scholarly journals Outcomes of Re-fixation after the First Intraocular Lens Scleral Fixation

2021 ◽  
Vol 62 (9) ◽  
pp. 1189-1197
Author(s):  
Seung Kwan Nah ◽  
Jong Woo Kim ◽  
Chul Gu Kim ◽  
Jae Hui Kim

Purpose: To investigate the outcomes of re-fixation after the first intraocular lens (IOL) scleral fixation. Methods: We retrospectively reviewed the charts of patients who underwent second IOL scleral fixation and vitrectomy for dislocation of IOL after the first IOL scleral fixation. We compared the best-corrected visual acuity (BCVA) and spherical equivalent (SE) after 1 month of the first and second surgery, and noted the complications. Results: We included 21 eyes that underwent second IOL scleral fixation: 13 eyes (61.9%) with IOL exchange and eight (38.1%) with one-haptic fixation. Mean BCVAs (LogMAR) were 0.17 ± 0.25 and 0.11 ± 0.23 after the first and second surgery, respectively (<i>p</i> = 0.073); mean SEs were -0.94 ± 1.69 and -0.58 ± 1.46 diopters after the first and second surgery, respectively (<i>p</i> = 0.076). Postoperative complications occurred in eight eyes (38.1%), including temporarily increased intraocular pressure and suture knots exposure. However, none of the complications required re-operation. Conclusions: The outcomes of primary and secondary IOL fixation were similar, and there were no serious complications of the second surgery.

2013 ◽  
Vol 13 (2) ◽  
pp. 33-41
Author(s):  
Devendra Maheshwari ◽  
Rengappa Ramakrishanan ◽  
Mohideen Abdul Kader ◽  
Neelam Pawar ◽  
Ankit Gupta

Aim: To evaluate the effect of phacoemulsification with intraocular lens implantation in eyes with pre-existing trabeculectomy.Methods: This prospective single-center clinical study evaluated intraocular pressure in 60 eyes of 60 patients who underwent phacoemulsification and implantation of a foldable intraocular lens after a previous successful trabeculectomy. Patients who had a trabeculectomy more than one year prior to the study were included. Intraocular pressure, number of antiglaucoma medications, bleb appearance, and visual acuity were recorded preoperatively, and at each follow-up examination and 12 months after phacoemulsification.Results: The mean intraocular pressure before phacoemulsification was 12.42 mmHg (SD, 4.60 mmHg), which increased to 14.98 mmHg (SD, 4.18 mmHg), 14.47 mmHg (SD, 3.58 mmHg), 15.44 mmHg (SD, 3.60 mmHg), and 15.71 mmHg (SD, 3.47 mmHg) after one, three, six, and 12 months, respectively. At each follow-up visit, the mean IOP was significantly higher than the preoperative value (p < 0.001, p = 0.015, p ≤ 0.001, and p = 0.001 at month one, three, six, and 12, respectively). The mean preoperative best-corrected visual acuity was 0.98 logMAR (SD, 0.44 logMAR) and the mean postoperative best-corrected visual acuity at 12 months was 0.20 logMAR (SD, 0.21 logMAR) [p = 0.0001]. The mean preoperative number of antiglaucoma medications used was 0.57 (SD, 0.63), which increased to 0.65 (SD, 0.63 ), 0.70 (SD, 0.72 ) 0.68, (SD, 0.70), and 0.67 (SD, 0.77 ) at one, three, six, and 12 months, respectively, but there were no statistically significant differences. Bleb size decreased clinically after phacoemulsification. Nineteen of 60 eyes (32%) developed fibrosis of bleb with decreased bleb size.Conclusion: Phacoemulsification with intraocular lens implantation significantly increased intraocular pressure and increased the number of antiglaucoma medications in eyes with pre-existing functioning filtering blebs.


2021 ◽  
Vol 7 (2) ◽  
pp. 415-418
Author(s):  
Subramanya K Giliyar ◽  
Ravi Bypareddy ◽  
Kamakshi N Moger ◽  
Vinutha Moger ◽  
Deeksha Bekal

