Clinical Study of Scleral Fixated Intraocular Lens Implantation in Blunt Ocular Trauma

Aim: to assess visual outcome and complications associated with SFIOL implantation in traumatic lens subluxation/ dislocation cases. Methods: This is a retrospective study of 45 patients who were managed for traumatic dislocation/subluxation of clear or cataractous lenses from June 2019 to July 2020 in a Krishna hospital, Karad, Satara. All cases underwent anterior vitrectomy/3 port pars plana vitrectomy + removal of lens and ab externo 2 point scleral fixation with rigid or foldable sfiol. In posteriorly dislocated/subluxated lens, vitrectomy was done and the lens was removed using pick forceps and retrieved by hand shake technique. In anteriorly dislocated cataractous lens, the lens was removed through the tunnel incision. Results: Majority of the patients were between 55-65 years of age with male pre-ponderance (73.3%).Out of 45 cases, 21 cases (46.6%) were traumatic dislocated lens and 24 cases (53.3%) were traumatic subluxated lens. The mean preoperative BCVA was 0.13 ± 0.24 logMAR, which improved 0.39 ± 0.366 logMAR postoperatively (P <0.0001 ).Preoperatively BCVA in logMAR in 39 cases (86.6%) was 0.3 or better, 6 cases (13.3%) was 0.3 to 1.0 . Postoperatively BCVA in logMAR in 21 cases (46.67%) was 0.3 or better, 24 cases (53.3%) was 0.3 to 1. P-value is 0.00057 which is significant. Early postoperative complications noted were raised intraocular pressure in 12 cases (26.6%), corneal edema in 9 cases (20%), vitreous hemorrhage in 8 cases (17.7%) and hypotony in 3 cases (6.67%).Late postoperative complications were persistent elevation of intraocular pressure in 10 cases (22.2%), cystoid macular edema in 3 cases (6.67%), epiretinal membrane in 3 cases (6.67%). Conclusion: In every horrendous case, long haul follow-up is needed to distinguish confusions and start treatment at the most punctual.

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

Journal of VitreoRetinal Diseases ◽

10.1177/2474126419895691 ◽

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.

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Phacoemulsification surgery by a nationally-trained cataract surgeon of Nepal

Nepalese Journal of Ophthalmology ◽

10.3126/nepjoph.v4i2.6540 ◽

2012 ◽

Vol 4 (2) ◽

pp. 248-255

Author(s):

S Bajimaya ◽

B R Sharma ◽

J B Shrestha ◽

I M Maharjan ◽

H Matsushima ◽

...

Keyword(s):

Visual Acuity ◽

Postoperative Complications ◽

Corneal Edema ◽

Visual Outcome ◽

Corneal Epithelial ◽

Corneal Epithelial Defect ◽

Posterior Capsule Rupture ◽

The Mean ◽

Phaco Time

Introduction: A one month phacoemulsification training course had been implemented by the Nepal Netra Jyoti Sangh (NNJS) in collaboration with Association for Ophthalmic Cooperation to Asia, Japan (AOCA). Objective: To evaluate the visual outcomes of phacoemulsification surgery by a nationally trained surgeon in Nepal. Materials and methods: A retrospective study of patients that underwent phacoemulsification with foldable intraocular lens implantation during a period of 18 months was carried out. Cases that had a six-week follow-up period were included. Effective phaco time (EPT), intra-operative and postoperative complications were noted. Uncorrected visual acuity (UCVA) at day 1 and best corrected visual acuity (BCVA) at week 6 were noted. The data were analyzed using SPSS 11.5. Results: A total of172 patients that had completed a 6 week follow-up evaluation were included in the study. The mean age of patients was 57.12±10.19 years. The mean effective phaco time (EPT) was 9.74±7.41 seconds. Posterior capsule rupture (PCR) with vitreous loss occurred in 2 eyes (1.2%), Descemet’s membrane detachment in 1 eye (0.6%), capsulorhexis extension in 1 eye (0.6%) and wound site thermal injury (WSTI) occurred in 3 eyes (1.7%). Postoperative complications were mild to moderate striate keratopathy (9/ 172), corneal edema (1/172), corneal epithelial defect (1/172) and uveitis (1/172). At 6 weeks post-operatively, 165 eyes (95.9%) had a BCVA better than 6/18 and 7 eyes (4.1%) had a BCVA of 6/18 to 6/60.Conclusion: Patients undergoing phacoemulsification had a good visual outcome as a result of the procedure performed by cataract surgeon trained from AOCA/NNJS national phacoemulsification training program of Nepal.DOI: http://dx.doi.org/10.3126/nepjoph.v4i2.6540 Nepal J Ophthalmol 2012; 4 (2): 248-255

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Intraocular pressure change with face-down positioning after macular hole surgery

