Effects of a change in the direction of view to near uncorrected visual acuity following implantation of monofocal 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.

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Refractive Lens Exchange with Multifocal Intraocular Lens for Treatment of Chronic Intermittent Spasm of the Near Reflex

Case Reports in Ophthalmology ◽

10.1159/000481705 ◽

2017 ◽

Vol 8 (3) ◽

pp. 539-544 ◽

Cited By ~ 2

Author(s):

Guy Sallet

Keyword(s):

Visual Acuity ◽

Intraocular Lens ◽

Spontaneous Recovery ◽

Multifocal Intraocular Lens ◽

Refractive Lens Exchange ◽

Final Treatment ◽

Uncorrected Visual Acuity ◽

Refractive Lens ◽

Near Visual Acuity ◽

Near Reflex

We report the case of an emmetropic 32-year-old female with decreased uncorrected visual acuity and diplopia due to intermittent episodes of spasm of the near reflex. Neurologic, general, and ophthalmic examination could not find an organic cause. Attempts at spontaneous recovery, psychogenic therapy, and cycloplegic therapy were unsuccessful and the symptoms persisted for almost 5 years, leading to psychogenic distress. Final treatment with refractive lens exchange and implantation of a toric trifocal intraocular lens resolved the spasm of the near reflex, resulting in an uncorrected distance and near visual acuity of 20/20.

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Correction of High Corneal Astigmatism during Cataract Surgery

Ophthalmology in Russia ◽

10.18008/1816-5095-2018-4-405-410 ◽

2019 ◽

Vol 15 (4) ◽

pp. 405-410 ◽

Cited By ~ 1

Author(s):

K. B. Pershin ◽

N. F. Pashinova ◽

M. E. Konovalov ◽

E. P. Gurmizov ◽

O. Yu. Zubenko ◽

...

Keyword(s):

Visual Acuity ◽

Surgical Treatment ◽

Clinical Experience ◽

Intraocular Lens ◽

Surgical Intervention ◽

Corneal Astigmatism ◽

Intraocular Lenses ◽

Toric Intraocular Lens ◽

Surgical Interventions ◽

Uncorrected Visual Acuity

Patients, who need cataract surgical treatment, often fail to achieve a high uncorrected visual acuity after surgery due to the concomitant astigmatism involved. Currently, surgeons are increasingly performing combined surgical interventions, including relaxing limbal keratotomic incisions (manual keratotomy) or femtoarcuatous keratotomy, as well as implanting toric intraocular lenses. In recent years, additional toric intraocular lenses have been available. Purpose: to analyze our own clinical experience of implanting an additional toric intraocular lens to correct corneal astigmatism in three clinical cases. The article presents our clinical experience of successful correction of residual corneal astigmatism after previous cataract phacoemulsification with the implantation of a monofocal toric intraocular lens in three patients patients aged 70, 61 and 54 years. In all cases, an additional toric intraocular lens Add-on Torica-sPB pre-filled in the cartridge with a good refractive effect was implanted. The uncorrected visual acuity was 1.0 in all the investigated cases at the follow-upo period of 6 months after the surgical intervention. Calculation of the toric intraocular lens optical power was performed using an online calculator. A feature of surgical intervention was the repositioning of the additional toric intraocular lens into the ciliary sulcus. Changes in the data of keratotopography before and after surgery were absent. In none of the investigated cases, intra- and postoperative complications and dislocation of the implanted additional toric intraocular lens were determined. Based on these cases, high predictability, efficacy and safety of implantation of an additional toric intraocular lens are shown, in the case of residual middle-grade corneal astigmatism after the initial cataract phacoemulsification with the toric intraocular lens implantation. This approach can be successfully used in patients during one-stage surgical treatment of cataract and associated high-grade corneal astigmatism, expanding existing protocols for the treatment of this group of patients.

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Enhancement of Refractive Results after Intraocular Lens Implantation

European Ophthalmic Review ◽

10.17925/eor.2011.05.01.59 ◽

2011 ◽

Vol 05 (01) ◽

pp. 59

Author(s):

Michael Amon ◽

Guenal Kahraman ◽

◽

Keyword(s):

