scholarly journals Two-stage treatment of ametropia in patients with keratoconus and cataracts

2021 ◽  
Vol 6 (6-1) ◽  
pp. 204-213
Author(s):  
M. M. Bikbov ◽  
O. I. Orenburkina ◽  
A. E. Babushkin ◽  
I. F. Nuriev
Keyword(s):  
Visual Acuity ◽  
Rotational Stability ◽  
Posterior Chamber ◽  
Two Stage ◽  
Intrastromal Corneal Ring ◽  
Uncorrected Visual Acuity ◽  
Posterior Chamber Intraocular Lens ◽  
The Russian Federation ◽  
Stage 1

Keratoconus (KC) is a progressive degenerative corneal disease, leads to the aberration of biomechanical and optical properties and thinning of the cornea, causes astigmatism and decreases visual acuity.Materials and methods. 33 patients (35 eyes) with stages II–III of non-progressive keratoconus and concomitant cataracts of various stages of maturity were operated on. The average age of the patients was 46.5 ± 2.7 (41–63) years old. The operations were performed according to our proposed two-stage method of treating ametropia in patients with KC and cataracts (Patent of the Russian Federation No. 2748634 of 28.05.2021). The first stage was the implantation of FERRARA intrastromal corneal ring segments (ICRS) with thickness from 150 to 350 μm. To correct residual refractive error in 5–7 months after stage 1, patients underwent stage 2: cloudy lens was removed and replaced with toric posterior chamber intraocular lens (TIOL) – AcrySof IQ Toric (Alcon, USA), T-fl ex Toric RayOne (Rayner, UK).Results and discussion. After stage 1 of the operation (ICRS implantation), the uncorrected visual acuity (NCVA) was 0.2 ± 0.03, the best corrected visual acuity (BCVA) was 0.4 ± 0.02. In 1 month after stage 2 (phacoemulsifi cation + TIOL) NCVA was 0.64 ± 0.11 and BCVA was 0.74 ± 0.12. During the entire follow-up period after the surgery visual functions, refraction, and rotational stability of TIOL were stable.Conclusions. Conducting a two-stage surgical intervention in patients with keratoconus and cataracts allows to stop the progression of the disease and effectively correct the ametropia concomitant with keratoconus.

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.

Clinical effectiveness of intrastromal corneal ring segments among keratoconus patients

2020 ◽  
Vol 1 (3) ◽  
pp. 140-144
Author(s):  
Abdullhamid Alghamdi ◽  
Keyword(s):  
Visual Acuity ◽  
Femtosecond Laser ◽  
Surgical Intervention ◽  
Clinical Effectiveness ◽  
Ophthalmic Examination ◽  
Visual Outcomes ◽  
Intrastromal Corneal Ring ◽  
Uncorrected Visual Acuity ◽  
The Mean

AIM: To evaluate the clinical effectiveness of intrastromal corneal ring segments (ICRS) among the patients suffering from keratoconus. METHODS: A retrospective and non-comparative interventional design had been utilized on the basis of postoperative follow-up among 56 keratoconus patients. Visual acuity was significantly assessed during complete ophthalmic examination of the patients. The femtosecond laser had been used to create the corneal tunnels in 15 eyes; whereas, the corneal tunnels were created in 72 eyes mechanically. RESULTS: The ranges and standard deviations had been used to obtain results. It had been revealed through ophthalmic assessment that the mean preoperative uncorrected visual acuity observed was 1.38±0.37 logarithm of Minimal Angle of Resolution. Moreover, a significant improvement was observed postoperatively in visual acuity by 0.58±0.32 during the 4th month. The improvement was also witnessed in the 16th month by 0.48±0.30. CONCLUSION: The implantation of ICRS is an efficient and effective surgical intervention for the treatment of keratoconus. Thus, identified intervention seems to be associated with appropriate visual outcomes and safety after the development of femtosecond as well as mechanical tunnels.