To evaluate post operative visual outcome and complications of retro-pupillary iris fixated Intracoular lens (IOL) in aphakia. This is a prospective interventional case study conducted at our tertiary eye care centre from March 2018 to February 2019 All monocular aphakias secondary to any cause with no capsular support, good iris diaphragm support and BCVA of better than 6/60 were included. Patients who required combined procedures like trabeculectomy and retinal procedure were excluded. Patients with poor endothelial count/ corneal decompensation, any posterior segment pathologies, pre existing glaucoma and any form of uveitis were also excluded from the study. Pre operative 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 was to assess the post operative visual acuity and secondary outcome was to analyse post operative complications at various intervals up to 6 months after surgery. Our study comprised of thirty eyes of 30 aphakic patients. RPIFIOL was inserted as primary intraocular lens in 18 patients (%) and secondary intraocular lens in 12 patients(%). Baseline best corrected visual acuity was 0.831±0.66 logMAR. Four patients had light perception at baseline. The mean best corrected visual acuity was 0.77±0.35 logMAR at month 1, 0.64±0.36logmAR at month 3 and 0.53±0.33logmAR at month 6 respectively. Mean intraocular pressure at baseline was 16mmHg. Mean intraocular pressure at month 1, 3 and 6 were 17mmHg, 16mmHg, and 16mmHg. Among the complications, twelve eyes (40%) had significant ovalisation of pupil at post operative month 1 which persisted at month 6, two eyes(6.66%) had transient ocular hypertension (OHT), and none of the eyes progressed to glaucoma. Choroidal detachment was noted in 2 eyes (6.66%), CME in 3 eyes (9.99%), 1 eye (3.33%) had retinal detachment and 2 eyes (6.66%) had one haptic disenclavation. Among the complications, ovalisation of pupil was the most common observed one. Retro-pupillary Iris fixated IOL is an effective, safe and simple procedure for management of aphakia in eyes with no posterior capsular support.


2020 ◽  
pp. 112067212091906
Author(s):  
David Vladimir Diamint ◽  
Juan Martin Giambruni

Objective To present the surgical outcome of posterior chamber intraocular lens scleral fixation using a 27-gauge trocar-assisted transconjunctival sutureless technique in aphakic patients due to cataract surgery complications with inadequate capsular support. Methods Six consecutive patients with aphakia due to cataract surgery complications with inadequate capsular bag support were operated by two surgeons. Intraocular lens scleral fixation was performed with a 27-gauge trocar-assisted transconjunctival sutureless technique. Patients were followed-up for 12 months. Preoperative and postoperative best-corrected visual acuities were assessed with Early Treatment Diabetic Retinopathy Study charts and expressed in decimals. Results All patients showed statistically significant best-corrected visual acuity improvement and excellent anatomic results. Mean preoperative best-corrected visual acuity was 0.17 (range of 0.1–0.2). Mean postoperative best-corrected visual acuity was 0.84 (range of 0.63–1.00). Mean initial spherical equivalent refractive error was +11.85 (range of +9.00 to +15.00). Mean final spherical equivalent refractive error was –0.25 (range of –1.25 to +2.25). There were no postoperative complications during the whole follow-up. Conclusion Fixation of a posterior chamber intraocular lens using a 27-gauge trocar-assisted transconjunctival sutureless intrascleral technique is an excellent option for aphakic patients secondary to cataract surgery complications with inadequate capsular support.


2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
Gianluca Besozzi ◽  
Chiara Posarelli ◽  
Maria Carmela Costa ◽  
Alessio Montericcio ◽  
Giuseppe Nitti ◽  
...  

Purpose. To assess the visual and refractive outcome of immediate intraoperative vitrectomy and intrascleral intraocular lens implantation using a “standardized” sutureless Yamane technique during cataract luxation in the vitreous chamber as a complication of phacoemulsification. Design. A prospective, interventional, consecutive case series. Materials and Methods. Twelve patients underwent vitrectomy and intrascleral intraocular lens fixation using a standardized Yamane technique as the primary procedure during complicated phacoemulsification. Patients were evaluated preoperatively and 6 months postoperatively for best-corrected distance visual acuity, correspondence to the preoperative refractive target in the spherical equivalent, endothelial cell count, and complications. Results. Mean preoperative best-corrected visual acuity was 1.16 ± 0.3 logarithm of the minimum angle of resolution (logMAR), the endothelial cell count was 1910.5 ± 297.64, and target refraction at baseline was −0.197 ± 0.087. Postoperatively, best-corrected visual acuity was significantly improved; the mean value was 0.05 logMAR ± 0.06. Mean baseline target refraction in the spherical equivalent was −0.20 ± −0.09 (range: −0.08 to −0.37), and mean final refraction was −0.44 ± −0.14 (range: −0.25 to −0.75) with no significant difference p = 0.87 . No complication was registered intra- and postoperatively. Conclusion. Standardization of the Yamane technique seemed a valuable option for patients who had complicated phacoemulsification to achieve a predictable refractive outcome. Synopsis. The predictable refractive outcome could be achieved with the immediate standardized Yamane technique in patients with intraoperative cataract luxation in the vitreous chamber during phacoemulsification.


