoperative spherical equivalent was within ±1 diopter of target refraction in all patients. The average preoperative uncorrected distance visual acuity was 1.13 ± 0.35 LogMAR, which significantly improved to 0.41 ± 0.24 LogMAR postoperatively (P = 0.008). There were no intraor postoperative complications during the 22.4 ± 9.5 months of follow-up. Conclusion: Secondary piggyback IOL implantation is an effective and safe technique for the correction of residual ametropia following cataract surgery. Three-piece IOLs can be safely placed as secondary piggyback IOLs in situations where specifically designed IOLs are not available.

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Hyperopic Shift caused by Capsule Contraction Syndrome after Microincision Foldable Intraocular Lens Implantation: case series

10.21203/rs.2.153/v1 ◽

2018 ◽

Author(s):

Tae Gi Kim ◽

Sang Woong Moon

Keyword(s):

Cataract Surgery ◽

Intraocular Lens ◽

Refractive Error ◽

Nd:Yag Laser ◽

Case Series ◽

Intraocular Lens Implantation ◽

Lens Implantation ◽

Hyperopic Shift ◽

The Mean ◽

Anterior Capsulotomy

Abstract Background: Increasing interest in microincision cataract surgery has led to the use of more flexible intraocular lens (IOL). Flexible IOL may cause more IOL deformation and refractive error when capsule contraction syndrome (CCS) occurred. In this retrospective observational case series study, the aim was to report four cases of hyperopic shift caused by CCS after phacoemulsification with microincision foldable intraocular lens implantation. Case presentation: All of four patients underwent phacoemulsification and in-the-bag implantation of an Akreos MI60 (Bausch and Lomb) IOL from 2010 to 2016 in our clinic. These patients had been diagnosed with CCS and had undergone Nd:YAG laser anterior capsulotomy. The mean age of the patients with CCS was 66.8 ± 6.7 years and the mean time for development of CCS after the cataract surgery was 9.3 ± 6.9 months. The mean spherical equivalent (SE) value at the time of the CCS diagnosis was 0.88 ± 0.91 D, which had shown a hyperopic shift compared to the SE value of − 0.91 ± 1.29 D after cataract surgery. The mean SE decreased by − 0.47 ± 1.14 D after Nd:YAG laser anterior capsulotomy. The mean age, axial length, anterior chamber depth, and preoperative SE were not significantly different between the patient with CCS and the patients without CCS. Conclusions: In the case of IOL implantation with flexible materials in microincision cataract surgery, CCS can cause a hyperopic shift. Refractive error caused by CCS can be effectively corrected by Nd:YAG laser anterior capsulotomy. Key Words: Capsule contraction syndrome, Microincision cataract surgery, Refractive change, Nd:YAG laser anterior capsulotomy, Intraocular lens

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

International Journal of Retina ◽

10.35479/ijretina.2019.vol002.iss002.73 ◽

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.

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Prognostic Factors for Low Visual Acuity after Cataract Surgery with Vitreous Loss

Journal of Ophthalmology ◽

10.1155/2021/6691904 ◽

2021 ◽

Vol 2021 ◽

pp. 1-6

Author(s):

Michael Mimouni ◽

Michal Schaap-Fogler ◽

Philip Polkinghorne ◽

Gilad Rabina ◽

Rita Ehrlich

Keyword(s):

Visual Acuity ◽

Prognostic Factors ◽

Cataract Surgery ◽

Intraocular Lens ◽

Axial Length ◽

Visual Outcome ◽

Multivariable Logistic Regression Analysis ◽

Iol Implantation ◽

Secondary Iol Implantation ◽

Vitreous Loss

Purpose. The purpose of this study is to find prognostic factors associated with low visual acuity in patients experiencing vitreous loss during cataract surgery. Methods. A retrospective, noncomparative, interventional, case study of patients experiencing vitreous loss during cataract surgery. Data collected included demographics, best corrected visual acuity (BCVA), axial length (AL), presence of ocular comorbidity affecting central vision, timing of intraocular lens (IOL) implantation, position of the implanted lens, and the presence of corneal sutures. Low visual outcome was defined as BCVA < 20/40. Results. Overall, 179 patients (60.3% males) with a mean age of 73 ± 12 years and axial length of 23.5 ± 1.3 mm with a mean follow-up of 12 ± 13 months were included. In multivariable logistic regression analysis, low visual outcome was independently associated with persisting postoperative complications (OR 6.25, 95% CI 1.378–30.9), preexisting ocular comorbidities (OR 4.45, 95% CI 1.1–18.00), and secondary intraocular lens (IOL) implant (OR 10.36, 95% CI 1.8–60.00). Conversely, pars plana vitrectomy (PPV) for dislocated fragments of lens material, age > 70 years, gender, axial length, degree of surgeon, corneal suturing, and anterior chamber lens implantation were not found to have significant associations with low visual outcomes ( P > 0.05 ). Conclusions. Low visual outcome after vitreous loss during cataract surgery was associated with ocular comorbidities, secondary IOL implantation, development of cystoid macular edema, and additional surgical complications.

