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Bedda AM, ElGoweini HF, Abdelhadi AM, Elhady AM. Evaluation of suturless scleral fixation with posterior chamber foldable intraocular lens implantation. Int J Ophthalmol 2019; 12:1283-1289. [PMID: 31456918 DOI: 10.18240/ijo.2019.08.08] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Accepted: 03/12/2019] [Indexed: 11/23/2022] Open
Abstract
AIM To assess the sutureless scleral fixation technique for posterior chamber foldable intraocular lens (PCIOL) implantation in aphakic eyes with insufficient or no capsular support. METHODS A technique for sutureless intrascleral fixation of the haptics of a standard 3-piece PCIOL was used which ensures sutureless fixation by permanent incarceration of the haptics in a scleral tunnel parallel to the limbus. All patients were evaluated for preoperative status [visual acuity, refractive error, K readings, intraocular pressure (IOP) measurement, slit lamp examination, fundus examination and optical biometry], postoperative status and complications. Ultrasound biomicroscopy (UBM) was done for 10 cases to evaluate optic tilt. RESULTS The study evaluated 42 eyes of 42 patients. The follow-up period was 6mo. Improvement of best corrected visual acuity (BCVA) one line occurred in 10 cases (23.8%) and loss of one line in 3 cases (7.1%). Intraoperative complications included: haptic kink in 4 cases (9.5%), haptic breakage in 1 case (2.4%), haptic dislocation in 1 case (2.4%), haptic slippage in 3 cases (7.1%), IOL dislocation in 1 case (2.4%) and sclerotomy related bleeding in 1 case (2.4%). Postoperative complications included: transient mild vitreous hemorrhage in 3 cases (7.1%), choroidal detachment in 1 case (2.4%), cystoid macular edema (CME) in 1 case (2.4%), optic capture in 1 case (2.4%), subconjunctival haptic in 2 cases (4.8%), ocular hypotony in 4 cases (9.5%) and ocular hypertension in 1 case (2.4%). There were no cases of retinal detachment or endophthalmitis. UBM showed optic tilt in 3 cases (30%). CONCLUSION Fixation of three-piece foldable IOL haptics in scleral tunnel parallel to the limbus-provided axial stability and proper centration of the IOL with minimal or no tilt in most cases and a low complication rate during the follow up period which lasted 6mo.
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Affiliation(s)
- Ahmed M Bedda
- Department of Ophthalmology, Alexandria University, Alexandria 11511, Egypt
| | - Hesham F ElGoweini
- Department of Ophthalmology, Alexandria University, Alexandria 11511, Egypt
| | - Ahmed M Abdelhadi
- Department of Ophthalmology, Alexandria University, Alexandria 11511, Egypt
| | - Amr M Elhady
- Department of Ophthalmology, the General Ophthalmology Hospital, Alexandria 21515, Egypt
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Yusef YN, Yusef SN, Ivanov MN, Fokina ND, Alkharki L. [Methods of out-of-the-bag intraocular lens implantation]. Vestn Oftalmol 2019; 135:104-108. [PMID: 31393453 DOI: 10.17116/oftalma2019135031104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The article reviews the main modern methods of out-of-the-bag IOL implantation. Literature data shows that the most pressing question to date is comparative assessment of retropupillary iris-claw lens implantation and trans-scleral posterior chamber IOL fixation.
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Affiliation(s)
- Yu N Yusef
- Research Institute of Eye Disease, 11A Rossolimo St., Moscow, Russian Federation, 119021
| | - S N Yusef
- Research Institute of Eye Disease, 11A Rossolimo St., Moscow, Russian Federation, 119021
| | - M N Ivanov
- Research Institute of Eye Disease, 11A Rossolimo St., Moscow, Russian Federation, 119021
| | - N D Fokina
- I.M. Sechenov First Moscow State Medical University, Department of Ophthalmology, 8-2 Trubetskaya St., Moscow, Russian Federation, 119991
| | - L Alkharki
- Research Institute of Eye Disease, 11A Rossolimo St., Moscow, Russian Federation, 119021
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Kansal V, Onasanya O, Colleaux K, Rawlings N. Outcomes of Using Sutureless, Scleral-Fixated Posterior Chamber Intraocular Lenses. Semin Ophthalmol 2019; 34:488-496. [DOI: 10.1080/08820538.2019.1652761] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Vinay Kansal
- Department of Ophthalmology, University of Saskatchewan, Saskatoon, Canada
| | | | - Kevin Colleaux
- Saskatoon Retinal Consultants, Department of Ophthalmology, University of Saskatchewan, Saskatoon, Canada
| | - Nigel Rawlings
- Saskatoon Retinal Consultants, Department of Ophthalmology, University of Saskatchewan, Saskatoon, Canada
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Postorino M, Meduri A, Inferrera L, Tumminello G, Rechichi M, Caparello O, Aragona P. Scleral pockets for an innovative technique of intrascleral fixation of intraocular lens. Eur J Ophthalmol 2019; 30:985-990. [PMID: 31353945 DOI: 10.1177/1120672119866018] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The aim of this article is to report the results of an innovative technique for a scleral fixation of a posterior chamber intraocular lens using our new modified technique. We retrospectively reviewed the medical records of 15 eyes of 15 patients who underwent sutureless intrascleral intraocular lens fixation using our modified technique. We used a 23-gauge knife to perform sclerotomy and create two parallel scleral pockets for the haptics. The mean follow-up period was 3 years (3 ± 1). No complications were detected during the follow-up period. The creation of two parallel scleral pockets, parallel to the limbus, greatly simplifies the introduction of intraocular lens haptics.
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Affiliation(s)
| | - Alessandro Meduri
- Department of Biomedical Sciences, Eye Clinic, University of Messina, Messina, Italy
| | - Leandro Inferrera
- Department of Biomedical Sciences, Eye Clinic, University of Messina, Messina, Italy
| | - Giuseppe Tumminello
- Department of Biomedical Sciences, Eye Clinic, University of Messina, Messina, Italy
| | | | - Ottavio Caparello
- Azienda Sanitaria Provinciale Cosenza, Stabilimento Ospedaliero "G.Iannelli" Cetraro, Cetraro, Italy
| | - Pasquale Aragona
- Department of Biomedical Sciences, Eye Clinic, University of Messina, Messina, Italy
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Miyamoto N, Yamakawa M, Akimoto M. Intrascleral Fixation of an Intraocular Lens through the Pars Plana Prevents Corneal Endothelial Damage. Case Rep Ophthalmol 2019; 10:53-60. [PMID: 31097945 PMCID: PMC6489085 DOI: 10.1159/000496534] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Accepted: 01/03/2019] [Indexed: 12/03/2022] Open
Abstract
We report two cases of aphakia in whom an intraocular lens (IOL) was intrasclerally fixated through the pars plana to minimize further corneal endothelial damage. A modified lock-and-lead technique was used. A sclerotomy and scleral incision were made 2.5 mm from the limbus. A 24-G catheter needle was used for penetration of the leading haptic, and two ultrathin 30-G needles were used to bury the ends of the haptics. The scleral incision was sutured with 8-0 nylon. Corneal endothelial cells were preserved after surgery. Neither intra- nor postoperative complications were observed. Intrascleral fixation of an IOL through the pars plana effectively minimizes further damage to corneal endothelial cells in select cases.
