scholarly journals Surgical Outcome of Refixation versus Exchange of Dislocated Intraocular Lens: A Retrospective Cohort Study

2020 ◽  
Vol 9 (12) ◽  
pp. 3868
Author(s):  
Young In Shin ◽  
Un Chul Park
Keyword(s):  
Group Treatment ◽  
Intraocular Lenses ◽  
Suture Fixation ◽  
Spherical Equivalent ◽  
Exchange Group ◽  
Corneal Endothelial Cell Density ◽  
Pars Plana ◽  
Transscleral Suture Fixation ◽  
Iol Dislocation

We compared the surgical outcomes and complications of refixation vs. exchange of dislocated intraocular lenses (IOLs) in patients who underwent transscleral suture fixation combined with pars plana vitrectomy for the treatment of IOL dislocation. A total of 83 eyes (n = 83 patients) with postoperative follow-up of ≥6 months were evaluated: 40 received refixation of dislocated IOL (refixation group) while 43 received IOL exchange (exchange group) treatment. Treatment outcomes, including best-corrected visual acuity (BCVA), spherical equivalent, corneal cylinder, intraocular pressure (IOP), central macular thickness (CMT), and corneal endothelial cell density (ECD), and postoperative complications were retrospectively reviewed. BCVA improvement at 6 months after surgery was comparable between the groups. Postoperative decrease in corneal ECD was significantly greater in the exchange group than in the refixation group, but no significant differences were found in spherical equivalent, corneal cylinder, IOP, or CMT changes. The exchange group experienced significantly more frequent postoperative vitreoretinal complications, such as retinal detachment, choroidal effusion, cystoid macular edema, and secondary epiretinal membrane, than the refixation group. Without any reason to extract the dislocated IOL, reuse of the dislocated IOL would be a better surgical option for transscleral suture fixation to protect corneal endothelial cells and prevent postoperative vitreoretinal complications.

Endoscope-assisted transscleral suture fixation of intraocular lenses

1996 ◽  
Vol 22 (7) ◽  
pp. 879-881 ◽  
Author(s):  
Ignasi Jürgens ◽  
Juan Lillo ◽  
José A. Buil ◽  
Miguel Castilla
Keyword(s):  
Intraocular Lenses ◽  
Suture Fixation ◽  
Transscleral Suture Fixation

Pars plana vitrectomy and iris suture fixation of posteriorly dislocated intraocular lenses

2015 ◽  
Vol 41 (7) ◽  
pp. 1454-1460 ◽  
Author(s):  
Uri Soiberman ◽  
Peter L. Gehlbach ◽  
Peter Murakami ◽  
Walter J. Stark
Keyword(s):  
Pars Plana Vitrectomy ◽  
Intraocular Lenses ◽  
Suture Fixation ◽  
Pars Plana

Scleral Fixation of Posterior Chamber Intraocular Lenses Using Gore-Tex Suture: Clinical Outcomes From a Single Institution

2018 ◽  
Vol 2 (5) ◽  
pp. 276-281 ◽  
Author(s):  
Benjamin Botsford ◽  
Andrew M. Williams ◽  
Ian P. Conner ◽  
Andrew W. Eller ◽  
Joseph N. Martel
Keyword(s):  
Postoperative Complications ◽  
Clinical Outcomes ◽  
Vitreous Hemorrhage ◽  
Retrospective Chart Review ◽  
Crystalline Lens ◽  
Intraocular Lenses ◽  
Posterior Chamber ◽  
Scleral Fixation ◽  
Pars Plana

Purpose: The purpose of this article is to examine the clinical outcomes of scleral fixation of intraocular lenses (IOLs) using Gore-Tex suture at our institution. Methods: A retrospective chart review was conducted of patients who underwent scleral fixation of an IOL with Gore-Tex suture with concurrent pars plana vitrectomy. Intraoperative and postoperative complications were assessed. Results: Seventy-four eyes of 74 patients were included with a mean follow-up interval of 210 days (range, 33–720 days). The mean best-corrected visual acuity improved from 20/480 (1.38 logarithm of the minimum angle of resolution [logMAR]) preoperatively to 20/78 (0.59 logMAR) postoperatively ( P < .001). Indications included dislocated lens implant (42), aphakia without capsular support (18), and subluxation of crystalline lens (14). Bausch and Lomb Akreos AO60 IOL was implanted in 52 eyes, Alcon CZ70BD in 15, and Bausch and Lomb enVista MX60 in 6. Postoperative complications included temporary ocular hypertension in 9 eyes (12%), temporary hypotony in 7 (9%), cystoid macular edema in 3 eyes (4%), corneal decompensation in 2 eyes (3%), IOL dislocation requiring exchange in 1 case (1.4%), vitreous hemorrhage in 2 cases (3%), and retinal detachment in 2 cases (3%). There were no cases of postoperative suture breakage or erosion, endophthalmitis, or hyphema. Conclusions: The use of Gore-Tex suture in scleral fixation of posterior chamber IOLs was well tolerated at a mean follow-up interval of 210 days. There were no suture-related complications.

