1
|
Cameron NW, Karadaghy A, Mitchell MK, Ajlan RS. Optic inversion of scleral-fixated intraocular lens after vitrectomy with fluid-air exchange: case series and review of the literature. J Surg Case Rep 2023; 2023:rjad600. [PMID: 38026751 PMCID: PMC10640673 DOI: 10.1093/jscr/rjad600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 10/10/2023] [Indexed: 12/01/2023] Open
Abstract
Lens dislocation is a significant complication after cataract surgery. Scleral fixation of 3-piece intraocular lens provides favorable visual outcome and can spare patients the need for lens exchange. Two patients presented with dislocated 3-piece lenses implanted over 10 years earlier. Both patients underwent pars plana vitrectomy and dropped lens rescue with scleral fixation. Postoperatively, the lens optic was found flipped nearly 90° at the optic-haptic junctions secondary to fluid-air exchange performed during vitrectomy. Both patients underwent intraocular lens exchange with a four point sclera fixated lens. Our study found that air tamponade is better avoided during rescue of old dislocated 3-piece lens implants. Intraocular lens exchange is preferred, when possible, to avoid complications associated with old dislocated lenses. Larger studies are needed to determine the effect of time on dislocated lens implants materials.
Collapse
Affiliation(s)
- Nathaniel W Cameron
- Department of Ophthalmology, University of Kansas Medical Center, Kansas City, KS, United States
| | - Amin Karadaghy
- Department of Ophthalmology, University of Kansas Medical Center, Kansas City, KS, United States
| | - Mary K Mitchell
- Department of Ophthalmology, University of Kansas Medical Center, Kansas City, KS, United States
| | - Radwan S Ajlan
- Department of Ophthalmology, University of Kansas Medical Center, Kansas City, KS, United States
| |
Collapse
|
2
|
Zhang J, Han X, Zhang M, Liu Z, Chen X, Qiu X, Lin H, Li J, Liu B, Zhang C, Wei Y, Jin G, Tan X, Luo L. Predicting the risk of clinically significant intraocular lens tilt and decentration in vitrectomized eyes. J Cataract Refract Surg 2022; 48:1318-1324. [PMID: 35786811 PMCID: PMC9622369 DOI: 10.1097/j.jcrs.0000000000000997] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2022] [Accepted: 06/21/2022] [Indexed: 02/04/2023]
Abstract
PURPOSE To identify predictors and develop a prognostic nomogram for clinically significant intraocular lens (IOL) tilt and decentration in vitrectomized eyes. SETTING Zhongshan ophthalmic center, Guangzhou, China. DESIGN Prospective observational study. METHODS Patients with previous pars plana vitrectomy who underwent phacoemulsification with IOL implantation were enrolled in this study. The tilt and decentration of the lens and IOL were assessed by a swept-source anterior segment optical coherence tomography (CASIA2). Multiple logistic regression analysis and prognostic nomogram models were used to explore factors associated with clinically significant IOL tilt and decentration (defined as tilt ≥7 degrees and decentration ≥0.4 mm). RESULTS 375 patients (375 eyes) with a mean age of 56.1 ± 9.81 years were included. Lens tilt (odds ratio [OR] = 1.44), lens decentration (OR = 1.74), lens diameter (OR = 0.49), and hydrophilic IOL (OR = 2.36) were associated with IOL tilt over 7 degrees (all P < .05). Lens tilt (OR = 1.24), lens decentration (OR = 2.30), and incomplete capsulorhexis-IOL overlap (OR = 2.44) increased the risk of IOL decentration over 0.4 mm (all P < .05). Preoperative lens tilt together with lens decentration was identified as the strongest predictor of incident clinically significant IOL tilt (area under the curve [AUC] = 0.82, 95% CI, 0.76-0.88) and decentration (AUC: 0.84, 95% CI, 0.78-0.89), and the nomogram was constructed accordingly. CONCLUSIONS The tilt and decentration of the crystalline lens, hydrophilic IOL, and incomplete capsulorhexis-IOL overlap were risk factors for clinically significant IOL misalignment. Clinicians could use a prognostic nomogram model based on the preoperative lens position to make a strategy for higher-risk patients.
