Comparative analysis of secondary implantation of Iris claw intraocular lens (ICIOL) & Scleral fixated intraocular lens (SFIOL) in terms of visual outcome and complications

2020 ◽  
Vol 7 (4) ◽  
pp. 110-117
Author(s):  
Dr. Priyanka S. Kanekar ◽  
Dr. Smita Patare ◽  
Dr. Roopa Naik
Keyword(s):  
Visual Acuity ◽  
Intraocular Lens ◽  
Treatment Options ◽  
Randomized Study ◽  
Visual Outcome ◽  
Posterior Chamber ◽  
Pigment Dispersion ◽  
Surgical Time ◽  
Iris Claw

Background: The modern cataract surgery involves implantation of posterior chamber intraocular lens (PCIOL) when the posterior capsule is intact. However, in case of weak or no capsular support, PCIOL implantation is not possible. In such situations, implantation of secondary Iris claw lens (ICIOL) or Scleral fixated IOL(SFIOL) remains as treatment options. The aim of this study was to compare the efficacy of ICIOL and SFIOL in terms of visual outcomes and complications in aphakic patients. Methods: This prospective randomized study was done from January 2019 to December 2019. Forty aphakic patients fulfilling inclusion criteria, who attended the ophthalmology outpatient department of VVPF’s Medical college and hospital, Ahmednagar were included in this study. These patients were randomly divided into two groups such as Group 1 included 20 patients who underwent ICIOL implantation and Group 2 included 20 patients who underwent SFIOL implantation. The preoperative and postoperative evaluation was done with visual acuity, slit-lamp examination, IOP, fundus examination for the follow up period of 6 months. Results were analysed with Chi square test and t-test using SPSS software. Results: 85% ICIOL and 80% of SFIOL patients had final Best Corrected Visual Acuity (BCVA) of 6/18-6/6. Surgical time in ICIOL was significantly less than SFIOL group (p=0.00). Suture related complications were significantly more in SFIOL group. However, oval pupil and pigment dispersion were seen more in ICIOL group but were harmless. One patient in SFIOL group developed Cystoid Macular Edema (CME) which persisted till final follow up and 1 haptic of ICIOL was disenclavated which was re-enclavated. Conclusion: Comparable final visual outcome was found between ICIOL group and SFIOL group. However, Implantation of ICIOL required less surgical time with fewer complications and hence is a better alternative to SFIOL implantation in correction of aphakia.

Factors Influencing Visual Outcome after Penetrating Keratoplasty Combined with Intraocular Lens Implantation

2003 ◽  
Vol 13 (2) ◽  
pp. 134-138 ◽  
Author(s):  
J.B. Jonas ◽  
R.M. Rank ◽  
W.M. Budde ◽  
G. Sauder
Keyword(s):  
Visual Acuity ◽  
Intraocular Lens ◽  
Penetrating Keratoplasty ◽  
Visual Outcome ◽  
Intraocular Lens Implantation ◽  
Postoperative Visual Acuity ◽  
Factors Influencing ◽  
Lens Implantation ◽  
Preoperative Visual Acuity

Purpose To establish which factors influence visual outcome after penetrating keratoplasty combined with intraocular lens implantation. Methods This retrospective noncomparative clinical interventional case series study included 135 consecutive patients (mean age 70.2 ± 13.6 years) who underwent central penetrating allogenic keratoplasty combined with intraocular lens (IOL) implantation, all operated by the same surgeon. There were 79 triple procedures, 33 keratoplasties combined with an exchange of IOL, and 23 penetrating keratoplasties combined with a secondary implantation of a posterior chamber lens. Mean follow-up was 28.3 ± 18.7 months (range 3.3–112 months). Reasons for keratoplasty were herpetic or traumatic corneal scars or defects (46), Fuchs corneal endothelial dystrophy (22), pseudophakic or aphakic bullous keratopathy (49), corneal endothelial decompensation due to other reasons (15), and keratoconus (3). Main outcome measures were postoperative visual acuity and gain in visual acuity. Results Mean postoperative visual acuity and mean gain in visual acuity were 0.33 ± 0.21 (median 0.30) and 0.25 ± 0.20 (median 0.20), respectively. Compared with the preoperative measurements, mean visual acuity increased in 129 patients (129/135, 95.6%). Factors influencing postoperative visual outcome and gain in visual acuity were preoperative visual acuity (p<0.005), reason for keratoplasty (p<0.005), and diameter of the graft (p = 0.046). Postoperative visual outcome was independent of age, sex, right or left eye, presence of diabetes mellitus, preoperative refractive error, length of follow-up, duration of surgery, and preoperative intraocular pressure. Conclusions The most important factors influencing visual outcome after central penetrating allogenic keratoplasty combined with IOL surgery are preoperative visual acuity, graft size, and reason for keratoplasty. Other factors such as age, sex, diabetes mellitus, and preoperative refractive error do not substantially influence postoperative visual outcome.