Visual Acuity ◽

Intraocular Lens ◽

Convex Surface ◽

Ultrasound Biomicroscopy ◽

Rotational Stability ◽

Convex Shape ◽

Multifocal Iol ◽

Primary Implant ◽

Uncorrected Visual Acuity ◽

One Year

Summary:An overview on polypseudophakia (‘piggyback’ intraocular lens [IOLs]) is given. Requirements on a sulcus-supported supplementary IOL are defined. Two-year results of a new IOL (Sulcoflex®) are presented and indications for this IOL are defined.Methods:The IOL is especially designed for implantation into the ciliary sulcus in pseudophakic eyes (piggyback). It is a single-piece implant made of hydrophilic acrylic. Optic- and haptic-edges are round. The optic has a diameter of 6.5mm and a concave/convex shape for perfect fit on the anterior convex surface of the primary IOL. The haptic is angulated, and has an undulated design to preclude IOL rotation. A monofocal, a multifocal or a toric version of the sulcoflex IOL were implanted into the ciliary sulcus of pseudophakic eyes. All IOLs were implanted by injector through a 3mm clear cornea incision. After surgery near and far uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA) and eye pressure were assessed. Inflammation was measured by laser flare/cell meter. Position and rotational stability of the IOL were documented regularly at all control visits. Furthermore, Scheimpflug photography and ultrasound biomicroscopy were performed.Results:Surgery was performed without any complication in all cases. Two years after surgery there were no severe intra- or post-operative complications detected. Emmetropia was achieved in all cases (±0.25dpt) and the refraction was stable. Flare values were lower than the values measured after standard cataract procedures. Rotational stability and centration were excellent. Intraocular pressure was within the normal range at all visits. After one year of follow-up no iris-chafing was documented. In all cases, a good distance was found between iris and the Sulcoflex-IOL and primary implant and the Sulcoflex-IOL. In those cases with the multifocal IOL-version all patient achieved independency from glasses.Conclusion:Surgery with implantation of a sulcus-IOL is safe and less traumatic than IOL-exchange. The material and design of the Sulcoflex IOL ensure that the implants are well tolerated within the eye. The implant can be used at the same time with the primary implant or as secondary implant. Indications for implantation of this IOL are the correction of ‘post-surgical’ ametropia, of astigmatism (toric IOL) of higher order aberrations (aspherical IOL) and of ‘pseudophakic presbyopia’ (multifocal IOL). In the future, other potential indications will be established.

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Xtra focus pinhole IOL (Morchers GMBH) a novel approach to tackle irregular astigmatism and large pupillary defects with a single step surgery

BMJ Case Reports ◽

10.1136/bcr-2018-228902 ◽

2019 ◽

Vol 12 (4) ◽

pp. e228902 ◽

Cited By ~ 1

Author(s):

Prateek Agarwal ◽

Samuel Edward Navon

Keyword(s):

Visual Acuity ◽

Cataract Surgery ◽

Intraocular Lens ◽

Visual Outcome ◽

Single Step ◽

Novel Approach ◽

Uncorrected Distance Visual Acuity ◽

Uncorrected Visual Acuity ◽

Corneal Scar ◽

History Of

A 69-year-old patient presented to us with traumatic mydriasis with irregular pupil measuring 7 mm, with superior loss of iris tissue and large inferior peripheral iridotomy and pseudophakia. The patient had history of blunt trauma 3 years ago in a fire cracker injury. He was operated elsewhere primarily after the trauma for cataract surgery with intraocular lens implantation and had suboptimal visual outcome with glare and photophobia. He presented to us with irregular pupil and inferior iridectomy with pseudophakia. The uncorrected visual acuity was 20/150 improving to 20/50 with glasses. He had a history of cataract surgery with intraocular lens (IOL) implantation done elsewhere several years back. The patient was not a diabetic or hypertensive. There was a para central corneal scar causing irregular corneal astigmatism. Extra focus pinhole IOL was implanted in sulcus having a pinhole aperture 1.36 mm. Preoperative total corneal higher-order aberrations were 3.3 µ and total corneal coma was 0.97 µ. Postoperatively uncorrected distance visual acuity improved to 20/40 intermediate uncorrected visual acuity improved to 20/30 and uncorrected near visual acuity was J3.

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Relation Between Corneal Astigmatism and Uncorrected Visual Acuity in Eyes Implanted With Multifocal Intraocular Lens

JAPANESE ORTHOPTIC JOURNAL ◽

10.4263/jorthoptic.044f012 ◽

2015 ◽

Vol 44 (0) ◽

pp. 111-120

Author(s):

Eri Hiruta ◽

Chikako Suto ◽

Emiko Shimamura ◽

Itsumi Watanabe ◽

Chihiro Kobayashi

Keyword(s):

Visual Acuity ◽

Intraocular Lens ◽

Corneal Astigmatism ◽

Multifocal Intraocular Lens ◽

Uncorrected Visual Acuity

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Toric intraocular lens for correction of high corneal astigmatism in cataract patients

International Eye Research ◽

10.18240/ier.2020.02.04 ◽

2020 ◽

Vol 1 (2) ◽

pp. 83-88

Author(s):

Irene Simo ◽

◽

Laura Remón ◽

Keyword(s):