Collapse
|
3
|
Chen Y, Meng J, Cheng K, Lu Q, Wei L, Lu Y, Zhu X. Influence of IOL Weight on Long-Term IOL Stability in Highly Myopic Eyes. Front Med (Lausanne) 2022; 9:835475. [PMID: 35479960 PMCID: PMC9035698 DOI: 10.3389/fmed.2022.835475] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 03/07/2022] [Indexed: 01/17/2023] Open
Abstract
Purpose This study aimed to investigate the influence of intraocular lens (IOL) weight on long-term IOL stability in highly myopic eyes. Materials and Methods A total of 205 highly myopic cataract eyes of 205 patients implanted with the MC X11 ASP (Group A, 86 eyes) or 920H IOL (Group B, 119 eyes) were included in this retrospective study. Eyes were divided into 3 subgroups according to the IOL power: low (≥-5 to <5 D), medium (≥5 to <14 D), and high (≥14 D) IOL power. At 3 years after surgery, IOL decentration and tilt, high-order aberrations, and anterior capsular opening (ACO) area were measured. The influence of IOL weight on long-term IOL stability was evaluated. Results Group B had a significantly greater IOL weight than Group A (Group B vs. Group A: 28.31 ± 2.01 mg vs. 25.71 ± 4.62 mg, P < 0.001). Correspondingly, Group B presented significantly greater overall and inferior decentration than Group A, especially for low and medium IOL power (all P < 0.05). In both groups, overall and vertical decentration was significantly correlated with IOL weight (all P < 0.05). Group B showed a significantly greater ACO area than Group A (P < 0.05). Multivariate analysis showed that decentration in Group A was affected by IOL weight, while decentration in Group B was affected by IOL weight and AL. Conclusions Higher IOL weight may lead to greater long-term IOL decentration in highly myopic eyes, while the haptic design may play a role in anterior capsular contraction.
Collapse
Affiliation(s)
- Yuxi Chen
- Department of Ophthalmology and Eye Institute, Eye and Ear, Nose, and Throat Hospital of Fudan University, Shanghai, China
- Key Laboratory of Myopia (Fudan University), National Health Commission, Shanghai, China
- Key Laboratory of Myopia, Chinese Academy of Medical Science, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
- State Key Laboratory of Medical Neurobiology, Fudan University, Shanghai, China
| | - Jiaqi Meng
- Department of Ophthalmology and Eye Institute, Eye and Ear, Nose, and Throat Hospital of Fudan University, Shanghai, China
- Key Laboratory of Myopia (Fudan University), National Health Commission, Shanghai, China
- Key Laboratory of Myopia, Chinese Academy of Medical Science, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
- State Key Laboratory of Medical Neurobiology, Fudan University, Shanghai, China
| | - Kaiwen Cheng
- Department of Ophthalmology and Eye Institute, Eye and Ear, Nose, and Throat Hospital of Fudan University, Shanghai, China
- Key Laboratory of Myopia (Fudan University), National Health Commission, Shanghai, China
- Key Laboratory of Myopia, Chinese Academy of Medical Science, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
- State Key Laboratory of Medical Neurobiology, Fudan University, Shanghai, China
| | - Qiang Lu
- Department of Ophthalmology and Eye Institute, Eye and Ear, Nose, and Throat Hospital of Fudan University, Shanghai, China
- Key Laboratory of Myopia (Fudan University), National Health Commission, Shanghai, China
- Key Laboratory of Myopia, Chinese Academy of Medical Science, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
- State Key Laboratory of Medical Neurobiology, Fudan University, Shanghai, China
| | - Ling Wei
- Department of Ophthalmology and Eye Institute, Eye and Ear, Nose, and Throat Hospital of Fudan University, Shanghai, China
- Key Laboratory of Myopia (Fudan University), National Health Commission, Shanghai, China
- Key Laboratory of Myopia, Chinese Academy of Medical Science, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
- State Key Laboratory of Medical Neurobiology, Fudan University, Shanghai, China
| | - Yi Lu
- Department of Ophthalmology and Eye Institute, Eye and Ear, Nose, and Throat Hospital of Fudan University, Shanghai, China
- Key Laboratory of Myopia (Fudan University), National Health Commission, Shanghai, China
- Key Laboratory of Myopia, Chinese Academy of Medical Science, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
- State Key Laboratory of Medical Neurobiology, Fudan University, Shanghai, China
- Yi Lu
| | - Xiangjia Zhu
- Department of Ophthalmology and Eye Institute, Eye and Ear, Nose, and Throat Hospital of Fudan University, Shanghai, China
- Key Laboratory of Myopia (Fudan University), National Health Commission, Shanghai, China
- Key Laboratory of Myopia, Chinese Academy of Medical Science, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
- State Key Laboratory of Medical Neurobiology, Fudan University, Shanghai, China
- *Correspondence: Xiangjia Zhu
| |
Collapse
|
4
|
Yuan B, Li J, Song H. Effect of misalignment at different orientations associated with angle κ on optical performance of aspheric intraocular lenses with different surface designs. APPLIED OPTICS 2021; 60:5917-5924. [PMID: 34263818 DOI: 10.1364/ao.423000] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Accepted: 06/22/2021] [Indexed: 06/13/2023]
Abstract
Intraocular lens (IOL) misalignment and angle κ have had significant negative impact on post-operative quality of vision. ZEMAX software has been used to imitate the optical performance of pseudophakic eyes with different IOL surface designs at different orientations of IOL misalignment (decentration of 0.4 mm and tilt of 7°, and with the existence of 0.5 mm angle κ). We found that an aspheric balanced curve optic surface maintained better optical performance via inducing less coma aberration. Coma aberration played an unexpectedly important role in the optical performance. With angle κ, the impact of IOL misalignment on visual quality was associated with the orientation of decentration and tilt, indicating that the coma compensation also took effect in pseudophakic eyes. Due to the high incidence of post-operative IOL misalignment, our results provide evidence of the importance of considering personalized angle κ before cataract surgery for patients.
