251
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Kara N. A Modified Glued Transscleral Intraocular Lens Implantation: Suture-Assisted Sutureless Technique. J Refract Surg 2015; 31:488-91. [DOI: 10.3928/1081597x-20150623-08] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2015] [Accepted: 05/28/2015] [Indexed: 11/20/2022]
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252
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Brandner M, Thaler-Saliba S, Plainer S, Vidic B, El-Shabrawi Y, Ardjomand N. Retropupillary Fixation of Iris-Claw Intraocular Lens for Aphakic Eyes in Children. PLoS One 2015; 10:e0126614. [PMID: 26110864 PMCID: PMC4482151 DOI: 10.1371/journal.pone.0126614] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2014] [Accepted: 04/05/2015] [Indexed: 12/17/2022] Open
Abstract
Purpose To report outcome, complications and safety of retropupillary fixated iris-claw intraocular lenses in a pediatric population. Design Retrospective study. Patients and Methods Ten consecutive pediatric patients (15 eyes) underwent placement of retropupillary fixated iris-claw intraocular lenses between October 2007 and July 2013 at the Department of Ophthalmology, Medical University Graz and General Hospital Klagenfurt, Austria. Postoperative visual acuity and complications were analyzed. Results Median final best-corrected visual acuity improved by 0.12 logMAR from preoperative baseline. Mean postoperative spherical equivalent was -0.05 ± 1.76 D. No serious complications were observed intra- or postoperatively during the entire follow-up period of up to 40 months. One patient experienced a haptic disenclavation with IOL subluxation immediately after a car accident. Conclusion Our study demonstrates that iris-claw intraocular lens implantation behind the iris is safe in children with lack of capsular support and yields excellent visual outcome with low complication rate.
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Affiliation(s)
- Martina Brandner
- Department of Ophthalmology, Medical University Graz, Graz, Austria
| | | | - Sophie Plainer
- Department of Ophthalmology, General Hospital Klagenfurt, Klagenfurt, Austria
| | - Bertram Vidic
- Department of Ophthalmology, Medical University Graz, Graz, Austria
| | - Yosuf El-Shabrawi
- Department of Ophthalmology, General Hospital Klagenfurt, Klagenfurt, Austria
| | - Navid Ardjomand
- Department of Ophthalmology, Medical University Graz, Graz, Austria
- * E-mail:
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253
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Benevento J, Song J, Tongbai R. Intravenous catheter-assisted scleral fixation of an intraocular lens in eyes without adequate capsular support. Ophthalmic Surg Lasers Imaging Retina 2015; 46:475-6. [PMID: 25932726 DOI: 10.3928/23258160-20150422-12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2014] [Accepted: 01/12/2015] [Indexed: 11/20/2022]
Abstract
BACKGROUND AND OBJECTIVE Sutureless scleral fixation is an effective technique for placement of a secondary intraocular lens. The authors propose a modification that may simplify intraoperative technical challenges. STUDY DESIGN Description of surgical technique. RESULTS Successful placement of stable secondary intraocular lens. CONCLUSION This modified technique has the potential to reduce intraoperative complications. Studies including more patients with longer follow-up are needed to test the viability.
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254
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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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255
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Narang P, Agarwal A, Kumar DA. Glued intraocular lens scaffolding for Soemmerring ring removal in aphakia with posterior capsule defect. J Cataract Refract Surg 2015; 41:708-13. [DOI: 10.1016/j.jcrs.2015.02.020] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2014] [Revised: 10/19/2014] [Accepted: 11/26/2014] [Indexed: 11/24/2022]
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Comparision of surgical outcomes of intraocular lens refixation and intraocular lens exchange with perfluorocarbon liquid and fibrin glue-assisted sutureless scleral fixation. Eye (Lond) 2015; 29:757-63. [PMID: 25853441 DOI: 10.1038/eye.2015.22] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2014] [Accepted: 01/23/2015] [Indexed: 11/08/2022] Open
Abstract
AIM The purpose of this study was to compare the surgical outcomes of intraocular lens (IOL) refixation with intraocular lens exchange using perfluorocarbon liquid (PFCL) and fibrin glue-assisted sutureless scleral fixation surgery in patients with dislocation of the IOL. METHODS Twenty-five eyes of 25 patients who underwent surgery for dislocated IOLs with PFCL and fibrin glue-assisted scleral fixation were studied; 13 eyes experienced IOL refixation (in-the-bag and out-of-the-bag), and 12 eyes experienced IOL exchange. Preoperative and postoperative clinical features from patient charts and 25 eyes with >6 months' follow-up information were reviewed and analyzed. RESULTS At postoperative 6 months, best-corrected visual acuity (BCVA) and spherical equivalent of IOL refixation and exchange were significantly improved (P=0.042, P=0.001), and endothelial cell density was significantly decreased in the two groups with no significant difference between them. Surgically induced astigmatism of IOL refixation improved from 0.90±0.47 to 0.61±0.37 (P=0.012), and IOL exchange improved from 1.17±0.64 to 0.73±0.37 (P=0.037) at postoperative 6 months, with no significant difference between the two groups. Complications occurred in four eyes in the IOL refixation group and in three eyes in the IOL exchange group. CONCLUSION PFCL and fibrin glue-assisted IOL sutureless scleral refixation or exchanged fixation was an effective surgical treatment for IOL dislocation. Also, because postoperative BCVA, surgical outcomes, and complications did not differ significantly between IOL refixation and exchange surgery, if IOL exchange surgery is not indicated, IOL refixation surgical techniques should be considered.