Visual Function after Implantation of Aniridia Intraocular Lens for Traumatic Aniridia in Vitrectomized Eye

2007 ◽  
Vol 17 (4) ◽  
pp. 660-665 ◽  
Author(s):  
S. Moghimi ◽  
M. Riazi Esfahani ◽  
M. Maghsoudipour
Keyword(s):  
Visual Acuity ◽  
Contrast Sensitivity ◽  
Intraocular Lens ◽  
Visual Function ◽  
Secondary Glaucoma ◽  
Posterior Chamber ◽  
Antiglaucoma Medication ◽  
Posterior Chamber Intraocular Lens ◽  
Previous Trauma

Purpose To evaluate the efficacy and safety of aniridia posterior chamber intraocular lens (PCIOL) in traumatic aniridia and aphakia in vitrectomized eyes. Methods Four aphakic patients with traumatic aniridia and previous pars plana vitrectomy (PPV) due to posterior segment trauma enrolled in the study, and had secondary implantation of an aniridia PCIOL. Two patients were men and two women with mean age of 39.25 years. Complete ophthalmic examinations, including preoperative and postoperative visual acuity in dark and light, glare disability, visual function (using VF-9 questions modified from VF-14), stereopsis, and contrast sensitivity in 3, 6, 12, and 18 cycle per degree frequencies, were done for all patients. Postoperative intraocular pressure (IOP), IOL centration, and intraocular inflammation were monitored. Mean follow-up was 12.25 months (range 7 to 15 months). Results Visual acuity improved in all four patients, especially in the light. Glare was subjectively reduced in all of them. Stereopsis was measurable in three of them postoperatively. Contrast sensitivity improved in all patients, especially in brightness and lower frequencies. All four eyes had improved VF-9. All eyes achieved the desired anatomic results. Two cases developed elevated IOP early after surgery. In one eye, IOP elevation was transient and controlled with antiglaucoma medication, but the other eye, which had secondary glaucoma from previous trauma, required cyclophotocoagulation for the IOP to be controlled. No patient developed chronic uveitis or redetachment. Conclusions The aniridia PCIOL can overcome aphakia, reduce glare, and increase visual function, contrast sensitivity, and stereopsis in vitrectomized eyes with traumatic aniridia. Although this kind of IOL appears safe, some disadvantages are secondary glaucoma and reduced visibility of peripheral fundus, and caution should be used in its implantation until more patients with longer follow-up are studied.

scholarly journals Intrastromal Corneal Ring Segment Implantation (Keraring 355°) in Patients with Central Keratoconus: 6-Month Follow-Up

2015 ◽  
Vol 2015 ◽  
pp. 1-8 ◽  
Author(s):  
Khosrow Jadidi ◽  
Seyed Aliasghar Mosavi ◽  
Farhad Nejat ◽  
Mostafa Naderi ◽  
Leila Janani ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Invasive Procedure ◽  
Cost Effective ◽  
Corrected Visual Acuity ◽  
Intrastromal Corneal Ring ◽  
Uncorrected Visual Acuity ◽  
Ring Segment ◽  
Efficacy Index ◽  
Preliminary Study

We evaluate the efficacy and safety of Keraring 355° intrastromal corneal ring segment (ICRS) implantation aided by PocketMaker microkeratome for the correction of keratoconus. Patients underwent ICRS insertion using mechanical dissection with PocketMaker microkeratome and completed 6 months of follow-up. Uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity (BSCVA), refraction, topographic findings, safety, efficacy index, and adverse events were reported for six months postoperatively. We evaluated 15 eyes of 15 patients (12 men) with a mean age of 28.87 ± 6.94 years (range 21–49 years). At final postoperative examination, there was a statistically significant reduction in the spherical equivalent refractive error compared to preoperative measurements (−5.46 ± 1.52 to −2.01 ± 1.63 D,P<0.001). Mean preoperative UCVA (logMAR) before implantation was 0.79 ± 0.48, and postoperative UCVA was 0.28 ± 0.15,P=0.001. Mean preoperative BSCVA (logMAR) before implantation was 0.36 ± 0.21; at final follow-up examination BSCVA was 0.18 ± 0.9,P=0.009. MeanKdecreased from 48.33 to 43.31 D,P<0.001. All patients were satisfied with ICRS implantation; 86.7% were moderately to very happy with the results. No intraoperative or postoperative complications were demonstrated. This preliminary study shows that ICRS (Keraring 355°) implantation is an efficient, cost-effective, and minimally invasive procedure for improving visual acuity in nipple type keratoconic corneas.