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Congenital and developmental cataract surgery with undercorrected Intraocular lens (IOL) power implantation targeting emmetropia at 8 years of age and post-operative refractive status

Asian Journal of Medical Sciences ◽

10.3126/ajms.v12i9.36890 ◽

2021 ◽

Vol 12 (9) ◽

pp. 126-129

Author(s):

Kabindra Bajracharya ◽

Anjita Hirachan ◽

Kriti Joshi ◽

Bimala Bajracharya

Keyword(s):

Cataract Surgery ◽

Intraocular Lens ◽

Axial Length ◽

Iol Implantation ◽

Refractive Status ◽

Developmental Cataract ◽

Iol Power ◽

The Mean ◽

One Year

Background: In congenital and developmental cataract primary undercorrection of intraocular lens (IOL) power is a common practice. However, long-term refractive status of these children is largely unknown. Aims and Objective: To analyse refractive status after cataract surgery with undercorrected IOL power implantation in congenital and developmental cataract. Materials and Methods: This study was descriptive, retrospective conducted for three years from 1st January 2013 to 31st December 2015. The children (> 6 months to <=7 years of age) who underwent cataract surgery for congenital and developmental cataract with a primary IOL implantation and had reached the age of 8 years were studied. The data were collected in terms of demography, axial length, biometry, IOL implanted, hyperopic correction and postoperative refractive status at 8 years. Results: Total numbers of children operated were 181 with total eyes 288. Unilateral cases were 74 (40.88%) and bilateral 107 (59.12%). Male were 121 (66.85%) and female were 60 (33.15%) with male is to female ratio of 2:1. Right eye was involved in 152 (52.8%) and left eye 136 (47.2%). The mean axial length at the age of one year was 20.75 mm, and gradually increased as age increased which was 22.47 mm at 6 years. The mean biometry was 27.9 diopter (D) at the age of one year which gradually decreased as age increased. Of the total 288 congenital cataract operated, complete follow-up documents were available for 77 (26.74%) eyes up to 8 years which showed emmetropia achieved in 25.97%, myopia in 28.57% and hypermetropia in 45.45%. Conclusion: Primary IOL implantation with hyperopic correction is accepted practice in congenital and developmental cataract. Emmetropia can be achieved however some hyperopic or myopic refractive status at the age of 8 years is not a surprise. Myopic shift continues as the age increases. Parent awareness for early detection and surgery, optical correction and regular follow-up are essential for good outcome.

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Primary and Secondary Intraocular Lens Implantation in Congenital Cataract Surgery: A Retrospective Comparative Study of the Visual Outcomes

Journal of Ophthalmology & Clinical Research ◽

10.33140/jocr/01/01/00004 ◽

2017 ◽

Vol 1 (1) ◽

Keyword(s):

