scholarly journals Anterior Capsule Opening Contraction and Late Intraocular Lens Dislocation after Cataract Surgery in Patients with Weak or Partially Absent Zonular Support

Medicina ◽  
2021 ◽  
Vol 57 (1) ◽  
pp. 35
Author(s):  
Juris Vanags ◽  
Renārs Erts ◽  
Guna Laganovska
Keyword(s):  
Cataract Surgery ◽  
Intraocular Lens ◽  
Yttrium Aluminum Garnet ◽  
Late Complications ◽  
High Rate ◽  
Anterior Capsule ◽  
Capsular Tension Ring ◽  
Hydrophobic Acrylic ◽  
Capsular Bag

Background and objectives: To evaluate anterior capsule opening (ACO) contraction and late intraocular lens (IOL) dislocation after cataract surgery in patients with weak or partially absent zonular support and assess methods of reducing these complications. Materials and methods: For this prospective study, we enlisted cataract surgery patients in our hospital with preoperative diagnoses of weak zonules. All patients received phacoemulsification surgery with implantation of a hydrophobic acrylic IOL and capsular tension ring (CTR). ACO reductions were measured for six months after enrolment. Data on late IOL dislocations were collected five years after enrolment of the last patient. Results: Fifty-three patients were enrolled from 2011 to 2015. Over the six-month active follow-up period, ACO area reduction was 23% in patients receiving CTRs of 11 mm diameter and 8% for patients with CTRs of 12 mm, with an overall mean of 15% reduction. Five years after the last patient was enrolled, seven patients (13%) had experienced late IOL-CTR-capsular bag dislocation. For these patients, the mean ACO reduction in the first six months of follow-up was 33%, including for those who had received neodymium-doped yttrium aluminum garnet (Nd: YAG) anterior capsulotomies. Conclusion: Use of hydrophobic acrylic lenses and CTR reduces ACO contraction, with rates comparable to those after cataract surgery without ocular comorbidity. Our patients experienced a relatively high rate of late IOL-CTR-capsular bag dislocation. However, dislocated complexes were easily repositioned and few patients required IOL exchange. Frequent visits are warranted to promptly detect late complications of cataract surgery in patients with weak zonular support.

scholarly journals Long-Term Outcome of Cataract Surgery in Eyes with Pseudoexfoliation Syndrome Associated with Weak Zonules: A Case Report

2020 ◽  
Vol 11 (1) ◽  
pp. 54-59 ◽  
Author(s):  
Juris Vanags ◽  
Guna Laganovska
Keyword(s):  
Cataract Surgery ◽  
Yttrium Aluminum Garnet ◽  
Pseudoexfoliation Syndrome ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Capsular Tension Ring ◽  
Initial Surgery ◽  
Nd:Yag Laser Capsulotomy ◽  
The Right ◽  
Capsular Bag

A cataract surgery in both eyes was scheduled for an 81-year-old female patient. However, ophthalmic examination revealed marked iridodonesis, phacodonesis and pseudoexfoliative material on the surface of the lens in both eyes indicating weak zonules caused by pseudoexfoliation syndrome, which was more pronounced in the left eye. Cataract surgery was performed initially in the left eye by phacoemulsification. Additionally, iris hooks and capsular tension ring (CTR) were used to stabilize the capsular bag, and the haptic of the intraocular lens (IOL) was sutured to the iris at the end of the surgery. The same procedure except haptic suturing was performed in the right eye after 6 months. The left eye remained stable, whereas the right eye developed considerable anterior capsular contraction 2 months postoperatively. Neodymium-doped yttrium aluminum garnet (Nd:YAG) laser capsulotomy was performed to treat the condition. Moreover, 3 years after the initial surgery, late IOL-CTR-capsular-bag complex dislocation developed in the right eye, and reposition surgery was performed. Three days after IOL-CTR-capsular-bag complex reposition surgery, endophthalmitis developed; the eye responded well to 1 mg intravitreal vancomycin treatment. IOL in the right eye remained stable 3 years postoperatively.

scholarly journals Late within the Capsular Bag Intraocular Lens Dislocation (Ten – Year Experience)

2021 ◽  
Vol 37 (2) ◽  
Author(s):  
Munir Amjad Baig ◽  
Rabeeya Munir
Keyword(s):  
Cataract Surgery ◽  
Intraocular Lens ◽  
Inclusion Criteria ◽  
Lens Dislocation ◽  
Mature Cataract ◽  
Intraocular Lens Dislocation ◽  
Plate Design ◽  
Capsular Bag ◽  
Iol Dislocation