2012 ◽  
Vol 6 (4) ◽  
pp. 168
Author(s):  
Gilbert W. S. Simanjuntak

Ada keterbatasan laporan implementasi lensa intraokuler sekunder di Indonesia. Penelitian ini bertujuan untuk melaporkan hasil implementasi lensa intraokuler sekunder di Rumah Sakit Communion of Churches in Indonesia (CCI) Cikini, Fakultas Kedokteran Universitas Kristen IndonesiaJakarta. Penelitian dengan sumber data sekunder rekam medis pasien dengan bedah inclusi eventful dengan atau tanpa implementasi lensa dan setiap komplikasi post operasi, termasuk penurunan penglihatan dan inflamasi katarak. Segmen anterior dan posterior diperiksa secara menyeluruh dan dicatat. Sinechiolisis dilakukan 360o dan viskoelastik disuntikkan untuk membuka ruangan antara iris dan kapsul rensi remain. Remain vitreous di depan chamber dipotong dan diangkat. Intraocular lens (IOL) ditanam di sulkus. Hasilnya yaitu ada 8 pasien yang memenuhi kriteria inklusi yang kemudian dievaluasi (50% adalah pria), 6 pasien underwent extracapsular catarac extraction (ECCE), dan 2 pasien underwent phacoemulsification before. Semua pasien mempunyai kornea sentral yang jernih. Ada 5 pasien denganuveitis dan opasitas vitreous. Ada 1 pasien dengan (AC IOL), 2 pasien dengan (PCIOL) terdislokasi sebagian pada rongga vitreous dan sisanya aphakic. Semua prosedur bedah dikerjakan dengan anastesi lokal retrobulbar dan diimplementasi IOL pada sulkus tanpa fiksasi. Rata-rata umuradalah 56,3 + 18,5 tahun. Rata-rata best corrected visual acuity (BCVA) sebelum operasi 0,33 + 0,26 dan setelah operasi 0,89 + 0,16 (p = 0,000). Rata-rata intraocular pressure (IOP) adalah 20,25 + 8,2 dan 15,25 + 3,5 mmHg sebelum dan sesudah operasi secara berurutan (p = 0,140). Pemantauan dilakukan 1 - 60 bulan. Implementasi IOL sekunder dapatmemperbaiki penglihatan dan mengurangi subjektif dan temuan klinik setelah operasi katarak sebelumnya.Kata kunci: Intraokuler, implementasi, katarakAbstractThere are limited reports of secondary intraocular lens implantation in Indonesia. The purpose of study is to report the result of secondary intraocular lens implantation in Cikini Communion of Churches in Indonesia (CCI) Hospital/Faculty of Medicine University Universitas Kristen Indonesia Jakarta. Retrospective study of medical records of patients with inclusioneventful cataract surgery with or without lens implantation with any complications postoperatively, including reduced vision and inflammation. Anterior and posterior segment findings were examine thoroughly and recorded. Synechiolysis done 360 degree and viscoelastic injected to open space between iris and remain lens capsule. Remain vitreous in anterior chambercut and removed. Intraocular lens (IOL) implanted in the sulcus. There are 8 patients that fulfills inclusion criteria which then evaluated (50% are men), 6 patients underwent extracapsular catarac extraction (ECCE), and 2 patientsunderwent phacoemulsification before. All patient have clear central cornea. There are 5 patients with uveitis and vitreous opacity. There are 1 patients with (AC IOL), 2 patients with (PC IOL) dislocated some part to vitreous cavity and the rest aphakic. All surgical procedures were done under local retrobulbar anesthesia and IOL implanted in the sulcus withoutfixation. Mean age were 56,3 + 18,5 years. Mean best corrected visual acuity (BCVA) preoperatively 0,33 + 0,26 and postoperatively 0,89 + 0,16 (p = 0,000). Mean intraocular pressure (IOP) were 20,25 + 8,2 and 15,25 + 3,5 mmHg pre and post operative respectively (p = 0,140). Follow up was 1 - 60 months. Secondary IOL implantation can improve vision and reduce subjective and clinical findings after remarkable cataract surgery.Key words: Intraocular, implementation, cataract


2020 ◽  
Vol 30 (3) ◽  
pp. 612-615 ◽  
Author(s):  
Chiara Veronese ◽  
Chiara Maiolo ◽  
Grayson W Armstrong ◽  
Laura Primavera ◽  
Carlo Torrazza ◽  
...  