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Affiliation(s)
- Naomi Miyamoto
- Department of Ophthalmology, Osaka Red Cross Hospital, Osaka, Japan
| | - Momoko Yamakawa
- Department of Ophthalmology, Osaka Red Cross Hospital, Osaka, Japan
| | - Masayuki Akimoto
- Department of Ophthalmology, Osaka Red Cross Hospital, Osaka, Japan
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Walia S, Kashyap S, Bhaisare V, Rawat P, Kori N. Novel technique of sutureless glueless scleral fixated intraocular lens (SFIOL). Indian J Ophthalmol 2019; 67:64-68. [PMID: 30574895 PMCID: PMC6324104 DOI: 10.4103/ijo.ijo_447_18] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Purpose: To report results of a novel technique for sutureless, glueless intrascleral fixation of three-piece posterior chamber intraocular lens (IOL) using 26-G needle for management of aphakia. Methods: In this prospective series, 30 eyes of 20 patients with aphakia, subluxated IOL, or crystalline lens were included. 26-G-needle-guided intrascleral fixation of three-piece posterior chamber IOL was performed according to the described technique. The patients were evaluated on day 2, 1 week, 6 weeks, and 3 months postoperatively for change in best-corrected visual acuity (BCVA), intraocular pressure (IOP), IOL centration, and any other complications. The postoperative tilt of the IOL was indirectly measured by determining the lenticular astigmatism which in turn was calculated by the difference between net corneal astigmatism and refractive astigmatism. Paired t-test was used to determine the significance of any association between the preoperative and postoperative BCVA and IOP. P < 0.05 was considered significant. Results: Of 30 eyes (n = 30 patients), 18 were surgical aphakia, 6 traumatic aphakia, 5 subluxated IOL, and 1 ectopia lentis (Marfan syndrome). The mean preoperative BCVA was 1.37 ± 0.37 (logMAR) and postoperative BCVA at 3 months was 0.37 ± 0.29 (logMAR). A significant improvement in the mean BCVA (P < 0.05) was observed after the procedure. The mean IOP preoperatively was 13.33 ± 4.18 and postoperatively at 3 months was 12.82 ± 3.97 (P > 0.05), which was not significant. None of the eyes developed any intraoperative and postoperative complications. The IOLs had appropriate centration and stability. Conclusion: We have developed this new technique for intrascleral IOL fixation which is quite simple, cost-effective, minimally invasive, neither requires glue nor suture and gives consistent outcome.
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Affiliation(s)
- Shweta Walia
- Department of Ophthalmology, Mahatma Gandhi Memorial Medical College, M.Y. Hospital, Indore, Madhya Pradesh, India
| | - Santosh Kashyap
- Department of Ophthalmology, Mahatma Gandhi Memorial Medical College, M.Y. Hospital, Indore, Madhya Pradesh, India
| | - V Bhaisare
- Department of Ophthalmology, Mahatma Gandhi Memorial Medical College, M.Y. Hospital, Indore, Madhya Pradesh, India
| | - P Rawat
- Department of Ophthalmology, Mahatma Gandhi Memorial Medical College, M.Y. Hospital, Indore, Madhya Pradesh, India
| | - N Kori
- Department of Ophthalmology, Mahatma Gandhi Memorial Medical College, M.Y. Hospital, Indore, Madhya Pradesh, India
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Sugiura T, Kaji Y, Tanaka Y. Ciliary sulcus suture fixation of intraocular lens using an auxiliary device. J Cataract Refract Surg 2019; 45:711-718. [PMID: 30879719 DOI: 10.1016/j.jcrs.2019.01.021] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2018] [Revised: 01/15/2019] [Accepted: 01/15/2019] [Indexed: 12/21/2022]
Abstract
We developed an injector with a tip that matches the shape of the ciliary sulcus (Ciliary Sulcus Pad Injector) and is used in ciliary sulcus suture fixation of intraocular lenses. The injector is inserted through the corneal incisions and slid along the posterior surface of the iris to the opposite side. When the tip of injector is fitted in the ciliary sulcus, the plunger is pressed, causing the needle to pierce the ciliary sulcus. A suture is inserted in the ciliary sulcus without direct observation. In 91.4% of cases, the needle correctly pierced the ciliary sulcus in a single attempt. The difference between the preoperative expected refractive power and the postoperative spherical equivalent power was -0.63 diopter 6 months after surgery.
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Affiliation(s)
| | - Yuichi Kaji
- Department of Ophthalmology, Majors in Clinical Sciences, Tsukuba University, Japan
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Moon TK, Jang JY, Jung HH, Ji YS. Short-term Clinical Outcomes of Scleral Fixation of Intraocular Lenses Using a Scleral Tunnel and Groove. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2019. [DOI: 10.3341/jkos.2019.60.3.246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Tae Kyu Moon
- Department of Ophthalmology, Chonnam National University Medical School, Gwangju, Korea
| | - Jae Yong Jang
- Department of Ophthalmology, Chonnam National University Medical School, Gwangju, Korea
| | - Hyun Ho Jung
- Department of Ophthalmology, Chonnam National University Medical School, Gwangju, Korea
| | - Yong Sok Ji
- Department of Ophthalmology, Chonnam National University Medical School, Gwangju, Korea
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Sutureless Intrascleral Haptic-Hook Lens Implantation Using 25-Gauge Trocars. J Ophthalmol 2018; 2018:9250425. [PMID: 30687549 PMCID: PMC6327285 DOI: 10.1155/2018/9250425] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2018] [Revised: 10/31/2018] [Accepted: 11/12/2018] [Indexed: 11/22/2022] Open
Abstract
Purpose To report a new technique for sutureless intrascleral fixation of three-piece foldable intraocular lenses (IOLs) using 25-gauge trocars. Methods We performed this technique on patients with insufficient posterior capsule support. Seventeen eyes from 15 patients with aphakia, dislocated IOL, or subluxated crystalline lens undergoing posterior chamber sutureless implantation of an IOL were studied. The haptics of the IOL were externalized using two 25-gauge forceps. The haptics were bended back (hook-like) into the vitreous cavity through a scleral incision made by using a 25-gauge trocar. And, IOL tilt was determined by using a slit lamp and UBM, and complications were recorded. Results The IOLs were fixed with exact centration and axial stability. No wound leakage was reported even without the use of sutures. The mean best-corrected visual acuity (BCVA) was 0.82 logarithm of the minimum angle of resolution (logMAR) units preoperatively, and the mean BCVA was 0.44 logMAR units at the 6-month follow-up visit. No postoperative retinal detachment, endophthalmitis, IOL tilt or dislocation, or vitreous hemorrhage was noted. Conclusion Sutureless intrascleral haptic-hook posterior chamber IOL implantation using 25-gauge trocars provides good IOL fixation with reliable wound closure without the use of sutures. This trial is registered with ChiCTR1800017436.
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Secondary IOLs: ACIOL vs Iris Sutured vs Scleral Fixated vs Phakic IOL in Aphakic Settings. CURRENT OPHTHALMOLOGY REPORTS 2018. [DOI: 10.1007/s40135-018-0184-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Obata S, Kakinoki M, Saishin Y, Ohji M. Endophthalmitis Following Exposure of a Haptic After Sutureless Intrascleral Intraocular Lens Fixation. ACTA ACUST UNITED AC 2018. [DOI: 10.1177/2474126418808997] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
An 88-year-old woman who had undergone sutureless intrascleral fixation of the intraocular lens (IOL) 3 years previously was seen at an eye clinic because of ocular pain and loss of vision 2 days prior to this visit. She was diagnosed with endophthalmitis and referred to our hospital. At her first presentation here, the best-corrected visual acuity (BCVA) was 0.01 in the left eye, and conjunctival hyperemia and hypopyon were apparent. A haptic was exposed outside the conjunctiva at the nasal upper quadrant, with a white substance around the haptic. The fundus was not visible. We diagnosed endophthalmitis. That same day, we performed vitrectomy and IOL removal, immediately followed by intravitreal injection of antibiotic. The inflammation resolved gradually, and at the 1-year follow-up her BCVA had recovered to 0.6. Patients should receive careful, long-term follow-up after sutureless intrascleral IOL fixation.
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Affiliation(s)
- Shumpei Obata
- Department of Ophthalmology, Shiga University of Medical Science, Shiga, Japan
| | - Masashi Kakinoki
- Department of Ophthalmology, Shiga University of Medical Science, Shiga, Japan
| | - Yoshitsugu Saishin
- Department of Ophthalmology, Shiga University of Medical Science, Shiga, Japan
| | - Masahito Ohji
- Department of Ophthalmology, Shiga University of Medical Science, Shiga, Japan
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Current status of late and recurrent intraocular lens dislocation: analysis of real-world data in Japan. Jpn J Ophthalmol 2018; 63:65-72. [PMID: 30426259 DOI: 10.1007/s10384-018-0637-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2017] [Accepted: 10/02/2018] [Indexed: 10/27/2022]
Abstract
PURPOSE To describe relevant patient demographic characteristics and investigate the influence of known risk factors for late intraocular lens (IOL) dislocation. To explore the associations between these risk factors and the incidence of recurrent IOL dislocation. STUDY DESIGN Retrospective cohort study. METHODS This study was performed using Nationwide Diagnostic Procedure Combination data in Japan from April 1, 2008 through July 31, 2016. Descriptive statistics for late and recurrent IOL dislocation, incidence rates, and risk factors for recurrent IOL dislocation were analyzed using a Cox proportional hazard model. RESULTS We identified 678 patients with late IOL dislocation. Most were men (72%, 488/678), and the men were younger than their women counterparts (mean age 65.2 years vs. 74.5 years). The incidence rate of recurrent IOL dislocation was 5.1 per 100 person-years. All 20 cases of recurrent IOL dislocation were observed within the year following surgery. There were no significant associations between potential risk factors and recurrent IOL dislocation (adjusted hazard ratio [HR] 1.53, 95% confidence interval [CI] 0.55-4.26 for diabetes mellitus; adjusted HR 0.77, 95%CI 0.09-6.40 for atopic dermatitis); no recurrences occurred in patients with pseudoexfoliation syndrome, retinitis pigmentosa, or connective tissue disease. CONCLUSIONS Late IOL dislocation occurs more frequently in men. We found that recurrent IOL dislocation was rare during long-term follow-up and there were no significant associations between the potential risk factors and recurrent IOL dislocation. Further studies are needed to clarify the sex-related differences involved in IOL dislocation.