Purpose:  To find out the frequency and causes of within the bag intraocular lens dislocation. Study Design:  Descriptive, retrospective study. Place and Duration of Study:  Federal Government Services Hospital Islamabad, from 2008 to 2018. Methods:  Records of all the patients who underwent uneventful phacoemulsification were studied. Patients with Pseudoexfoliation and glaucoma were excluded. Out-of-the bag IOL dislocations and early dislocations that occurred within first three months after the cataract surgery were also not included. Percentage of patients with dislocated lens within the capsular bag after three months or more was calculated and the cause of dislocation was found. Results were presented in percentages. Results:  Three thousand patients underwent uneventful phacoemulsification. Two thousand nine hundred thirty two (2932) patients fulfilled the inclusion criteria while 68 patients did not return for follow up. Age ranged between 25 and 75 years. There were 1600 males and 1332 were females. One thousand seven hundred and sixty were right eyes and one thousand one hundred and seventy two were left eyes. Sixty one (2.08%) developed late IOL dislocations, 35 (57.3%) males and 26 (42.7%) females. Patients of age group 50 – 75 years had more IOL dislocations. Causes of dislocation included; advanced mature cataract 21.3%, 19.7% with postoperative trauma, uveitis 14.7%, Myopia 9.8%, Silicon plate design in 9.8%, eccentric capsulorhexis 8.1%, small capsulorhexis 6.5%, retinitis pigmentosa 3.2% and in 6.5% no cause was found. Conclusion:  Advanced mature cataract and postoperative trauma were the commonest causes of IOL dislocation. Key Words:  Cataract surgery, Phacoemulsification, Trauma, Capsulorhexis. Intra ocular lens dislocation.

Trans-iris fixation of dislocated in-the-bag intraocular lenses

2019 ◽  
Vol 30 (3) ◽  
pp. 538-542
Author(s):  
Amir Faramarzi ◽  
Sepehr Feizi ◽  
Shahin Yazdani
Keyword(s):  
Cataract Surgery ◽  
Intraocular Lens ◽  
Intraocular Lenses ◽  
Posterior Chamber ◽  
Lens Dislocation ◽  
Capsular Tension Ring ◽  
Intraocular Lens Dislocation ◽  
Late Dislocation ◽  
Iris Fixation ◽  
Capsular Bag

Purpose: The aim of this article is to describe the safety and efficacy of trans-iris suture fixation for the management of late dislocation of in-the-capsular-bag intraocular lenses following uncomplicated cataract surgery. Patients and methods: Eleven eyes of 11 patients with late in-the-capsular-bag intraocular lens dislocation following uneventful phacoemulsification cataract surgery were recruited in the study. The dislocated intraocular lens–capsular bag complex was sutured to the iris at two points 180° apart using 9-0 polypropylene sutures on long needles. Results: Mean patient age was 67 ± 6 years. Seven eyes had pseudoexfoliation syndrome, one eye had Marfan syndrome, and another eye had a traumatic cataract; no risk factor was identified for intraocular lens dislocation in two eyes. A capsular tension ring had been implanted during cataract surgery in four eyes. In six eyes, the posterior chamber intraocular lenses were one-piece foldable while the remaining were three-piece intraocular lenses. Compared to the preoperative value, corrected distance visual acuity was significantly improved postoperatively ( p < 0.005). Intraoperative hyphema occurred in two eyes. Pupil ovalization was observed in all eyes. Mean endothelial cell count decreased by 4 ± 1.7% after intraocular lens fixation. The capsular bag–intraocular lens complex was stable and well-centered in the pupillary area in all eyes at the final follow-up examination which was performed 16 ± 4 months postoperatively. Conclusion: Trans-iris fixation is a simple and effective procedure for management of late intraocular lenses–capsular bag complex dislocation, without major complications.

Comparing capsular bag performance of a hydrophilic and a hydrophobic intraocular lens: A randomised two-centre study

2018 ◽  
Vol 28 (6) ◽  
pp. 639-644 ◽  
Author(s):  
John Koshy ◽  
Nino Hirnschall ◽  
Ashok Kumar V Vyas ◽  
R Narendran ◽  
Alja Crnej ◽  
...  
Keyword(s):  
Cataract Surgery ◽  
Intraocular Lens ◽  
Posterior Capsule Opacification ◽  
Intraocular Lenses ◽  
Posterior Capsule ◽  
Fort Worth ◽  
Slit Lamp ◽  
Significant Difference ◽  
Capsular Bag

Purpose: To evaluate the capsular bag performance and posterior capsule opacification development of two intraocular lenses differing in material and design. Methods: This study included patients who were scheduled for cataract surgery and compared a hydrophilic intraocular lens (Super flex® intraocular lens; Rayner Surgical, Worthing, UK) with a hydrophobic intraocular lens (AcrySof® SA60AT; Alcon, Fort Worth, TX, USA). Follow-ups were performed 1 month and 2 years after cataract surgery, including a slit lamp examination and retroillumination images. Results: In total, 80 eyes of 80 patients were recruited. At the 1-month follow-up, 6 of 39 cases had a gap between the posterior lens capsule and intraocular lens (1 case in the hydrophilic intraocular lens group and 5 cases in the hydrophobic intraocular lens group; p = 0.348). Objective and subjective posterior capsule opacification scoring showed no statistically significant difference between both groups (p = 0.123). Conclusion: Both intraocular lens showed a good capsular bag performance and a relatively low posterior capsule opacification development within the first 2 years after surgery.

Visual axis opacification after cataract surgery and hydrophobic acrylic intraocular lens implantation in the first year of life

2011 ◽  
Vol 37 (1) ◽  
pp. 83-87 ◽  
Author(s):  
Rupal H. Trivedi ◽  
Edward M. Wilson ◽  
Abhay R. Vasavada ◽  
Sajani K. Shah ◽  
Vaishali Vasavada ◽  
...  
Keyword(s):  
Cataract Surgery ◽  
Intraocular Lens ◽  
First Year ◽  
Intraocular Lens Implantation ◽  
Visual Axis ◽  
Lens Implantation ◽  
First Year Of Life ◽  
Hydrophobic Acrylic
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