Explantation of domestic models of posterior chamber phakic intraocular lenses in the development of subcapsular cataract in higly myopic patients: clinical features

To date, the operation of choice in young patients with high myopia, is the implantation of posterior chamber phakic intraocular lenses (PIOL), provided that there are contraindications to keratorefractive interventions, However, in the late postoperative period, cataracts may occur, which requires the development of surgical tactics for lens explantation with simultaneous phacoemulsification of cataract (FEC) implementation.The purpose is to develop and analyze a method for removing a PIOL through a 2 mm corneal incision in subcapsular cataract cases.Material and methods. Posterior chamber domestic models of PIOL type RSK-1(3) and RSK-3 in 22 patients (37 eyes), implanted in the S.N. FEDOROV “EYE MICROSURGERY” clinic in 1994 – 2001 had to be removed due to the development of secondary cataracts. PIOL stayed in the eye 2 to 26 years (averagely 14.30 ± 1.30 yrs). In all cases, the P IOL was removed followed by FEC with implantation of a posterior chamber IOL. The optical power of the IOL was calculated mainly in such a way that the residual myopic refraction was 2.0–3.0 D.Results. The intraoperative condition of the anterior chamber was stable, the volume of irrigation fluid consumed was within 90–120 ml. No complications were detected in the early and late postoperative periods. The results of dynamic ophthalmological follow up of patients showed that visual acuity without correction and with correction after surgery averaged 0.2 ± 0.1 and 0.60 ± 0.15, respectively.Conclusion. The proposed method of explantation of domestic lenses of S.N. FEDOROV NMRC MNTK “EYE MICROSURGERY” shows that it enables a safe, simple removal of PIOL in the event of secondary subcapsular cataract, which allows achieving high clinical and functional results without overspending the irrigation solution.

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Evaluation of the efficacy, safety, and stability of posterior chamber phakic intraocular lenses for correcting intractable myopic anisometropic amblyopia in a pediatric cohort

BMC Ophthalmology ◽

10.1186/s12886-021-02074-3 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Fathy Fawzy Morkos ◽

Nader F. Fawzy ◽

Mohamed El Bahrawy ◽

Nada Fathy ◽

Rania Serag Elkitkat

Keyword(s):

Visual Acuity ◽

Conventional Therapy ◽

Case Series ◽

Intraocular Lenses ◽

Posterior Chamber ◽

Anisometropic Amblyopia ◽

Occlusion Therapy ◽

Phakic Intraocular Lenses ◽

Safety And Stability

Abstract Background Myopic anisometropic amblyopia in pediatrics is one of the most challenging clinical situations that can face an ophthalmologist. Conventional correction modalities for myopic anisometropia, using spectacles, contact lenses, and/or occlusion therapy, may not be suitable for some pediatric patients or for some ocular conditions. This may lead to the development of anisometropic amblyopia. The aim of the present study was to evaluate the visual and the refractive efficacy, safety, and stability of Posterior Chamber Phakic Intraocular Lenses (PC-pIOLs) for correcting myopic anisometropic amblyopia in a pediatric cohort. Methods This case series, prospective, interventional study was conducted at Watany Eye Hospital, Cairo, Egypt. It comprised children and teenagers with myopic anisometropic amblyopia and unsuccessful conventional therapy. After implantation of Intraocular Collamer Lenses “ICLs” (Visian ICL, Model V4c, STAAR Surgical, Monrovia, California, USA), postoperative follow-up visits were scheduled, with automated refraction and Pentacam imaging performed. Results The study enrolled 42 eyes of 42 patients. The age range was 3 to 18 years (mean ± SD = 10.74 years ±4.16). The mean preoperative spherical equivalent (SE) was − 12.85 D ± 2.74. The results declared a significant improvement in the postoperative Corrected Distance Visual Acuity “CDVA” (P value < 0.01) and SE (P value < 0.01). The efficacy index had a value of 1.18 ± 0.3 and the safety index was 1.09 ± 0.24. The follow-up visits had a mean ± SD of 14.67 months ±16.56 (range of 1 to 54 months). The results showed a refractive stability, with statistically insignificant improvements in the patients’ visual acuity and refractive status on evaluating the enrolled pediatrics during the follow-up visits compared to the first postoperative visits. No postoperative complications were encountered. Worthy of mention is that there was a significant (80%) non-compliance with the prescribed postoperative occlusion therapy. Conclusions The present study, with the longest reported follow-up range, declared the long-term efficacy, safety, and stability of Visian ICLs for correcting myopic anisometropic amblyopia in pediatrics. The reported non-compliance with occlusion therapy validates the early implantation of Visian ICLs in cases with failed conventional therapy to guard against anisometropic amblyopia.