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Sutureless Intrascleral Intraocular Lens Fixation Using a Microtube-Assisted Technique. Retina 2018; 39 Suppl 1:S39-S43. [PMID: 30395044 DOI: 10.1097/iae.0000000000002371] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Comparative Analysis of the Safety and Functional Outcomes of Anterior versus Retropupillary Iris-Claw IOL Fixation. J Ophthalmol 2018; 2018:8463569. [PMID: 30524757 PMCID: PMC6247566 DOI: 10.1155/2018/8463569] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Revised: 09/26/2018] [Accepted: 10/08/2018] [Indexed: 12/13/2022] Open
Abstract
Purpose To compare the functional and clinical outcomes of the iris-claw intraocular lens (IOL) placed on the anterior versus posterior surface of the iris. Patients and Methods A multicenter, retrospective study. Data on eyes that underwent anterior or retropupillary iris-claw IOL implantation because of inadequate capsular support secondary to complicated cataract surgery, trauma, and dislocated/opacified IOLs since January 2015 were analyzed. For study inclusion, evaluation results had to be available in the medical records both preoperatively and at 1 and 12 months after implantation. The following parameters were compared between the groups: best-corrected distance visual acuity (BCDVA), spherical and cylindrical refractive error, endothelial cell density (ECD), central macular thickness (CMT), and percentage and type of postoperative complications. Results In total, 60 eyes of 60 patients aged 73 ± 13 years were included: 28 eyes (47%) involved anterior, and 32 eyes (53%) retropupillary, iris-claw IOL fixations. Preoperatively, the groups were similar in all parameters except for a significantly higher proportion of retropupillary fixations in patients who had previously experienced a closed-globe trauma (p=0.03). The groups showed comparable improvements in BCDVA after surgery (final BCDVA: 0.34 ± 0.45 vs. 0.37 ± 0.50 logMAR in the anterior and retropupillary placement groups, respectively). During follow-up, no group difference was observed in refractive error or CMT. Both groups experienced similarly marked ECD loss and showed similar incidence of postoperative complications, with cystoid macular edema being the most common complication. Multivariable linear regression showed that BCDVA at 1 month was the best predictor of the final BCDVA. Conclusions Anterior chamber and posterior chamber iris-claw IOL fixations proved equally effective and safe for aphakic correction in eyes with inadequate capsular support.
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Combined Keratoplasty, Pars Plana Vitrectomy, and Flanged Intrascleral Intraocular Lens Fixation to Restore Vision in Complex Eyes With Coexisting Anterior and Posterior Segment Problems. Cornea 2018; 37 Suppl 1:S78-S85. [DOI: 10.1097/ico.0000000000001716] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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SILICONE MICROTUBE-ASSISTED SCLERAL FIXATION OF A POSTERIOR CHAMBER INTRAOCULAR LENS. Retina 2018; 38 Suppl 1:S146-S153. [PMID: 29561385 DOI: 10.1097/iae.0000000000002143] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE To report a novel technique for intrascleral fixation of a posterior chamber intraocular lens using a silicone microtube to manipulate the haptics into position. METHODS Intrascleral fixation was performed in six eyes and the results evaluated in this retrospective case series. A silicone microtube with a 0.2-mm external diameter was passed from a sclerocorneal incision through the chamber and a sclerotomy made using a 30-gauge needle. The tips of the intraocular lens haptics were connected to the silicone microtube outside the eye. After the intraocular lens was injected into the posterior chamber, the haptics were drawn through the scleral incision through their attachment to the silicone microtube. RESULTS The mean postoperative corrected visual acuity was 0.62 logarithm of the minimum angle of resolution (20/43) with a mean refraction error of -0.06 ± 0.4 diopter, which did not differ significantly (P = 0.53) from the expected value. The postoperative complications included transient ocular hypotension, vitreous hemorrhage, and choroidal detachment. CONCLUSION Our technique using a silicone microtube reduces the number of intraocular procedures compared with previous methods using forceps or needles for moving the intraocular lens haptics from the posterior chamber to the outside through sclerotomies.
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Tian T, Chen C, Jin H, Jiao L, Zhang Q, Zhao P. Capture of intraocular lens optic by residual capsular opening in secondary implantation: long-term follow-up. BMC Ophthalmol 2018; 18:84. [PMID: 29609595 PMCID: PMC5880010 DOI: 10.1186/s12886-018-0741-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Accepted: 03/05/2018] [Indexed: 11/17/2022] Open
Abstract
Background To introduce a novel surgical technique for optic capture by residual capsular opening in secondary intraocular lens (IOL) implantation and to report the outcomes of a long follow-up. Methods Twenty patients (20 eyes) who had received secondary IOL implantation with the optic capture technique were retrospectively reviewed. We used the residual capsular opening for capturing the optic and inserted the haptics in the sulcus during surgery. Baseline clinical characteristics and surgical outcomes, including best-corrected visual acuity (BCVA), refractive status, and IOL position were recorded. The postoperative location and stability of IOL were evaluated using the ultrasound biomicroscopy. Results Optic capture technique was successfully performed in all cases, including 5 cases with large area of posterior capsular opacity, 6 cases with posterior capsular tear or rupture,and 9 cases with adhesive capsules. BCVA improved from 0.60 logMAR at baseline to 0.36 logMAR at the last follow-up (P < 0.001). Spherical equivalent changed from 10.67 ± 4.59 D at baseline to 0.12 ± 1.35 D at 6 months postoperatively (P < 0.001). Centered IOLs were observed in all cases and remained captured through residual capsular opening in 19 (95%) eyes at the last follow-up. In one case, the captured optic of IOL slid into ciliary sulcus at 7 months postoperatively. No other postoperative complications were observed in any cases. Conclusions This optic capture technique by using residual capsule opening is an efficacious and safe technique and can achieve IOL stability in the long follow-up.
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Affiliation(s)
- Tian Tian
- Department of Ophthalmology, Xinhua Hospital, Affiliated to Medicine School of Shanghai Jiaotong University, No. 1665, Kongjiang Road, Shanghai, 200092, China
| | - Chunli Chen
- Department of Ophthalmology, Shengli Oilfield Central Hospital, No.31, Jinan Road, Dong Ying, Shandong, China
| | - Haiying Jin
- Department of Ophthalmology, Xinhua Hospital, Affiliated to Medicine School of Shanghai Jiaotong University, No. 1665, Kongjiang Road, Shanghai, 200092, China
| | - Lyu Jiao
- Department of Ophthalmology, Xinhua Hospital, Affiliated to Medicine School of Shanghai Jiaotong University, No. 1665, Kongjiang Road, Shanghai, 200092, China
| | - Qi Zhang
- Department of Ophthalmology, Xinhua Hospital, Affiliated to Medicine School of Shanghai Jiaotong University, No. 1665, Kongjiang Road, Shanghai, 200092, China
| | - Peiquan Zhao
- Department of Ophthalmology, Xinhua Hospital, Affiliated to Medicine School of Shanghai Jiaotong University, No. 1665, Kongjiang Road, Shanghai, 200092, China.
