scholarly journals The Effect of Scleral Sutured Intraocular Lens with Optic-haptic Junction Fixation in the Capsular Bag

2021 ◽  
Vol 62 (9) ◽  
pp. 1172-1180
Author(s):  
Sun Young Lee ◽  
Yang Kyung Cho
Keyword(s):  
Anterior Chamber ◽  
Intraocular Lens ◽  
Anterior Chamber Depth ◽  
Fixation Method ◽  
Scleral Fixation ◽  
Sulcus Fixation ◽  
Refractive Change ◽  
The Stability ◽  
Target Refraction ◽  
Capsular Bag

Purpose: To compare the stability of intraocular lens (IOL) insertion methods of sutured haptics in the bag with scleral fixation to those of in the bag insertion and scleral sulcus fixation. Methods: In group of only phacodonesis, two IOL insertion methods, in the bag insertion and sutured haptics in the bag with scleral fixation were compared. In group of phacodonesis with less than 90° zonulysis, two IOL insertion methods, sutured haptics in the bag with scleral fixation and scleral sulcus fixation were compared. Postoperative 2 months and 12 months refraction were compared with target refraction and the refractive change between postoperative 2 and 12 months were compared in each group. The change of anterior chamber depth (ACD) at postoperative 2 and 12 months were compared with preoperative ACD, and the change of ACD between postoperative 2 and 12 months were compared in each group. Results: In group of only phacodonesis, the typical in the bag insertion group showed significant ACD change between postoperative 2 and 12 months (p = 0.010), but the group of sutured haptics in the bag with scleral fixation didn’t show the significant ACD change (p = 0.515). In group of phacodonesis with less than 90° zonulysis, the sulcus scleral fixation method showed significant ACD change and significant refractive change (p = 0.015, p = 0.004), but the group of sutured haptics in the bag with scleral fixation method didn’t show the significant ACD nor refractive change (p = 0.713, p = 0.106) between postoperative 2 and 12 months. Conclusions: In eyes with zonular instability, sutured haptics in the bag with scleral fixation method can promote the postoperative stability of IOL.

scholarly journals Progress in Modern Cataract Surgery – New Steps and Algorithms for Precise Measuring and Intraocular-lens Calculations

2017 ◽  
Vol 11 (02) ◽  
pp. 95
Author(s):  
Fritz H Hengerer ◽  
Gerd U Auffarth ◽  
Ina Conrad-Hengerer ◽  
◽  
◽  
...  
Keyword(s):  
Cataract Surgery ◽  
Anterior Chamber ◽  
Intraocular Lens ◽  
Axial Length ◽  
Refractive Surgery ◽  
Anterior Chamber Depth ◽  
Corneal Surface ◽  
Intraocular Lens Calculations ◽  
Target Refraction ◽  
Intraocular Lens Calculation

In standard cataract surgery, one of the major goals is to reach target refraction. Based on keratometry measurements, axial length and anterior chamber depth, most of the intraocular lens calculation formulae are suitable to achieve this aim. Further evaluation of corneal refractive parameters like anterior and posterior corneal surface by Scheimpflug devices led to a significant enhancement of precision in astigmatic and post-refractive surgery cases.

scholarly journals Continuous Curvilinear Capsulorhexis in Cataract Surgery Using a Modified 3-Bend Cystotome

2015 ◽  
Vol 2015 ◽  
pp. 1-5
Author(s):  
Yuan Zeng ◽  
Jian-hua Gao
Keyword(s):  
Cataract Surgery ◽  
Anterior Chamber ◽  
Intraocular Lens ◽  
Completion Time ◽  
Anterior Chamber Depth ◽  
Corneal Edema ◽  
Group A ◽  
Capsular Rupture ◽  
Phacoemulsification Cataract Surgery ◽  
Capsular Bag