Visual Acuity ◽

Intraocular Lens ◽

Medical Engineering ◽

Toric Intraocular Lens ◽

Toric Iol ◽

Corrected Visual Acuity ◽

Uncorrected Visual Acuity ◽

Before And After ◽

The Mean ◽

Axis Rotation

AIM: To evaluate the efficacy of Bi-Flex toric intraocular lens (T-IOL; Medicontur, Medical Engineering, Ltd., Inc.) implantation to correct preexisting astigmatism in patients having cataract surgery. METHODS: This retrospective consecutive study included 22 eyes of 16 patients with more than 2.50 diopters (D) of corneal preexisting astigmatism having cataract. Preoperative and postoperative uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), objective and subjective refraction and keratometric and topographic cylinder were measured. Postoperative the toric IOL axis was evaluated using vector analysis. RESULTS: Postoperatively, subjective refractive cylinder was reduced significant (P<0.05) from 4.05±1.53 D to 1.35±0.86 D. The component J0 reduced in magnitude from -0.81±2.02 D to -0.12±0.62 D (P<0.05). Both, UCVA and BCVA improved significantly at 1mo after surgery (P<0.05 in both cases). After the surgery, the UCVA and BCVA were 0.24±0.19 and 0.06±0.08, respectively. The mean toric IOL axis rotation was 2.95±5.25 degree, with rotation less than 10 degrees in 86.36% of eyes. No differences in mean keratometric values obtained before and after surgery were found (P>0.05 for J0 and J45). CONCLUSION: Implantation of the Bi-Flex toric IOL is a safe and effective method to correct the preexisting regular astigmatism (greater than 2.50D).

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Visual assessment between phacoemulsification and small incision with 5.2mm non-foldable intraocular lens implant.

The Professional Medical Journal ◽

10.29309/tpmj/2021.28.11.6753 ◽

2021 ◽

Vol 28 (11) ◽

pp. 1668-1672

Author(s):

Noman Ahmed ◽

Asadullah Jatoi ◽

Mona Liza Mahesar ◽

Ashok Kumar Narsani

Keyword(s):

Visual Acuity ◽

Intraocular Lens ◽

Visual Assessment ◽

University Hospital ◽

Complication Rates ◽

Small Incision ◽

Uncorrected Visual Acuity ◽

Group A ◽

Group B ◽

Capsular Rupture

Objective: To compare visual assessment between phacoemulsification and small incision with 5.2mm non-foldable intraocular lens implant. Study Design: Experiential Study. Setting: Institute of Ophthalmology, Liaquat University Hospital Jamshoro, Period: September 2019 to August 2020. Material & Methods: We performed cataract surgeries using the non-foldable intraocular lens in 100 patients. Two techniques were performed, dividing patients equally into Phaco (Group-A) and SI (Group-B) cataract surgery. The outcomes of both were analyzed uncorrected visual acuity and complications. Results: Of the total 50 patients who underwent phacoemulsification, 55% were male and 45% females in Group-A while Group B (SI surgery) were 45% were male and 35% were female. The intra-operative success rate was 90% in Phaco group and 74% in SI group. In comparison, small Incision group had 10% of patients had difficulty in capsulorhexis, 8% in posterior capsular rupture, 6% in zonular dialysis, 2% iridodialysis, and 0% showing nucleus drip with all complications being higher than in Phaco Group except for nucleus drip (2% vs. 0%). Although, post-operatively, individually groups have similar complications with no notable difference seen, yet astigmatism was lesser in Group A than in Group B. Conclusion: Both techniques showed similar outcomes in the uncorrected visual acuity; however, astigmatism and complication rates were lesser in the phacoemulsification study group.

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Persistent troublesome floaters necessitating the explantation of XtraFocus Pinhole IOL (Morcher)

BMJ Case Reports ◽

10.1136/bcr-2018-229057 ◽

2019 ◽

Vol 12 (4) ◽

pp. e229057 ◽

Cited By ~ 1

Author(s):

Prateek Agarwal ◽

Samuel Edward Navon

Keyword(s):

Visual Acuity ◽

Intraocular Lens ◽

Cataract Extraction ◽

Blurred Vision ◽

Uncorrected Visual Acuity ◽

History Of ◽

Irregular Astigmatism

A 41-year-old patient presented with blurred vision and photophobia in the left eye with an uncorrected visual acuity of 20/150, improving to 20/30 with pinhole and diagnostic rigid gas permeable lens trial. He had a history of trauma with subsequent cataract extraction with residual irregular astigmatism and traumatic mydriasis. XtraFocus Pinhole intraocular lens (Morcher) was implanted in the left eye and the vision improved to 20/40. Postoperatively, the patient experienced significant floaters which persisted to the extent of necessitating explantation of implant.

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