scholarly journals Management of bilateral microspherophakia with secondary angle closure glaucoma

2015 ◽  
Vol 7 (1) ◽  
pp. 69-73
Author(s):  
K PS Malik ◽  
R Goel ◽  
K Jain ◽  
S Nagpal ◽  
S Singh
Keyword(s):  
Visual Acuity ◽  
Angle Closure Glaucoma ◽  
Angle Closure ◽  
Posterior Chamber ◽  
Middle Aged ◽  
Aged Patients ◽  
Posterior Chamber Intraocular Lens ◽  
Shallow Anterior Chamber ◽  
The Right

Background: Microspherophakia is characterized by lenticular myopia, late development of lens dislocation, shallow anterior chamber and angle-closure glaucoma. If it is associated with angle closure glaucoma, the management can be challenging.Objective: To report the management of a case of bilateral secondary angle closure glaucoma with isolated microspherophakia and right subluxated lens in a middle aged lady. Case: A 47-year-old female presented with bilateral secondary angle closure glaucoma with isolated microspherophakia, right subluxated lens and left operated trabeculectomy. The patient`s best corrected log mar visual acuity improved from 1.0 to 0.2 and intraocular pressure (IOP) decreased from 24.9mm of Hg to lower teens following lensectomy with scleral ¿xation of posterior chamber intraocular lens in the right eye. The left eye IOP remained in mid teens without medication in two year follow up. Conclusion: This case demonstrates that microspherophakia should be ruled out even in middle aged patients presenting as angle closure glaucoma. The possibility of thickened cornea must be kept in mind requiring an IOP correction. Lensectomy with scleral ¿xation of posterior chamber IOL provides a satisfactory recovery of visual acuity and IOP control. Though in this patient, the lens was held in position by posterior synechiae in the left eye, future stability of zonules needs to be monitored.

scholarly journals Bandage Therapeutic-Optical Keratoplasty in Keratoconus Patients after Intrastromal Corneal Segments Implantation

2019 ◽  
Vol 16 (3) ◽  
pp. 283-288
Author(s):  
G. A. Osipyan ◽  
V. M. Sheludchenko ◽  
N. Y. Youssef ◽  
Kh. Khraystin
Keyword(s):  
Visual Acuity ◽  
Past History ◽  
Functional Results ◽  
Intrastromal Corneal Ring ◽  
Uncorrected Visual Acuity ◽  
Long Term Follow Up ◽  
History Of ◽  
Optical Zone

Purpose — to evaluate the functional results of bandage therapeutic-optical keratoplasty (BTOK) in keratoconus eyes after implantation of intrastromal corneal ring segments (CRS). Material and methods. The study included 18 patients with stage II and III keratoconus (as per Amsler-Krumeich classification) who had underwent implantation of CRS with unsatisfactory long-term outcomes. The patients were divided into two groups. The first group consisted of 7 patients (7 eyes) of 27 ± 3 years old with had past history of CRS implantation followed by the absence of predicted improvement of visual acuity during the observation period of up to 18 months. The second group included 11 patients (11 eyes) who had visual acuity improvements after CRS implantation, but had regression in the long-term follow-up of 2 to 5 years. The surgical algorithm consisted of two steps: first, all 18 patients had the intrastromal ring segments removed; second, 3 months later they underwent BTOK. Outcomes. After the removal of CRS, patients of both groups showed improvements in central corneal refraction, their visual acuity decreased to 0.07 ± 0.02 and 0.09 ± 0.04, respectively. The 36 months follow-up after BTOK revealed significant improvements in visual acuity — up to 0.48 ± 0.04 and 0.54 ± 0.11, respectively — in all patients in both group due to marked flattening of the cornea in the optical zone. Conclusion. Bandage therapeutic-optical keratoplasty allows treatment of patients with complicated or who had unsatisfactory results after implantation of intrastromal ring segments. The surgery leads to stabilization of keratectasia in keratoconus patients and significantly increases uncorrected visual acuity.