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257
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Joshi M, Walsh MK. Scleral-Fixated Intraocular Lenses: An Update on the Current Surgical Approaches. CURRENT SURGERY REPORTS 2015. [DOI: 10.1007/s40137-015-0087-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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258
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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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259
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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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260
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Implantation of glued intraocular lenses in eyes with microcornea. J Cataract Refract Surg 2015; 41:327-33. [DOI: 10.1016/j.jcrs.2014.05.039] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2013] [Revised: 04/10/2014] [Accepted: 05/05/2014] [Indexed: 11/21/2022]
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261
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Jacob S, Agarwal A, Agarwal A, Narasimhan S. Closed-chamber haptic reexternalization for posteriorly displaced sclerotomy and inadequate haptic tuck in glued posterior chamber intraocular lenses. J Cataract Refract Surg 2015; 41:268-71. [DOI: 10.1016/j.jcrs.2014.12.035] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2014] [Revised: 07/15/2014] [Accepted: 08/01/2014] [Indexed: 12/01/2022]
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262
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Kumar DA, Agarwal A, Agarwal A, Chandrasekar R, Priyanka V. Long-term Assessment of Tilt of Glued Intraocular Lenses. Ophthalmology 2015; 122:48-55. [DOI: 10.1016/j.ophtha.2014.07.032] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2014] [Revised: 07/14/2014] [Accepted: 07/18/2014] [Indexed: 10/24/2022] Open
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Abbey AM, Hussain RM, Shah AR, Faia LJ, Wolfe JD, Williams GA. Sutureless scleral fixation of intraocular lenses: outcomes of two approaches. The 2014 Yasuo Tano Memorial Lecture. Graefes Arch Clin Exp Ophthalmol 2015; 253:1-5. [PMID: 25367831 DOI: 10.1007/s00417-014-2834-9] [Citation(s) in RCA: 74] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2014] [Accepted: 10/08/2014] [Indexed: 11/28/2022] Open
Abstract
PURPOSE We sought to assess the clinical outcomes and complications of two approaches to scleral fixation of intraocular lenses (IOLs): transconjunctival fixation through trocar cannulas and fixation using scleral tunnels created with a microvitreoretinal (MVR) blade. METHODS This retrospective chart review was comprised of 23 eyes that received scleral fixation of a three-piece IOL with concurrent pars plana vitrectomy between June 2012 and June 2014. Scleral fixation was performed either by transconjunctival fixation through trocar cannulas (cannula fixation) or by the creation of scleral tunnels using an MVR blade (tunnel fixation). The preoperative and postoperative corrected distance visual acuities (CDVA), spherical equivalents (SE), and complications were evaluated. RESULTS 15 cannula fixations and 8 tunnel fixations were performed. Mean follow-up was 353 days (Range: 94 - 790 days). Fifteen IOLs were fixated 2 mm posterior to the limbus. Seven IOLs were fixated 1.5 mm posterior to the limbus, and one IOL was fixated 0.75 mm posterior to the limbus. Mean preoperative CDVA was logMAR 1.17 (Snellen 20/297), and mean postoperative CDVA was logMAR 0.37 (Snellen 20/47) (p <0.0001). At last follow-up, none of the IOLs have dislocated or subluxed and there has been no erosion of the subconjunctival haptics. CONCLUSIONS Scleral fixation of IOLs using trocar cannulas or scleral tunnels is an effective surgical option for the treatment of aphakia or IOL dislocation. Both techniques result in significant visual improvement with minimal postoperative complications.
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Affiliation(s)
- Ashkan M Abbey
- Oakland University William Beaumont School of Medicine and Associated Retinal Consultants, 3535 West 13 Mile Road, Suite 344, Royal Oak, Michigan, 48073, USA
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Glued capsular hook: Technique for fibrin glue–assisted sutureless transscleral fixation of the capsular bag in subluxated cataracts and intraocular lenses. J Cataract Refract Surg 2014; 40:1958-65. [DOI: 10.1016/j.jcrs.2014.10.009] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2014] [Revised: 06/03/2014] [Accepted: 06/08/2014] [Indexed: 11/24/2022]
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265
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Modified scleral suture fixation technique for foldable IOL with fenestrations in the proximal part of the haptics. Eur J Ophthalmol 2014; 25:254-7. [PMID: 25449641 DOI: 10.5301/ejo.5000538] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/22/2014] [Indexed: 11/20/2022]
Abstract
PURPOSE To present a modified surgical technique for scleral suture fixation of a new foldable intraocular lens (IOL) design with fenestrations in the proximal part of the haptics. METHODS An experimental model of a double continuous-loop 4-point scleral suture fixation of IOL with fenestrations in the proximal part of the haptics showed that with conventional techniques, the lens is located in a horizontal plane 90° to the expected iris plane. To achieve proper IOL positioning, we modified the technique so as to perform 2 needle passes through the sclera for each haptic in the same meridian, resulting in the external part of the suture being radial to the limbus. The technique was performed in 14 eyes. Mean follow-up time was 9.8 months. RESULTS In all cases, the lens was successfully implanted through clear corneal tunnel incision and the scleral fixation, as mentioned above, was performed with the use of Hoffman scleral pockets. Good centration of the IOLs without signs of tilt was achieved. CONCLUSIONS It is possible to decrease the risk of tilt of the IOL with fenestrations in the proximal part of the haptics by modifying the technique so that the 2 needle passes through the sclera for each haptic are done in the same meridian, resulting in a layout of the external part of the suture being radial to the limbus.