We modified a 2-bend cystotome for continuous curvilinear capsulorhexis (CCC) in manual or phacoemulsification cataract surgery to improve the safety and ease of performance. A 26G needle was converted into a cystotome with 3 bends. In this retrospective study, the performance of modified 3-bend cystotome was compared with conventional 2-bend cystotome. During cataract surgery, in the 3-bend cystotome group, mean completion time of CCC was shorter, mean times of viscoelastic agent supplement were less, and CCC success rate was higher than that in 2-bend group. Complication incidence, such as postoperative transient corneal edema and irreparable V-shaped tear, was also lower in 3-bend group. No posterior capsular rupture or no other complication was observed in either group. A polymethyl methacrylate intraocular lens or a hydrogel intraocular lens was implanted in the capsular bag in all eyes. We conclude that it is safe and efficient to accomplish a CCC using the 3-bend cystotome due to its ability to sustain the anterior chamber depth (ACD) and keep the posterior lip intact. Using the 3-bend cystotome also allowed for an adequate view into the anterior chamber from lack of wound deformation.

scholarly journals A Case of Repeating Transient Increase in Intraocular Pressure by Instability of an Intraocular Lens Implanted in the Capsular Bag

2020 ◽  
Vol 11 (1) ◽  
pp. 60-67
Author(s):  
Yukihisa  Takada ◽  
Takayoshi Sumioka ◽  
Nobuyuki Ishikawa ◽  
Shingo Yasuda ◽  
Ryoko Komori ◽  
...  
Keyword(s):  
Intraocular Pressure ◽  
Anterior Chamber ◽  
Intraocular Lens ◽  
Anterior Chamber Depth ◽  
Acute Angle ◽  
University Hospital ◽  
Angle Closure ◽  
Light Reaction ◽  
Narrow Angle ◽  
Medical University

We observed repeated episodes of rapid increases in intraocular pressure (IOP) considered to be caused by an in-the-bag intraocular lens (IOL) instability in a patient with an implanted IOL. As acute glaucoma attack-like increase in IOP was noted in the left eye on November 8, she was admitted to Wakayama Medical University Hospital. The findings at the first examination included an IOP of 62 mm Hg, instability of a PMMA one-piece IOL, shallow anterior chamber, narrow angle, moderate mydriasis, and loss of pupillary light reaction in the left avitreous eye. On November 15, a 6-mm Hg increase in IOP was observed during 60-min dark room prone provocative testing. After the first examination, the patient perceived pain and reduced visual acuity of the left eye and emergently consulted our hospital twice. Despite miosis, normalization of the anterior chamber depth and IOP with widening of the angle were achieved by resting in the supine position. These episodes were thought to be caused by instability and anterior shift of the IOL. On January 17, 2018, suture fixation of the in-the-bag IOL was performed. The IOL was fixed by transscleral suturing of the bilateral supporting parts to the sclera. Recurrence of sudden ophthalmalgia, instability of the in-the-bag IOL, and an increase in IOP have not been observed for 1 year after surgical treatment. Instability of an in-the-bag IOL caused repeated acute angle-closure glaucoma-like attacks. The situation was well treated by suturing and fixing the haptics of IOL to the sclera.

scholarly journals Scleral fixation of a dexamethasone intravitreal implant in a case of subluxated bag–intraocular lens complex

2019 ◽  
Vol 11 ◽  
pp. 251584141985652
Author(s):  
Carlos M. Rangel ◽  
Nathalia J. Moreno ◽  
M. Margarita Parra
Keyword(s):  
Macular Edema ◽  
Anterior Chamber ◽  
Intraocular Lens ◽  
Corneal Edema ◽  
Conventional Technique ◽  
Endothelial Damage ◽  
Scleral Fixation ◽  
Surgical Tool ◽  
Number Of Patients ◽  
Capsular Support

Macular edema is a condition of retinal tissue treated with anti-inflammatory agents including placement of an intravitreal sustained-release dexamethasone device, designed to deliver a controlled amount of the medication for a prolonged time, representing an excellent therapy. Nonetheless, the implantation cannot be carried out without an anatomical barrier, such as the presence of posterior capsular support, lens, or intraocular lens. The absence of these barriers could lead to several complications, due to migration of the device from the vitreous cavity to the anterior chamber, causing corneal endothelial damage, corneal edema, glaucoma, and uveitis, among others. In consequence, a large number of patients cannot be treated with this useful surgical tool, resulting in chronicity of macular edema and severe visual acuity impairment. Therefore, we modified the conventional technique, through scleral fixation of the device providing a continuous delivering of dexamethasone, avoiding its migration to the anterior chamber in a patient without capsular support.

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