scholarly journals Secondary IOL Implantation without Capsular Support: A Laser Flare Cell Meter Study

2011 ◽  
Vol 2011 ◽  
pp. 1-5 ◽  
Author(s):  
Mauro Cellini ◽  
Ernesto Strobbe ◽  
Pier Giorgio Toschi ◽  
Emilio C. Campos
Keyword(s):  
Intraoperative Complications ◽  
Standard Of Care ◽  
Posterior Chamber ◽  
Iol Implantation ◽  
Secondary Iol Implantation ◽  
Secondary Implantation ◽  
Laser Flare ◽  
Capsular Support ◽  
Capsular Bag

Phacoemulsification and the contemporary implantation of intraocular lens (IOL) within the capsular bag represent the standard of care in cataract surgery, but sometimes a primary IOL implant is not possible due to intraoperative complications or preexisting conditions so that a secondary implantation of IOL within the anterior or posterior chamber is necessary. The aim of our study was to assess the degree of inflammation due to a secondary implant of claw lenses, angle-supported IOLs, and scleral-fixated IOLs by means of an objective, repeatable, and noninvasive device, the laser flare cell meter, which evaluates aqueous flare and cells within the anterior chamber in vivo and to show the contribution of the single IOLs to the genesis of inflammation.

scholarly journals Secondary IOL implantation without capsular support. A laser flare cell-meter study

2007 ◽  
Vol 85 ◽  
pp. 0-0
Author(s):  
GO BRAVETTI ◽  
P LEONETTI ◽  
M MANDRIOLI ◽  
E STROBBE ◽  
M CELLINI ◽  
...  
Keyword(s):  
Iol Implantation ◽  
Secondary Iol Implantation ◽  
Laser Flare ◽  
Capsular Support

scholarly journals Comparison of the Techniques of Secondary Intraocular Lens Implantation after Penetrating Keratoplasty

2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Katarzyna Krysik ◽  
Dariusz Dobrowolski ◽  
Ewa Wroblewska-Czajka ◽  
Anita Lyssek-Boron ◽  
Edward Wylegala
Keyword(s):  
Surgical Techniques ◽  
Vitreous Body ◽  
Iol Implantation ◽  
Scleral Fixation ◽  
Lens Extraction ◽  
Secondary Iol Implantation ◽  
Secondary Implantation ◽  
Significant Difference ◽  
Corrected Distance Visual Acuity ◽  
Secondary Intraocular Lens Implantation

Aim. To conduct a retrospective analysis of secondary IOL implantation in patients who underwent PK with no simultaneous IOL implantation. Materials and Methods. The retrospective study of the secondary implantation of IOLs was conducted in 46 eyes that underwent a primary operation with PK and cataract/lens extraction with no IOL implantation due to capsule rupture or combining corneal or intraocular complications. The minimum period from PK was 12 months. All secondary IOL implantations were performed from January 2011 to August 2017. Aphakic postkeratoplasty patients were treated using one of the surgical techniques for secondary IOL implantation. In-the-bag IOL implantation was possible if the posterior capsule was complete. If the lens capsule remnants were sufficient to provide secure IOL support, an in-the-sulcus IOL implantation was performed. Scleral fixation was offered in eyes with extensive capsular deficiency or the presence of the vitreous body in anterior chamber. BCVA and expected and achieved refraction were evaluated; we included using two biometry devices, and results were compared. Results. The corrected distance visual acuity (CDVA) before surgery ranged from 0.1 to 0.8 (mean 0.54 ± 0.17). After secondary IOL implantation, CDVA ranged from 0.2 to 0.8 (mean 0.43 ± 0.14) at postoperative 1 month and from 0.3 to 0.9 (mean 0.55 ± 0.15) at postoperative 6 months (p<0.05). Comparison of the final refraction using two methods of biometry showed no statistically significant difference in the group that underwent scleral fixation of the IOL, similar to the findings for the in-the-bag and in-the-sulcus IOL implantation groups. In the scleral-fixation group, p=0.55 for the USG biometry technique and p=0.22 for the OB technique. p values for the IOL-implantation group were p=0.49 and p=0.44, respectively. Conclusion. Both implantation methods are safe for the patients. Final refraction is depending on the technique and indication to keratoplasty. Both biometry techniques deliver precise data for IOL choice.

scholarly journals Microperipheral Iridectomy for Troublesome Posterior Synechiolysis in Secondary Intraocular Lens Implantation