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266
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Clinical outcomes of glued transscleral fixated intraocular lens in functionally one-eyed patients. Eye Contact Lens 2014; 40:e23-8. [PMID: 25390553 DOI: 10.1097/icl.0000000000000039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To analyze the indications, visual outcome, mental status, and quality of life after glued transscleral fixated intraocular lens (IOL) in functionally one-eyed individuals. SETTING Dr Agarwal's Eye Hospital and Eye Research Centre, Chennai, India. DESIGN Prospective observational comparative case series. METHODS Patients with one functioning eye with surgical indications (aphakia, luxated IOL, or dislocated lens) and the fellow eye with no perception of light were included. Indications, uncorrected distant visual acuity (UDVA), corrected distant visual acuity (CDVA), mental status (Amsterdam Preoperative Anxiety and Information Scale) and quality of life (visual function scoring VF-14) were assessed. Outcomes of nonsurgical and surgical management were evaluated and compared. RESULTS Of 22 patients, 10 (45.4%) patients underwent glued IOL (group A) and 12 (54.5%) wore spectacles (group B). There was a strong association between the initial clinical presentation and management (χ, P=0.000). Subluxated cataract and dislocated lens (or IOL) required surgical treatment. Postoperative aphakia with adequate spectacle correction were conservatively treated. There was change (P=0.005) in UDVA and CDVA after glued IOL surgery. There was no loss of CDVA. There was difference between the 2 groups in reading small prints (P=0.021), sporting activities (P=0.000), and night driving (P=0.000). Surgical anxiety was higher in group B (P=0.014). Females were more anxious than the males (P=0.014). There was an association of increasing age and the decision for nonsurgical management (χ, P=0.005). CONCLUSION Glued transscleral fixated IOL can be safely performed in one-eyed patients for specific indications to provide good functional results.
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267
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Gooi P, Teichman JC, Ahmed IIK. Sutureless intrascleral fixation of a custom-tailored iris prosthesis with an intraocular lens. J Cataract Refract Surg 2014; 40:1759-63. [DOI: 10.1016/j.jcrs.2014.09.015] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2014] [Revised: 04/01/2014] [Accepted: 04/07/2014] [Indexed: 11/24/2022]
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268
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McKee Y, Price FW, Feng MT, Price MO. Implementation of the posterior chamber intraocular lens intrascleral haptic fixation technique (glued intraocular lens) in a United States practice: Outcomes and insights. J Cataract Refract Surg 2014; 40:2099-105. [PMID: 25457381 DOI: 10.1016/j.jcrs.2014.04.027] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2014] [Revised: 04/17/2014] [Accepted: 04/20/2014] [Indexed: 11/26/2022]
Abstract
PURPOSE To evaluate intrascleral haptic posterior chamber intraocular lens (PC IOL) fixation (glued IOL). SETTING North American tertiary referral center, private practice. DESIGN Noncomparative interventional case series. METHODS A retrospective review of early cases of the technique performed at the same center evaluated outcomes and complications. Based on early experience, 2 modifications were made to the standard technique. The first was to transition to IOLs with more flexible and resilient haptic materials than poly(methyl methacrylate) or polypropylene. Second, the scleral flap was created with a diamond knife and only 2 edges were lifted, leaving the side adjacent to the tunnel uncut. This allowed reliable creation of a scleral tunnel at equal depth to the flap bed and improved ease of subsequent haptic enclavation; it also strengthened the anterior aspect of the tunnel entrance. RESULTS Fifty PC IOLs were successfully placed with intrascleral haptic fixation by 1 of 3 experienced surgeons to treat a variety of IOL complications or aphakia. Two cases involved the successful placement of iris prostheses. Staged endothelial keratoplasty was performed in 11 cases without complication. No IOL dislocated, decentered, or was unstable. Self-resolving hypotony occurred in 11 eyes (22%). The median visual acuity improved from 20/200 to 20/50. CONCLUSIONS The glued IOL technique reliably provided secure IOL fixation in the absence of capsule support and successfully treated a variety of IOL complications, aphakia, and aniridia. Minor technique modifications minimized some difficulties associated with this surgery.
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Affiliation(s)
- Yuri McKee
- From the Price Vision Group (McKee, F.W. Price, Feng) and the Cornea Research Foundation of America (M.O. Price), Indianapolis, Indiana, USA.
| | - Francis W Price
- From the Price Vision Group (McKee, F.W. Price, Feng) and the Cornea Research Foundation of America (M.O. Price), Indianapolis, Indiana, USA
| | - Matthew T Feng
- From the Price Vision Group (McKee, F.W. Price, Feng) and the Cornea Research Foundation of America (M.O. Price), Indianapolis, Indiana, USA
| | - Marianne O Price
- From the Price Vision Group (McKee, F.W. Price, Feng) and the Cornea Research Foundation of America (M.O. Price), Indianapolis, Indiana, USA
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Totan Y, Karadag R. New approach: removal of silicone oil and trocar assisted sutureless scleral fixated intraocular lens implantation at the same session. Int J Ophthalmol 2014; 7:734-6. [PMID: 25161953 DOI: 10.3980/j.issn.2222-3959.2014.04.28] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2013] [Accepted: 09/26/2013] [Indexed: 11/02/2022] Open
Affiliation(s)
- Yuksel Totan
- Department of Ophthalmology, Fatih University School of Medicine, Emek, Ankara 06500, Turkey
| | - Remzi Karadag
- Department of Ophthalmology, Istanbul Medeniyet University School of Medicine, Istanbul 34730, Turkey
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270
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Akimoto M, Taguchi H, Takahashi T. Using catheter needles to deliver an intraocular lens for intrascleral fixation. J Cataract Refract Surg 2014; 40:179-83. [PMID: 24461497 DOI: 10.1016/j.jcrs.2013.12.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2013] [Revised: 09/20/2013] [Accepted: 10/03/2013] [Indexed: 10/25/2022]
Abstract
UNLABELLED A new method for delivering intraocular lens (IOL) haptics through sclerotomies for intrascleral fixation using catheter needles was evaluated in pig eyes. A bent catheter needle was used to penetrate the surgical corneal wound from the presumed sclerotomy. Extraocularly, the leading haptic of the IOL was fixated between the external tube and the internal needle of the catheter needle. The fixation was strong enough to support the IOL and to extract the leading haptic through the sclerotomy site. The trailing haptic was fixated using another catheter needle extraocularly and was subsequently delivered through another sclerotomy site. Guiding with a needle was the only intraocular manipulation when delivering the trailing haptic and catheter needle through the sclerotomy. This new method is easy and safe and does not require special devices compared with other methods. Clinical evaluation in human eyes should be performed. FINANCIAL DISCLOSURE Dr. Akimoto is a consultant to Kowa Co. Ltd. A patent application on the modified catheter needle is planned. No other author has a financial or proprietary interest in any material or method mentioned.