Collapse
|
5
|
Tan X, Liu Z, Chen X, Zhu Y, Xu J, Qiu X, Yang G, Peng L, Gu X, Zhang J, Luo L, Liu Y. Characteristics and Risk Factors of Intraocular Lens Tilt and Decentration of Phacoemulsification After Pars Plana Vitrectomy. Transl Vis Sci Technol 2021; 10:26. [PMID: 34003961 PMCID: PMC7995916 DOI: 10.1167/tvst.10.3.26] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Purpose The purpose of this study was to investigate the characteristics and risk factors of intraocular lens (IOL) tilt and decentration of phacoemulsification after pars plana vitrectomy (PPV) using swept-source optical coherence tomography (SS-OCT). Methods One hundred four eyes with prior PPV and 104 eyes without PPV undergoing uneventful cataract surgery were enrolled in this study. IOL tilt and decentration were measured by SS-OCT (CASIA2) 3 months postoperatively. Results The mean IOL tilt and decentration were greater in the PPV group (5.36 ± 2.50 degrees and 0.27 ± 0.17 mm, respectively) than in the non-PPV group (4.54 ± 1.46 degrees, P = 0.005; 0.19 ± 0.12 mm, P < 0.001, respectively). Multiple logistic regression showed that silicone oil (SO) tamponade (odds ratio [OR] = 5.659, P = 0.021) and hydrophilic IOL (OR = 5.309, P = 0.022) were associated with IOL tilt over 7 degrees, and diabetes mellitus (DM; OR = 5.544, P = 0.033) was associated with IOL decentration over 0.4 mm. Duration of SO tamponade was positively correlated with IOL tilt (P = 0.014) and decentration (P < 0.001). The internal total higher-order aberration, coma, trefoil, and secondary astigmatism in the PPV group were higher than in the non-PPV group, and positively correlated with IOL tilt (P < 0.05). Conclusions Patients with prior vitrectomy had greater IOL tilt and decentration than the non-PPV group. Longer duration of SO tamponade, hydrophilic IOL, as well as DM were the risk factors of greater IOL tilt and decentration in patients with prior PPV. Translational Relevance Optically sophisticated designed IOLs should be used cautiously in vitrectomized eyes.
Collapse
Affiliation(s)
- Xuhua Tan
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Zhenzhen Liu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Xiaoyun Chen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Yi Zhu
- Department of Molecular and Cellular Pharmacology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Jingmin Xu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Xiaozhang Qiu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Guangyao Yang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Lulu Peng
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Xiaoxun Gu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Jiaqing Zhang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Lixia Luo
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Yizhi Liu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, China
| |
Collapse
|
6
|
Ning Y, Shao Y, Zhao J, Zhang J, Wang M, Qin Y. Stability of Various Types of Aspheric Intraocular Lenses After Implantation: A One-Year Retrospective Study. Int J Gen Med 2021; 14:2183-2190. [PMID: 34103973 PMCID: PMC8179812 DOI: 10.2147/ijgm.s301887] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 04/28/2021] [Indexed: 11/23/2022] Open
Abstract
Objective The aim of the present study was to evaluate the stability of four different types of aspheric intraocular lenses (IOLs) after implantation. Methods This retrospective study included 124 eyes implanted with four different types of aspheric IOLs including a one-piece four-loop fixed hydrophilic acrylic IOL, a one-piece flat fixed acrylic IOL, a one-piece two-loop fixed acrylic IOL, and a three-piece two-loop fixed silicone IOL. IOL decentration, tilt, and ocular coma-like aberration (coma) at one-week, one-month, three-month, and one-year time points were evaluated postoperatively. Results IOL decentration, tilt, and coma in the AO, 36A, IQ, and KS-AiN implantation groups were statistically significantly different one week and one year postoperatively (p < 0.01). There were significant differences between each of the pairs of groups (p < 0.01), except for coma between the AO and 36A implantation groups one week postoperatively (p > 0.05). When comparing the different time points (ie, one week, one month, three months, and one year postoperatively), IOL decentration, tilt, and coma were significantly different in each group (p < 0.05). IOL decentration, tilt, and coma in each group increased over the period from one week to one year postoperatively. A positive linear correlation was observed between IOL decentration or tilt and coma one year postoperatively (p < 0.01). Conclusion One-piece multi-point fixed acrylic IOLs demonstrate better stability when compared with three-piece two-point fixed silicone IOLs. IOL decentration, tilt, and coma increase gradually over time. Ocular coma-like aberrations are influenced by the stability of IOLs.
