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Friehmann A, Sharon T, Ophir SS, Assia EI. Fracture of a polyimide-elastimide posterior chamber intraocular lens following blunt orbital trauma. Eur J Ophthalmol 2019; 30:NP79-NP81. [PMID: 30897947 DOI: 10.1177/1120672119838125] [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: 11/16/2022]
Abstract
PURPOSE Fracture of a three-piece polyimide-elastimide intraocular lens at the optic-haptic junction following blunt trauma is a possible complication after cataract surgery. We report a case of an isolated posterior chamber intraocular lens fracture caused by direct ocular blunt trauma. CASE A 51-year-old patient underwent blunt orbital trauma caused by a raw chicken egg that was thrown at him, as he was walking. The posterior chamber intraocular lens was found in the anterior chamber, with a broken optic-haptic junction. The intraocular lens was exchanged, followed by iris fixation and pupilloplasty, with satisfactory postoperative anatomical and optical outcomes. DISCUSSION The three-piece polyimide-elastimide intraocular lens was fractured at the optic-haptic junction. Although the fractured intraocular lens surface had a regular appearance, it has been previously reported that the polyimide haptic's durability is probably inferior to that of polymethylmethacrylate. Therefore, it is highly susceptible to shear stress induced by a blunt trauma. CONCLUSION To our knowledge, this is an uncommon report of an implanted posterior chamber polyimide-elastimide intraocular lens fracture following blunt orbital trauma. Intraocular lens exchange and fixation had successful optical and anatomical results.
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Affiliation(s)
- Asaf Friehmann
- Department of Ophthalmology, Meir Medical Center, Kfar Saba, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Tal Sharon
- Department of Ophthalmology, Meir Medical Center, Kfar Saba, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Shira Sheen Ophir
- Department of Ophthalmology, Meir Medical Center, Kfar Saba, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Ein Tal Eye Center, Tel Aviv, Israel
| | - Ehud I Assia
- Department of Ophthalmology, Meir Medical Center, Kfar Saba, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Ein Tal Eye Center, Tel Aviv, Israel
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Çaça I, Ünlü K, Ari S, Aksit I. Spontaneous Fracture of an Implanted Posterior Chamber Intraocular Lens. Eur J Ophthalmol 2018. [DOI: 10.1177/112067210501500416] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Purpose Spontaneous fracture of an intraocular lens (IOL) haptic is a rare complication of cataract surgery. The authors report a case of spontaneous fracture of an implanted posterior chamber IOL. Case Five years ago, a 12-year-old patient underwent linear lens extraction, posterior capsulotomy, and anterior vitrectomy due to traumatic cataract and received a polymethyl methacrylate (PMMA) biconvex posterior chamber IOL implanted in ciliary sulcus. Five years later, IOL optic was found in anterior chamber with its haptics broken from the optic-haptic junction. Discussion The broken haptic was examined with scanning electron microscopy. The fracture site of the haptic was on the optic-haptic junction. The fractured surface had a regular appearance. Conclusions To our knowledge, this is the fourth report of spontaneous fracture of an implanted posterior chamber IOL.
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Affiliation(s)
- I. Çaça
- Department of Ophthalmology, Dicle University Faculty of Medicine, Diyarbakyr
| | - K. Ünlü
- Department of Ophthalmology, Dicle University Faculty of Medicine, Diyarbakyr
| | - S. Ari
- Department of Ophthalmology, Dicle University Faculty of Medicine, Diyarbakyr
| | - I. Aksit
- Technological Research and Developing Center, Erciyes University, Kayseri - Turkey
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Singh H, Kwan SL, Tam D, Mamalis N, MacLean K, Ahmed IIK. Fracture and dislocation of a glass intraocular lens optic as a complication of neodymium:YAG laser posterior capsulotomy: Case report and literature review. J Cataract Refract Surg 2016; 41:2323-8. [PMID: 26703310 DOI: 10.1016/j.jcrs.2015.09.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2015] [Revised: 08/25/2015] [Accepted: 08/27/2015] [Indexed: 10/22/2022]
Abstract
UNLABELLED An 83-year-old man presented with a 1-year history of blurry vision in his left eye. Bilateral cataract surgery and ciliary sulcus posterior chamber intraocular lens (IOL) implantation had been performed 11 years earlier. The corrected distance visual acuity (CDVA) was 20/60 in the left eye. Slitlamp examination revealed moderate posterior capsule opacification. Neodymium:YAG laser posterior capsulotomy was performed and complicated by IOL fracture and immediate dislocation of optic fragments into the anterior chamber. An IOL exchange was performed, and the damaged IOL was removed in 7 pieces. A 3-piece acrylic IOL was suture fixated to the posterior iris. Pathologic analysis showed that the damaged IOL was made of glass supported by a polyimide frame. Twelve months after the IOL exchange, the CDVA was 20/60. FINANCIAL DISCLOSURE Dr. Ahmed is a consultant to Alcon Laboratories, Inc., Abbott Medical Optics, Inc., and Bausch & Lomb. Dr. Mamalis is a consultant to Anew Optics, Inc., and Medennium, Inc. No other author has a financial or proprietary interest in any material or method mentioned.