scholarly journals Intrascleral Suture Anchoring: A Flapless/Grooveless Four-Point Intraocular Lens Fixation Technique

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Xin Hu ◽  
Bo Zhao ◽  
Haiying Jin
Keyword(s):  
Intraocular Lenses ◽  
Surgical Trauma ◽  
Suture Fixation ◽  
Fixation Technique ◽  
Retinal Tear ◽  
Present Technique ◽  
Aphakic Eyes ◽  
The Mean ◽  
Anchoring Technique

Purpose. We describe a minimally invasive suture fixation technique for four-point fixation of intraocular lenses (IOLs) in the treatment of aphakic eyes, namely, the intrascleral suture anchoring technique. Neither scleral flaps nor large conjunctival dissections are required. Methods. This study included 11 eyes (11 patients). After looping the eyelets on the IOL haptics and externalizing the threads, the curved needle attached to the externalized thread was started with two sequential intrascleral passes from the first fixation point to reach the second fixation point. The same procedure was performed for the other side of the IOL. A fixation knot was created in the sclerotomy by the two ends of the thread to close the suture loop for IOL fixation. Another knot was created about 2 to 3 mm from the exiting point and was intrasclerally anchored by the aid of the attached curved needle. Results. The mean postoperative follow-up period was 9.7 ± 5.8 months (range 5–15 months). The IOLs of all eyes remained well positioned and stable postoperatively. The postoperative visual acuities were improved. No suture erosion, suture loosening, hypotony, scleral atrophy, chronic inflammation, retinal tear, and/or detachment were observed within the follow-up period. Conclusion. The present technique is an alternative, flapless method for the four-point suture fixation of IOLs. It provides both minimal surgical trauma and reliable stability.

Eight-year follow-up of Artiflex and Artiflex Toric phakic intraocular lens

2021 ◽  
pp. 112067212110356
Author(s):  
Mariano Royo ◽  
Ángel Jiménez ◽  
Irene Martínez-Alberquilla ◽  
José F Alfonso
Keyword(s):  
Intraocular Lenses ◽  
Physiological Changes ◽  
Spherical Equivalent ◽  
Efficacy And Safety ◽  
Phakic Intraocular Lens ◽  
Uncorrected Distance Visual Acuity ◽  
Manifest Refraction ◽  
Phakic Intraocular Lenses

Purpose: To analyse long-term efficacy, safety, visual and refractive stability and physiological changes of Artiflex Myopia and Toric phakic intraocular lenses (pIOL) separately throughout an 8-year follow-up. Design: Retrospective cohort study. Methods: A total of 67 eyes of 37 patients underwent Artiflex Myopia (47 eyes) or Artiflex Toric (20 eyes) implantation for correcting myopia and/or astigmatism. Follow-up evaluations were performed 1, 3, 5 and 8 years after surgery. Preoperative and postoperative data included corrected (CDVA) and uncorrected distance visual acuity (UDVA), manifest refraction, endothelial cell density (ECD) and intraocular pressure (IOP) assessments. Efficacy and safety indexes were analysed. The vectorial analysis was performed using the Thibos method. Results: Mean CDVA and UDVA of both pIOLs significantly improved from preoperative to 1 year after implantation, and then it remained stable over the 8-year follow-up. The efficacy and safety indexes after 8 years were 0.94 ± 0.16 and 1.07 ± 0.18 for Artiflex Myopia and 1.00 ± 0.11 and 1.10 ± 0.15 for Artiflex Toric, respectively. The spherical equivalent (SE) significantly improved after surgery. J0, J45 and SE refractive components showed no changes between postoperative visits. A total ECD loss of 4.8% ( p < 0.001) and 10.4% ( p = 0.005) was found after 8 years for Artiflex Myopia and Toric, respectively. Conclusions: Artiflex Myopia and Toric pIOLs are a safe, efficient and predictable option for the correction of myopia and/or astigmatism. The vectorial analysis showed excellent rotation stability for the toric version.