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
Wu Xiang ◽  
Jing Li ◽  
Wan Chen ◽  
Haotian Lin ◽  
Weirong Chen
Keyword(s):  
Intraocular Lens ◽  
Pediatric Patients ◽  
Posterior Chamber ◽  
Intraoperative Bleeding ◽  
Iol Implantation ◽  
Secondary Iol Implantation ◽  
Peripheral Iridectomy ◽  
Surgical Incisions ◽  
Posterior Synechiae ◽  
Secondary Intraocular Lens Implantation

Purpose. To introduce an effective method for separating extensive posterior synechiae and those located under or adjacent to surgical incisions. Methods. Pediatric patients who had been subjected to cataract surgery and developed troublesome posterior synechiae requiring secondary intraocular lens (IOL) implantation were recruited. All patients underwent microperipheral iridectomy at the 12 o’clock position. Then, an ophthalmic viscosurgical device was injected into the posterior chamber through the iris fistula to mechanically separate the posterior synechiae, using scissors to cut robust posterior synechiae if necessary. The results of posterior synechiolysis and the position of the implanted IOL were analyzed. Results. Sixteen patients (median age, 51.56 months; range, 28–80 months) were included. The scope of posterior synechia in clock was 4.42 (range, 1–10). All troublesome posterior synechiae were successfully separated using the microperipheral iridectomy method, and all patients underwent IOL implantation in the ciliary sulcus. There was one case of peripheral iridectomy-related early intraoperative bleeding; no bleeding was observed at the end of surgery. Conclusions. Microperipheral iridectomy is a useful method for the management of troublesome posterior synechiae during secondary IOL implantation in pediatric patients, which makes secondary IOL implantation an easier and safer method in some challenging cases.

scholarly journals The Balanced Two-String Technique for Sulcus Intraocular Lens Implantation in the Absence of Capsular Support

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Hesham A. Ibrahim ◽  
Heba Nabil Sabry
Keyword(s):  
Intraocular Lens ◽  
Wound Closure ◽  
Anterior Segment ◽  
Iol Implantation ◽  
Corrected Visual Acuity ◽  
Alternative Approach ◽  
Secondary Implantation ◽  
The Stability ◽  
Capsular Support

Purpose. To describe and explore an alternative approach for sulcus intraocular lens (IOL) implantation in the absence of capsular support.Methods. The commonly available one-piece poly(methyl methacrylate) (PMMA) lens is stabilized in the sulcus by two intraocular horizontal strings of 10/0 polypropylene suture passed through the lens dialing holes in opposite directions to achieve a mechanical balance. The horizontal strings of 10/0 polypropylene work as a rail track for the IOL optics, allowing some side to side lens adjustment even following wound closure. The stability of the IOL was tested in vitro. Six aphakic patients underwent in-sulcus IOL secondary implantation using the balanced two-string technique. Patients were followed up for a minimum of six months. Best spectacle corrected vision was assessed. Lens centration and lens tilt were measured by anterior segment optical coherence tomography (AS-OCT).Results. All patients had successful lens insertion. Best spectacle corrected visual acuity (BSCVA) improved in all patients. Lens decentration ranged between 0.21 mm and 0.9 mm (average 0.53 mm). Lens tilt ranged between 1.2° and 2.8° (average 2.17°).Conclusion. The mechanically balanced two-string technique is an alternative option for sulcus IOL implantation in absence of capsular support, allowing lens centration adjustment with no additional risks.

Clinical Profile and Visual Outcome of Pediatric Cataract Surgeries in West Malaysia

2020 ◽  
Vol 26 (2) ◽  
pp. 27-34
Author(s):  
Xiao Wei Ting ◽  
Wee Min Teh ◽  
Chin Sern Chan ◽  
Nor Fadzillah Abdul Jalil ◽  
Julieana Muhammed
Keyword(s):  
Cataract Surgery ◽  
Visual Outcome ◽  
Clinical Profile ◽  
Posterior Capsular Opacification ◽  
Posterior Chamber ◽  
Pediatric Cataract ◽  
Iol Implantation ◽  
Secondary Iol Implantation ◽  
Paediatric Patients ◽  
Significant Difference