PLoS ONE ◽

10.1371/journal.pone.0242567 ◽

2020 ◽

Vol 15 (11) ◽

pp. e0242567

Author(s):

Sung Won Choi ◽

Chong Eun Lee ◽

Yu Cheol Kim

Keyword(s):

Intraocular Pressure ◽

Macular Hole ◽

Axial Length ◽

Pressure Change ◽

Idiopathic Macular Hole ◽

Pars Plana ◽

Intravitreal Gas ◽

The Mean ◽

Iop Elevation

This study evaluated changes in intraocular pressure (IOP) with face-down positioning (FDP) following surgical treatment of idiopathic macular hole. We retrospectively reviewed the records of 130 patients diagnosed with idiopathic macular hole who underwent pars plana vitrectomy (PPV) with intravitreal gas injection after fluid-gas exchange. We analyzed IOP changes in both eyes following FDP over the course of 7 days. The mean IOP of the operated eyes was 14.98±2.95 mmHg preoperatively and 16.82±3.12 and 15.57±6.10 mmHg on postoperative days 2 and 7, respectively. In contralateral eyes, the mean IOP changed from 14.78±3.15 mmHg preoperatively to 16.27±1.87 and 14.40±4.14 mmHg on postoperative days 2 and 7, respectively. On postoperative day 2, the IOP increased in both eyes compared to the preoperative values, but the increase was significant only in operated eyes (p = 0.039). In contralateral eyes, the IOP on postoperative day 7 was significantly decreased compared with that on postoperative day 2 (p = 0.021) and in eyes with an axial length ≥ 23.0 mm, compared with the preoperative values (p = 0.042). The IOP of the operated eyes on postoperative day 7 was higher than that of the contralateral eyes (p = 0.039). Based on a short-term follow-up, FDP after PPV with intravitreal gas tamponade for the treatment of idiopathic macular hole may cause IOP elevation not only in the operated, but also in the contralateral eyes; the IOP increase in contralateral eyes was not as significant as that in operated eyes and was not maintained over 7 days after surgery; the IOP change seems to be affected by axial length and lens status.

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Outcome and Complications of Combined Phacoemulsification and 23-Gauge Pars Plana Vitrectomy

Journal of Ophthalmology ◽

10.1155/2019/7918237 ◽

2019 ◽

Vol 2019 ◽

pp. 1-6 ◽

Cited By ~ 1

Author(s):

Selcuk Sizmaz ◽

Ebru Esen ◽

Puren Isik ◽

Burcu Cam ◽

Nihal Demircan

Keyword(s):

Intraocular Pressure ◽

Retinal Detachment ◽

Pars Plana Vitrectomy ◽

Intraoperative Complications ◽

Vitreous Hemorrhage ◽

Patient Demographics ◽

Posterior Synechia ◽

Pars Plana ◽

23 Gauge

Background. With the advances in surgical tools, simultaneous removal of cataract associated with vitreoretinal disorders is gaining popularity. This combined surgery offers several advantages besides limitations. The aim of this study is to assess the outcome and complications of phacoemulsification combined with pars plana vitrectomy (PPV). Patients and Methods. In this retrospective review, medical charts of patients undergoing phacovitrectomy for coexisting cataract and various vitreoretinal disorders were analyzed. Patient demographics, retinal diagnosis, visual acuities (VA) in logMAR, intraocular pressure (IOP), intraoperative and postoperative complications were assessed. Clear corneal phacoemulsification and 23-gauge transconjunctival PPV were administered in all cases. Results. Eighty-four eyes of 64 (76.2%) males and 20 (23.8%) females were enrolled. The average age of patients was 59.5 ± 13.8 (18–81). The average period of follow-up was 7.2 ± 7.5 months (1–36). The vitreoretinal diagnoses were as follows: 28 (33.3%) rhegmatogenous retinal detachment, 23 (27.4%) vitreous hemorrhage, 12 (14.3%) intraocular foreign body, 12 (14.3%) epiretinal membrane, 4 (4.8%) macular hole, 4 (4.8%) tractional retinal detachment, and 1 (1.2%) vitreomacular traction. The most common intraoperative complications were miosis and rupture of the posterior capsule (92.9% and 8.3%, respectively). In 8 (9.5%) cases, there was fibrin in the anterior chamber. Posterior synechia developed in 7 (8.3%) of cases. No severe increase in intraocular pressure was evident. Conclusion. Phacoemulsification combined with PPV is a safe and efficient way of management in cases where cataract coexists with vitreoretinal pathologies.