scholarly journals The influence of intraocular lens dislocation surgical correction method on corneal endothelium

2021 ◽  
Vol 14 (2) ◽  
pp. 37-45
Author(s):  
Vitaly V. Potyomkin ◽  
Sergey Yu. Astakhov ◽  
Elena V. Goltsman ◽  
Xiaoyuan Wang ◽  
Yulduz Sh. Nizametdinova
Keyword(s):  
Endothelial Cell ◽  
Surgical Treatment ◽  
Cell Density ◽  
Coefficient Of Variation ◽  
Corneal Endothelium ◽  
Suture Fixation ◽  
Transscleral Suture Fixation ◽  
Iol Dislocation ◽  
Iris Claw ◽  
Iol Exchange

BACKGROUND:Intraocular lens (IOL) dislocation is a rare but serious complication of surgical treatment of patients with cataract. Among the factors contributing to its development, the main ones are pseudoexfoliation syndrome (PEX), high axial myopia, chronic uveitis, history of eye injury and age. There is no universal IOL dislocation correction technique. PURPOSE:To evaluate the impact on corneal endothelium of two different methods of IOL dislocation correction: IOL repositioning with transscleral suture fixation or IOL exchange to iris-claw one. MATERIALS AND METHODS:Within the study, 78 patients were examined and operated. All patients were divided into two groups: in the first group, IOL was repositioned with transscleral suture fixation, and in the second group IOL was exchanged to iris-claw IOL. Groups were equal by gender and age. Key estimated indicators were endothelial cell density and coefficient of variation reflecting the degree of polymegatism. RESULTS:Endothelial cell density was significantly lower both before surgery and at any term after it, in the group with IOL exchange, and coefficient of variation was significantly higher in the group with IOL exchange throughout this study. CONCLUSION:The choice of technique for IOL dislocation correction is the basis of success in surgical treatment. Certain preoperative examination data should be definitely considered, including the degree of dislocation, IOL type, IOP level, endothelial cell density and presence of concomitant ocular conditions.

scholarly journals A modified intrascleral intraocular lens fixation technique with fewer anterior segment manipulations: 27-gauge needle-guided procedure with built-in 8–0 absorbable sutures

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Yuan Yang ◽  
Teng-teng Yao ◽  
Ya-li Zhou ◽  
Yi-xiao Wang ◽  
Zhao-yang Wang
Keyword(s):  
Visual Acuity ◽  
Intraocular Lens ◽  
Anterior Segment ◽  
Vitreous Hemorrhage ◽  
Fixation Technique ◽  
Absorbable Sutures ◽  
Corneal Endothelial Cell Density ◽  
Iol Fixation ◽  
Iol Dislocation

Abstract Background To report a modified surgical technique for intrascleral intraocular lens (IOL) fixation with fewer anterior segment manipulations in eyes lacking sufficient capsular support. Methods Eyes from 14 patients who underwent 27-gauge needle-guided intrascleral IOL fixation with built-in 8–0 absorbable sutures were studied. The 8–0 absorbable sutures were inserted into 27-gauge round needles and used to create sclerotomies at the 4 o’clock and 10 o’clock positions under the scleral flap. The sutures were used to tie knots at the end of each haptic and guide haptic externalization through the sclerotomy. After externalization, a sufficient flange was created at the end of each haptic and fixed under the scleral flaps. The best corrected visual acuity (BCVA), corneal endothelial cell density (ECD), IOL tilt and decentration, previous surgery history, and complications were determined. Results Fourteen cases were analyzed. The majority of eyes exhibited an improvement in the BCVA after surgery. When comparing the last follow-up to preoperative visual acuity, the mean change in BCVA was + 26.32 letters (p = 0.011). Postoperative complications included postoperative hypotony in 3 eyes, ocular hypertension in 2 eyes. No cases of postoperative cystoid macular edema (CME), vitreous hemorrhage (VH), IOL dislocation, or endophthalmitis were observed. Conclusions The 27-gauge needle-guided intrascleral IOL fixation technique with built-in 8–0 absorbable sutures is easy to perform with fewer anterior chamber manipulations and achieves both anatomical and optical stability.

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