Purpose: We aim to describe the clinical profile and visual outcome of paediatric patients who underwent cataract surgery in a tertiary ophthalmology referral centre in West Malaysia from 2013 to 2018. Methods: This is a retrospective review of all paediatric patients who underwent cataract surgery in our centre from 2013-2018. Results: A total of 35 eyes from 23 patients were included. There were 10 (43.5%) female and 13 (56.5%) male patients. Twelve patients (24 eyes) had bilateral cataract while 11 patients had unilateral cataract. Sixteen (45.7%) eyes had congenital cataract, followed by ectopia lentis (n=10, 28.6%), traumatic cataract (n=8, 22.9%) and steroid induced cataract (n=1, 2.8%). Three types of intraocular lens (IOL) were implanted: which were posterior chamber IOL (n=22, 62.9%), iris claw IOL (n=12, 34.3%) and scleral-fixated IOL (n=1, 2.8%). Majority of eyes (n=28, 80%) had primary IOL implantation. Twenty-five (71.4%) eyes achieved best corrected visual acuity (BCVA) of 6/12 and better at 6 months post-IOL implantation. There was no statistically significant difference in the BCVA at 6 months post-IOL implantation among the different cataract aetiology, primary or secondary IOL implantation and types of IOL implant. Eight (22.9%) eyes developed post-operative complications, which included posterior capsular opacification (PCO) (n=6, 17.1%), IOL decentration (n=4, 11.4%) and glaucoma (n=1, 2.8%). Nineteen (82.6%) patients required glasses for visual rehabilitation. Conclusion: Majority of the paediatric cataract patients achieved BCVA of 6/12 or better at 6 months post-IOL implantation. The visual outcome among the different cataract aetiology, primary or secondary IOL implantation and types of IOL implanted were similar. PCO was the most common post-operative complication.

scholarly journals Retropupillary Iris Claw Lens Implantation – A Prospective Observational Study at a Tertiary Health Care Centre in Jaipur, Rajasthan

2021 ◽  
Vol 8 (22) ◽  
pp. 1752-1757
Author(s):  
Rajesh Goel ◽  
Sukriti Upadhyay ◽  
Akshi Agarwal ◽  
Dharmesh Sharma ◽  
Sunita Goyal ◽  
...  
Keyword(s):  
Contact Lenses ◽  
Visual Rehabilitation ◽  
Health Care Centre ◽  
Iol Implantation ◽  
Good Visual Acuity ◽  
Secondary Implantation ◽  
Lens Implantation ◽  
Capsular Support ◽  
Iris Claw Lens ◽  
Iris Claw

BACKGROUND Visual rehabilitation of aphakic patients include spectacle correction, contact lenses, and primary or secondary intra ocular lens (IOL) implantation. Spectacles are rarely used nowadays because of limited visual field, aniseikonia and peripheral refractive errors. Contact lenses are other options for correcting aphakia but can cause a lot of corneal complications. Options for correction of aphakic patients with lack of adequate capsular support include anterior chamber IOL (ACIOL), scleral fixated IOL (SFIOL), and iris fixated IOL. Implantation of a retropupillary IC-IOL provides the benefits of a PCIOL, and the duration of the surgery is also less. The retropupillary IC-IOL because of its position lowers the risk of endothelial decompensation is a better option. We wanted to evaluate the functional outcomes of retropupillary iris claw lens implantation. METHODS Secondary implantation of IC-IOL was done in 50 surgical aphakic eyes as a result of intraoperative posterior capsular rent with zonular dialysis (N = 43, 86 %) & large (> 7 clock hours) zonular dehiscence (N = 7, 14 %). Follow up was done on 1 st day, 7th day, 1 month, 3 months and 6 months. RESULTS 22 males and 28 females in the age group 40 - 78 years were operated. 78 % eyes (N = 39) had vision better than 6 / 12 while only 10 % eyes (N = 5) had < 6 / 60 vision and the remainder 12 % (N = 6) had vision between 6 / 18 & 6 / 36. Complications like acute postoperative iritis (N = 18, 36 %) pupillary distortion (N = 15, 30 %), pigment clumping (N = 10, 24 %), iris chaffing (N = 9, 21 %), secondary glaucoma (N = 5, 12 %) and IOL decentration (N = 3, 7 %) were seen. The mean difference in central endothelial counts before surgery and 6 months after surgery was 109 cell / mm2 (5.92 %). CONCLUSIONS Iris claw lens gives the dual benefit of good visual acuity and less complication rate in aphakic patients with lack of adequate capsular support. KEYWORDS Retropupillary Iris Claw Lens, Surgical Aphakia, Secondary implantation, Zonular Dialysis, Aneisokonia

scholarly journals Supporting IOL’S in a Deficient Capsular Environment: The Tale of No “Tails”

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Domenico Boccuzzi ◽  
Date Purva ◽  
Vincenzo Orfeo ◽  
Pasquale Napolitano ◽  
Alessandro Mularoni ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Surgical Procedures ◽  
Vitreous Hemorrhage ◽  
Corneal Edema ◽  
Iol Implantation ◽  
Secondary Iol Implantation ◽  
Implantation Techniques ◽  
Retrospective Comparative Study ◽  
Capsular Support ◽  
Iris Claw