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Management of Dislocated Intraocular Lenses with Iris Suture

European Journal of Ophthalmology ◽

10.5301/ejo.5000823 ◽

2016 ◽

Vol 27 (1) ◽

pp. 45-48 ◽

Cited By ~ 5

Author(s):

Mun Y. Faria ◽

Nuno P. Ferreira ◽

Mario Canastro

Keyword(s):

Visual Acuity ◽

Cataract Surgery ◽

Macular Edema ◽

Clinical Signs ◽

Intraocular Lenses ◽

Posterior Chamber ◽

Pigment Dispersion ◽

Corneal Incision ◽

The Mean

Purpose Subluxated or malpositioned intraocular lenses (IOLs) and inadequate capsular support is a challenge for every ophthalmic surgeon. Iris suture of an IOL seems to be an easy technique for the management of dislocated 3-piece IOL, allowing the IOL to be placed behind the iris, far from the trabecular meshwork and corneal endothelium. The purpose of this study is to assess the results of pars plana vitrectomy (PPV) and iris suture of dislocated 3-piece acrylic IOLs. Methods In this retrospective, nonrandomized, interventional case consecutive study, of a total of 103 dislocated IOLs, 36 eyes were considered for analysis. All 36 eyes had subluxated or totally luxated 3-piece IOL and underwent iris suture at the Ophthalmology Department of Santa Maria Hospital-North Lisbon Hospital Center, Portugal, from January 2011 until November 2015. All patients underwent 3-port 23-G PPV. The optic zone of the dislocated IOL was placed anterior to the iris with the haptics behind, in the posterior chamber. Haptics were sutured to iris followed by placement of the optics behind iris plane. Postoperative measures included best-corrected visual acuity (BCVA), IOL position, intraocular pressure, pigment dispersion, clinical signs of endothelial cell loss, and development of macular edema. Results A total of 36 eyes of 36 patients were included. All underwent successful iris fixation of dislocated 3-piece IOL. Mean overall follow-up was 15.9 months (range 3-58 months). At presentation, 16 eyes (44.4%) had a luxated IOL and 20 eyes (55.6%) a subluxated IOL. As underlying cause, 17 eyes (47.2%) had a history of complicated cataract surgery, 5 eyes (13.9%) had a traumatic dislocation of the IOL, and 6 eyes (16.7%) had a previous vitreoretinal surgery. A total of 8 eyes (22.2%) had late spontaneous IOL dislocation after uneventful cataract surgery. The mean preoperative BCVA was 1.09 ± 0.70 logarithm of the minimal angle of resolution (logMAR) units and mean postoperative BCVA was 0.48 ± 0.58 of logMAR units. The mean visual acuity improvement was 4.08 ± 5.33 lines on the logMAR scale. In this study, every IOL was stable at the last follow-up. As late complications, macular edema occurred in 1 patient and retinal detachment occurred in 2 patients. There were no cases of endophthalmitis. Conclusions Iris suture fixation of subluxated IOL is a good treatment option for eyes with dislocated IOLs, leading to long-term stability of the IOL. The advantage of this procedure is using the same IOL in a closed eye surgery. No astigmatic difference is expected as no large corneal incision is needed.

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Posterior chamber collagen copolymer phakic intraocular lenses to correct myopia: Five-year follow-up

Journal of Cataract & Refractive Surgery ◽

10.1016/j.jcrs.2010.11.040 ◽

2011 ◽

Vol 37 (5) ◽

pp. 873-880 ◽

Cited By ~ 84

Author(s):

José F. Alfonso ◽

Begoña Baamonde ◽

Luis Fernández-Vega ◽

Paulo Fernandes ◽

Jose M. González-Méijome ◽

...