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Affiliation(s)
- Masayuki Akimoto
- From the Department of Ophthalmology, Osaka Red Cross Hospital, Osaka, Japan.
| | - Hogara Taguchi
- From the Department of Ophthalmology, Osaka Red Cross Hospital, Osaka, Japan
| | - Toshihide Takahashi
- From the Department of Ophthalmology, Osaka Red Cross Hospital, Osaka, Japan
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271
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Reply: To PMID 24509489. Retina 2014; 34:e18-9. [PMID: 25011033 DOI: 10.1097/iae.0000000000000291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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272
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Jacob S, Agarwal A, Kumar DA, Agarwal A, Agarwal A, Satish K. Modified Technique for Combining DMEK With Glued Intrascleral Haptic Fixation of a Posterior Chamber IOL as a Single-Stage Procedure. J Refract Surg 2014; 30:492-6. [DOI: 10.3928/1081597x-20140527-04] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2014] [Accepted: 04/16/2014] [Indexed: 11/20/2022]
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273
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Simplified and safe method of sutureless intrascleral posterior chamber intraocular lens fixation: Y-fixation technique. J Cataract Refract Surg 2014; 40:2-7. [PMID: 24355716 DOI: 10.1016/j.jcrs.2013.11.003] [Citation(s) in RCA: 93] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2013] [Revised: 06/22/2013] [Accepted: 06/26/2013] [Indexed: 11/22/2022]
Abstract
We report a new surgical technique that allows intrascleral fixation of a posterior chamber intraocular lens (IOL) without sutures. The Y-fixation technique does not involve complicated intraocular manipulation and achieves safe sutureless fixation. A Y-shaped incision is made in the sclera and a 24-gauge microvitreoretinal (MVR) knife is used to create the sclerotomy instead of a needle. The Y-shaped incision eliminates the need to raise a large lamellar scleral flap and to use fibrin glue because the haptic can be fixed both inside the tunnel and in the groove, and performing the sclerotomy with the 24-gauge MVR knife simplifies extraction of the haptic and improves wound closure. There is no risk of infection from exposure of the haptic on the sclera and no use of fibrin glue. There was significantly less IOL decentration and tilt than with suture fixation.
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274
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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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275
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Beiko G. May consultation #2. J Cataract Refract Surg 2014; 40:844-5. [PMID: 24767920 DOI: 10.1016/j.jcrs.2014.03.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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276
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Karadag R, Bayramlar H. Re: Yamane et al.: Sutureless 27-gauge needle-guided intrascleral intraocular lens implantation with lamellar scleral dissection (Ophthalmology 2014;121:61-6). Ophthalmology 2014; 121:e42. [PMID: 24780406 DOI: 10.1016/j.ophtha.2014.03.019] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2013] [Accepted: 03/14/2014] [Indexed: 11/15/2022] Open
Affiliation(s)
- Remzi Karadag
- Department of Ophthalmology, Istanbul Medeniyet University, School of Medicine, Istanbul, Turkey
| | - Huseyin Bayramlar
- Department of Ophthalmology, Istanbul Medeniyet University, School of Medicine, Istanbul, Turkey
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278
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279
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Modified method of sutureless intrascleral posterior chamber intraocular lens fixation without capsular support. Eur J Ophthalmol 2014; 24:976. [PMID: 24474380 DOI: 10.5301/ejo.5000430] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/08/2014] [Indexed: 11/20/2022]
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280
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Beiko GHH. February consultation #4. J Cataract Refract Surg 2014; 40:340-1. [PMID: 24461512 DOI: 10.1016/j.jcrs.2013.11.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Jakobsson G, Zetterberg M, Sundelin K, Stenevi U. Surgical repositioning of intraocular lenses after late dislocation: Complications, effect on intraocular pressure, and visual outcomes. J Cataract Refract Surg 2013; 39:1879-85. [DOI: 10.1016/j.jcrs.2013.06.023] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2013] [Revised: 05/30/2013] [Accepted: 06/02/2013] [Indexed: 11/25/2022]
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Kumar DA, Agarwal A, Jacob S, Agarwal A. Glued trans-scleral intraocular lens exchange for anterior chamber lenses in complicated eyes: analysis of indications and results. Am J Ophthalmol 2013; 156:1125-1133.e2. [PMID: 24011519 DOI: 10.1016/j.ajo.2013.07.013] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2013] [Revised: 07/12/2013] [Accepted: 07/16/2013] [Indexed: 10/26/2022]
Abstract
