Clinical case of phakic intraocular lens rotation

2021 ◽  
pp. 50-53
Author(s):  
Y.V. Belonozhenko ◽  
◽  
T.K. Semenova ◽  
S.V. Krivko ◽  
A.E. Lugovskoy ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Intraocular Lens ◽  
Clinical Case ◽  
Clinical Signs ◽  
Vertical Position ◽  
Phakic Intraocular Lens ◽  
Ciliary Processes ◽  
Uncorrected Visual Acuity ◽  
The Right ◽  
Preoperative Examination

Purpose. To analyze causes of the emerged postoperative rotation of the phakic intraocular lens (PIOL) of the IPCLT V2.0 model, to assess the effectiveness of its elimination and the outcomes. Clinical case. Patient A., 42 years old. Clinical diagnosis: High myopia, chorioretinal form, direct corneal astigmatism in both eyes. The combination of thin cornea with limbal vascularization did not allow to perform for him photorefractive surgery. The implantation of PIOL IPCLT V2.0 model was performed according to the method recommended by the manufacturer. On the first day after the operation, the position of the PIOL was correct in both eyes. Indicators of uncorrected visual acuity significantly increased from initial 0.01–0.02 to 0.4–0.5. The best corrected visual acuity also increased, amounting to 0.7–0.9 for the right/left eye, respectively. 1.5 months after the operation, the patient complained of a decrease and the appearance of instability in visual acuity in both eyes. Biomicroscopic examination revealed the PIOL rotation along the plane from a horizontal to a vertical position. Conclusion. At the stage of preoperative examination, special attention should be paid to the presence of circular symmetry of the zonule of Zinn attachment to the ciliary processes and to the lens capsule. Such indirect clinical signs as prolapse of the iris, asymmetry of the distances «ciliary processes – the edge of the lens» may indicate the presence of individual unfavorable anatomical features of the shape of the eye, which with high probability can lead to displacement or rotation of the PIOL IPCLT V2.0 model. Key words: myopia, phakic intraocular lens (PIOL), PIOL IPCLT V2.0 model.

scholarly journals Postsurgical Cystoid Macular Edema following Posterior Chamber Toric Phakic Intraocular Lens Implantation Surgery: A Case Report

2015 ◽  
Vol 6 (2) ◽  
pp. 223-227 ◽  
Author(s):  
Julide Canan Umurhan Akkan ◽  
Kemal Tuncer ◽  
Ahmet Elbay
Keyword(s):  
Visual Acuity ◽  
Case Report ◽  
Macular Edema ◽  
Intraocular Lens ◽  
Cystoid Macular Edema ◽  
Posterior Chamber ◽  
Phakic Intraocular Lens ◽  
Distance Visual Acuity ◽  
Initial Surgery ◽  
The Right

Purpose: To describe a case of cystoid macular edema (CME) developing after posterior chamber toric phakic intraocular lens (PIOL) implantation. Methods: Case report. Results: A 33-year-old male underwent implantation of toric implantable collamer lenses (ICL), a new generation of PIOLs, for both eyes. Preoperative best spectacle-corrected distance visual acuity (BCVA) was 20/25 in the right eye and 20/32 in the left eye, with a manifest refraction of -9.25 -4.0 × 4° and -9.75 -4.25 × 171°, respectively. On day 1 postoperatively, the left eye had an uncorrected distance visual acuity (UDVA) of 20/60 with a refraction of +2.0 -3.5 × 11°. Despite the rotation of the PIOL, the cylindrical refractive component persisted in the left eye with a refraction of +2.0 -3.5 × 11°. Two weeks after the initial surgery, he presented with a decrease in his visual acuity in the left eye. The UDVA and BCVA were both 20/100 in the left eye with a refraction of +2.0 -4.25 × 3°. Dilated fundus examination and macular optical coherence tomography revealed a CME in the left eye. Following topical nepafenac therapy and explantation of the ICL, we observed a complete resolution of the CME at 3 months with an improvement in BCVA to 20/32 in the left eye. Conclusions: To our knowledge, this is the first reported case of postsurgical CME following toric ICL implantation. In cases of phakic eyes with an intact posterior capsule, postsurgical CME can develop, thus highlighting the purpose of this report.

scholarly journals Off-Label Use of Phakic Intraocular Lens with a “Piggyback” Technique

2018 ◽  
Vol 9 (3) ◽  
pp. 465-472 ◽  
Author(s):  
Tadgh Schempf ◽  
Hoon C. Jung
Keyword(s):  
Visual Acuity ◽  
Intraocular Lens ◽  
Posterior Chamber ◽  
Off Label Use ◽  
Phakic Intraocular Lens ◽  
Fellow Eye ◽  
Off Label ◽  
Label Placement ◽  
The Right ◽  
Label Use