scholarly journals Sutureless retropupillary iris claw intraocular lens implantation is a viable option in aphakic patients

2019 ◽  
Vol 7 (1) ◽  
pp. 350
Author(s):  
Neepa R. Gohil ◽  
Sandeep Kumar Yadav ◽  
Kaumudi Shinde
Keyword(s):  
Visual Acuity ◽  
Intraocular Lens ◽  
Visual Outcome ◽  
Good Alternative ◽  
Intraocular Lenses ◽  
Intraocular Lens Implantation ◽  
Visual Rehabilitation ◽  
Lens Implantation ◽  
Iris Claw Lens ◽  
Iris Claw

Visual rehabilitation in aphakia has been a challenge with a wide variety of surgical options available for ophthalmologist. We report the visual outcome with retropupillary iris claw lens secondary to intra operative complications and secondary implantation in aphakia. An interventional study on 4 eyes of 4 patients was conducted. Preoperative 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 measure was best-corrected visual acuity and secondary postoperative complication was recorded at various intervals. All patients had visual acuity of ≥6/18 postoperatively. Sutureless retropupillary iris claw intraocular lens implantation is a good alternative of scleral-fixated intraocular lenses in aphakic patients.

scholarly journals Visual outcome following scleral fixated intraocular lens implantation

2017 ◽  
Vol 16 (2) ◽  
pp. 63-68
Author(s):  
Chunu Shrestha ◽  
Sabina Shrestha ◽  
Aparajita Manoranjan
Keyword(s):  
Visual Acuity ◽  
Intraocular Lens ◽  
Visual Outcome ◽  
Posterior Chamber ◽  
Visual Rehabilitation ◽  
Post Surgery ◽  
Corrected Visual Acuity ◽  
The Common ◽  
Best Corrected Visual Acuity ◽  
Scleral Fixated Intraocular Lens

Introduction: Scleral fixated intraocular lens(SFIOL) implantation to correct aphakia offers superior visual rehabilitation in comparison to aphakic spectacles or contact lens. This study was done to evaluate a simplified technique of scleral fixation of posterior chamber intra-ocular lens (IOL) in terms of visual outcome and complications.Methods: This was a prospective study enrolling 23 eyes of 23 patients who underwent anterior vitrectomy followed by ab-externo sclera fixation of posterior chamber IOL using 10.0 polypropylene sutures from January 2016 to February 2017 in Nepal Eye Hospital.Scleral flap was made at 3 and 9'o clock meridian to cover the knots which prevent erosion of the knots through conjunctiva.  Main outcome measures were post-operative best corrected visual acuity and post-operative complications.Result: Best corrected visual acuity were 6/6 - 6/18 in 86.9% (n=20), 6/24 - 6/60 in 8.7% (n=2) and worse than 6/60 in 4.3% (n=1)at six months followup. The mean spherical equivalent before surgery was +10.60 diopter and -1.14 diopter post-surgery. The common indicationsfor scleral fixated intraocular lens weretrauma in 60.86% (n=14), surgical aphakia in21.73% (n=5), spontaneous posterior dislocation of lens in 13.0% (n=3) and subluxated intraocular lens in 4.34% (n=1). The common complications were astigmatism in 91.30% (n=21), decentered IOL in 4.34% (n=1) and uveitis in 4.35% (n=1).Conclusion: Ab-externosclerated fixated intraocular lens is a safe and effective method for visual rehabilitation with low post-operative risk.

scholarly journals Robotic assisted CyberKnife radiosurgery for the treatment of iris melanoma

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Valerie Schmelter ◽  
Sarah Heidorn ◽  
Alexander Muacevic ◽  
Siegfried G. Priglinger ◽  
Paul Foerster ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Treatment Options ◽  
Visual Outcome ◽  
Proton Beam Therapy ◽  
Tumor Thickness ◽  
Robotic Assisted ◽  
Iris Melanoma ◽  
Department Of Ophthalmology ◽  
Cyberknife Radiosurgery