PURPOSE To determine the clinical outcomes after glued trans-scleral posterior chamber intraocular lens (IOL) exchange for anterior chamber (AC) IOL. DESIGN Retrospective case series. METHODS Eyes with AC IOL explantation with glued IOL implantation in a single setting at the Dr Agarwal Eye Hospital and Eye Research Centre, Chennai, India, from 2008 through 2012 were included. Data were collected from the patient records. MAIN OUTCOME MEASURES Corrected distance visual acuity (CDVA) in logarithm of the minimal angle of resolution units, intraocular pressure, AC reaction, AC depth, central corneal thickness, central macular thickness, endothelial cell density, and endothelial cell loss (percentage) were determined before and after IOL exchange. RESULTS Thirty-eight eyes with mean follow-up of 24.1 ± 15.4 months (range, 8 to 60 months) were analyzed. The indications were corneal decompensation (39.4%), malpositioned AC IOL (28.9%), uveitis (15.7%), glaucoma (13.1%), and broken haptic (2.6%). There was significant improvement in the postoperative CDVA (P = .000) and central corneal thickness (P = .000) after AC IOL removal. CDVA better than 20/60 was obtained in 65.7% eyes. Thirty-four (86.8%) eyes showed an increase in the CDVA after IOL exchange. The mean endothelial cell loss was 3.4 ± 2.4% (range, 0.13% to 10.5%). There was significant correlation between the CDVA and the central corneal thickness (P = .000). There was significant change in the AC depth (P = .000), the intraocular pressure (P = .005), and the AC inflammation (P = .000) after IOL exchange. The preoperative macular edema in 3 eyes resolved after surgery (mean central macular thickness, 205.6 ± 7.2 μm). CONCLUSIONS Glued trans-scleral fixated posterior chamber IOL exchange for AC IOL can be an excellent alternative in eyes with ocular complications related to AC IOL.
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284
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Hoffman RS, Snyder ME, Devgan U, Allen QB, Yeoh R, Braga-Mele R. Management of the subluxated crystalline lens. J Cataract Refract Surg 2013; 39:1904-15. [DOI: 10.1016/j.jcrs.2013.09.005] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2013] [Revised: 07/14/2013] [Accepted: 07/18/2013] [Indexed: 10/26/2022]
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285
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Sutureless 27-gauge needle-guided intrascleral intraocular lens implantation with lamellar scleral dissection. Ophthalmology 2013; 121:61-66. [PMID: 24148655 DOI: 10.1016/j.ophtha.2013.08.043] [Citation(s) in RCA: 191] [Impact Index Per Article: 17.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2013] [Revised: 08/14/2013] [Accepted: 08/29/2013] [Indexed: 11/20/2022] Open
Abstract
PURPOSE To report a new technique for performing sutureless intrascleral fixation of a posterior chamber intraocular lens (IOL). DESIGN Prospective, noncomparative, interventional case series on the results of sutureless intrascleral fixation of a posterior chamber IOL. PARTICIPANTS Thirty-five eyes of 34 consecutive patients with aphakia, dislocated IOL, or subluxated crystalline lens who underwent posterior chamber sutureless implantation of an IOL were studied. METHODS The haptics of the IOL were externalized with a 27-gauge needle passed through the ciliary sulcus using the double needle technique. The haptics were fixed in a scleral tunnel made by lamellar scleral dissection. The postoperative tilt of the IOL was measured by swept source optical coherence tomography. MAIN OUTCOME MEASURES The best-corrected visual acuity (BCVA), corneal endothelial cell density, IOL tilt, and complications were determined. RESULTS The IOLs were fixed with exact centration and axial stability. No wound leakage was seen even without any sutures. The mean BCVA was 0.48 logarithm of the minimum angle of resolution (logMAR) units preoperatively and 0.17 logMAR units at 3 months postoperatively (P = 0.003). The mean corneal endothelial cell loss was 6.0±7.3% (P = 0.63) at 3 months. The mean IOL tilt was 2.3±1.9°. The postoperative complications included iris capture by the IOL in 3 eyes (8.6%), ocular hypertension in 2 (5.7%), and cystoid macular edema in 1 (2.9%). There was no postoperative retinal detachment, endophthalmitis, IOL dislocation, or vitreous hemorrhage. CONCLUSIONS The 27-gauge needle-guided intrascleral posterior chamber IOL implantation technique provides good IOL fixation with reliable wound closure without the use of any sutures. We recommend this technique for secondary IOL implantation.
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Benayoun Y, Petitpas S, Turki K, Adenis JP, Robert PY. Implants à fixation sclérale sans suture : série de neuf cas et revue de la littérature. J Fr Ophtalmol 2013; 36:658-68. [DOI: 10.1016/j.jfo.2012.09.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2012] [Revised: 09/14/2012] [Accepted: 09/24/2012] [Indexed: 11/29/2022]
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Seki M, Yamamoto S, Abe H, Fukuchi T. Modified ab externo method for introducing 2 polypropylene loops for scleral suture fixation of intraocular lenses. J Cataract Refract Surg 2013; 39:1291-6. [PMID: 23988241 DOI: 10.1016/j.jcrs.2013.07.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2013] [Revised: 05/07/2013] [Accepted: 05/23/2013] [Indexed: 11/16/2022]
Abstract
We describe a method that enables the introduction of 2 suture loops for scleral fixation of an intraocular lens (IOL) by a single ab externo procedure. A long needle carrying a polypropylene suture loop is inserted through the scleral fixation site and docked with a hollow needle inserted through the opposite fixation site. The hollow needle pulls the suture needle out, but the suture loop end is left external. Another polypropylene suture loop is placed through the first loop. As the first (leading) suture is pulled, the second (trailing) suture is drawn into the eye. The suture loops are retrieved through the main incision. The IOL haptics are secured with a polypropylene loop by cow hitches. After the IOL is placed in the eye, the sutures are fixated to the sclera. This technique enhances efficiency and control during the introduction of suture loops for scleral fixation of IOLs.