Purpose: We report a case of a highly myopic pseudophakic patient who received off-label placement of a phakic intraocular lens (pIOL) via a “piggyback” technique, allowing the placement of an intraocular lens (IOL) in his fellow eye, resulting in improved visual acuity and emmetropia. Case Report: A 66-year-old, highly myopic, pseudophakic male with an IOL implant in his left eye was referred for second opinion for surgical options for his phakic right eye. Given the severe myopic status of both eyes, he received off-label placement of a posterior chamber pIOL with a piggyback technique for the pseudophakic left eye followed by standard cataract surgery and intraocular lens implantation in the right eye. For the left eye, uncorrected best visual acuity improved from 20/70 to 20/25. Conclusion: This case demonstrates the successful off-label use of a phakic IOL in a pseudophakic, highly myopic patient with a piggyback technique, resulting in improved visual acuity and ultimately allowing IOL placement in the fellow eye for emmetropia. This off-label use of pIOL can offer ophthalmologists an alternative option for pseudophakic patents with severe refractive error.

scholarly journals Corneal Collagen Cross-Linking Combined with an Artiflex Iris-Fixated Anterior Chamber Phakic Intraocular Lens Implantation in a Patient with Progressive Keratoconus

2017 ◽  
Vol 8 (3) ◽  
pp. 482-488 ◽  
Author(s):  
Sharif Hashmani ◽  
Nauman Hashmani ◽  
Roha Saeed Memon
Keyword(s):  
Visual Acuity ◽  
Anterior Chamber ◽  
Intraocular Lens ◽  
Vision Loss ◽  
Cross Linking ◽  
Phakic Intraocular Lens ◽  
Corrected Visual Acuity ◽  
Uncorrected Visual Acuity ◽  
Collagen Cross Linking ◽  
Corneal Collagen

We present here the case of a 24-year-old male who experienced progressive keratoconus and vision loss which adversely affected his ability to carry out everyday tasks. This landed him in the Hashmanis Hospital for consultation. He had a preoperative best corrected visual acuity of 6/12. He underwent multiple Oculus Pentacam examinations, which showed progressive keratoconus. Corneal collagen cross-linking (CXL) was performed to stabilize his cornea and, subsequently, an Artiflex anterior chamber iris-fixated phakic intraocular lens (ACIF-PIOL) was implanted to alleviate his refractive errors. The patient achieved a postoperative uncorrected visual acuity of 6/12. This report shows that CXL combined with ACIF-PIOL can be safe and effective in those with progressive keratoconus.

scholarly journals Bilateral Toric Phakic Intraocular Lens Implantation for Correction of High Myopic Astigmatism in a Patient with Marfan Syndrome with Lens Coloboma: A Case Report

2021 ◽  
pp. 208-213
Author(s):  
Bhupesh Singh ◽  
Sourabh Sharma ◽  
Suchit Dadia ◽  
Neha Bharti ◽  
Sudhank Bharti
Keyword(s):  
Visual Acuity ◽  
Marfan Syndrome ◽  
Intraocular Lens ◽  
Refractive Error ◽  
Treatment Options ◽  
Complication Rates ◽  
Phakic Intraocular Lens ◽  
High Loss ◽  
Error Treatment ◽  
The Right

Marfan syndrome (MFS) is known to cause significant refractive error. Treatment options are limited in this condition for correcting refractive error. Clear lens exchange is done in these cases, but complication rates are high. Loss of accommodation is another concern in these young adults. We report toric phakic intraocular lens (pIOL) implantation in improving the uncorrected visual acuity (UCVA) in a known case of MFS with lens coloboma. A 22-year-old female patient with MFS with inferior lens coloboma underwent bilateral toric pIOL implantation in the same sitting. Pre- and post-operative UCVA and best-corrected visual acuity were assessed. Central and peripheral vaulting of the pIOL in relation to the natural lens was also assessed. UCVA improved from 20/500 to 20/20 in the right and 20/550–20/20 in the left eye. Marked central vaulting with partial peripheral vaulting was achieved. There were no post-operative complications. Phakic IOL implantation surgery could be an effective approach to achieve excellent uncorrected refractive outcome in patients with MFS to treat high myopia.

scholarly journals Early Results with a New Posterior Chamber Phakic Intraocular Lens in Patients with High Myopia

2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Dilek Yaşa ◽  
Ufuk Ürdem ◽  
Alper Ağca ◽  
Yusuf Yildirim ◽  
Burçin Kepez Yildiz ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Endothelial Cell ◽  
Intraocular Lens ◽  
High Myopia ◽  
Posterior Chamber ◽  
Phakic Intraocular Lens ◽  
Phakic Iol ◽  
Distance Visual Acuity ◽  
Early Results ◽  
Manifest Refraction