AbstractIris melanoma is a rare form of uveal melanoma with potential metastic spread. Treatment options include surgical resection, enucleation or irradiation. We analysed visual outcome, complication appearance and management in eight patients with iris melanoma following robotic-assisted CyberKnife treatment. Consecutive patients from the Department of Ophthalmology at University of Munich were included in the study if they had an iris melanoma that was treated with CyberKnife and had a minimum follow-up of 12 months. We evaluated tumor thickness, largest diameter, visual acuity and complications. 8 patients were included in this report. The median age was 74 years (range: 53–86 years). The median follow-up was 23 months (range 12–48 months). Tumor thickness decreased from 2.1 to 1.4 mm on average. Four out of eight patients showed stable or increased visual acuity compared to visual acuity at first visit. We did not find a correlation of applied radiation volume or radiation dose on visual outcome. Radiation keratopathy was the most common complication in five patients. No recurrences were noted. Robotic-assisted radiosurgery following CyberKnife is a promising non-invasive, single session treatment option for iris melanoma with comparable results regarding recurrence rate or complications to brachytherapy and proton beam therapy. All included patients showed good visual outcome.

Visual Function after Implantation of Aniridia Intraocular Lens for Traumatic Aniridia in Vitrectomized Eye

2007 ◽  
Vol 17 (4) ◽  
pp. 660-665 ◽  
Author(s):  
S. Moghimi ◽  
M. Riazi Esfahani ◽  
M. Maghsoudipour
Keyword(s):  
Visual Acuity ◽  
Contrast Sensitivity ◽  
Intraocular Lens ◽  
Visual Function ◽  
Secondary Glaucoma ◽  
Posterior Chamber ◽  
Antiglaucoma Medication ◽  
Posterior Chamber Intraocular Lens ◽  
Previous Trauma

Purpose To evaluate the efficacy and safety of aniridia posterior chamber intraocular lens (PCIOL) in traumatic aniridia and aphakia in vitrectomized eyes. Methods Four aphakic patients with traumatic aniridia and previous pars plana vitrectomy (PPV) due to posterior segment trauma enrolled in the study, and had secondary implantation of an aniridia PCIOL. Two patients were men and two women with mean age of 39.25 years. Complete ophthalmic examinations, including preoperative and postoperative visual acuity in dark and light, glare disability, visual function (using VF-9 questions modified from VF-14), stereopsis, and contrast sensitivity in 3, 6, 12, and 18 cycle per degree frequencies, were done for all patients. Postoperative intraocular pressure (IOP), IOL centration, and intraocular inflammation were monitored. Mean follow-up was 12.25 months (range 7 to 15 months). Results Visual acuity improved in all four patients, especially in the light. Glare was subjectively reduced in all of them. Stereopsis was measurable in three of them postoperatively. Contrast sensitivity improved in all patients, especially in brightness and lower frequencies. All four eyes had improved VF-9. All eyes achieved the desired anatomic results. Two cases developed elevated IOP early after surgery. In one eye, IOP elevation was transient and controlled with antiglaucoma medication, but the other eye, which had secondary glaucoma from previous trauma, required cyclophotocoagulation for the IOP to be controlled. No patient developed chronic uveitis or redetachment. Conclusions The aniridia PCIOL can overcome aphakia, reduce glare, and increase visual function, contrast sensitivity, and stereopsis in vitrectomized eyes with traumatic aniridia. Although this kind of IOL appears safe, some disadvantages are secondary glaucoma and reduced visibility of peripheral fundus, and caution should be used in its implantation until more patients with longer follow-up are studied.

scholarly journals Management of Dislocated Intraocular Lenses with Iris Suture

2016 ◽  
Vol 27 (1) ◽  
pp. 45-48 ◽  
Author(s):  
Mun Y. Faria ◽  
Nuno P. Ferreira ◽  
Mario Canastro
Keyword(s):  
Visual Acuity ◽  
Cataract Surgery ◽  
Macular Edema ◽  
Clinical Signs ◽  
Intraocular Lenses ◽  
Posterior Chamber ◽  
Pigment Dispersion ◽  
Corneal Incision ◽  
The Mean