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Affiliation(s)
- Masaaki Seki
- Seki Eye Clinic, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan.
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288
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Modification of externalized haptic support of glued intraocular lens technique. J Cataract Refract Surg 2013; 39:323-5. [PMID: 23506915 DOI: 10.1016/j.jcrs.2013.01.017] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2012] [Revised: 10/22/2012] [Accepted: 10/29/2012] [Indexed: 11/21/2022]
Abstract
The original technique for scleral fixation of an intraocular lens using fibrin glue requires an assistant to grasp and hold an externalized haptic with forceps. We present a modification of the technique in which the externalized haptic is maintained by a silicone "tire" without the aid of an assistant.
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289
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Management of posteriorly dislocated crystalline lens with perfluorocarbon liquid and fibrin glue-assisted scleral-fixated intraocular lens implantation. J Cataract Refract Surg 2013; 39:334-8. [PMID: 23506917 DOI: 10.1016/j.jcrs.2013.01.022] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2012] [Revised: 10/28/2012] [Accepted: 10/28/2012] [Indexed: 11/24/2022]
Abstract
We describe a technique that uses a 23-gauge transconjunctival sutureless vitrectomy with perfluorocarbon liquid (PFCL) and phacoemulsification to manage a dropped nucleus. The PFCL is injected into the vitreous space until the dislocated lens reaches the iris plane and is then removed using phacoemulsification in the anterior chamber. After intraocular lens (IOL) implantation, a 23-gauge forceps is passed through the sclerotomy to grasp the IOL haptic, which is pulled onto the ocular surface. Tunnels are made at the edge of the flap with a 26-gauge needle into which the 2 haptics are tucked for additional stability. The scleral flaps and conjunctiva are then glued using biological glue. Perfluorocarbon liquid reduces lens repulsion and blocks the transmission of the ultrasound stream to the retina. The fibrin glue-assisted sutureless IOL implantation technique could reduce complications and suture-related problems.
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290
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Shingleton BJ, Yang Y, O’Donoghue MW. Management and outcomes of intraocular lens dislocation in patients with pseudoexfoliation. J Cataract Refract Surg 2013; 39:984-93. [DOI: 10.1016/j.jcrs.2013.01.044] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2012] [Revised: 01/26/2013] [Accepted: 01/28/2013] [Indexed: 12/01/2022]
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Narang P, Agarwal A, Kumar DA, Jacob S, Agarwal A, Agarwal A. Clinical outcomes of intraocular lens scaffold surgery: a one-year study. Ophthalmology 2013; 120:2442-2448. [PMID: 23810446 DOI: 10.1016/j.ophtha.2013.05.011] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2013] [Revised: 05/04/2013] [Accepted: 05/07/2013] [Indexed: 10/26/2022] Open
Abstract
PURPOSE To evaluate the safety and 1-year outcome of the intraocular lens (IOL) scaffold technique in eyes with soft to moderate nuclear remnants after intraoperative posterior capsule rupture (PCR). DESIGN Single-center, retrospective, interventional, noncomparative, consecutive case series. PARTICIPANTS A total of 20 eyes of 20 patients who had intraoperative PCR underwent IOL scaffold surgery in a tertiary clinic. METHODS A retrospective analysis of medical records of a consecutive series of patients who underwent IOL scaffold surgery from August 2011 to February 2013 was reviewed. All surgeries were performed by a single surgeon, and a 3-piece, 6.0-mm optic, acrylic, foldable IOL with a modified C-loop haptic configuration was implanted in all eyes. MAIN OUTCOME MEASURES The preoperative and postoperative parameters evaluated were uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), specular microscopy, gonioscopy, ultrasound biomicroscopy, central macular thickness, intraocular pressure (IOP), and anterior and posterior segment inflammation. The final visual outcome at 1 year was evaluated. RESULTS At 1-year follow-up, the mean postoperative UDVA and CDVA in Snellen's decimal equivalent was 0.58 ± 0.15 and 0.90 ± 0.17, respectively. The IOL was placed in the sulcus for 14 eyes and in the capsular bag for 3 eyes, and glued intrascleral fixation of IOL was performed in 3 eyes. The mean postoperative refractive error at the final examination was -0.4 ± 0.05 diopter (standard error of mean). Postoperative CDVA of 20/20 and 20/30 was achieved in 75% (15 eyes) and 25% (5 eyes), respectively. There was no correlation between preoperative specular count and percentage loss of cells (P = 0.602; r(2)=0.015). The mean central macular thickness at 1 year was 182.5 ± 11.79 μm. Clinical macular edema was observed in 1 of 20 eyes (5%). CONCLUSIONS The IOL scaffold provided an effective, relatively noninvasive means of emulsifying moderate to soft nuclear remnants in eyes with intraoperative PCR, with a good visual outcome and a favorable complication rate.