Purpose. To report clinical results of a foldable, hydrophilic acrylic, single-piece, injectable, posterior chamber phakic intraocular lens (pIOL).Material and Methods. Medical records of patients who underwent posterior chamber phakic IOL (Eyecryl Phakic IOL, Biotech Vision Care, Ahmedabad, India) implantation for surgical correction of myopia were retrospectively reviewed. Only patients with at least a one-year follow-up were included. Manifest refraction, uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), endothelial cell density (ECD), and pIOL vault were analyzed at 1, 3, 6, and 12 months after surgery. Complications observed during and after surgery were also recorded.Results. The study included 58 eyes of 29 patients. Mean patient age was 32 ± 7 years. Spherical equivalent of manifest refraction was −13.41 ± 3.23 D preoperatively and −0.44 ± 0.55 D postoperatively. Preoperative CDVA was 0.29 ± 0.71 logMAR. Postoperative UDVA and CDVA were 0.21 ± 0.66 and 0.15 ± 0.69 logMAR, respectively, at the 12-month visit. At the 12-month visit, the efficacy index was 1.20 and the safety index was 1.39. Mean ECD was 2713 ± 339 cells/mm2at the preoperative visit and 2608 ± 362 cells/mm2at the 12-month visit (3.9% loss,p<0.001). ECD loss from 3 months to 12 months was not statistically significant. No significant cataract formation, significant endothelial cell loss, glaucoma, uveitis, or any other vision-threatening complication was observed.Conclusion. Based on postoperative experience, we have found that Eyecryl Phakic IOL is safe and effective for treating high myopia.

scholarly journals Evaluation of Sutureless, Glueless, Flapless, Intrascleral Fixated Posterior Chamber Intraocular Lens in Children with Ectopia Lentis

2018 ◽  
Vol 2018 ◽  
pp. 1-6 ◽  
Author(s):  
Kannan NB ◽  
Piyush Kohli ◽  
Bhanu Pratap Singh Pangtey ◽  
Kim Ramasamy
Keyword(s):  
Visual Acuity ◽  
Intraocular Lens ◽  
Pediatric Population ◽  
Intraoperative Complications ◽  
Vitreous Hemorrhage ◽  
Posterior Chamber ◽  
Ectopia Lentis ◽  
Uncorrected Visual Acuity ◽  
Posterior Chamber Intraocular Lens

Aim. This paper aims at evaluating refractive outcome and complication profile of sutureless, glueless, flapless, intrascleral fixation of intraocular lens (SFIOL) in pediatric population. Methods. This retrospective study included patients ≤18 years of age who underwent SFIOL for ectopia lentis. Details obtained included preoperative uncorrected visual acuity (UCVA), cycloplegic refraction, and best-corrected visual acuity (BCVA); intraoperative complications; and postoperative UCVA, cycloplegic refraction, and BCVA and complications. Results. Median pre- and postoperative UCVA was logMAR 1.78 (Snellen 20/1200) and logMAR 0.30 (Snellen 20/40), respectively, (p<0.001). Median pre- and postoperative BCVA was logMAR 0.24 (Snellen 20/34) and logMAR 0.18 (Snellen 20/30), respectively. UCVA ≥20/60 was attained in 90% of eyes. BCVA ≥20/30 was attained in 85.0% of eyes. Most common early postoperative complications were hyphaema (10%), transient vitreous hemorrhage (2.5%), and ocular hypotony (2.5%). None of these developed any long-term sequelae. Only one case of subluxation of IOL was seen. No case of late endophthalmitis or retinal detachment was seen. Conclusion. Since refractive error induced is minimal, the procedure is suitable for IOL implantation in children, who are noncompliant with spectacles. The complication profile is similar to that reported in adults.

scholarly journals Refractive Lens Exchange with Multifocal Intraocular Lens for Treatment of Chronic Intermittent Spasm of the Near Reflex

2017 ◽  
Vol 8 (3) ◽  
pp. 539-544 ◽  
Author(s):  
Guy Sallet
Keyword(s):  
Visual Acuity ◽  
Intraocular Lens ◽  
Spontaneous Recovery ◽  
Multifocal Intraocular Lens ◽  
Refractive Lens Exchange ◽  
Final Treatment ◽  
Uncorrected Visual Acuity ◽  
Refractive Lens ◽  
Near Visual Acuity ◽  
Near Reflex

We report the case of an emmetropic 32-year-old female with decreased uncorrected visual acuity and diplopia due to intermittent episodes of spasm of the near reflex. Neurologic, general, and ophthalmic examination could not find an organic cause. Attempts at spontaneous recovery, psychogenic therapy, and cycloplegic therapy were unsuccessful and the symptoms persisted for almost 5 years, leading to psychogenic distress. Final treatment with refractive lens exchange and implantation of a toric trifocal intraocular lens resolved the spasm of the near reflex, resulting in an uncorrected distance and near visual acuity of 20/20.

