scholarly journals Long Term Clinical and Visual Outcomes of Retrofixated Iris Claw Lenses Implantation in Complicated Cases

2016 ◽  
Vol 10 (1) ◽  
pp. 111-118 ◽  
Author(s):  
Sri Ganesh ◽  
Sheetal Brar ◽  
Kirti Relekar
Keyword(s):  
Visual Outcome ◽  
Intraocular Lenses ◽  
Safety Index ◽  
Visual Outcomes ◽  
Lens Implantation ◽  
Distant Visual Acuity ◽  
The Mean ◽  
Group 2 ◽  
Iris Claw ◽  
Group 1

Aims: To evaluate the visual outcomes and complications after implantation of retrofixated iris claw (RFIC) lens in various challenging situations. Settings and Design: Retrospective, single centre, 8 year clinical audit. Materials and Methods: A retrospective analysis of cases who underwent RFIC lens implantation alone (group 1) or in combination with vitreoretinal (VR), corneal or glaucoma procedures (group 2) was performed. The main outcomes evaluated were corrected distant visual acuity (CDVA) and postoperative complications. The mean follow up was 13.09±6.8 (range 6-24) months. Results: The study involved 100 eyes of 83 patients with mean age of 51.1±25.4 years. Group 1 included 59 eyes and group 2 had 41 eyes. In group 1, the mean CDVA improved from 0.86±0.81 to 0.38±0.51 LogMAR (p<0.001) with 72.8% eyes having gain in lines (≥ 2 lines) of CDVA with safety index of 1.73. The mean CDVA in group 2 improved from 0.71±0.65 to 0.38±0.34 LogMAR (p=0.003) with 65.8% eyes having gain in lines (≥ 2 lines) of CDVA with a safety index of 1.54. Group 2 showed a higher complication rate of 36.59% compared to group 1 (20.34%). Significant complications noted were secondary glaucoma (8%), disenclavation of haptic (4%), subluxation of RFIC lens (1%). Conclusion: The visual outcome with RFIC lenses when combined with other intraocular procedures is mainly affected by the complexity of co-existing pathologies .The complications are more related to the combined procedures performed rather than RFIC lens implantation alone. This may still be acceptable when complication profile of other intraocular lenses is evaluated in similar challenging situations.

Comparison of Visual Outcomes after Bilateral Implantation of Extended Range of Vision and Trifocal Intraocular Lenses

2017 ◽  
Vol 27 (4) ◽  
pp. 460-465 ◽  
Author(s):  
Ramón Ruiz-Mesa ◽  
Antonio Abengózar-Vela ◽  
Ana Aramburu ◽  
María Ruiz-Santos
Keyword(s):  
Visual Acuity ◽  
Contrast Sensitivity ◽  
Intraocular Lenses ◽  
Patient Questionnaire ◽  
Visual Outcomes ◽  
Uncorrected Distance Visual Acuity ◽  
Extended Range ◽  
Near Visual Acuity ◽  
Group 2 ◽  
Group 1

Purpose To compare visual outcomes after cataract surgery with bilateral implantation of 2 intraocular lenses (IOLs): extended range of vision and trifocal. Methods Each group of this prospective study comprised 40 eyes (20 patients). Phacoemulsification followed by bilateral implantation of a FineVision IOL (group 1) or a Symfony IOL (group 2) was performed. The following outcomes were assessed up to 1 year postoperatively: binocular uncorrected distance visual acuity (UDVA), binocular uncorrected intermediate visual acuity (UIVA) at 60 cm, binocular uncorrected near visual acuity (UNVA) at 40 cm, spherical equivalent (SE) refraction, defocus curves, mesopic and photopic contrast sensitivity, halometry, posterior capsule opacification (PCO), and responses to a patient questionnaire. Results The mean binocular values in group 1 and group 2, respectively, were SE -0.15 ± 0.25 D and -0.19 ± 0.18 D; UDVA 0.01 ± 0.03 logMAR and 0.01 ± 0.02 logMAR; UIVA 0.11 ± 0.08 logMAR and 0.09 ± 0.08 logMAR; UNVA 0.06 ± 0.07 logMAR and 0.17 ± 0.06 logMAR. Difference in UNVA between IOLs (p<0.05) was statistically significant. There were no significant differences in contrast sensitivity, halometry, or PCO between groups. Defocus curves were similar between groups from 0 D to -2 D, but showed significant differences from -2.50 D to -4.00 D (p<0.05). Conclusions Both IOLs provided excellent distance and intermediate visual outcomes. The FineVision IOL showed better near visual acuity. Predictability of the refractive results and optical performance were excellent; all patients achieved spectacle independence. The 2 IOLs gave similar and good contrast sensitivity in photopic and mesopic conditions and low perception of halos by patients.