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Kurimori HY, Inoue M, Hirakata A. Adjustments of haptics length for tilted intraocular lens after intrascleral fixation. Am J Ophthalmol Case Rep 2018; 10:180-184. [PMID: 29780933 PMCID: PMC5956722 DOI: 10.1016/j.ajoc.2018.02.025] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Revised: 01/12/2018] [Accepted: 02/26/2018] [Indexed: 11/23/2022] Open
Abstract
Purpose To report the findings and surgical techniques on two cases of severe tilting of an intraocular lens (IOL) that had been implanted with intrascleral fixation and the tilting was detected by anterior segment optical coherence tomography (AS-OCT). Observations Two patients underwent flanged intrascleral fixation of an IOL with the double needle technique. AS-OCT showed that the tilt of IOL was 25.3° in Case 1 and was 38.1° in Case 2, and a second surgery was planned to reduce the IOL tilt. Both edges of the flanged haptics were externalized and shortened by 2–3 mm. Then, the haptics edges were inserted intrasclerally. The tilt of the IOLs was reduced to 7.7° and 5.7°, and the myopia-shifted refraction was reduced from −2.75 diopters (D) and −4.50 D to −0.13 D and −0.50 D of the approximate planned refraction in the two cases. Conclusions and importance An excessive tilt of an intrasclerally fixed IOL can be corrected by shortening the length of the haptics. AS-OCT was useful in not only detecting the tilted IOL but also in monitoring the degree of tilt after adjustment surgery.
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Affiliation(s)
- Helena Yuri Kurimori
- Kyorin Eye Center, Kyorin University School of Medicine, Tokyo, Japan.,Department of Ophthalmology, Santa Casa de São Paulo Medical School, São Paulo, Brazil
| | - Makoto Inoue
- Kyorin Eye Center, Kyorin University School of Medicine, Tokyo, Japan
| | - Akito Hirakata
- Kyorin Eye Center, Kyorin University School of Medicine, Tokyo, Japan
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Chantarasorn Y, Techalertsuwan S, Siripanthong P, Tamerug A. Reinforced scleral fixation of foldable intraocular lens by double sutures: comparison with intrascleral intraocular lens fixation. Jpn J Ophthalmol 2018; 62:365-372. [PMID: 29464488 DOI: 10.1007/s10384-018-0579-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2017] [Accepted: 01/21/2018] [Indexed: 12/01/2022]
Abstract
PURPOSE The purpose of this study is to describe a new technique for small-incision scleral fixation of intraocular lens (IOL) using double 10-0 polypropylene sutures, and to report the outcomes of IOL position compared with intrascleral IOL fixation at 12-month follow-up. STUDY DESIGN A retrospective comparative study. METHOD This new technique, called double sutured scleral fixated-IOL (DSF-IOL), was created to help with long-term knots strengthening by applying double sutures to each IOL haptic using an augmented Clove-hitch knot instead of the conventional knots tied by single suture. The tilt and decenter of IOL were measured by Scheimpflug camera and other refractive outcomes were compared between two groups at 12-month follow-up. RESULTS This study consisted of 26 eyes (54.2%) from the DSF-IOL group, and 22 eyes (45.8%) from the intrascleral fixated IOL (ISF-IOL) group. No significant differences of mean absolute degree of IOL tilt (2.90 ± 0.77 vs 2.82 ± 0.72; p = 0.633) and IOL decenter (151.90 ± 59.80 vs 175.0 ± 73.14 microns; p = 0.265) were found between the two groups. Post-operative LogMAR visual acuity was not statistically different between the two groups (0.32 ± 0.17 vs 0.41 ± 0.19, p = 0.089). Early post-operative hypotony was only present in the ISF-IOL group (13.6%). CONCLUSION This study shows that DSF-IOL is as effective as ISF-IOL. This technique can be a simpler approach to optimize small-incision scleral fixation of IOL without the complications associated with intrascleral IOL fixation.
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Affiliation(s)
- Yodpong Chantarasorn
- Department of Ophthalmology, Vajira Hospital, Navamindradhiraj University, 681 Samsen Street, Dusit, Bangkok, 10300, Thailand.
| | - Settapong Techalertsuwan
- School of medicine, Vajira Hospital, Navamindradhiraj University, 681 Samsen Street, Bangkok, 10300, Thailand
| | - Pongsavit Siripanthong
- School of medicine, Vajira Hospital, Navamindradhiraj University, 681 Samsen Street, Bangkok, 10300, Thailand
| | - Anurak Tamerug
- School of medicine, Vajira Hospital, Navamindradhiraj University, 681 Samsen Street, Bangkok, 10300, Thailand
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Benarous A, Drimbea A, Milazzo S. [Study of the results scleral-fixated intraocular lenses in the absence of capsular support]. J Fr Ophtalmol 2018; 41:1-13. [PMID: 29331294 DOI: 10.1016/j.jfo.2017.05.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2017] [Revised: 05/24/2017] [Accepted: 05/29/2017] [Indexed: 10/18/2022]
Abstract
INTRODUCTION In the absence of sufficient capsular support, scleral fixation of the intraocular lens is an interesting alternative. The goal is to evaluate this implantation technique when traditional implantation is impossible. PATIENTS AND METHODS This is an observational, retrospective, monocentric study at the Amiens university medical center between August 2013 and March 2016. Patients all underwent scleral fixation of a three-piece implant without suturing of the haptics, after posterior vitrectomy. All patients requiring implantation in the absence of stable capsular support were included. Patients with adequate iris or capsular support were excluded from our study. RESULTS Eighteen patients were included, with an average age of 69.3±16.9 years. The surgical indications were: complicated surgery, trauma and endothelial decompensation. The preoperative mean corrected visual acuity was 1.2±0.4 LogMAR while the postoperative acuity was 0.7±0.5 LogMAR. The mean postoperative corneal astigmatism was 1.9±1.9 diopters. The main complications observed were ocular hypertension, macular edema, retinal detachment, iris incarceration and exteriorization of the haptic. DISCUSSION There are two alternatives when faced with lack of a sufficient capsular support: scleral fixation or iris fixation. Our technique is the only one achievable in the presence of iris atrophy. Furthermore, it induces less astigmatism and enables the repositioning of a three-piece implant dislocated into the vitreous. CONCLUSION Scleral fixation is a technique allowing both a satisfactory and a lasting functional result and is to be considered when faced with a lack of sufficient capsular support.
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Affiliation(s)
- A Benarous
- Service d'ophtalmologie, centre hospitalier universitaire d'Amiens-Picardie, chemin de Longpré, 80080 Amiens, France; Université de Picardie-Jules-Verne, 80080 Amiens, France.
| | - A Drimbea
- Institut ophtalmologique de Picardie, 80080 Amiens, France
| | - S Milazzo
- Service d'ophtalmologie, centre hospitalier universitaire d'Amiens-Picardie, chemin de Longpré, 80080 Amiens, France; Université de Picardie-Jules-Verne, 80080 Amiens, France; Centre européen n(o) 86 EVICR.net, chemin de Longpré, 80080 Amiens, France
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Lee MS, Chae SH, Bang CW, Jeon HM, Yoon HS. Clinical Outcomes of Combined Vitrectomy and Intrascleral Fixation of New Intraocular Lenses in In-the-bag Dislocations. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2018. [DOI: 10.3341/jkos.2018.59.7.657] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Abstract
Glued intrascleral haptic fixation of an intraocular lens (glued IOL) has evolved as a technique with various modifications that are adopted and practiced by several surgeons. With adequate and appropriate haptic tuck, glued IOL imparts a stable IOL fixation and is a secured method of secondary IOL placement with no pseudophacodonesis.
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Affiliation(s)
- Priya Narang
- Narang Eye Care and Laser Centre, Ahmedabad, Gujarat, India
| | - Amar Agarwal
- Dr. Agarwal's Eye Hospital and Research Centre, Chennai, Tamil Nadu, India
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Mohan S, John B, Rajan M, Malkani H, Nagalekshmi SV, Singh S. Glued intraocular lens implantation for eyes with inadequate capsular support: Analysis of the postoperative visual outcome. Indian J Ophthalmol 2017. [PMID: 28643711 PMCID: PMC5508457 DOI: 10.4103/ijo.ijo_375_16] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Aim: The aim of this study is to analyze the postoperative visual outcomes 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 in South India. Setting and Design: This is a retrospective, nonrandomized case series. Patients and Methods: This study analyzes 94 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 August 2009 to January 2014 were included in the study. Intra- and post-operative complications were analyzed. The postoperative best spectacle-corrected visual acuity (BSCVA) was evaluated and recorded at the end of 6 months. Statistical Analysis: The data were analyzed using SPSS version 16.1 (SPSS Inc., Chicago, Illinois, USA) using two sample paired t-test and independent t-test. Results: A total of 94 eyes of 92 patients that underwent glued IOL implantation over a period of 5 years were analyzed. Out of 94 eyes, 77 eyes (84.6%) maintained or improved on their preoperative BSCVA (P = 0.012). Conclusion: We conclude that glued IOL implantation is a feasible option in rehabilitating patients with aphakia without adequate capsular support.