Visual Acuity ◽

Intraocular Pressure ◽

Cataract Surgery ◽

Intraocular Lens ◽

Congenital Cataract ◽

Iol Implantation ◽

Visual Outcomes ◽

Secondary Iol Implantation ◽

Myopic Shift ◽

Congenital Cataract Surgery

Objectives: To compare visual outcomes, principally myopic shift, visual acuity, intraocular pressure and strabismus between primary and secondary intraocular lens (IOL) implantation following congenital cataract surgery. Methods: A retrospective study of the long-term ocular outcomes in primary versus secondary IOL implantation (IOL-I) following congenital cataract surgery was conducted. We analyzed the files of all children with congenital cataract who underwent unilateral or bilateral lensectomy, posterior capsulotomy and anterior vitrectomy followed by primary or secondary IOL-I between 2000 to 2012, at King Abdulaziz University Hospital, Jeddah. Preoperative and postoperative assessment of each operated eye in terms of axial length, refractive errors, strabismus as well as (post IOL-I) intraocular pressure (IOP) and best corrected visual acuity (BC-VA) were collected and analyzed. Results: Data of 26 eyes of 14 patients (9 males, 6 females) was analyzed: 16 (61.5%) eyes underwent lensectomty and anterior vasectomy with primary IOL-I and 10 (38.5%) eyes underwent lumpectomy and anterior vasectomy with secondary IOL-I. Mean age at cataract surgery was 67.53 (± 48.70) months in the group of primary IOL-I versus 5.90 (± 3.72) months in the group of secondary IOL-I; and patients were followed up for 49.33 (± 26.23) versus 86.50 (± 23.36) months, respectively (p=.051). In the secondary IOL-I group, the mean of time from primary lensectomy to IOL-I was 50.44 (± 18.41) months. Last BC-VA showed better outcomes in primary IOL-I group as 10 eyes (83.3%) with good VA versus only 2 eyes (20%) in the secondary IOL-I, (p=0.009). Myopic shift was greater in secondary IOL group 10.86 (± 11.62) versus 0.19 (± 2.38) diopters (D) in primary IOL (p=0.046*); while no significant difference was observed in IOP (p=0.697). No case of isotropic was detected in primary versus 6 cases in the secondary IOL group. Conclusion: Visual outcomes, including visual acuity, strabismus and myopic shift were better in the group of children who underwent primary IOL implantation at age of >2 years, when compared to those with secondary IOL implantation at the age of <2 years, following congenital cataract surgery. However, poor visual acuity in the secondary IOL group was mainly explained by the relatively higher prevalence of eye complications in this group.

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Evaluating newer generation intraocular lens calculation formulas in manual versus femtosecond laser-assisted cataract surgery

International Journal of Ophthalmology ◽

10.18240/ijo.2021.08.06 ◽

2021 ◽

Vol 14 (8) ◽

pp. 1174-1178

Author(s):

Harrish Nithianandan ◽

◽

Eric S. Tam ◽

Hannah Chiu ◽

Rajiv Maini ◽

...

Keyword(s):

Femtosecond Laser ◽

Cataract Surgery ◽

Radial Basis Function ◽

Intraocular Lens ◽

Refractive Error ◽

Basis Function ◽

Case Series ◽

Absolute Error ◽

Iol Power ◽

Intraocular Lens Calculation

AIM: To determine the refractive accuracy of the Haigis, Barrett Universal II (Barrett), and Hill-radial basis function 2.0 (Hill-RBF) intraocular lens (IOL) power calculations formulas in eyes undergoing manual cataract surgery (MCS) and refractive femtosecond laser-assisted cataract surgery (ReLACS). METHODS: This was a REB-approved, retrospective interventional comparative case series of 158 eyes of 158 patients who had preoperative biometry completed using the IOL Master 700 and underwent implantation of a Tecnis IOL following uncomplicated cataract surgery using either MCS or ReLACS. Target spherical equivalence (SE) was predicted using the Haigis, Barrett, and Hill-RBF formulas. An older generation formula (Hoffer Q) was included in the analysis. Mean refractive error (ME) was calculated one month postoperatively. The lens factors of all formulas were retrospectively optimized to set the ME to 0 for each formula across all eyes. The median absolute errors (MedAE) and the proportion of eyes achieving an absolute error (AE) within 0.5 diopters (D) were compared between the two formulas among MCS and ReLACS eyes, respectively. RESULTS: Of the 158 eyes studied, 64 eyes underwent MCS and 94 eyes underwent ReLACS. Among MCS eyes, the MedAE did not differ between the formulas (P=0.59), however among ReLACS eyes, Barrett and Hill-RBF were more accurate (P=0.001). Barrett and Hill-RBF were both more likely to yield AE<0.5 D among both groups (P<0.001). CONCLUSION: The Barrett and Hill-RBF formula lead to greater refractive accuracy and likelihood of refractive success when compare to Haigis in eyes undergoing ReLACS.

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Uveitis-glaucoma-hyphema syndrome associated with an in-the-bag square-edge intraocular lens

Precision Clinical Medicine ◽

10.1093/pcmedi/pbz026 ◽

2019 ◽

Vol 2 (4) ◽

pp. 283-287

Author(s):

Jin Yang ◽

Xiaodi Qiu ◽

Lei Cai ◽

Qi Fan ◽

Anjian Wang ◽

...

Keyword(s):

Intraocular Pressure ◽

Cataract Surgery ◽

Intraocular Lens ◽

Diagnostic Procedure ◽

Ocular Inflammation ◽

Local Hospital ◽

Blurred Vision ◽

Iol Implantation ◽

Elevated Intraocular Pressure ◽

One Year

Abstract A 54-year-old woman presented with recurrent redness and blurred vision of the left eye with elevated intraocular pressure (IOP) for one year. She was treated as “iridocyclitis” and ``Posner-Schlossman syndrome'' at the local hospitals. However, the patient developed intermittent ocular inflammation and hyphema. Patient had a cataract surgery and intraocular lens (IOL) implantation in the left eye one year before at the local hospital. A diagnostic procedure was performed and the possible pathogenesis was discussed.