Keyword(s):

Intraocular Lenses ◽

Posterior Chamber ◽

Phakic Intraocular Lenses

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A Long Term Follow Up of Posterior Chamber Phakic Intraocular Lenses for Correcting Intractable Pediatric Myopic Anisometropic Amblyopia

10.21203/rs.3.rs-381455/v1 ◽

2021 ◽

Author(s):

Fathy Fawzy Morkos ◽

Nader F. Fawzy ◽

Mohamed El Bahrawy ◽

Nada Fathy ◽

Rania Serag Elkitkat

Keyword(s):

Conventional Therapy ◽

Intraocular Lenses ◽

Posterior Chamber ◽

P Value ◽

Anisometropic Amblyopia ◽

Occlusion Therapy ◽

Phakic Intraocular Lenses ◽

Safety And Stability

Abstract Background Pediatric myopic anisometropic amblyopia is one of the most challenging clinical situations that can face an ophthalmologist. Conventional correction modalities for myopic anisometropic amblyopia, using spectacles, contact lenses, and/or occlusion therapy, may not be suitable for some pediatric patients or for some ocular conditions. This may lead to the development of amblyopia and loss of binocular vision. The aim of the present study was to evaluate the visual and refractive efficacy, safety, and stability of Posterior Chamber Phakic Intraocular Lenses (PC-pIOLs) for correcting pediatric myopic anisometropic amblyopia. Methods This case series, prospective, interventional study was conducted at Watany Eye Hospital, Cairo, Egypt. It comprised 42 eyes of 42 children with myopic anisometropic amblyopia and unsuccessful conventional therapy. After implantation of Intraocular Collamer Lenses “ICLs” (Visian ICL, Model V4c, STAAR Surgical, Monrovia, California, USA), postoperative follow up visits were scheduled, with subjective refraction and Pentacam imaging performed. Results The patients’ age range was 3 to 18 years (mean ± SD = 10.58 years ± 4.23). The mean preoperative SE was − 12.54 D ± 2.93. The results declared a significant improvement in the postoperative CDVA (P value < 0.01) and SE (P value < 0.01). The efficacy index had a value of 1.18 ± 0.3 and the safety index was 1.09 ± 0.24. The follow up visits had a mean ± SD of 14.67 months ± 16.56 (range of 1 to 54 months). The results showed a refractive stability, with slight (statistically insignificant) improvements in the subjective refraction between the first postoperative and the follow up visits. No postoperative complications were encountered. Conclusions The present study, with the longest reported follow up range, declared the long-term efficacy, safety, and stability of Visian ICLs for correcting pediatric myopic anisometropic amblyopia. The reported non-compliance with occlusion therapy validates the early implantation of Visian ICLs in cases of failed conventional therapy to guard against anisometropic amblyopia.

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Use of low-vault posterior chamber collagen copolymer phakic intraocular lenses for the correction of myopia: a 3-year follow-up

Graefe s Archive for Clinical and Experimental Ophthalmology ◽

10.1007/s00417-019-04336-9 ◽

2019 ◽

Vol 257 (7) ◽

pp. 1555-1560 ◽

Cited By ~ 1

Author(s):

Khosrow Jadidi ◽

Seyed Aliasghar Mosavi ◽

Farhad Nejat ◽

Neda Mohammadi ◽

Hosein Aghamolaei ◽

...

Keyword(s):

Intraocular Lenses ◽

Posterior Chamber ◽

Phakic Intraocular Lenses

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Long-term results of Descemet-stripping automated endothelial keratoplasty for endothelial failure caused by phakic intraocular lenses

European Journal of Ophthalmology ◽

10.1177/1120672120950936 ◽

2020 ◽

pp. 112067212095093

Author(s):

Diogo Hipólito-Fernandes ◽

Maria Elisa-Luís ◽

Miguel Vieira ◽

Sara Crisóstomo ◽

Nuno Alves ◽

...