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Affiliation(s)
- Sujatha Mohan
- Department of Cataract Surgery, Rajan Eye Care Hospital Pvt. Ltd., Chennai, Tamil Nadu, India
| | - Bina John
- Department of Cataract Surgery, Rajan Eye Care Hospital Pvt. Ltd., Chennai, Tamil Nadu, India
| | - Mohan Rajan
- Department of Cataract Surgery, Rajan Eye Care Hospital Pvt. Ltd., Chennai, Tamil Nadu, India
| | - Harsha Malkani
- Department of Cataract Surgery, Rajan Eye Care Hospital Pvt. Ltd., Chennai, Tamil Nadu, India
| | - S V Nagalekshmi
- Department of Cataract Surgery, Rajan Eye Care Hospital Pvt. Ltd., Chennai, Tamil Nadu, India
| | - Siddhartha Singh
- Department of Cataract Surgery, Rajan Eye Care Hospital Pvt. Ltd., Chennai, Tamil Nadu, India
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De Novelli FJ, Neto TLG, de Sena Rabelo G, Blumer ME, Suzuki R, Ghanem RC. Net technique for intraocular lens support in aphakia without capsular support. Int J Retina Vitreous 2017; 3:32. [PMID: 28856011 PMCID: PMC5572154 DOI: 10.1186/s40942-017-0085-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Accepted: 07/08/2017] [Indexed: 11/14/2022] Open
Abstract
Background This paper describes a modified surgical technique for intraocular lens implantation in aphakic eyes with no capsular support. Methods Retrospective case series. Seventeen eyes of 17 aphakic patients with no capsule support underwent intraocular lens (IOL) implantation using a standardized technique in which a net was created at the ciliary sulcus plane with two threads forming a net pattern. The net was used as support for the IOL. Follow-up ranged from 6 to 38 months, with an average of 23 months. Results In all cases, the IOL was safely implanted and remained stable during the follow-up. In 16 eyes, the IOL remained well centered; in one eye, slight decentration was observed. Distance-corrected visual acuity improved by a mean of 4 lines, from 1.13 (LogMAR) to 0.52 (P = 0.01). Conclusion This technique might be especially useful in cases of insufficient capsular support associated with tissue loss or iris atrophy. In these cases, iris fixation is not feasible; thus, the only surgical alternative is IOL scleral fixation. Electronic supplementary material The online version of this article (doi:10.1186/s40942-017-0085-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
| | | | | | - Marcel Eduardo Blumer
- Sadalla Amin Ghanem Eye Hospital, 35 Camboriu Street, Joinville, SC 89216-222 Brazil
| | - Ricardo Suzuki
- Sadalla Amin Ghanem Eye Hospital, 35 Camboriu Street, Joinville, SC 89216-222 Brazil
| | - Ramon Coral Ghanem
- Sadalla Amin Ghanem Eye Hospital, 35 Camboriu Street, Joinville, SC 89216-222 Brazil
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Kunita D, Inoue M, Itoh Y, Matsuki N, Nagamoto T, Hirakata A. Effects of optical diameter of intraocular lenses with intrascleral fixation on higher-order aberrations. BMC Ophthalmol 2017; 17:82. [PMID: 28578676 PMCID: PMC5457586 DOI: 10.1186/s12886-017-0478-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2017] [Accepted: 05/26/2017] [Indexed: 11/17/2022] Open
Abstract
Background Intrascleral fixation of an intraocular lens (IOL) is used in eyes that lack capsular support. The aim of the study is to determine whether a larger optical diameter IOL will decrease the higher-order aberrations (HOAs) when the haptics are extended for intrascleral fixation than a smaller diameter IOL. Methods Three-piece acrylic IOLs with 6.0 mm optics (X-60, VA-60BBR) and 7.0 mm optics (X-70, VA-70 AD) were fixed at lengths of 13, 14, 15, 16, or 17 mm. A wavefront analyzer was used to measure the HOAs within the central 3.0 and 5.2 mm optic diameter. Results The astigmatic aberration within the central 5.2 mm was greater than that within the central 3.0 mm for all IOLs. The HOAs increased significantly with an extension of the IOLs with both optical diameters (P < 0.001). The coma aberration within the central 5.2 mm was greater than that within the central 3.0 mm but it did not increase with an extension of the haptics. The astigmatic aberration of the X-60 IOL was significantly greater than that of the X-70 only at an extension of 17 mm. The astigmatic aberration of the VA-70 AD was not significantly different from that of the VA-60BBR. The cylindrical power changed from 0.047 D in the X-60 to 0.118 D in the VA-70 AD when the IOLs were extended from 13 to 17 mm. Conclusion When three-piece IOLs are highly extended for intrascleral fixation, the astigmatic aberration increases significantly. However, IOLs with 7 mm optics do not have less astigmatic and coma aberrations than IOLs with 6 mm optics.
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Affiliation(s)
- Daisuke Kunita
- Kyorin Eye Center, Kyorin University, School of Medicine, 6-20-2 Shinkawa, Mitaka, Tokyo, 181-8611, Japan
| | - Makoto Inoue
- Kyorin Eye Center, Kyorin University, School of Medicine, 6-20-2 Shinkawa, Mitaka, Tokyo, 181-8611, Japan.
| | - Yuji Itoh
- Kyorin Eye Center, Kyorin University, School of Medicine, 6-20-2 Shinkawa, Mitaka, Tokyo, 181-8611, Japan
| | - Naoko Matsuki
- Kyorin Eye Center, Kyorin University, School of Medicine, 6-20-2 Shinkawa, Mitaka, Tokyo, 181-8611, Japan
| | - Toshiyuki Nagamoto
- Kyorin Eye Center, Kyorin University, School of Medicine, 6-20-2 Shinkawa, Mitaka, Tokyo, 181-8611, Japan
| | - Akito Hirakata
- Kyorin Eye Center, Kyorin University, School of Medicine, 6-20-2 Shinkawa, Mitaka, Tokyo, 181-8611, Japan
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Yamane S, Sato S, Maruyama-Inoue M, Kadonosono K. Flanged Intrascleral Intraocular Lens Fixation with Double-Needle Technique. Ophthalmology 2017; 124:1136-1142. [PMID: 28457613 DOI: 10.1016/j.ophtha.2017.03.036] [Citation(s) in RCA: 344] [Impact Index Per Article: 49.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2016] [Revised: 02/20/2017] [Accepted: 03/16/2017] [Indexed: 10/19/2022] Open
Abstract
PURPOSE To report the clinical outcomes of a new technique for transconjunctival intrascleral fixation of an intraocular lens (IOL). DESIGN Prospective, noncomparative, interventional case series. PARTICIPANTS One hundred eyes of 97 consecutive patients with aphakia, dislocated IOL, or subluxated crystalline lens who underwent posterior chamber sutureless implantation of an IOL were studied. METHODS Two angled incisions parallel to the limbus were made by 30-gauge thin-wall needles. Haptics of an IOL were externalized with the needles and cauterized to make a flange of the haptics. The flange of the haptics were pushed back and fixed into the scleral tunnels. MAIN OUTCOME MEASURES Best-corrected visual acuity (VA), corneal endothelial cell density, IOL tilt, and complications were determined. RESULTS The IOLs were fixed with exact centration and axial stability. The mean preoperative best-corrected VA was 0.25 logarithm of the minimum angle of resolution (logMAR) units; after surgery, it improved significantly to 0.11 logMAR, 0.09 logMAR, 0.12 logMAR, and 0.04 logMAR at 6, 12, 24, and 36 months, respectively (P < 0.01, P < 0.01, P = 0.03, and P = 0.10, respectively). The mean corneal endothelial cell density decreased from 2341 cells/mm2 before surgery to 2313 cells/mm2, 2240 cells/mm2, 2189 cells/mm2, and 2244 cells/mm2 at 6, 12, 24, and 36 months, respectively (P < 0.01, P < 0.01, P < 0.01, and P = 0.17, respectively). The mean IOL tilt was 3.4°±2.5°. The postoperative complications included iris capture by the IOL in 8 eyes (8%), vitreous hemorrhage in 5 eyes (5%), and cystoid macular edema in 1 eye (1%). There were no incidents of postoperative retinal detachment, endophthalmitis, or IOL dislocation. CONCLUSIONS We have developed a new technique for intrascleral IOL fixation. The flanged IOL fixation technique is a simple and minimally invasive method for achieving good IOL fixation with firm haptic fixation.