Purpose Subluxated or malpositioned intraocular lenses (IOLs) and inadequate capsular support is a challenge for every ophthalmic surgeon. Iris suture of an IOL seems to be an easy technique for the management of dislocated 3-piece IOL, allowing the IOL to be placed behind the iris, far from the trabecular meshwork and corneal endothelium. The purpose of this study is to assess the results of pars plana vitrectomy (PPV) and iris suture of dislocated 3-piece acrylic IOLs. Methods In this retrospective, nonrandomized, interventional case consecutive study, of a total of 103 dislocated IOLs, 36 eyes were considered for analysis. All 36 eyes had subluxated or totally luxated 3-piece IOL and underwent iris suture at the Ophthalmology Department of Santa Maria Hospital-North Lisbon Hospital Center, Portugal, from January 2011 until November 2015. All patients underwent 3-port 23-G PPV. The optic zone of the dislocated IOL was placed anterior to the iris with the haptics behind, in the posterior chamber. Haptics were sutured to iris followed by placement of the optics behind iris plane. Postoperative measures included best-corrected visual acuity (BCVA), IOL position, intraocular pressure, pigment dispersion, clinical signs of endothelial cell loss, and development of macular edema. Results A total of 36 eyes of 36 patients were included. All underwent successful iris fixation of dislocated 3-piece IOL. Mean overall follow-up was 15.9 months (range 3-58 months). At presentation, 16 eyes (44.4%) had a luxated IOL and 20 eyes (55.6%) a subluxated IOL. As underlying cause, 17 eyes (47.2%) had a history of complicated cataract surgery, 5 eyes (13.9%) had a traumatic dislocation of the IOL, and 6 eyes (16.7%) had a previous vitreoretinal surgery. A total of 8 eyes (22.2%) had late spontaneous IOL dislocation after uneventful cataract surgery. The mean preoperative BCVA was 1.09 ± 0.70 logarithm of the minimal angle of resolution (logMAR) units and mean postoperative BCVA was 0.48 ± 0.58 of logMAR units. The mean visual acuity improvement was 4.08 ± 5.33 lines on the logMAR scale. In this study, every IOL was stable at the last follow-up. As late complications, macular edema occurred in 1 patient and retinal detachment occurred in 2 patients. There were no cases of endophthalmitis. Conclusions Iris suture fixation of subluxated IOL is a good treatment option for eyes with dislocated IOLs, leading to long-term stability of the IOL. The advantage of this procedure is using the same IOL in a closed eye surgery. No astigmatic difference is expected as no large corneal incision is needed.

Outcomes and Complications of Concurrent Pars Plana Vitrectomy and Scleral-Fixated Intraocular Lens Placement Using Gore-Tex Suture

2019 ◽  
Vol 4 (2) ◽  
pp. 119-124
Author(s):  
H. Russell Day ◽  
Alia K. Durrani ◽  
Stephen J. Kim ◽  
Shriji Patel
Keyword(s):  
Visual Acuity ◽  
Postoperative Complications ◽  
Intraocular Lens ◽  
Pars Plana Vitrectomy ◽  
Vitreous Hemorrhage ◽  
Posterior Chamber ◽  
Pars Plana ◽  
The Mean ◽  
Scleral Fixated Intraocular Lens

Purpose: The authors aim to describe the visual outcomes and postoperative complications of concurrent pars plana vitrectomy and scleral-fixated intraocular lens (IOL) placement using Gore-Tex suture. Methods: A retrospective review of medical records was performed on 27 eyes of 27 patients undergoing concurrent pars plana vitrectomy and scleral-fixated IOL with Gore-Tex suture. Outcome measures were change in preoperative and postoperative visual acuity, final manifest refraction, and incidence of intraoperative and postoperative complications. Results: The mean age was 69.2 ± 11.3 years; there were 16 male patients (59%). The duration of follow-up ranged from 33 to 576 days with a mean of 200 ± 143 days. All patients received Bausch + Lomb Akreos AO60 IOL. The overall mean best-corrected visual acuity in Snellen equivalent improved from 20/276 preoperatively to 20/44 postoperatively ( P < .001). The mean postoperative manifest spherical equivalent refraction was –0.35 ± 1.34 diopters (D). Seventy-five percent of eyes were ± 1.0 D of target refraction. Postoperative complications included corneal edema (26.0%), ocular hypertension (25.9%), hypotony (7.4%), cystoid macular edema (7.4%), vitreous hemorrhage (7.4%), and hyphema (3.7%). No cases of suture breakage, IOL dislocation, retinal detachment, or uveitis–glaucoma–hyphema syndrome were identified. Conclusions: The use of Gore-Tex suture for posterior chamber IOL fixation resulted in favorable outcomes. No suture-related complications occurred during the follow-up period. Final refraction in this setting is typically within ± 1.0 D of target.