scholarly journals Correction of High Corneal Astigmatism during Cataract Surgery

2019 ◽  
Vol 15 (4) ◽  
pp. 405-410 ◽  
Author(s):  
K. B. Pershin ◽  
N. F. Pashinova ◽  
M. E. Konovalov ◽  
E. P. Gurmizov ◽  
O. Yu. Zubenko ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Surgical Treatment ◽  
Clinical Experience ◽  
Intraocular Lens ◽  
Surgical Intervention ◽  
Corneal Astigmatism ◽  
Intraocular Lenses ◽  
Toric Intraocular Lens ◽  
Surgical Interventions ◽  
Uncorrected Visual Acuity

Patients, who need cataract surgical treatment, often fail to achieve a high uncorrected visual acuity after surgery due to the concomitant astigmatism involved. Currently, surgeons are increasingly performing combined surgical interventions, including relaxing limbal keratotomic incisions (manual keratotomy) or femtoarcuatous keratotomy, as well as implanting toric intraocular lenses. In recent years, additional toric intraocular lenses have been available. Purpose: to analyze our own clinical experience of implanting an additional toric intraocular lens to correct corneal astigmatism in three clinical cases. The article presents our clinical experience of successful correction of residual corneal astigmatism after previous cataract phacoemulsification with the implantation of a monofocal toric intraocular lens in three patients patients aged 70, 61 and 54 years. In all cases, an additional toric intraocular lens Add-on Torica-sPB pre-filled in the cartridge with a good refractive effect was implanted. The uncorrected visual acuity was 1.0 in all the investigated cases at the follow-upo period of 6 months after the surgical intervention. Calculation of the toric intraocular lens optical power was performed using an online calculator. A feature of surgical intervention was the repositioning of the additional toric intraocular lens into the ciliary sulcus. Changes in the data of keratotopography before and after surgery were absent. In none of the investigated cases, intra- and postoperative complications and dislocation of the implanted additional toric intraocular lens were determined. Based on these cases, high predictability, efficacy and safety of implantation of an additional toric intraocular lens are shown, in the case of residual middle-grade corneal astigmatism after the initial cataract phacoemulsification with the toric intraocular lens implantation. This approach can be successfully used in patients during one-stage surgical treatment of cataract and associated high-grade corneal astigmatism, expanding existing protocols for the treatment of this group of patients.

scholarly journals Case Report of Myopia Correction by ReLEx SMILE in a Patient with Superficial Corneal Opacity

2020 ◽  
Vol 17 (2) ◽  
pp. 295-299
Author(s):  
N. V. Maychuk ◽  
I. A. Mushkova ◽  
A. M. Mayorova ◽  
A. A. Shpak
Keyword(s):  
Visual Acuity ◽  
Case Report ◽  
Anterior Segment ◽  
Corneal Opacity ◽  
Optical Center ◽  
Interface Zone ◽  
Uncorrected Visual Acuity ◽  
Corneal Opacities ◽  
Different Depths ◽  
The Right

Introduction. Reduced corneal transparency leads to dissipation of energy of the femtosecond laser (FSL), which may complicate the formation of the intrastromal incision and limits the use of FSL in eyes with corneal opacities and scars. The purpose of this work is to demonstrate the possibility of successful ReLEx SMILE in a patient with superficial corneal opacity located in the paracentral zone. Case report. Patient R., 29 years old, complained of decreased vision in both eyes since childhood. Visual acuity OD = 0.1 sph –2.75D = 1.0; OS = 0.1 sph –3.50 D cyl –0.75D ax 165° = 1.0. Biomicroscopy of the right eye visualized a superficial semi-transparent corneal opacity of 5 x 3 mm located at 5.30–6 hours at a distance of 1.3 mm from the optical center. According to the anterior segment optical coherence tomography (AS-OCT) the depth of the opacity was 73–78 microns and was limited by the Bowman’s membrane. ReLEx SMILE for myopia correction was performed on both eyes with 6.7 mm lenticule diameter at a depth of 120 µm, which covered the opacity area by 1.1 mm. The surgery was standard and uncomplicated. Seven days postoperatively the patient did not complain. Uncorrected visual acuity (UCVA) was 1.0 for both eyes (and binocularly it was 1.2). According to the AS-OCT data, a hyperreflective line of the interface zone was visualized on the right eye at the depth of 141–147 µm; the opacified superficial corneal layers were detected in the lower paracental zone over the interface line. In one month after the surgery the visual acuity did not change: UCVA = 1.0 in both eyes (binocularly 1.2). Conclusion. ReLEx SMILE technology can be considered as one of the options for myopia correction in patients with superficial corneal opacity located in the paracental zone. More observations are required to evaluate the effectiveness of this technology on corneas with paracentral opacities different in sizes and located at different depths.

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