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Affiliation(s)
- Harmanjit Singh
- From the Department of Ophthalmology and Vision Sciences (Singh, Tam, Ahmed), University of Toronto, Toronto, and Trillium Health Partners (Tam, Ahmed), and Credit Valley Eye Care (Tam, Ahmed), Mississauga, Ontario, Canada; the School of Medicine (Kwan), Royal College of Surgeons in Ireland, Dublin, Ireland; Department of Ophthalmology and Vision Sciences (Mamalis, MacLean, Ahmed), University of Utah, Salt Lake City, Utah, USA
| | - Sarah L Kwan
- From the Department of Ophthalmology and Vision Sciences (Singh, Tam, Ahmed), University of Toronto, Toronto, and Trillium Health Partners (Tam, Ahmed), and Credit Valley Eye Care (Tam, Ahmed), Mississauga, Ontario, Canada; the School of Medicine (Kwan), Royal College of Surgeons in Ireland, Dublin, Ireland; Department of Ophthalmology and Vision Sciences (Mamalis, MacLean, Ahmed), University of Utah, Salt Lake City, Utah, USA
| | - Diamond Tam
- From the Department of Ophthalmology and Vision Sciences (Singh, Tam, Ahmed), University of Toronto, Toronto, and Trillium Health Partners (Tam, Ahmed), and Credit Valley Eye Care (Tam, Ahmed), Mississauga, Ontario, Canada; the School of Medicine (Kwan), Royal College of Surgeons in Ireland, Dublin, Ireland; Department of Ophthalmology and Vision Sciences (Mamalis, MacLean, Ahmed), University of Utah, Salt Lake City, Utah, USA
| | - Nick Mamalis
- From the Department of Ophthalmology and Vision Sciences (Singh, Tam, Ahmed), University of Toronto, Toronto, and Trillium Health Partners (Tam, Ahmed), and Credit Valley Eye Care (Tam, Ahmed), Mississauga, Ontario, Canada; the School of Medicine (Kwan), Royal College of Surgeons in Ireland, Dublin, Ireland; Department of Ophthalmology and Vision Sciences (Mamalis, MacLean, Ahmed), University of Utah, Salt Lake City, Utah, USA
| | - Kyle MacLean
- From the Department of Ophthalmology and Vision Sciences (Singh, Tam, Ahmed), University of Toronto, Toronto, and Trillium Health Partners (Tam, Ahmed), and Credit Valley Eye Care (Tam, Ahmed), Mississauga, Ontario, Canada; the School of Medicine (Kwan), Royal College of Surgeons in Ireland, Dublin, Ireland; Department of Ophthalmology and Vision Sciences (Mamalis, MacLean, Ahmed), University of Utah, Salt Lake City, Utah, USA
| | - Iqbal Ike K Ahmed
- From the Department of Ophthalmology and Vision Sciences (Singh, Tam, Ahmed), University of Toronto, Toronto, and Trillium Health Partners (Tam, Ahmed), and Credit Valley Eye Care (Tam, Ahmed), Mississauga, Ontario, Canada; the School of Medicine (Kwan), Royal College of Surgeons in Ireland, Dublin, Ireland; Department of Ophthalmology and Vision Sciences (Mamalis, MacLean, Ahmed), University of Utah, Salt Lake City, Utah, USA.
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Li B, Lin T, Tokarewicz AC. Prospective evaluation of intraoperative intraocular lens stress fracture during cataract surgery. J Cataract Refract Surg 2015; 41:2403-9. [PMID: 26703489 DOI: 10.1016/j.jcrs.2015.05.036] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2015] [Revised: 05/13/2015] [Accepted: 05/18/2015] [Indexed: 10/22/2022]
Abstract
PURPOSE To determine the incidence and risk factors of intraocular lens (IOL) stress fracture during cataract surgery. SETTING Ivey Eye Institute, London, Ontario, Canada. DESIGN Prospective, randomized cohort study. METHODS Patients scheduled for routine cataract surgery were randomized into 2 study groups. The 2 groups only differed in the use of Monarch IOL delivery cartridges for insertion of an Acrysof IQ SN60WF IOL. The cartridge C group used Monarch cartridge C, and the cartridge D group used Monarch cartridge D. Patients were examined for IOL stress fractures. RESULTS A total of 386 study eyes were enrolled. The overall incidence of IOL stress fracture was 6.22%. The incidence of IOL stress fracture with cartridge C and cartridge D groups were 3.16% and 9.18%, respectively (P = .01). The IOL stress fracture rate for IOL power less than 18.0 D was 3.45%, IOL power between 18.0 D to 23.5 D was 6.49%, and IOL power over 23.5 D was 10.81%. A total of 24 IOL stress fractures were observed. Among IOL stress fractures, 45.8% were equal to or less than 1.0 mm in length. Two thirds of stress fractures were located over the central 4 mm of the IOL optic. No subjective adverse visual outcomes were reported from any of the observed IOL stress fractures. CONCLUSION Intraocular lens stress fracture is recognizable risk during cataract surgery. Risk factors for IOL stress fracture include smaller IOL delivery cartridges and IOLs of higher refractive powers. There was a low risk for IOL stress fracture resulting in adverse subjective visual outcomes.
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Affiliation(s)
- Bo Li
- From the Ivey Eye Institute, Department of Ophthalmology, University of Western Ontario, London, Ontario, Canada.
| | - Tony Lin
- From the Ivey Eye Institute, Department of Ophthalmology, University of Western Ontario, London, Ontario, Canada
| | - Alexander C Tokarewicz
- From the Ivey Eye Institute, Department of Ophthalmology, University of Western Ontario, London, Ontario, Canada
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