Long-Term Stability of Sutured Scleral Fixation of a Posterior Chamber Intraocular Lens With 10-0 Polypropylene for More Than 30 Years

2021 ◽  
pp. 247412642097887
Author(s):  
Gregg T. Kokame ◽  
Tarin T. Tanji ◽  
Jase N. Omizo
Keyword(s):  
Intraocular Lens ◽  
Posterior Chamber ◽  
Scleral Flap ◽  
Scleral Fixation ◽  
Polypropylene Suture ◽  
Long Term Stability ◽  
Posterior Chamber Intraocular Lens ◽  
Polypropylene Sutures

Purpose: We report the longest follow-up to our knowledge of stable scleral fixation of a posterior chamber intraocular lens (PC IOL) with 10-0 polypropylene sutures. Methods: A retrospective review is presented of a case with more than 30 years’ follow-up after performing sutured scleral fixation with 10-0 polypropylene suture using 2 sutures tied together under a scleral flap. One suture was a cow-hitch looped around the haptic, and the other suture was passed through the sclera to create the scleral fixation. Results: The scleral fixation with 10-0 polypropylene suture knots for both haptics of the PC IOL allowed central optic positioning with excellent vision for more than 30 years without suture breakage. Conclusions: Polypropylene sutures for scleral fixation of PC IOLs remained stable for more than 30 years with central positioning of the PC IOL, without exposure of the fixation suture knots through the conjunctiva, and without suture breakage.

Outcomes of a 320-degree intrastromal corneal ring segment implantation for keratoconus: Results of a 6-month follow-up

2018 ◽  
Vol 30 (1) ◽  
pp. 139-146 ◽  
Author(s):  
Guilherme Andrade do Nascimento Rocha ◽  
Paulo Ferrara de Almeida Cunha ◽  
Leonardo Torquetti Costa ◽  
Luciene Barbosa de Sousa
Keyword(s):  
Visual Acuity ◽  
Spherical Equivalent ◽  
Distance Visual Acuity ◽  
Uncorrected Distance Visual Acuity ◽  
Intrastromal Corneal Ring ◽  
Corrected Distance Visual Acuity ◽  
Ring Segment ◽  
The Mean ◽  
Corneal Tomography

Importance: This study shows that a newer long-arc length intrastromal corneal ring segment is efficient and safe for keratoconus treatment. Background: To evaluate visual, tomographic results and complications of a 320-degree intrastromal corneal ring segment implantation with the femtosecond laser for keratoconus treatment. Design: A prospective, nonrandomized, and interventional study. Participants: A total of 34 eyes of 31 patients diagnosed with keratoconus were enrolled. Methods: Patients were divided into two groups based on the strategy used for 320-degree intrastromal corneal ring segment thickness selection. In one group, this selection was based on spherical equivalent (SE group) and in the other on the mean asphericity (Q group). The uncorrected and corrected distance visual acuities, spherical equivalent, K1, K2, Km, Kmax, and mean asphericity ( Q) on corneal tomography were evaluated preoperatively and at 3 and 6 months postoperatively. For astigmatism improvement, we analyzed the corneal tomographic vectorial astigmatism change preoperatively and at 6 months postoperatively. The mean follow-up period was 6.63 ± 0.96 months. Results: The mean uncorrected distance visual acuity and corrected distance visual acuity improved with a significant spherical equivalent improvement ( p < 0.05), with no differences between the 320-degree intrastromal corneal ring segment groups. All corneal tomographic parameters improved significantly ( p < 0.05) between the preoperative and postoperative intervals, with a significant better performance when we used spherical equivalent for the 320-degree intrastromal corneal ring segment thickness selection. Finally, the mean vectorial corneal tomographic astigmatism significantly improved after 6 months, again with no differences between groups. Conclusion: This study suggests that implanting a 320-degree intrastromal corneal ring segment is a safe and effective procedure for treating patients with keratoconus. It also suggests that for thickness selection spherical equivalent is the better strategy.