Purpose: The aim of this article is to describe a novel surgical technique for sutureless scleral fixation of an intraocular lens using the newly developed FIL SSF Carlevale IOL (Soleko, Italy). Methods: Four eyes of four patients with poor capsular support were recruited to our study, three resulting from intraocular lens subluxation and one case resulting from traumatic cataract. A novel sutureless sclera-fixated intraocular lens was implanted into the posterior chamber of each eye with sclerocorneal plugs fixating the lens to the wall of the eye. Results: Mean age of patients was 52 ± 16 years, ranging from 35 to 70 years. Mean follow-up was 6.50 ± 1.29 months (range: 5–7 months). Mean preoperative best-corrected visual acuity was 0.50 ± 0.33 logMAR (range: 1–0.3 logMAR). Postoperative best-corrected visual acuity improved to 0.08 ± 0.08 logMAR (range: 0.2–0 logMAR). There was no significant change in the mean intraocular pressure and there were no postoperative complications, such as iatrogenic distortion or breakage of the intraocular lens haptic, intraocular lens decentration, endophthalmitis, or retinal detachment. Discussion: To the best of our knowledge, this is the first report of outcomes using the novel sutureless sclera-fixated FIL SSF Carlevale IOL. This new surgical technique offers a simplified and effective approach for sutureless scleral intraocular lens fixation with good refractive outcomes.


2018 ◽  
Vol 29 (2) ◽  
pp. 210-215 ◽  
Author(s):  
Marta Misiuk-Hojlo ◽  
Maria Pomorska ◽  
Malgorzata Mulak ◽  
Marek Rekas ◽  
Joanna Wierzbowska ◽  
...  

Purpose: To assess tolerability and efficacy following a switch from benzalkonium chloride–latanoprost to preservative-free latanoprost in patients with glaucoma or ocular hypertension. Methods: A total of 140 patients with glaucoma or ocular hypertension controlled with benzalkonium chloride-latanoprost for at least 3 months were switched to treatment with preservative-free latanoprost. Assessments were made on days 15, 45, and 90 (D15, D45, and D90) and included best-corrected visual acuity, intraocular pressure, slit lamp examination, fluorescein staining, tear film break-up time, patient symptom evaluation, and subjective estimation of tolerability. Results: Mean best-corrected visual acuity remained unchanged during the study. Mean intraocular pressure compared with baseline (D0) remained stable throughout the study (D0, 15.9 mmHg (standard deviation = 2.6); D90, 15.3 mmHg (standard deviation = 2.4); p < 0.006). Tear film break-up time improved or remained unchanged relative to baseline in 92% of patients at D45 and in 93% at D90. Moderate-to-severe conjunctival hyperemia was seen in 56.8% of patients at D0, but this figure decreased to 13.7%, 2.2%, and 1.6% at D15, D45, and D90, respectively. Subjective assessment of tolerability (0–10 scale) indicated improvement with change of therapy (mean score: 5.3 (standard deviation = 2.2) at D0 versus 1.9 (standard deviation = 1.7) at D90; p < 0.0001). Conclusion: Preservative-free latanoprost has at least the same intraocular pressure-lowering efficacy as benzalkonium chloride–latanoprost, with a better tolerability profile. This may translate into greater control of treatment and improved quality of life.


Author(s):  
Ramez Barbara ◽  
David Zadok ◽  
Adel Barbara ◽  
Shay Gutfreund

ABSTRACT Intacs have yielded positive results for the treatment of keratoconus in terms of reducing the keratometry readings astigmatism and spherical equivalent and consequently improving the uncorrected and best corrected visual acuity. Intacs severe keratoconus (SK) are new design of Intacs with a smaller optical zone (6 mm) and oval shape, they are indicated for severe keratocnus. Pannus is one of the complications of Intacs, as it has never been reported after Intacs SK. We report on corneal neovascularization in the corneal periphery which developed few months after Intacs SK implantation in the cornea of a young female who suffered from advanced keratoconus. The uncorrected visual (UCVA) acuity was satisfactory and the Intacs SK where not removed. Four years after the implantation she presented to our clinic complaining about eye irritation and photophobia, lipid keratopathy was observed. We gave here the choice of explanting the Intacs SK or to try to treat the neovascularization by subconjunctival Avastin, she preferred the second option because of a satisfactory UCVA (0.9). Avastin was injected in the subconjunctival, 10 weeks later Avastin and Kenelog were injected in the subconjunctival, few days after the second injection perforation and melting developed in the cornea, the patient underwent a tectonic graft and few months later penetrating keratoplasty with no intraoperative or postoperative complications. How to cite this article Barbara A, Zadok D, Gutfreund S, Barbara R. Corneal Neovascularization and Lipid Keratopathy after Intacs SK in Keratoconus. J Kerat Ect Cor Dis 2013;2(3):133-138.