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Affiliation(s)
- Priya Narang
- Narang Eye Care and Laser Centre, Ahmedabad, India
| | - Amar Agarwal
- Dr. Agarwal's Eye Hospital and Eye Research Centre, Chennai, India.
| | - Dhivya A Kumar
- Dr. Agarwal's Eye Hospital and Eye Research Centre, Chennai, India
| | - Soosan Jacob
- Dr. Agarwal's Eye Hospital and Eye Research Centre, Chennai, India
| | - Ashvin Agarwal
- Dr. Agarwal's Eye Hospital and Eye Research Centre, Chennai, India
| | - Athiya Agarwal
- Dr. Agarwal's Eye Hospital and Eye Research Centre, Chennai, India
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Kumar DA, Agarwal A, Packiyalakshmi S, Jacob S, Agarwal A. Complications and visual outcomes after glued foldable intraocular lens implantation in eyes with inadequate capsules. J Cataract Refract Surg 2013; 39:1211-8. [PMID: 23726133 DOI: 10.1016/j.jcrs.2013.03.004] [Citation(s) in RCA: 74] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2013] [Revised: 02/28/2013] [Accepted: 03/06/2013] [Indexed: 11/30/2022]
Abstract
PURPOSE To evaluate the complications and visual outcomes of glued intrascleral-fixated foldable intraocular lens (IOL) in eyes with deficient capsules. SETTING Dr Agarwal's Eye Hospital and Eye Research Centre, Chennai, India. DESIGN Case series. METHODS Data were evaluated from the records of patients with a primary glued foldable IOL for intraoperative capsular loss or subluxated lens or secondary glued foldable IOL for aphakia. Exclusion criteria included preoperative glaucoma, aniridia, macular scar, traumatic subluxation, combined surgeries, incomplete operative medical records, and postoperative follow-up less than 6 months. The intraoperative and postoperative complication rates, reoperation rate, and visual outcomes were analyzed. RESULTS The study comprised 208 eyes (185 patients). The mean follow-up was 16.7 months ± 10.2 (SD). The intraoperative complications were hyphema (0.4%), haptic breakage (0.4%), and deformed haptics (0.9%). Early complications occurred in 29 eyes (13.9%) and included corneal edema (5.7%), epithelial defect (1.9%), and grade 2 anterior chamber reaction (2.4%). Late complications occurred in 39 eyes (18.7%) and included optic capture (4.3%), IOL decentration (3.3%), haptic extrusion (1.9%), subconjunctival haptic (1.4%), macular edema (1.9%), and pigment dispersion (1.9%). Reoperation was required in 16 eyes (7.7%). Haptic position was altered in eyes with IOL decentration. Corrected distance visual acuity (CDVA) improved or remained unchanged in 84.6% of eyes. The postoperative CDVA was 20/40 or better and 20/60 or better in 38.9% and 48.5% of eyes, respectively. CONCLUSIONS The foldable glued-IOL procedure showed satisfactory visual outcomes without serious complications. Intraocular lens decentration was due to haptic-related problems.
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In vivo analysis of glued intraocular lens position with ultrasound biomicroscopy. J Cataract Refract Surg 2013; 39:1017-22. [PMID: 23664356 DOI: 10.1016/j.jcrs.2013.01.039] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2012] [Revised: 01/24/2013] [Accepted: 01/24/2013] [Indexed: 11/23/2022]
Abstract
PURPOSE To report ultrasound biomicroscopic (UBM) findings of glued transscleral-fixated posterior chamber intraocular lenses (IOLs) in eyes with inadequate capsules. SETTING Dr. Agarwal's Eye Hospital and Eye Research Centre, Chennai, India. DESIGN Case series. METHODS Eyes with glued IOLs for inadequate capsule support were examined with UBM. Optic tilt was measured in relation to the iris plane. Haptic location, iris-IOL contact, vitreous incarceration, and central anterior chamber depth (ACD) were measured and correlated clinically with vision and refractive error. RESULTS The mean follow-up was 24.6 months ± 14.3 (SD). Of the 46 eyes, 8 (17.4%) showed optic tilt and 38 (82.6%) showed no optic tilt. Of 92 haptics examined, 85 (92.4%) were in the ciliary sulcus and 7 (7.6%) in the pars plicata. There was no significant association between the presence of optic tilt and haptic location (P=.585, chi-square test). The mean ocular residual astigmatism (ORA) was 0.5 ± 0.2 diopter (D). There was no significant difference in ORA between eyes with tilt and eyes without tilt (P=.079). There was no significant correlation between ORA and IOL position. There was no correlation of optic tilt and postoperative vision or cylinder. Other features included iris-IOL contact (6.5%), vitreous incarceration (5.4%), and ACD difference (P=.002). CONCLUSIONS No significant IOL optic tilt affecting the postoperative vision was detected with glued transscleral-fixated IOLs. The technique reliability was good, with the haptics located in the intended position in more than 90% of eyes. FINANCIAL DISCLOSURE Dr. Amar Agarwal is a paid consultant to Staar Surgical Co. No other author has a financial or proprietary interest in any material or method mentioned.