scholarly journals Sutureless retropupillary iris claw intraocular lens implantation is a viable option in aphakic patients

2019 ◽  
Vol 7 (1) ◽  
pp. 350
Author(s):  
Neepa R. Gohil ◽  
Sandeep Kumar Yadav ◽  
Kaumudi Shinde
Keyword(s):  
Visual Acuity ◽  
Intraocular Lens ◽  
Visual Outcome ◽  
Good Alternative ◽  
Intraocular Lenses ◽  
Intraocular Lens Implantation ◽  
Visual Rehabilitation ◽  
Lens Implantation ◽  
Iris Claw Lens ◽  
Iris Claw

Visual rehabilitation in aphakia has been a challenge with a wide variety of surgical options available for ophthalmologist. We report the visual outcome with retropupillary iris claw lens secondary to intra operative complications and secondary implantation in aphakia. An interventional study on 4 eyes of 4 patients was conducted. Preoperative 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 measure was best-corrected visual acuity and secondary postoperative complication was recorded at various intervals. All patients had visual acuity of ≥6/18 postoperatively. Sutureless retropupillary iris claw intraocular lens implantation is a good alternative of scleral-fixated intraocular lenses in aphakic patients.

Safety and visual outcomes following Iris-claw phakic intraocular lens bilensectomy

2020 ◽  
pp. 112067212094403
Author(s):  
Veronica Vargas ◽  
Antonio Marinho ◽  
Fouad El Sayyad ◽  
Jorge L Alio del Barrio ◽  
Jorge L Alio
Keyword(s):  
Endothelial Cell ◽  
Corneal Edema ◽  
Cell Loss ◽  
Significant Loss ◽  
Intraocular Lenses ◽  
Endothelial Cell Loss ◽  
Visual Outcomes ◽  
Refractive Outcomes ◽  
The Mean ◽  
Iris Claw

Purpose: To evaluate the visual outcomes, safety, efficacy, and causes of bilensectomy for iris fixated phakic intraocular lenses (pIOLs). Methods: This was a two center consecutive retrospective study that included 43 eyes that underwent iris-claw pIOL bilensectomy. Patients with follow up less than 4 months were excluded from the study. Uncorrected, corrected visual acuity (UCVA, CDVA), refractive outcomes, efficacy, safety (number of eyes in which the postoperative CDVA was worse than the preoperative CDVA), endothelial cell density (ECD), causes of bilensectomy, the time between the implantation of the pIOL and bilensectomy, intra and postoperative complications were analyzed. Results: There was a statistically significant improvement in UCVA and CDVA after surgery ( p = 0.001). The efficacy index was 0.7, four eyes had a postoperative CDVA worse than the preoperative CDVA. The mean spherical equivalent 1 year after bilensectomy was −0.78 ± 1.70 D. There was a statistically significant endothelial cell loss after iris claw lens bilensectomy ( p = .003). Cataract development and endothelial cell loss were the only reasons for bilensectomy. The mean time between pIOL implantation and bilensectomy was 12.2 ± 5.5 years. One patient had corneal edema 8 months after surgery and one had a retinal detachment 11 months after surgery. Conclusion: Bilensectomy was successful in improving UCVA and CDVA with an acceptable refractive outcome. Significant loss of ECD was found after surgery. The results recommend a larger ACD as selection criteria when choosing to implant an Artisan lens, and a close postoperative monitoring of the endothelial cell count.