Collapse
Affiliation(s)
- Yuan Ning
- Department of Ophthalmology, The Fourth Affiliated Hospital of China Medical University, Eye Hospital of China Medical University, Key Lens Research Laboratory of Liaoning Province, Shenyang, 110005, People's Republic of China
| | - Yushuang Shao
- Department of Ophthalmology, The Fourth Affiliated Hospital of China Medical University, Eye Hospital of China Medical University, Key Lens Research Laboratory of Liaoning Province, Shenyang, 110005, People's Republic of China
| | - Jiangyue Zhao
- Department of Ophthalmology, The Fourth Affiliated Hospital of China Medical University, Eye Hospital of China Medical University, Key Lens Research Laboratory of Liaoning Province, Shenyang, 110005, People's Republic of China
| | - Jinsong Zhang
- Department of Ophthalmology, The Fourth Affiliated Hospital of China Medical University, Eye Hospital of China Medical University, Key Lens Research Laboratory of Liaoning Province, Shenyang, 110005, People's Republic of China
| | - Mingwu Wang
- Department of Ophthalmology and Vision Science, The University of Arizona College of Medicine, Tucson, Arizona, 85711-1824, USA
| | - Yu Qin
- Department of Ophthalmology, The Fourth Affiliated Hospital of China Medical University, Eye Hospital of China Medical University, Key Lens Research Laboratory of Liaoning Province, Shenyang, 110005, People's Republic of China
| |
Collapse
|
7
|
Pérez-Gracia J, Ávila FJ, Ares J, Vallés JA, Remón L. Misalignment and tilt effect on aspheric intraocular lens designs after a corneal refractive surgery. PLoS One 2020; 15:e0243740. [PMID: 33315894 PMCID: PMC7735572 DOI: 10.1371/journal.pone.0243740] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2020] [Accepted: 11/26/2020] [Indexed: 12/19/2022] Open
Abstract
PURPOSE To numerically evaluate and compare the tolerance to misalignment and tilt of aspheric intraocular lenses (IOLs) designed for three eyes: with standard cornea and with simulated corneas after myopic and hyperopic laser ablation surgery. METHODS Three aspheric IOLs of +20.00 diopter (D) with different spherical aberration (SA) ([Formula: see text]) values have been designed using a theoretical model eye. Drastic changes on the theoretical eye anterior corneal asphericity have been performed to simulate myopic and hyperopic refractive surgeries. The effect of IOL misalignment and tilt on the image quality has been evaluated using a commercial optical software design for the three eye models. Image quality was assessed from the modulation transfer function (MTF), root mean square (RMS) values of defocus, astigmatism, coma and spherical aberration ([Formula: see text]), and retinal images obtained from a visual simulator using an aleatory optotype of 0.00 LogMar visual acuity (VA). RESULTS IOL misalignment and tilt reduced MTF values in general, and increased wavefront aberrations errors. Aberration-free IOLs maintained best the MTF values when misalignments were applied, together with good on-axis optical quality. IOLs with negative SA ([Formula: see text]) correction decreased the MTF value under 0.43 for misalignments values higher than 0.50 mm with the three corneas. The effect of misalignment on RMS astigmatism and coma was correlated with the IOL SA ([Formula: see text]) and with the three corneas. CONCLUSIONS This theoretical study shows that the largest degradation in image quality arises for the IOL with the highest amount of spherical aberration ([Formula: see text]). Moreover, it has been found that the aspherical design has a more influential role in misalignment tolerance than in tilt tolerance.
Collapse
Affiliation(s)
- Jesús Pérez-Gracia
- Departamento de Física Aplicada, Universidad de Zaragoza, Zaragoza, Spain
| | - Francisco J. Ávila
- Departamento de Física Aplicada, Universidad de Zaragoza, Zaragoza, Spain
| | - Jorge Ares
- Departamento de Física Aplicada, Universidad de Zaragoza, Zaragoza, Spain
| | - Juan A. Vallés
- Departamento de Física Aplicada, Universidad de Zaragoza, Zaragoza, Spain
| | - Laura Remón
- Departamento de Física Aplicada, Universidad de Zaragoza, Zaragoza, Spain
| |
Collapse
|