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Affiliation(s)
- Shin Yamane
- Department of Ophthalmology, Yokohama City University Medical Center, Yokohama, Japan.
| | - Shimpei Sato
- Department of Ophthalmology, Yokohama City University Medical Center, Yokohama, Japan
| | - Maiko Maruyama-Inoue
- Department of Ophthalmology, Yokohama City University Medical Center, Yokohama, Japan
| | - Kazuaki Kadonosono
- Department of Ophthalmology, Yokohama City University Medical Center, Yokohama, Japan
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Hung JH, Wang SH, Teng YT, Hsu SM. Motorized injector-assisted intrascleral intraocular lens fixation. Kaohsiung J Med Sci 2017; 33:137-143. [PMID: 28254116 DOI: 10.1016/j.kjms.2017.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Revised: 12/18/2016] [Accepted: 01/03/2017] [Indexed: 11/18/2022] Open
Abstract
For eyes with deficient capsular support, intraocular lens (IOL) implantation has long been a technical challenge. Recently, intrascleral fixation of the haptics of a three-piece posterior chamber IOL has become a popular option. In this procedure, externalization of the leading haptic during IOL injection is a stressful step. We present a modified technique to improve the ease and safety of this step. Our modified technique involves IOL injection with a motorized injector with several important modifications described here. With these modifications, a surgeon can easily maintain the correct orientation of the IOL in a well-controlled manner during IOL injection. The records of 13 patients who underwent this technique were retrospectively evaluated. Corrected-distance visual acuity improved significantly after surgery (p<0.05). No postoperative retinal detachment, endophthalmitis, IOL decentration, or vitreous hemorrhage was noted during the follow-up period. In conclusion, the motorized injector-assisted intrascleral IOL fixation technique is a safe and effective alternative to the conventional procedure. This technique makes the process of leading haptic externalization easier and more controllable.
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Affiliation(s)
- Jia-Horung Hung
- Department of Ophthalmology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Shih-Hao Wang
- Department of Ophthalmology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Yu-Ti Teng
- Department of Ophthalmology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Sheng-Min Hsu
- Department of Ophthalmology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Ophthalmology, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
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Helvaci S, Demirduzen S, Oksuz H. Iris-claw intraocular lens implantation: Anterior chamber versus retropupillary implantation. Indian J Ophthalmol 2016; 64:45-9. [PMID: 26953023 PMCID: PMC4821121 DOI: 10.4103/0301-4738.178139] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Purpose: To compare the outcomes of anterior chamber and retropupillary implantation of iris-claw Artisan intraocular lenses (IOL). Design: Prospective, randomized, single-blinded study. Patients and Methods: Forty eyes of forty aphakic patients were enrolled. Patients were randomized into two groups. Each group includes twenty patients. Group 1 received anterior chamber Artisan IOL implantation. Group 2 received retropupillary Artisan IOL implantation. Preoperative and postoperative corrected distance visual acuity (CDVA), intraocular pressure (IOP), and all complications were noted and compared at 6 months follow-up. Results: Each two groups obtained a significant improvement in CDVA (P < 0.05). Four patients in Group 1 and five patients in Group 2 had significant but nonpermanent increase at IOP values. There were one and two pupillary irregularity in Group 1 and Group 2, respectively. In one patient, a shallow and inferior located retinal detachment were encountered in anterior chamber group. Conclusions: The results were not significantly different between the two fixation techniques for iris-claw lens. The surgery procedure is dependent to surgeon experience and eye's conditions.
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Affiliation(s)
- Sezer Helvaci
- Department of Ophthalmology, Adana Numune Training and Research Hospital, Adana, Turkey
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Karadag R, Celik HU, Bayramlar H, Rapuano CJ. Sutureless Intrascleral Fixated Intraocular Lens Implantation. J Refract Surg 2016; 32:586-97. [DOI: 10.3928/1081597x-20160601-03] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2016] [Accepted: 05/19/2016] [Indexed: 11/20/2022]
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Trocar-Assisted, Sutureless, Scleral-Fixated Intraocular Lens Implantation Combined With Penetrating Keratoplasty. Cornea 2016; 35:1261-5. [DOI: 10.1097/ico.0000000000000944] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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81
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Liu HT, Jiang ZX, Tao LM. New two-point scleral-fixation technique for foldable intraocular lenses with four hollow haptics. Int J Ophthalmol 2016; 9:469-71. [PMID: 27158623 DOI: 10.18240/ijo.2016.03.26] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2014] [Accepted: 08/08/2015] [Indexed: 11/23/2022] Open
Abstract
The study was to report a new two-point scleral-fixation technique for foldable intraocular lenses with four haptics. Lenses were slid into the anterior chamber from a 2.8 mm corneal incision and fixed under two sclera flaps at two opposite points. The postoperative best-corrected visual acuities (BCVAs) of all patients were significantly better than their preoperative BCVA. The results demonstrate that two-point, scleral fixations of foldable, intraocular lenses might be practicable and effective.
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Affiliation(s)
- He-Ting Liu
- Department of Ophthalmology, the Second Hospital Affiliated to Anhui Medical University, Hefei 230601, Anhui Province, China
| | - Zheng-Xuan Jiang
- Department of Ophthalmology, the Second Hospital Affiliated to Anhui Medical University, Hefei 230601, Anhui Province, China
| | - Li-Ming Tao
- Department of Ophthalmology, the Second Hospital Affiliated to Anhui Medical University, Hefei 230601, Anhui Province, China
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Kawaji T, Sato T, Tanihara H. Sutureless intrascleral intraocular lens fixation with lamellar dissection of scleral tunnel. Clin Ophthalmol 2016; 10:227-31. [PMID: 26869757 PMCID: PMC4734824 DOI: 10.2147/opth.s101515] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose To report the results of sutureless scleral fixation of a posterior chamber intraocular lens (IOL) by using our developed simple technique. Methods We retrospectively reviewed the medical records of 48 eyes of 47 patients who underwent sutureless intrascleral IOL fixation by using our modified technique. A 25-gauge microvitreoretinal knife was used to perform sclerotomies and create limbus-parallel scleral tunnels with lamellar dissection in which the haptics were fixed. Results The IOLs were fixed and centered well. The mean follow-up period was 26.7 months. Postoperative complications included smooth vitreous hemorrhage in four eyes (8.3%), cystoid macular edema in two eyes (4.2%), and iris capture of the IOL in two eyes (4.2%). No other complications, such as breakage of the IOL, spontaneous IOL dislocation, or retinal detachment, were detected during the follow-up period. Conclusion The lamellar dissection of the limbus-parallel scleral tunnel can simplify the forceps-assisted introduction of the haptics into the scleral tunnel, and this technique seemed to be safe.
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Affiliation(s)
- Takahiro Kawaji
- Department of Ophthalmology, Faculty of Life Sciences, Kumamoto University, Chuo-ku, Japan; Sato Eye & Internal Medicine Clinic, Kumamoto, Japan
| | - Tomoki Sato
- Sato Eye & Internal Medicine Clinic, Kumamoto, Japan
| | - Hidenobu Tanihara
- Department of Ophthalmology, Faculty of Life Sciences, Kumamoto University, Chuo-ku, Japan
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Safety Barricade Suture for Preventing Pupillary Capture of Intraocular Lens With Scleral Fixation. Retina 2016; 36:206-10. [DOI: 10.1097/iae.0000000000000821] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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SURGICAL OUTCOME OF SIMULTANEOUS INTRAOCULAR LENS RESCUE AND SUTURELESS INTRASCLERAL TUNNEL FIXATION OF DISLOCATED INTRAOCULAR LENSES. Retina 2015; 35:1450-7. [PMID: 26102441 DOI: 10.1097/iae.0000000000000484] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE To report short-term surgical outcomes of single-stage simultaneous rescue and sutureless intrascleral fixation of dislocated intraocular lens (IOLs). METHODS Sixteen eyes of 16 patients who underwent simultaneous rescue and intrascleral fixation of dislocated 3-piece IOLs were retrospectively evaluated. Partial thickness limbal-based scleral flaps (2.0 × 2.0 mm) were created, and a 22-gauge round needle was used to create a sclerotomy at 1.5 mm from the limbus under the previously created scleral flap, and a 23-gauge trans pars plana vitrectomy was performed. Bimanual maneuvers using two 23-gauge end-grasping forceps under chandelier illumination and a wide-angle viewing system enabled 1 step rescue of IOLs from the posterior vitreous cavity with 1 hand and simultaneous haptic externalization through sclerotomy with the other hand. An externalized haptic was placed into the 3-mm intrascleral tunnel created using a bent 26-gauge needle. Fibrin glue was used to fixate haptics and close the scleral flaps. RESULTS Intraocular lenses were successfully rescued and sclera-fixated through intrascleral tunnels in all 16 eyes (mean age, 56.56 ± 19.89 years). The mean preoperative logarithm of the minimum angle of resolution best-corrected visual acuity was 0.92 ± 0.68, and this significantly improved at 6 months to 0.289 ± 0.36 (P = 0.003). During the follow-up period (10.1 ± 3.21 months), no significant change of endothelial cell count or central foveal thickness was noted postoperatively (P = 0.203 and P = 0.979, respectively). There were no significant postoperative complications such as IOL dislocation, IOL decentration, retinal detachment, endophthalmitis, or postoperative hypotony. CONCLUSION Simultaneous rescue and sutureless intrascleral haptic fixation of dislocated 3-piece IOLs using bimanual maneuvers is an effective, safe, and minimally invasive surgical method to rescue and fixate the dislocated IOL without further explant.