scholarly journals Comparison between different techniques for treatment of sub macular haemorrhage due to Age Related Macular Degeneration

2019 ◽  
Author(s):  
Ahmed Abdelwahab Saad ◽  
Daniela Vaideanu-Collins ◽  
Lyudmila Kishikova ◽  
Marco Isac ◽  
Dina Hamada ◽  
...  
Keyword(s):  
Macular Degeneration ◽  
Visual Outcome ◽  
Age Related Macular Degeneration ◽  
University Hospital ◽  
James Cook ◽  
Age Related ◽  
Significant Difference ◽  
The Mean ◽  
Group 2 ◽  
Group 1

Abstract Background To compare the outcome of vitrectomy, subretinal tissue plasminogen activator (TPA), and gas with and without subretinal air versus Intravitreal TPA and gas in the treatment of sub macular haemorrhage (SMH) due to Neovascular age related macular degeneration Methods We analysed the notes of 29 cases presented with SMH in the period between 01/2016 and 09/2018 in James Cook University Hospital. Presenting visual acuity (BCVA), size and location of SMH, Procedure done, final BCVA at 6 months and any surgical complications were recorded. 11 Cases (Group 1) received intravitreal TPA (50ug in 0.1 ML), 0.3 ml of pure SF6. 18 cases (Group 2) received 23 G Pars Plana vitrectomy, Subretinal TPA injection (25ug in 0.1 ml), and 20% SF6 gas filling. Group 2 was further divided into 2A (10 patients) who received only subretinal TPA and group 2B (8 patients) who received additional 0.1 ml subretinal air.Results The mean BCVA at presentation was 0.0068 in group 1 and 0.0067 in group 2 (p= 0.8734). The mean postoperative BCVA at six months was 0.31 in group 1 and 0.58 in group 2 (p=0.0015). Subgroup analysis of group 2 didn’t show statistically significant difference in outcome when adding subretinal air to the vitrectomy procedure (p=0.7009).Conclusion Vitrectomy, gas and subretinal TPA has more successful displacement rate and better visual outcome than Intravitreal TPA & Gas alone in treating SMH involving the fovea in AMD. Additional subretinal air doesn't seem to improve the outcome in cases having vitrectcomy.

scholarly journals Comparing the Effect of Monofocal and Multifocal Intraocular Lenses on Macular Surgery

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
A. Altun
Keyword(s):  
Intraocular Lenses ◽  
Ophthalmological Examination ◽  
Ilm Peeling ◽  
Macular Surgery ◽  
Multifocal Intraocular Lenses ◽  
Significant Difference ◽  
The Mean ◽  
Group 2 ◽  
Refraction Error ◽  
Group 1

Aim. To compare the effects of previously implanted monofocal and multifocal intraocular lenses (IOL) on macular surgery. Methods. Seventy eyes of 70 patients with epiretinal membrane (ERM) and symptomatic vitromacular traction syndrome that previously had IOL implantation for cataract surgery were included in this prospective randomized clinical trial. Cases were divided into two groups. Group 1 and Group 2 were composed of eyes with monofocal and multifocal IOLs, respectively. The effects of refraction error and IOL decentration at the time of macular surgery performed for ERM and ILM peeling, according to the lens type, were investigated. Pars plana vitrectomy (PPV) was performed to peel ERM and ILM in all cases. Complete ophthalmological examination, fundus fluorescein angiography, and optical coherence tomography imaging were made to all cases, preoperatively and postoperatively. Results. The mean BCVA in Group 1 and Group 2 improved from 0.69 ± 0.15 and 0.38 ± 0.14 logMAR to 0.40 ± 0.14 and 0.10 ± 0.04 logMAR, respectively, at the 6th month. There was no statistically significant difference between the groups in terms of the mean spherical refraction error (P>0.05) and IOL decentration level (P>0.05). The mean time required for macular surgery in Group 2 was statistically significantly longer than that for Group 1 (P<0.05). There was no statistically significant relationship between IOL decentration and macular surgery time in Group 1 (P>0.05), but there it was found in Group 2 (P<0.05). In Group 2, there was a positive correlation between IOL decentration and macular surgery time. Conclusion. In cases with multifocal IOL implants, especially with lens decentration, the time of macular surgery for ERM and ILM peeling during PPV is longer than that of eyes with monofocal IOL due to fluctuations in the clarity of the surgeon’s view.