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294
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Kumar DA, Agarwal A, Jacob S, Lamba M, Packialakshmi S, Meduri A. Combined Surgical Management of Capsular and Iris Deficiency With Glued Intraocular Lens Technique. J Refract Surg 2013; 29:342-7. [DOI: 10.3928/1081597x-20130415-05] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2012] [Accepted: 02/26/2013] [Indexed: 11/20/2022]
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295
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Saleh M, Heitz A, Bourcier T, Speeg C, Delbosc B, Montard M, Gaucher D. Sutureless intrascleral intraocular lens implantation after ocular trauma. J Cataract Refract Surg 2013; 39:81-86. [PMID: 23245361 DOI: 10.1016/j.jcrs.2012.08.063] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2012] [Revised: 07/25/2012] [Accepted: 08/13/2012] [Indexed: 11/24/2022]
Abstract
PURPOSE To report the results and safety of sutureless intrascleral haptic fixation in traumatized eyes and to compare this procedure with retropupillary iris-claw intraocular lens (IOL) fixation. SETTING University Hospital of Strasbourg, Strasbourg, France. DESIGN Interventional case series. METHODS Patients with traumatic cataract and severely damaged capsular bags were divided into 2 groups (Group 1: intrascleral IOLs [Acrysof MN60 AC]; Group 2: retropupillary iris-claw IOLs [Verisyse]). The main outcome was the final visual acuity. The surgically induced astigmatism (SIA) was calculated by the vectorial method. RESULTS Twenty-six eyes of 23 patients were studied, 8 eyes in Group 1 and 18 eyes in Group 2. The mean follow-up was 14 months. There was no difference in corrected distance visual acuity (CDVA) at the time of the surgery (P>.05). The mean CDVA (logMAR) was 1.68 ± 1.15 (SD) preoperatively and 0.55 ± 0.9 postoperatively in Group 1 (P = .03) and 1.11 ± 1.13 and 0.32 ± 0.47, respectively, in Group 2 (P = .003). The final CDVA was not different between groups (P>.05). The mean SIA was 1.91 ± 1.66 diopters (D) in Group 1 and 2.74 ± 1.92 D in Group 2 (P>.05). No intraoperative complications occurred in Group 2; a haptic broke in Group 1. Macular edema occurred in both groups. CONCLUSIONS Sutureless intrascleral IOLs corrected posttraumatic aphakia. The SIA was comparable between groups. This procedure should be considered after trauma when other implantation techniques are not possible.
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Affiliation(s)
- Maher Saleh
- From the Department of Ophthalmology (Saleh, Heitz, Bourcier, Speeg, Gaucher), Nouvel Hopital Civil, University Hospital of Strasbourg, Strasbourg, and the University Hospital of Besançon (Saleh, Delbosc, Montard), University of Franche-Comté, Besancon, France.
| | - Antoine Heitz
- From the Department of Ophthalmology (Saleh, Heitz, Bourcier, Speeg, Gaucher), Nouvel Hopital Civil, University Hospital of Strasbourg, Strasbourg, and the University Hospital of Besançon (Saleh, Delbosc, Montard), University of Franche-Comté, Besancon, France
| | - Tristan Bourcier
- From the Department of Ophthalmology (Saleh, Heitz, Bourcier, Speeg, Gaucher), Nouvel Hopital Civil, University Hospital of Strasbourg, Strasbourg, and the University Hospital of Besançon (Saleh, Delbosc, Montard), University of Franche-Comté, Besancon, France
| | - Claude Speeg
- From the Department of Ophthalmology (Saleh, Heitz, Bourcier, Speeg, Gaucher), Nouvel Hopital Civil, University Hospital of Strasbourg, Strasbourg, and the University Hospital of Besançon (Saleh, Delbosc, Montard), University of Franche-Comté, Besancon, France
| | - Bernard Delbosc
- From the Department of Ophthalmology (Saleh, Heitz, Bourcier, Speeg, Gaucher), Nouvel Hopital Civil, University Hospital of Strasbourg, Strasbourg, and the University Hospital of Besançon (Saleh, Delbosc, Montard), University of Franche-Comté, Besancon, France
| | - Michel Montard
- From the Department of Ophthalmology (Saleh, Heitz, Bourcier, Speeg, Gaucher), Nouvel Hopital Civil, University Hospital of Strasbourg, Strasbourg, and the University Hospital of Besançon (Saleh, Delbosc, Montard), University of Franche-Comté, Besancon, France
| | - David Gaucher
- From the Department of Ophthalmology (Saleh, Heitz, Bourcier, Speeg, Gaucher), Nouvel Hopital Civil, University Hospital of Strasbourg, Strasbourg, and the University Hospital of Besançon (Saleh, Delbosc, Montard), University of Franche-Comté, Besancon, France
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Agarwal A, Jacob S, Agarwal A, Narasimhan S, Kumar DA, Agarwal A. Glued intraocular lens scaffolding to create an artificial posterior capsule for nucleus removal in eyes with posterior capsule tear and insufficient iris and sulcus support. J Cataract Refract Surg 2013; 39:326-33. [DOI: 10.1016/j.jcrs.2013.01.018] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2012] [Revised: 10/03/2012] [Accepted: 10/04/2012] [Indexed: 10/27/2022]
Affiliation(s)
- Amar Agarwal
- Dr. Agarwal's Eye Hospital and Eye Research Centre, Chennai, India.
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Agarwal A, Jacob S, Kumar DA, Agarwal A, Narasimhan S, Agarwal A. Handshake technique for glued intrascleral haptic fixation of a posterior chamber intraocular lens. J Cataract Refract Surg 2013; 39:317-22. [DOI: 10.1016/j.jcrs.2013.01.019] [Citation(s) in RCA: 83] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2012] [Revised: 11/15/2012] [Accepted: 11/19/2012] [Indexed: 11/27/2022]
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300
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Totan Y, Karadag R. Two Techniques for Sutureless Intrascleral Posterior Chamber IOL Fixation. J Refract Surg 2013; 29:90-4. [DOI: 10.3928/1081597x-20130117-02] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2012] [Accepted: 11/27/2012] [Indexed: 11/20/2022]
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