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Can E, Gül A, Birinci H. A safe method of ciliary sulcus fixation of foldable intraocular lens using a ciliary sulcus guide. Int Ophthalmol 2015; 36:463-8. [PMID: 26439372 DOI: 10.1007/s10792-015-0132-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2015] [Accepted: 09/29/2015] [Indexed: 11/29/2022]
Abstract
To describe a novel technique for implantation of intraocular lens in the absence of capsular support using a ciliary sulcus guide. Based on the anatomic knowledge of the ciliary sulcus and the sclera, a new instrument was developed to pierce the needle safely through the ciliary sulcus and sclera. While the foldable lens is stored inside the cartridge, the leading haptic is sutured with a cow-hitch knot. The needle is then inserted into the ciliary sulcus guide. The tip of the guide is inserted from the corneal incision and proceeded under the iris to touch and fit the ciliary sulcus. The needle is pushed from back side. The needle comes out at precise point at the sclera. Implantation of the lens was performed through a 2.8 mm clear cornea incision using the injector. The trailing haptic is tied after implantation, and then the same procedure is performed at the opposite side. We performed this technique to 15 aphakic eyes without sufficient capsular support. There was no bleeding or other intraoperative complication. All the points coming out the sclera were between 2 and 2.5 mm from the limbus. The ab interno technique for scleral fixation of IOL is quicker, easier and less traumatic then ab externo techniques. A new ciliary sulcus guide which is usable with both straight and curved needles eliminates the blind maneuvers of ab interno technique and makes this technique more safe and precise.
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Affiliation(s)
- Ertuğrul Can
- Department of Ophthalmology, Faculty of Medicine, Ondokuz Mayis University, 55139, Samsun, Turkey.
| | - Adem Gül
- Department of Ophthalmology, Faculty of Medicine, Ondokuz Mayis University, 55139, Samsun, Turkey
| | - Hakkı Birinci
- Department of Ophthalmology, Faculty of Medicine, Ondokuz Mayis University, 55139, Samsun, Turkey
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86
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Long C, Wei Y, Yuan Z, Zhang Z, Lin X, Liu B. Modified technique for transscleral fixation of posterior chamber intraocular lenses. BMC Ophthalmol 2015; 15:127. [PMID: 26432550 PMCID: PMC4592543 DOI: 10.1186/s12886-015-0118-8] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2015] [Accepted: 09/28/2015] [Indexed: 12/19/2022] Open
Abstract
Background Suture exposure remains to be a potential problem of transscleral fixated posterior chamber intraocular lens (PCIOL). We report a modified technique to minimize the risk of suture exposure for the transscleral fixation of PCIOL. Methods The modified surgical technique is as following: at first, two 3 mm × 4 mm square scleral pockets were created from groove incisions at opposite positions. A straight needle attached to a 10–0 polypropylene suture was passed through one incision groove. Then, a 27-Gauge hollow needle passed through the opposite sclera incision bed was used to retrieve the straight fine needle via its barrel. The sutures were tied to themselves after one more bite on the scleral bed. At last, the suture ends were left long (about 4 mm) and laid flat into corresponding laminar scleral pockets. This modified technique of PCIOL was performed in 48 post-traumatic aphakic vitrectomized eyes from 48 patients (47 male, one female) with mean age of 34.8 ± 14.8 years. Main outcome measures included best corrective visual acuity (BCVA), IOL decentration, IOL tilt, and postoperative complications. Results The mean follow-up was 32.3 ± 10.8 months (3–67 months). The LogMAR BCVA remained stable, from a preoperative value of 0.46 ± 0.34 to postoperative 0.44 ± 0.34 (p = 0.69). Mild IOL tilt (5–10°) was observed in five eyes, and slight IOL decentration (0.5–1.0 mm) was seen in three cases. No case of suture exposure, suture breakage, IOL dislocation, or endophthalmitis was observed during the follow up period. Conclusion The modified technique allowed stable placement of PCIOLs in post-traumatic aphakic eyes with a wide range of follow-up. Our procedure might have the potential benefit to avoid suture exposure in scleral-fixated IOL implantation. Electronic supplementary material The online version of this article (doi:10.1186/s12886-015-0118-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Chongde Long
- From the State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, 54 South Xianlie Road, Guangzhou, 510060, Guangdong, China.
| | - Yantao Wei
- From the State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, 54 South Xianlie Road, Guangzhou, 510060, Guangdong, China.
| | - Zhaohui Yuan
- From the State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, 54 South Xianlie Road, Guangzhou, 510060, Guangdong, China.
| | - Zhiqing Zhang
- From the State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, 54 South Xianlie Road, Guangzhou, 510060, Guangdong, China.
| | - Xiaofeng Lin
- From the State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, 54 South Xianlie Road, Guangzhou, 510060, Guangdong, China.
| | - Bingqian Liu
- From the State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, 54 South Xianlie Road, Guangzhou, 510060, Guangdong, China.
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87
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Khan MA, Gupta OP, Smith RG, Ayres BD, Raber IM, Bailey RS, Hsu J, Spirn MJ. Scleral fixation of intraocular lenses using Gore-Tex suture: clinical outcomes and safety profile. Br J Ophthalmol 2015; 100:638-43. [PMID: 26319945 DOI: 10.1136/bjophthalmol-2015-306839] [Citation(s) in RCA: 96] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2015] [Accepted: 08/08/2015] [Indexed: 11/03/2022]
Abstract
BACKGROUND/AIMS To report the short-term safety profile and clinical outcomes of scleral fixation of intraocular lenses (IOLs) using Gore-Tex suture. METHODS Retrospective, interventional case series. 85 eyes of 84 patients undergoing ab externo scleral fixation of a Bausch and Lomb Akreos AO60 or Alcon CZ70BD IOL using Gore-Tex suture. Primary outcome measures were change in visual acuity and occurrence of intraoperative and postoperative complications with minimum follow-up of 90 days. RESULTS 85 eyes of 84 patients were identified. Mean logarithm of the minimum angle of resolution visual acuity improved from 1.43±0.72 (20/538 Snellen equivalent) preoperatively to 0.64±0.61 (20/87 Snellen equivalent) postoperatively (p<0.001). Mean follow-up was 325 days (median 264 days, range 90-996 days). There were no intraoperative complications noted. Postoperative complications included hypotony in eight patients (9.4%), ocular hypertension in six eyes (7%), vitreous haemorrhage in six eyes (7%), hyphema in two eyes (2%), serous choroidal detachment in two eyes (2%), cystoid macular oedema in two eyes (2%) and corneal oedema in one eye (1%). There were no cases of postoperative endophthalmitis, suture erosion/breakage, retinal detachment, suprachoroidal haemorrhage, uveitis-glaucoma-hyphema syndrome or persistent postoperative inflammation in the follow-up period. CONCLUSIONS Ab externo scleral fixation of IOLs with Gore-Tex suture was well tolerated in all cases. No suture-related complications were encountered. This procedure led to improvement in visual acuity and was not associated with significant intraoperative or postoperative complications.