scholarly journals Comparison between different techniques for treatment of submacular haemorrhage due to Age-Related Macular Degeneration

2020 ◽  
pp. 112067212095955
Author(s):  
Lyudmila Kishikova ◽  
Ahmed Abdelwahab A Saad ◽  
Daniela Vaideanu-Collins ◽  
Marco Isac ◽  
Dina Hamada ◽  
...  
Keyword(s):  
Macular Degeneration ◽  
Sulfur Hexafluoride ◽  
Visual Outcome ◽  
Age Related Macular Degeneration ◽  
University Hospital ◽  
Age Related ◽  
Significant Difference ◽  
The Mean ◽  
Group 2 ◽  
Group 1

Purpose: To compare the outcome of vitrectomy, subretinal tissue plasminogen activator (TPA), and gas with and without subretinal air versus Intravitreal TPA and gas in the treatment of submacular haemorrhage (SMH) due to Neovascular age related macular degeneration. Methods: We analysed the notes of 29 cases presented with SMH in the period between 01/2016 and 09/2018 at James Cook University Hospital. Presenting visual acuity (BCVA), size and location of SMH, Procedure done, final BCVA at 6 months and any surgical complications were recorded. 11 Cases (Group 1) received intravitreal TPA (50 µg in 0.1 ML), 0.3 ml of pure sulfur hexafluoride (SF6). 18 cases (Group 2) received 23 G Pars Plana vitrectomy, Subretinal TPA injection (25 µg in 0.1 ml), and 20% SF6 gas filling. Group 2 was further divided into 2A (10 patients) who received only subretinal TPA and group 2B (8 patients) who received additional 0.1 ml subretinal air. Results: The mean BCVA at presentation was 0.0068 in group 1 and 0.0067 in group 2 ( p = 0.8734). The mean postoperative BCVA at 6 months was 0.31 in group 1 and 0.58 in group 2 ( p = 0.0015). Subgroup analysis of group 2 didn’t show statistically significant difference in outcome when adding subretinal air to the vitrectomy procedure ( p = 0.7009). Conclusion: Vitrectomy, gas and subretinal TPA has more successful displacement rate and better visual outcome than Intravitreal TPA & Gas alone in treating SMH involving the fovea in age-related macular degeneration. Additional subretinal air doesn’t seem to improve the outcome in cases having vitrectomy.

scholarly journals Flaremetric evaluation of blood-aqueous barrier breakdown in diabetic patients after phacoemulsification and intraocular lenses with or without heparin-coated surface implantation

2020 ◽  
Vol 7 (2) ◽  
pp. 85-89
Author(s):  
Anna Górnik ◽  
Piotr Jurowski
Keyword(s):  
Prospective Trial ◽  
Intraocular Lenses ◽  
Diabetic Patients ◽  
Blood Aqueous Barrier ◽  
Laser Flare ◽  
Barrier Breakdown ◽  
The Mean ◽  
Group 2 ◽  
Surface Modified ◽  
Group 1