Purpose. To evaluate the efficacy and safety of the following three distinct surgical procedures for secondary IOL implantation without capsular support: Iris-claw lens, flanged transscleral fixated IOLs (Yamane technique), and sutureless transscleral hook IOL fixation (Carlevale IOL). Materials and Methods. In this retrospective comparative study, three different sutureless IOL implantation techniques were compared in patients without any capsular support. Visual acuity and outcomes were analyzed in 24 eyes of 23 patients (14 male and 9 female). Study included 13 iris-claw lenses (Artisan Ophtec), 6 flanged transscleral fixated IOLs (Yamane technique using a MA60MA Alcon Inc IOL), and 5 transscleral Carlevale IOLS (Carlevale IOL, Soleko, Italy). Results. logMAR mean best-corrected visual acuity (BCVA) improved from 0.49 ± 0.19 to 0.19 ± 0.10 at three months after surgery p < 0.05 . Postoperative BCVA was similar in all three groups, and no intergroup difference was noted. Three eyes (12.5%) had a raised IOP >25 mmHg, 2 eyes (8%) presented a subluxated/dislocated IOL, 4 eyes (16%) had corneal edema longer than 7 days, 3 eyes (12.5%) had irregular pupil profile, 2 eyes (8%) had vitreous hemorrhage, 7 eyes had (29%) corneal astigmatism over 3 diopters, and one patient (4%) developed cystoid macular edema (CME). Conclusions. All three surgical procedures can be considered adequate to correct aphakia in patients without capsular support with significant improvement in visual acuity and low complication.

scholarly journals Safety and efficacy of glued intraocular lens implantation in eyes with inadequate capsular support

2020 ◽  
Vol 8 (4) ◽  
pp. 1419
Author(s):  
Payal P. Gonde ◽  
Sagar Aghadate
Keyword(s):  
Fibrin Glue ◽  
Intraocular Lens ◽  
Case Series ◽  
Implantation Technique ◽  
Posterior Chamber ◽  
P Value ◽  
Iol Implantation ◽  
Significant Difference ◽  
Feasible Option ◽  
Capsular Support

Background: Aim of the study was to analyze the postoperative visual outcomes, complication rate of fibrin glue-assisted, suture-less posterior chamber (PC) intraocular lens (IOL) implantation technique in eyes with inadequate capsule support at a tertiary eye care hospital.Methods: This is a retrospective, nonrandomized case series. This study analyzes 50 eyes which underwent PC-IOL implantation by fibrin glue-assisted, suture-less technique. All patients who had IOL implants by the fibrin glue-assisted PC-IOL technique from 2017 to 2019 were included in the study. Intra- and post-operative complications were analyzed. The postoperative best corrected visual acuity (BCVA) was evaluated and recorded at the end of 6 months.Results: Mean age of distribution are 42.94 years in glued IOL implantation. Among 50 cases 30 are males and 20 are females. There is significant difference in BCVA between preoperatively and postoperatively, p value for pre-operative to post-operative vision in glued intraocular lens group is <0.0001 i.e. there is definite improvement in vision  in glued intraocular group. BCVA ≥6/24 was 18 (48%) in Glued IOL subjects.Conclusions: Glued IOL implantation is a feasible option in rehabilitating patients with aphakia without adequate capsular support.

Opiophobia in Cancer Biology- Justified? - The Role of Perioperative Use of Opioids in Cancer Recurrence

2019 ◽  
Vol 25 (28) ◽  
pp. 3020-3027 ◽  
Author(s):  
Mir W. Sekandarzad ◽  
Chris Doornebal ◽  
Markus W. Hollmann
Keyword(s):  
Pain Management ◽  
Cancer Biology ◽  
Tumor Biology ◽  
Cancer Recurrence ◽  
Standard Of Care ◽  
Cancer Surgery ◽  
Perioperative Pain Management ◽  
Tumor Growth And Metastasis

: Opioids remain the standard of care in the provision of analgesia in the patient undergoing cancer surgery preoperatively. : The effects of opioids on tumor growth and metastasis have been discussed for many years. In recent years their use as part of the perioperative pain management bundle in the patients undergoing cancer surgery has been thought to promote cancer recurrence and metastasis. : This narrative review highlights earlier and more recent in vitro, in vivo and human retrospective studies that yield conflicting results as to the immune-modulatory effects of morphine on tumor biology. The article examines and explains the discrepancies with regards to the seemingly opposite results of morphine in the tumor milieu. The results of both, earlier studies that demonstrated procarcinogenic effects versus the data of more recent refined rodent studies that yielded neutral or even anti-carcinogenic effects are presented here. : Until the results of prospective randomized controlled trials are available to clarify this important question, it is currently not warranted to support opiophobia and opioids continue to constitute a pivotal role in the pain management of cancer patients.

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