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Affiliation(s)
- M Ali Khan
- Retina Service Wills Eye Hospital, Philadelphia, Pennsylvania, USA
| | - Omesh P Gupta
- Retina Service Wills Eye Hospital, Philadelphia, Pennsylvania, USA
| | - Ryan G Smith
- Retina Service Wills Eye Hospital, Philadelphia, Pennsylvania, USA
| | - Brandon D Ayres
- Cornea Service, Wills Eye Hospital, Philadelphia, Pennsylvania, USA
| | - Irving M Raber
- Cornea Service, Wills Eye Hospital, Philadelphia, Pennsylvania, USA
| | - Robert S Bailey
- Cataract and Primary Eye Care Service, Wills Eye Hospital, Philadelphia, Pennsylvania, USA
| | - Jason Hsu
- Retina Service Wills Eye Hospital, Philadelphia, Pennsylvania, USA
| | - Marc J Spirn
- Retina Service Wills Eye Hospital, Philadelphia, Pennsylvania, USA
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88
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Modified side-based scleral flap for intrascleral intraocular lens fixation. J Cataract Refract Surg 2015; 41:1533-5. [PMID: 26287892 DOI: 10.1016/j.jcrs.2015.04.028] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2015] [Accepted: 04/14/2015] [Indexed: 11/22/2022]
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89
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Matsui Y, Matsubara H, Hanemoto T, Kondo M. Exposure of haptic of posterior chamber intraocular lens after sutureless intrascleral fixation. BMC Ophthalmol 2015; 15:104. [PMID: 26272766 PMCID: PMC4535536 DOI: 10.1186/s12886-015-0102-3] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2015] [Accepted: 08/06/2015] [Indexed: 11/10/2022] Open
Abstract
Background A technique of sutureless intrascleral fixation of an intraocular lens (IOL) in an eye that lacks a posterior capsular support has been reported. The advantage of this technique was that the suture-related complications did not develop. However, the long-term complications of a sutureless IOL implantation have not been reported. Case presentation A 75-years-old man had a sutureless intrascleral fixation (Y-fixation) of an IOL 4 months before our examination. The nasal haptic became exposed and the temporal haptic was seen in the subconjunctiva. The tilted IOL was removed and replaced by a posterior chamber IOL that was sutured to the sclera. At the 6 months examination, the eye was quiet and the IOL was stable. Conclusion We suggest that the exposure of the nasal haptic of an IOL that was implanted by sutureless intrascleral fixation (Y-fixation) was due to poor surgical technique and/or the erosion of a fragile sclera. Thus, eyes should be carefully and frequently monitored after sutureless intrascleral posterior chamber IOL implantation.
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Affiliation(s)
- Yoshitsugu Matsui
- Department of Ophthalmology, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan.
| | - Hisashi Matsubara
- Department of Ophthalmology, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan.
| | | | - Mineo Kondo
- Department of Ophthalmology, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan.
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90
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Saffra N, Rakhamimov A, Masini R, Rosenthal KJ. Anterior Chamber Iris Claw Lens for the Treatment of Aphakia in a Patient with Megalocornea. Case Rep Ophthalmol 2015; 6:164-9. [PMID: 26120314 PMCID: PMC4478314 DOI: 10.1159/000431251] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Megalocornea in isolation is a rare congenital enlargement of the cornea greater than 13 mm in diameter. Patients with megalocornea are prone to cataract formation, crystalline lens subluxation, zonular deficiencies and dislocation of the posterior chamber intraocular lens (PCIOL) within the capsular bag. A 55-year-old male with megalocornea in isolation developed subluxation of the capsular bag and PCIOL. The PCIOL and capsular bag were explanted, and the patient was subsequently implanted with an anterior chamber iris claw lens. An anterior chamber iris claw lens is an effective option for the correction of aphakia in patients with megalocornea.
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Affiliation(s)
- Norman Saffra
- Department of Ophthalmology, Maimonides Medical Center, Brooklyn, N.Y., USA
| | | | - Robert Masini
- Department of Medical Photography, New York Eye and Ear Infirmary, New York, N.Y., USA
| | - Kenneth J Rosenthal
- Department of Ophthalmology, New York Eye and Ear Infirmary, New York, N.Y., USA
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91
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Takayama K, Akimoto M, Taguchi H, Nakagawa S, Hiroi K. Transconjunctival sutureless intrascleral intraocular lens fixation using intrascleral tunnels guided with catheter and 30-gauge needles. Br J Ophthalmol 2015; 99:1457-9. [PMID: 25855502 DOI: 10.1136/bjophthalmol-2014-306579] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2014] [Accepted: 03/22/2015] [Indexed: 11/04/2022]
Abstract
We invented a new method for fixing an intraocular lens (IOL) in the scleral tunnel without using a wide conjunctival incision. Modified bent catheter needles were used to penetrate the IOL haptics through the sclerotomy sites. The IOL haptics were inserted into 30-guage (G) scleral tunnels guided by double 30-G needles piercing the sclera. All procedures were performed through the conjunctiva without wide incision. The procedure does not require special forceps, trocars or fibrin glue, only catheter and 30-G needles. The aid of an assistant was not required to support the IOL haptic. The procedures were easily learnt based on our previous method. As with other transconjunctival sutureless surgeries, patients feel less discomfort and the conjunctiva can be conserved for future glaucoma surgery. Complications included two cases of vitreous haemorrhage (16.7%), and one case each of postoperative hypotony, and iris capture (8.3%). Astigmatism induced by intraocular aberration was the same as we reported previously. Our method for fixing the IOL into the scleral tunnel is innovative, less expensive, less invasive and quick. This modified method is a good alternative for fixing IOL haptics into the sclera.
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92
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Kongsap P. A knotless, one-haptic fixation of posterior chamber intraocular lenses: one-year results. Int J Ophthalmol 2015; 8:104-6. [PMID: 25709917 DOI: 10.3980/j.issn.2222-3959.2015.01.19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2014] [Accepted: 08/08/2014] [Indexed: 11/02/2022] Open
Abstract
AIM To assess the results of a modified technique for scleral fixation of a posterior chamber intraocular lens (IOL) in eyes which had deficient of posterior capsular support. METHODS This retrospective study was comprised of ten patients with deficient posterior capsular support who underwent one-haptic fixation of posterior chamber IOLs, between February 2010 and October 2011. IOL as implanted with one haptic supported on the capsular remnant and the other haptic drawn into the sulcus by anchoring suture without a knot. All patients were evaluated for pre- and postoperative visual acuity, lens centration, intra-and postoperative complications. RESULTS A knotless, one-haptic fixation of posterior chamber IOLs has successfully been performed on ten eyes. All cases had inadequate capsular support (i.e. a capsular tear ranged from 5 to 7 clock hours). The average age was 74.25±8.87y (SD). The average postoperative uncorrected visual acuity was 0.51 logMAR. Complications included hyphema in one eye, a mild inflammatory reaction in the anterior chamber in two eyes, and a transient rise in IOP in one eye. Neither IOL tilt nor dislocation was observed and there were no later complications. CONCLUSION In the presence of insufficient capsular support, a knotless, one-haptic fixation of posterior chamber IOLs is a safe and viable option which reduces the operation time, and minimizes postoperative suture-related complications.
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Affiliation(s)
- Pipat Kongsap
- Department of Ophthalmology, Prapokklao Hospital, Chanthaburi 22000, Thailand
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93
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Oskala P. Friction knot to fixate scleral sutures. J Cataract Refract Surg 2015; 41:497-500. [PMID: 25669722 DOI: 10.1016/j.jcrs.2015.01.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2014] [Revised: 09/30/2014] [Accepted: 10/20/2014] [Indexed: 11/17/2022]
Abstract
UNLABELLED A technique for fixating polypropylene sutures to the sclera is presented. The technique avoids certain risks of earlier techniques and enhances the speed and ease of the procedure. FINANCIAL DISCLOSURE The author has no financial or proprietary interest in any material or method mentioned.
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Affiliation(s)
- Pertti Oskala
- From the Department of Vitreoretinal Surgery, Helsinki University Eye Clinic, Helsinki, Finland.
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94
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Akimoto M, Taguchi H, Takayama K, Nakagawa S, Hiroi K. Intrascleral fixation technique using catheter needles and 30-gauge ultrathin needles: Lock-and-lead technique. J Cataract Refract Surg 2015; 41:257-61. [DOI: 10.1016/j.jcrs.2014.08.030] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2014] [Accepted: 08/08/2014] [Indexed: 11/25/2022]
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95
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Karadag R, Bayramlar H, Sari U. Is this really sutureless scleral intraocular lens fixation? J Cataract Refract Surg 2014; 40:851. [DOI: 10.1016/j.jcrs.2014.02.028] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2014] [Indexed: 10/25/2022]
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