Background: This study compared the intensity of blood-aqueous barrier breakdown in diabetic patients after phacoemulsification with heparin surface-modified and non-modified intraocular lens (IOL) implantation. Material and methods: In this prospective trial, 68 diabetic patients were enrolled and divided into two groups: 33 patients with heparin surface-modified IOL implants (group 1) and 35 patients with standard hydrophobic IOL implants (group 2). Blood-aqueous barrier breakdown was assessed using a Laser Flare Meter 1 day, 7 days, 14 days, 1 month, and 3 months postoperatively. Results: On postoperative days 1 and 7, the mean flare value was significantly higher in group 2 compared with group 1. On day 14, the mean flare value in both groups was similar and then higher in group 2. Conclusions: The implantation of foldable heparin-coated IOLs led to a lower intensity and faster recovery of blood-aqueous barrier breakdown postoperatively.

scholarly journals The clinical profile of childhood optic neuritis

2001 ◽  
Vol 59 (2B) ◽  
pp. 311-317 ◽  
Author(s):  
Marco Aurélio Lana-Peixoto ◽  
Gustavo Cardoso de Andrade
Keyword(s):  
Multiple Sclerosis ◽  
Optic Neuritis ◽  
Clinical Features ◽  
Medical Records ◽  
Visual Loss ◽  
Visual Outcome ◽  
The Mean ◽  
Group 2 ◽  
Group 1

PURPOSE: To report the clinical features and outcome of a series of children with optic neuritis. METHODS: We reviewed the medical records of patients up to 16 years old with optic neuritis. Group 1 comprised children seen up to two weeks after the onset of visual loss; Group 2 comprised patients already harboring optic atrophy. RESULTS: There were 15 boys and 12 girls. The mean age was 10.9 years. Bilateral optic neuritis occurred in 10. Optic disc pallor was found in 35%, edema in 46%, and 19% had normal fundus. During follow-up visual acuity improved in all but one eye in Group 1, and in six of seven eyes in children in Group 2. Just one child converted to multiple sclerosis. CONCLUSIONS: This study shows that the clinical features of childhood optic neuritis differ from those observed in adults. In children it has a better visual outcome and a lower conversion rate to multiple sclerosis than in adults.

Creation of physiologic rhythm by closed loop stimulation in heart failure patients with severe chronotropic incompetence: worldwide first results of a pilot study

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
J Proff ◽  
B Merkely ◽  
R Papp ◽  
C Lenz ◽  
P.J Nordbeck ◽  
...  
Keyword(s):  
Heart Rate ◽  
Closed Loop ◽  
Funding Source ◽  
Chronotropic Incompetence ◽  
First Results ◽  
The Mean ◽  
Group 2 ◽  
Group 1

Abstract Background The prevalence of chronotropic incompetence (CI) in heart failure (HF) population is high and negatively impacts prognosis. In HF patients with an implanted cardiac resynchronisation therapy (CRT) device and severe CI, the effect of rate adaptive pacing on patient outcomes is unclear. Closed loop stimulation (CLS) based on cardiac impedance measurement may be an optimal method of heart rate adaptation according to metabolic need in HF patients with severe CI. Purpose This is the first study evaluating the effect of CLS on the established prognostic parameters assessed by the cardio-pulmonary exercise (CPX) testing and on quality of life (QoL) of the patients. Methods A randomised, controlled, double-blind and crossover pilot study has been performed in CRT patients with severe CI defined as the inability to achieve 70% of the age-predicted maximum heart rate (APMHR). After baseline assessment, patients were randomised to either DDD-CLS pacing (group 1) or DDD pacing at 40 bpm (group 2) for a 1-month period, followed by crossover for another month. At baseline and at 1- and 2-month follow-ups, a CPX was performed and QoL was assessed using the EQ-5D-5L questionnaire. The main endpoints were the effect of CLS on ventilatory efficiency (VE) slope (evaluated by an independent CPX expert), the responder rate defined as an improvement (decrease) of the VE slope by at least 5%, percentage of maximal predicted heart rate reserve (HRR) achieved, and QoL. Results Of the 36 patients enrolled in the study, 20 fulfilled the criterion for severe CI and entered the study follow-up (mean age 68.9±7.4 years, 70% men, LVEF=41.8±9.3%, 40%/60% NYHA class II/III). Full baseline and follow-up datasets were obtained in 17 patients. The mean VE slope and HRR at baseline were 34.4±4.4 and 49.6±23.8%, respectively, in group 1 (n=7) and 34.5±12.2 and 54.2±16.1% in group 2 (n=10). After completing the 2-month CPX, the mean difference between DDD-CLS and DDD-40 modes was −2.4±8.3 (group 1) and −1.2±3.5 (group 2) for VE slope, and 17.1±15.5% (group 1) and 8.7±18.8% (group 2) for HRR. Altogether, VE slope improved by −1.8±2.95 (p=0.31) in DDD-CLS versus DDD-40, and HRR improved by 12.9±8.8% (p=0.01). The VE slope decreased by ≥5% in 47% of patients (“responders to CLS”). The mean difference in the QoL between DDD-CLS and DDD-40 was 0.16±0.25 in group 1 and −0.01±0.05 in group 2, resulting in an overall increase by 0.08±0.08 in the DDD-CLS mode (p=0.13). Conclusion First results of the evaluation of the effectiveness of CLS in CRT patients with severe CI revealed that CLS generated an overall positive effect on well-established surrogate parameters for prognosis. About one half of the patients showed CLS response in terms of improved VE slope. In addition, CLS improved quality of life. Further clinical research is needed to identify predictors that can increase the responder rate and to confirm improvement in clinical outcomes. Funding Acknowledgement Type of funding source: Private company. Main funding source(s): Biotronik SE & Co. KG