scholarly journals Intra-ocular lens opacification in the anterior chamber leading to loss of vision in an adolescent

2014 ◽  
Vol 6 (1) ◽  
pp. 102-104
Author(s):  
Mrindu Chaudhry ◽  
Keerti Mundey ◽  
Shikha Baisakhiya ◽  
Sumita Sethi
Keyword(s):  
Visual Acuity ◽  
Anterior Chamber ◽  
Intraocular Lens ◽  
Rare Case ◽  
Intraocular Inflammation ◽  
Posterior Chamber ◽  
Ocular Lens ◽  
Posterior Chamber Intraocular Lens ◽  
Developmental Cataract ◽  
Posterior Chamber Iol

Objective: To report a rare case of intraocular lens (ACIOL) opacification in the anterior chamber in an adolescent and to discuss the possible mechanism of its occurrence and the ways of its prevention. Case: A 16-year-old male underwent cataract surgery for developmental cataract with placement of a foldable posterior chamber IOL in the anterior chamber. There was subsequent opacification of the IOL, which was replaced by a scleral fixated posterior chamber intraocular lens. The post-operative visual acuity improved to 6/18. Conclusion: The posterior chamber IOL implanted in the anterior chamber can get opacified possibly due to postoperative intraocular inflammation. DOI: http://dx.doi.org/10.3126/nepjoph.v6i1.10780   Nepal J Ophthalmol 2014; 6 (2): 102-104

scholarly journals Comparison of the Outcomes of Manual Small Incision Cataract Surgery (MSICS) and Phacoemulsification (PHACO) in Ghana

2021 ◽  
Vol 18 (3) ◽  
pp. 143-149
Author(s):  
Samuel Kyei ◽  
Ebenezer Zaabaar ◽  
Frank Assiamah ◽  
Michael Agyemang Kwarteng ◽  
Kofi Asiedu
Keyword(s):  
Visual Acuity ◽  
Postoperative Complications ◽  
Cataract Surgery ◽  
Medical Records ◽  
Cross Sectional Study ◽  
Small Incision Cataract Surgery ◽  
Cross Sectional ◽  
Small Incision ◽  
Uncorrected Visual Acuity

Background: The growing middle-class population of Ghana has seen more people being employed in visually demanding occupations  and hence there is an increased desire for quality post-cataract surgical visual outcomes. This study aimed at comparing the outcomes of manual small incision cataract surgery (MSICS) and phacoemulsification (PHACO) among Ghanaians. Methods: This was a retrospective cross-sectional study in which records of patients who underwent MSCIS or phacoemulsification by the same surgeon were reviewed. Results: Medical records of 248 eyes were reviewed, out of which 132 underwent PHACO and 116 had MSICS. A significant number of the  PHACO group had good (6/6–6/18) uncorrected visual acuity (UCVA) compared to the MSICS group at 1–2 weeks follow-up (p = 0.003) and 4–6 weeks follow-up (p = 0.002). MSICS resulted in a higher total astigmatic change compared to PHACO (p < 0.001). The PHACO grouphad a higher number of postoperative complications compared with the MSICS group (p <0.001). Postoperative borderline and poor  uncorrected visual acuity were associated with age, total astigmatic change, and postoperative complications. Conclusion: The postoperative UCVA outcomes at 4–6 weeks’ follow-up indicates that PHACO resulted in noticeably less spectacle dependency when compared to MSICS.

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