Keyword(s):

Endothelial Cell ◽

Young Patients ◽

Case Series ◽

Intraocular Lenses ◽

Long Term Results ◽

Endothelial Keratoplasty ◽

Visual Rehabilitation ◽

Phakic Intraocular Lenses

Purpose: To describe the surgical approach and long-term outcomes of Descemet-stripping automated endothelial keratoplasty (DSAEK) for endothelial failure secondary to phakic intraocular lenses (pIOL). Methods: Retrospective, interventional case series of 18 eyes of 13 patients who developed endothelial failure secondary to pIOL implant. Patients were submitted to pIOL explant and DSAEK for visual rehabilitation, with or without phacoemulsification plus posterior-chamber intraocular lens implant. The minimum follow-up time was 3 years and the main outcome measures were best-corrected visual acuity (BCVA), endothelial cell density (ECD) and percentage of endothelial cell loss (ECL), intraoperative and postoperative complications. Results: Patients’ mean age was 47.44 (7.86) years with a mean follow-up time of 55.61 (14.13) months. Sixteen eyes (88.9%) had an angle-supported pIOL. The mean pIOL implant-to explant time was 8.17 (2.73) years. BCVA improved from 1.00 (0.36) logMAR preoperatively to 0.29 (0.36) logMAR at 1 year of follow-up ( p < 0.001), remaining stable over the entire follow-up period ( p > 0.05). At the last visit, all corneas were clear, with a mean ECD of 724.74 (325.57) cells/mm2. During the follow-up, two eyes (11.1%) required a re-DSAEK due to early graft failure (<3 months). Conclusion: Our outcomes reveal that an individualized and careful approach may result in a stable visual rehabilitation in young patients with corneal decompensation following pIOL implant.

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ZB5M Anterior Chamber and Fyodorov's Posterior Chamber Phakic Intraocular Lenses: Long-term Follow-up

Journal of Refractive Surgery ◽

10.3928/1081-597x-20061101-12 ◽

2006 ◽

Vol 22 (9) ◽

pp. 906-910 ◽

Cited By ~ 6

Author(s):

Canan A Utine ◽

Sukru Bayraktar ◽

Vedat Kaya ◽

Hakan Eren ◽

Irfan Perente ◽

...

Keyword(s):

Anterior Chamber ◽

Intraocular Lenses ◽

Posterior Chamber ◽

Long Term Follow Up ◽

Phakic Intraocular Lenses

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Atomic force microscopy comparative analysis of the surface roughness of two posterior chamber phakic intraocular lens models: ICL versus IPCL

BMC Ophthalmology ◽

10.1186/s12886-021-02039-6 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Juan Gros-Otero ◽

Samira Ketabi ◽

Rafael Cañones-Zafra ◽

Montserrat Garcia-Gonzalez ◽

Cesar Villa-Collar ◽

...

Keyword(s):

Surface Roughness ◽

Atomic Force Microscopy ◽

Intraocular Lenses ◽

Posterior Chamber ◽

Anterior Surface ◽

Contact Mode ◽

Force Microscopy ◽

Atomic Force ◽

Phakic Intraocular Lenses ◽

Roughness Measurements

Abstract Background To compare the anterior surface roughness of two commercially available posterior chamber phakic intraocular lenses (IOLs) using atomic force microscopy (AFM). Methods Four phakic IOLs were used for this prospective, experimental study: two Visian ICL EVO+ V5 lenses and two iPCL 2.0 lenses. All of them were brand new, were not previously implanted in humans, were monofocal and had a dioptric power of − 12 diopters (D). The anterior surface roughness was assessed using a JPK NanoWizard II® atomic force microscope in contact mode immersed in liquid. Olympus OMCL-RC800PSA commercial silicon nitride cantilever tips were used. Anterior surface roughness measurements were made in 7 areas of 10 × 10 μm at 512 × 512 point resolution. The roughness was measured using the root-mean-square (RMS) value within the given regions. Results The mean of all anterior surface roughness measurements was 6.09 ± 1.33 nm (nm) in the Visian ICL EVO+ V5 and 3.49 ± 0.41 nm in the iPCL 2.0 (p = 0.001). Conclusion In the current study, we found a statistically significant smoother anterior surface in the iPCL 2.0 phakic intraocular lenses compared with the VISIAN ICL EVO+ V5 lenses when studied with atomic force microscopy.

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