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Hyperopic Shift caused by Capsule Contraction Syndrome after Microincision Foldable Intraocular Lens Implantation: case series

10.21203/rs.2.153/v2 ◽

2019 ◽

Author(s):

Tae Gi Kim ◽

Sang Woong Moon

Keyword(s):

Cataract Surgery ◽

Intraocular Lens ◽

Refractive Error ◽

Nd:Yag Laser ◽

Case Series ◽

Intraocular Lens Implantation ◽

Lens Implantation ◽

Hyperopic Shift ◽

The Mean ◽

Anterior Capsulotomy

Abstract Background Increasing interest in microincision cataract surgery has led to the use of more flexible intraocular lens (IOL). Flexible IOL may cause more IOL deformation and refractive error when capsule contraction syndrome (CCS) occurred. In this retrospective observational case series study, the aim was to report four cases of hyperopic shift caused by CCS after phacoemulsification with microincision foldable intraocular lens implantation. Case presentation All of four patients underwent phacoemulsification and in-the-bag implantation of an Akreos MI60 (Bausch and Lomb) IOL from 2010 to 2016 in our clinic. These patients had been diagnosed with CCS and had undergone Nd:YAG laser anterior capsulotomy. The mean age of the patients with CCS was 66.8 ± 6.7 years and the mean time for development of CCS after the cataract surgery was 9.3 ± 6.9 months. The mean spherical equivalent (SE) value at the time of the CCS diagnosis was 0.88 ± 0.91 D, which had shown a hyperopic shift compared to the SE value of − 0.91 ± 1.29 D after cataract surgery. The mean SE decreased by − 0.47 ± 1.14 D after Nd:YAG laser anterior capsulotomy. The mean age, axial length, anterior chamber depth, and preoperative SE were not significantly different between the patient with CCS and the patients without CCS. Conclusions In the case of IOL implantation with flexible materials in microincision cataract surgery, CCS can cause a hyperopic shift. Refractive error caused by CCS can be effectively corrected by Nd:YAG laser anterior capsulotomy.

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Cataract surgery in children: visual acuity and refractive error outcomes one year after surgery

Journal of American Association for Pediatric Ophthalmology and Strabismus ◽

10.1016/j.jaapos.2017.07.119 ◽

2017 ◽

Vol 21 (4) ◽

pp. e34

Author(s):

Michael X. Repka ◽

Trevano W. Dean ◽

Raymond T. Kraker ◽

David K. Wallace ◽

Erick D. Bothun ◽

...

Keyword(s):

Visual Acuity ◽

Cataract Surgery ◽

Refractive Error ◽

One Year

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Comparisons of Visual and Surgical Outcomes after Reuse or Replacement of Dislocated in-the-Bag Intraocular Lens

Journal of Ophthalmology ◽

10.1155/2018/7342917 ◽

2018 ◽

Vol 2018 ◽

pp. 1-4 ◽

Cited By ~ 2

Author(s):

Takayuki Baba ◽

Tomohiro Nizawa ◽

Toshiyuki Oshitari ◽

Shuichi Yamamoto

Keyword(s):

Visual Acuity ◽

Endothelial Cell ◽

Intraocular Lens ◽

Refractive Error ◽

Surgical Outcomes ◽

Case Series ◽

Cell Loss ◽

Significant Difference ◽

Group A ◽

Group B

Purpose. To compare the visual and surgical outcomes after a reuse or a replacement of a dislocated in-the-bag intraocular lens (IOL). Methods. This was a retrospective, nonrandomized case series at a single ophthalmological institution. Cases with an in-the-bag dislocation of an IOL were treated by pars plana vitrectomy and the reuse or the replacement of the IOL. The lens was held by intrascleral fixation of the haptics of the IOL under both conditions. The same dislocated IOL was reused in 6 eyes (group A) or it was replaced with another IOL in the other 9 eyes (group B). The pre- and postoperative parameters analyzed included the visual acuity, refractive error, corneal endothelial cell density, and intraocular pressure (IOP). Results. There was no significant difference between the two groups in the postoperative visual acuity (P=0.388), refractive error (P=0.955), IOP (P=0.529), and endothelial cell loss (P=0.940). A breakage or a tilting of the IOL was observed and required replacement in three eyes in the reuse group (P=0.044). Conclusions. Half of the cases with reused in-the-bag dislocated IOL had a breakage or a tilting of the IOL. The replacement of the in-the-bag dislocated IOL is better than the reuse of the IOL with intrascleral haptics fixation.

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