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Long-Term Outcomes of Initial Trabeculectomy in Glaucoma Associated with Granulomatous and Non-Granulomatous Uveitis

10.21203/rs.3.rs-372298/v1 ◽

2021 ◽

Author(s):

Faisal A. Almobarak ◽

Ali H. Alharbi ◽

Ibrahim Aljadaan ◽

Hassan Aldhibi

Keyword(s):

Intraocular Pressure ◽

Postoperative Complications ◽

Late Onset ◽

Success Rates ◽

Long Term Outcomes ◽

Granulomatous Uveitis ◽

The Mean ◽

Retrospective Comparative Study

Abstract Purpose To evaluate the outcomes of initial trabeculectomy in granulomatous and non-granulomatous uveitis. Methods Retrospective comparative study of 68 eyes that underwent an initial trabeculectomy. Results The mean follow-up was 74.18 and 74.86 months in both groups (p = 0.95). The intraocular pressure decreased from 40.03 mmHg (± 7.2) and 36.48 mmHg (± 11.3) to 14.00 mmHg (± 6.2) and 13.48 mmHg (± 5.7), the number of medications decreased from 3.73 (± 0.7) and 3.58 (± 0.9) to 1.00 (± 1.4) and 1.13 (± 1.4) on the last follow-up (p < 0.01) in the granulomatous and non-granulomatous groups, respectively. More eyes in the granulomatous uveitis group developed delayed postoperative complications like cataract, transient hypotony and glaucoma progression. Success rates were 64.9 and 71.0%, while failure rates were 35.1 and 29.0% in both groups (p = 0.84). Conclusions Trabeculectomy seems to have comparable IOP control and survival in granulomatous and non-granulomatous uveitis. Nevertheless, more eyes in the granulomatous uveitis group developed late onset complications.

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

Journal of VitreoRetinal Diseases ◽

10.1177/2474126418791701 ◽

2018 ◽

Vol 2 (5) ◽

pp. 276-281 ◽

Cited By ~ 3

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.

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Outcomes of implantable collamer lens V4 and V4c for correction of high myopia – a case series

Nepalese Journal of Ophthalmology ◽

10.3126/nepjoph.v7i2.14967 ◽

2016 ◽

Vol 7 (2) ◽

pp. 164-172 ◽

Cited By ~ 3

Author(s):

Smita Karandikar ◽

Vipul Bhandari ◽

Jagdeesh Reddy

Keyword(s):

Visual Acuity ◽

Intraocular Pressure ◽

High Myopia ◽

Case Series ◽

Visual Outcome ◽

Visual Disability ◽

Implantable Collamer Lens ◽

Distant Visual Acuity ◽

The Mean

Objective: To evaluate the visual outcomes and intraocular pressure changes after Visian Implantable Collamer Lens (ICL) implantation V4b and V4c (with centraflow technology) for correction of myopia. Materials and methods: A prospective, consecutive, comparative interventional case series of V4b and V4c ICL implantation done for correction of high myopia (>-6 diopter D) in patients unsuitable for laser vision correction. The outcome measures that were evaluated included preoperative and postoperative uncorrected distant visual acuity (UDVA), best spectacle corrected distant visual acuity (CDVA), endothelial cell count (ECC), presence of lens opacification, intraocular pressure (IOP) and ICL vaulting. A follow-up of upto 1 year was done. A questionnaire was given at the end of follow-up period. Results: A total of 30 eyes (24.56±4.8 years) underwent V4b ICL implantation (10 non-toric, 20 toric ICL-TICL) with intraoperative peripheral iridectomy (PI) and 34 eyes (26.13±3.8 years) had implantation of V4c ICL with centraflow (12 non-toric, 22 TICL). The mean preoperative manifest spherical equivalent (MSE) was 8.98±2.8 D and 9.24±2.4 D in the V4b and V4c groups respectively which reduced to postoperative values of -0.28±1.3 D and -0.19±1.18 D respectively. The mean preoperative astigmatism was -1.8±1.2 diopter cylinder (Dcyl) and -1.9±1.6 Dcyl which respectively reduced to -0.8±0.8 Dcyl and -0.9±0.3 Dcyl. At the end of 1 year follow up, mean ECC loss was 7.6% and 7.1%, mean vault was 583.12±231.12 μ and 602±241.24μ respectively in the V4b and V4c groups. Anterior subcapsular opacities were present in 6.66% and 2.94% of eyes with V4b and V4c groups respectively. Two eyes from both V4b (10%) and V4c (8.33%) had rotation of more than 30 degrees and required re-rotation surgery done successfully. Two eyes (6.66%) with V4b ICL implantation had high postoperative IOP (>35 mm Hg) and required Nd:Yag laser iridotomy later done with successful control of IOP. The safety indices were 1.12 and 1.15 and efficacy indices were 1.5 and 1.6 in the V4b and V4c groups respectively at the end of 1 year. The most common visual complaint was glare and haloes in 24% and 27% in the two groups respectively. However, they were not annoying enough to cause visual disability. Conclusions: Both V4b and V4c Visian ICL implantations are comparable in terms of visual outcome and safety profile for correction of high myopia. However, V4c ICL offers these advantages without the requirement of an additional PI.