2019 ◽  
Author(s):  
fei you

Abstract Background: malignant glaucoma after cataract surgery is still one of the serious complications, if not handled properly,it may lead to serious consequences. It is notoriously difficult to treat. 25G vitrectomy was performed to evaluate the safety and efficacy for the treatment of malignant glaucoma in pseudophakia. Methods: This is a retrospective, comparative case series study. A total of 20 eyes of 20 patients with malignant glaucoma after phacoemulsification were analyzed retrospectively in The First Affiliated Hospital Of Anhui Medical University from May 2015 to January 2018. All Medical Data including the best corrected visual acuity (BCVA), Change of intraocular pressure (IOP), the length of eye axis, and the depth of anterior chamber were recorded. SPSS 17.0 statistical software was used for analysis .Before surgery, the best corrected visual acuity (BCVA) was 1.8±0.6. The intraocular pressure was between 18-57mmHg, with an average of 35.2±10.4mmHg.The depth of anterior chamber was between 0.9-1.9mm, with an average of 1.3±0.2mm.The length of eye axis was 19.7-22.5mm,with an average of 20.6±0.5mm.All the patients were accomplished with 25G vitrectomy. Besides, anterior chamber inflammatory reaction and other complications were also observed postoperation. Results: The patients were followed up for 6-12 months with an average of 9 months. BCVA at the last follow up improved to 0.8±0.1, and there was significant difference compared to that before operation (P<0.01).IOP was from 12-19mmHg, an average of 16.1±2.5mmHg, there was significant difference compared to that before operation (t=7.6, p<0.01).Only one patient occurred low IOP (6mmHg) after surgery, IOP returned to normal level (14mmHg) after conservative treatment. No serious complications including corneal endothelium decompensation, intraocular lens (IOL) capture, intraocular hemorrhage, endophthalmitis and uncontrolled IOP were observed. Conclusions: 25G minimally invasive vitrectomy can treat malignant glaucoma after cataract surgery safely and effectively


2018 ◽  
Vol 28 (5) ◽  
pp. 552-558 ◽  
Author(s):  
Priya Narang ◽  
Amar Agarwal ◽  
Dhivya Ashok Kumar

Purpose: To demonstrate the efficacy and initial results of single-pass four-throw pupilloplasty in cases of Urrets-Zavalia syndrome. Methods: In this prospective interventional study, single-pass four-throw was performed to reconstruct the pupil in all symptomatic cases with Urrets-Zavalia syndrome. Applanation tonometry, indentation gonioscopy, and anterior segment optical coherence tomography for anterior chamber angle assessment were performed in all the cases. Results: Out of 10 cases that were identified with Urrets-Zavalia syndrome, the procedure was performed in 7 cases, whereas 3 cases were left untreated, as they did not have any visual complaints. Five out of seven eyes had preoperative raised intraocular pressure with appositional closure of the angle. Postoperatively, intraocular pressure was controlled in all the eyes, whereas one eye required antiglaucoma medications to control the intraocular pressure. The mean preoperative and postoperative best-corrected visual acuity was 1.1 ± 1.2 and 0.4 ± 0.4 LogMar, respectively. There was a significant improvement in the best-corrected visual acuity (p = 0.0169) in the postoperative period. The mean preoperative and postoperative intraocular pressure was 26.6 ± 11.23 and 16.3 ± 2.98 mm Hg, respectively (p = 0.0168). All the patients had a minimum of 6-month follow-up period (range = 6–8 months). Conclusion: Single-pass four-throw can be employed for cases with Urrets-Zavalia syndrome, and single-pass four-throw helps to prevent the postoperative glare and narrows down the pupil size effectively. Single-pass four-throw helps to alleviate the anterior chamber angle apposition in patients with Urrets-Zavalia syndrome by mechanically pulling the peripheral iris centrally as demonstrated on anterior segment optical coherence tomography. The study also reports the occurrence of Urrets-Zavalia syndrome after glued intraocular lens surgery.


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