Comparison of the ATRIA, CHA2DS2-VASc, and Modified Scores ATRIA-HSV, CHA2DS2-VASc-HS, for the Prediction of Coronary Artery Disease Severity

Angiology ◽  
2021 ◽  
pp. 000331972199141
Author(s):  
Arafat Yildirim ◽  
Mehmet Kucukosmanoglu ◽  
Fethi Yavuz ◽  
Nermin Yildiz Koyunsever ◽  
Yusuf Cekici ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Vascular Disease ◽  
Operating Characteristics ◽  
Coronary Artery Disease Severity ◽  
Group 3 ◽  
The Mean ◽  
Group 2 ◽  
Artery Disease ◽  
Group 1

Many parameters included in the Anticoagulation and Risk Factors in Atrial Fibrillation (ATRIA) and CHA2DS2-VASc (congestive heart failure, hypertension, age ≥75 years, diabetes mellitus, stroke, vascular disease, age 65-74 years, sex category) scores also predict coronary artery disease (CAD). We modified the ATRIA score (ATRIA-HSV) by adding hyperlipidemia, smoking, and vascular disease and also male sex instead of female. We evaluated whether the CHA2DS2-VASc, CHA2DS2-VASc-HS, ATRIA, and ATRIA-HSV scores predict severe CAD. Consecutive patients with coronary angiography were prospectively included. A ≥50% stenosis in ≥1epicardial coronary artery (CA) was defined as severe CAD. Patient with normal CA (n = 210) were defined as group 1, with <50% CA stenosis (n = 178) as group 2, and with ≥50% stenosis (n = 297) as group 3. The mean ATRIA, ATRIA-HSV, CHA2DS2-VASc, and CHA2DS2VASc-HS scores increased from group 1 to group 3. A correlation was found between the Synergy between PCI with Taxus and Cardiac Surgery score and ATRIA ( r = 0.570), ATRIA-HSV ( r = 0.614), CHA2DS2-VASc ( r = 0.428), and CHA2DS2-VASc-HS ( r = 0.500) scores ( Ps < .005). Pairwise comparisons of receiver operating characteristics curves showed that ATRIA-HSV (>3 area under curve [AUC]: 0.874) and ATRIA (>3, AUC: 0.854) have a better performance than CHA2DS2-VASc (>1, AUC: 0.746) and CHA2DS2-VASc-HS (>2, AUC: 0.769). In conclusion, the ATRIA and ATRIA-HSV scores are simple and may be useful to predict severe CAD.

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