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Intermediate-term outcomes of pars plana tube insertion of Aurolab aqueous drainage implant for refractory glaucoma

British Journal of Ophthalmology ◽

10.1136/bjophthalmol-2019-314639 ◽

2019 ◽

pp. bjophthalmol-2019-314639 ◽

Cited By ~ 1

Author(s):

Naresh Babu ◽

Girish Baliga ◽

Hiruni Kaushalya Wijesinghe ◽

George Varghese Puthuran

Keyword(s):

Intraocular Pressure ◽

Refractory Glaucoma ◽

Tube Insertion ◽

Safety And Efficacy ◽

Antiglaucoma Medication ◽

Kaplan Meier ◽

Pars Plana ◽

The Mean ◽

Cumulative Probabilities

PurposeTo report the safety and efficacy of parsplana tube insertion of Aurolab aqueous drainage implant(AADI) in patients with refractory glaucoma.MethodsCharts of patients with refractory glaucoma who underwent AADI via the parsplana route between June 2014 and June 2018with a minimum follow-up of 6 months were retrospectively reviewed. Success was defined as complete when the intraocular pressure (IOP) was ≥5 and18 mmHg or IOP reduction was >30%from baseline without antiglaucoma medication (AGM) andas qualified if requiring additional AGMs.ResultsThe study included 63 eyes of 63 patients with a mean age of 36.1±20.6 years and a mean follow-up of 19.7±15.7 months. Glaucoma postvitreoretinal surgery was the the most common aetiology (22 eyes, 35%). The mean IOP reduced from 36.6±10.7 mmHg to15.7±8.2 (57.1%), 15.02±7.3 (60%) and 17.2±8.5 mmHg (53%)at 6 months and 1 and 2 years, respectively. Kaplan-Meier estimates showed that the cumulative probabilities of failure were 8% (95% CI4.3% to 22.4%) at 6 months, 23% (95%CI12.8% to 38.6%) at 1 year, 30% (95%CI17.4% to 45.9%) at 18 months and 47% (95% CI13.4% to 64.9%) at the 2 years time points.Vitreous blocking tube tip was noted up to 8% of eyes on follow-up.ConclusionPars plana AADI insertion is a useful procedure for the control of IOP in patients with refractory glaucoma.

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Clear Corneal Phacovitrectomy with Posterior Capsulorhexis and IOL Implantation in Management of Selective Vitreoretinal Cases

Journal of Ophthalmology ◽

10.1155/2015/474072 ◽

2015 ◽

Vol 2015 ◽

pp. 1-9 ◽

Cited By ~ 1

Author(s):

Ernest V. Boiko ◽

Sergey V. Churashov ◽

Alexei N. Kulikov ◽

Dmitrii S. Maltsev

Keyword(s):

Case Series ◽

Vitreous Hemorrhage ◽

Visual Outcome ◽

Anterior Capsule ◽

Epiretinal Membranes ◽

Good Visual Outcome ◽

The Mean ◽

Capsular Bag ◽

Anterior Proliferative Vitreoretinopathy

Purpose. To describe our technique, clear corneal phacovitrectomy with posterior capsulorhexis (CCPV), for the management of selected posterior segment intraocular foreign body (IOFB), posteriorly dislocated lens fragments (PDLF), and proliferative diabetic retinopathy (PDR) cases.Methods. This was a single-center retrospective interventional case series. In 21 patients (21 eyes) we performed phacovitrectomy through three clear corneal tunnel incisions (CCTI) and posterior capsulorhexis to remove IOFB (n=8), PDLF from the vitreous cavity after complicated phacoemulsification (n=6), and vitreous hemorrhage and epiretinal membranes in PDR (n=7). The procedure was completed with implantation of a hydrophobic acrylic IOL through the CCTI.Results. The mean visual acuity (logMAR) was 0.90 preoperative and improved to 0.26 over a mean follow-up of 8.7 months (range, 6–12 months). The intraocular lens was implanted into the capsular bag (n=12) or onto the anterior capsule (n=9). One PDR patient experienced an intraprocedural complication, hemorrhage from isolated fibrovascular adhesions. One IOFB patient developed apparent anterior proliferative vitreoretinopathy and required a repeat intervention.Conclusion. Selected vitreoretinal IOFB, PDLF, and PDR cases can be successfully managed by a combined surgical approach involving clear corneal phacovitrectomy with posterior capsulorhexis and implantation of an IOL, with good visual outcome and a low complication rate.

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