Intraocular lens implantation in children with unilateral congenital cataract in the first 4 years of life

2018 ◽  
Vol 29 (3) ◽  
pp. 304-308 ◽  
Author(s):  
Sonam Yangzes ◽  
Savleen Kaur ◽  
Parul Chawla Gupta ◽  
Manu Sharma ◽  
Jitender Jinagal ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Intraocular Lens ◽  
Congenital Cataract ◽  
Retrospective Chart Review ◽  
Visual Outcome ◽  
Intraocular Lens Implantation ◽  
Visual Axis ◽  
Lens Implantation ◽  
The Mean

Purpose: To describe the outcome of phacoaspiration with intraocular lens implantation in children with unilateral congenital cataract in the first 4 years of life. Methods: A retrospective chart review of children with visually significant unilateral congenital cataract presenting in the first 4 years of life was done. Children with a minimum postsurgical follow-up of 1 year were included. Outcome measures were mean spherical equivalent, visual axis clarity, visual acuity and complications till the last follow-up. Results: Ninety-three children met the inclusion criteria. The mean age of surgery was 13.23 ± 11.89 months and the mean follow-up period was 24.37 ± 17.35 months. Nearly 40% of children presented during their first year of life. No difference was noted between the subgroups in terms of age ( p = 0.310), sex ( p = 0.475) or laterality ( p = 0.349). Surgical membranectomy was performed in 22 eyes (23.6%) after an average period of 4.85 ± 2.58 months after surgery. One eye underwent piggy back intraocular lens and four eyes underwent intraocular lens exchange after a mean duration of 50 months (range 40–60 months). The mean visual acuity was 0.79 ± 0.11 (log MAR chart). A total of 60.7% of these children ( n = 31) achieved best corrected visual acuity or 20/80 or better. Conclusion: The results of our study suggest that primary intraocular lens implantation in children with unilateral congenital cataract gives good structural and functional results. Besides a meticulous surgery, visual outcome is affected by the time of presentation and postoperative compliance to amblyopia therapy.

scholarly journals EVALUATION OF COMPLICATIONS OF PHACOEMULSIFICATION WITH PCIOL IMPLANTATION SURGERY

2019 ◽  
Vol 3 (10) ◽  
Author(s):  
Angli Manhas ◽  
Rameshwar S Manhas ◽  
Gaurav S Manhas ◽  
Dinesh Gupta
Keyword(s):  
Visual Acuity ◽  
Postoperative Complications ◽  
Intraocular Lens ◽  
Intraoperative Complications ◽  
Operating Time ◽  
Visual Outcome ◽  
Posterior Chamber ◽  
Extracapsular Cataract Extraction ◽  
Age Group ◽  
Posterior Chamber Intraocular Lens

Background: Phacoemulsification is a state of the art surgery for cata­ract removal. From the simple procedure of couching practiced by sushruta to latest method of phaco emulsification of Charles kelman, cataract surgery had undergone a tremendous metamorphosis. Phacoemulsification is one of the most successful surgical procedures performed, and its popularity is due to decreased operating time and a shorter postoperative healing period. The objective of the study was to evaluate intraoperative and postoperative complications of phacoemulsification with PCIOL implantation surgery. Materials & Methods: The present prospective study was conducted over a period of 6 months on patients having visually significant cataract that presented to or were referred to ophthalmology Department, GMCH, Jammu and after getting admission underwent planned extracapsular cataract extraction by phacoemulsification with posterior chamber intraocular lens ( PCIOL) implantation. After meeting inclusion & exclusion crieteria all the patients underwent complete examination as history, ocular examination, systemic examination and laboratory tests like haemoglobin etc. Results: Out of 200, maximum numbers of patients were in age group of 41-50 i.e. 90 followed by 82 patients in 51-60yrs age group. Males were 112.Total of 148 patients were from urban area. Best corrected preoperative visual acuity of ≤6/36 was seen in 102 patients whereas 6th week postoperatively only 7 patients had visual acuity of ≤6/36. The final 6th week postoperative best corrected visual acuity of 6/12- 6/6 was found in 171 patients. Among intraoperative complications hyphaema & constriction of pupil each were seen in 2 patients, followed by posterior capsule rent in 3 patients only while postoperatively mild uveitis was seen in 30 followed by striate keratopathy in 12 patients. Conclusion: From present study, we may conclude that phacoemulsification with posterior chamber intraocular lens implantation is a good surgical tecqinique for cataract which can be performed safely with good visual outcome, with few intraoperative and postoperative complications in expert hands. Keywords: Phacoemulsification , visual outcome, complications

Sign in / Sign up

Export Citation Format

Share Document