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Naujokaitis T, Auffarth GU, Łabuz G, Kessler LJ, Khoramnia R. Diagnostic Techniques to Increase the Safety of Phakic Intraocular Lenses. Diagnostics (Basel) 2023; 13:2503. [PMID: 37568866 PMCID: PMC10417808 DOI: 10.3390/diagnostics13152503] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 07/25/2023] [Accepted: 07/25/2023] [Indexed: 08/13/2023] Open
Abstract
Preoperative and postoperative diagnostics play an important role in ensuring the safety of patients with phakic intraocular lenses (pIOLs). The risk of endothelial cell loss can be addressed by regularly measuring the endothelial cell density using specular microscopy and considering the endothelial cell loss rate and the endothelial reserve in accordance with the patient's age when deciding whether to explant a pIOL. The anterior chamber morphometrics, including the anterior chamber depth and the distance between the pIOL and the endothelium, measured using Scheimpflug tomography and anterior segment optical coherence tomography (AS-OCT), can help to assess the risk of the endothelial cell loss. In patients undergoing posterior chamber pIOL implantation, accurate prediction of the vault and its postoperative measurements using AS-OCT or Scheimpflug tomography are important when assessing the risk of anterior subcapsular cataract and secondary glaucoma. Novel approaches based on ultrasound biomicroscopy and AS-OCT have been proposed to increase the vault prediction accuracy and to identify eyes in which prediction errors are more likely. Careful patient selection and regular postoperative follow-up visits can reduce the complication risk and enable early intervention if a complication occurs.
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Affiliation(s)
| | | | | | | | - Ramin Khoramnia
- Department of Ophthalmology, University of Heidelberg, 69120 Heidelberg, Germany
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2
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Zaleski M, Stahel M, Eberhard R, Alexander Blum R, Barthelmes D. OUTCOMES OF RETROPUPILLARY IRIS CLAW INTRAOCULAR LENS IMPLANTATION COMBINED WITH PARS PLANA VITRECTOMY. Retina 2022; 42:1284-1291. [PMID: 35174810 PMCID: PMC9200228 DOI: 10.1097/iae.0000000000003443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE To report 12-month visual outcomes, incidence of intraocular pressure (IOP) changes and postoperative complications after pars plana vitrectomy with retropupillary implantation of an iris claw intraocular lens (IOL) in aphakic eyes after complicated cataract surgery and eyes with a dislocation of the IOL. METHODS This is a retrospective analysis of eyes undergoing implantation of an iris claw IOL combined with pars plana vitrectomy from 1st of January 2009 until 30th of June 2018 after complicated cataract extraction with capsular loss (Group A) or dislocation of an IOL (Group B). Corrected distance visual acuity was analyzed in logarithm of the minimum angle of resolution (logMAR) units, IOP was recorded in mmHg. RESULTS Eyes in Group A (n = 49) improved from a preoperative median visual acuity of 0.523 logMAR (Snellen 20/65) to 0.201 logMAR (Snellen 20/30), P < 0.01. Eyes in Group B (n = 126) showed stable median visual acuity, preoperative 0.301 logMAR (Snellen 20/40) versus postoperative 0.222 logMAR (Snellen 20/30), P > 0.05. During 12 months in Group A, IOP >21 mmHg occurred in 9 (18.4%) eyes; no eye had an IOP <6 mmHg. In Group B, IOP >21 mmHg occurred in 15 (11.9%) eyes, IOP <6 mmHg in 5 (4%) cases. None of the eyes in Group A and B had IOP >21 mmHg or <6 mmHg at 12 months follow-up. CONCLUSION The retropupillary implantation of an iris claw IOL with pars plana vitrectomy provides adequate visual rehabilitation and seems to be safe in IOP changes.
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Affiliation(s)
- Marta Zaleski
- Department of Ophthalmology, University Hospital and University of Zurich, Zurich, Switzerland
| | - Marc Stahel
- Department of Ophthalmology, University Hospital and University of Zurich, Zurich, Switzerland
| | - Roman Eberhard
- Department of Ophthalmology, University Hospital and University of Zurich, Zurich, Switzerland
| | - Robert Alexander Blum
- Department of Ophthalmology, University Hospital and University of Zurich, Zurich, Switzerland
| | - Daniel Barthelmes
- Department of Ophthalmology, University Hospital and University of Zurich, Zurich, Switzerland
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Nemcova I, Pasta J, Hladikova K, Komarc M, Pospisilova D, Nemec P, Tesar J, Kratky V, Sin M. Myopic Correction with Iris-Fixated Phakic Intraocular Lenses: Twelve-Year Results. J Ophthalmol 2021; 2021:7027793. [PMID: 34659825 PMCID: PMC8516571 DOI: 10.1155/2021/7027793] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Accepted: 09/21/2021] [Indexed: 11/21/2022] Open
Abstract
PURPOSE To evaluate a 12-year follow-up of myopic patients after iris-fixated phakic intraocular lenses (IF pIOLs) implantation. Setting. Ophthalmology Department, Military University Hospital in Prague (Czech Republic). DESIGN Single-center retrospective cohort study. METHODS We describe the results of a cohort study that included 85 eyes of 46 myopic patients who underwent implantation of Verisyse myopia, Veriflex, and Verisyse myopia toric (all Abbott Medical Optics, Inc.) intraocular lenses. Refractive functions and adverse events were assessed preoperatively, at 6 months, and 1, 2, 5, and 12 years after IF pIOL implantation. RESULTS Mean spherical equivalent was measured as -9.37 ± 2.87 D, 0.14 ± 0.61 D, and -0.42 ± 1.08 D, preoperatively, at 6 months and 12 years postoperatively, respectively. There was a significant reduction in the cylinder after surgery. At 12 years postoperatively, 90% of eyes had uncorrected distance visual acuity (UDVA) of 20/40 and 64% of 20/20. The safety index was 1.10 for the whole postoperative follow-up period. We found cataract formation in 3 eyes (3.5%). The endothelial cells loss (EC loss) directly caused by IF pIOL implantation was 6.0%, 8.10%, 12.8%, and 11.9%, at 1, 2, 5, and 12 years, respectively. In our cohort, 95% of eyes lost a higher percentage of EC than would be expected from a physiological loss at 12 years postoperatively. We found a significant negative interaction between preoperative pachymetry and EC loss, indicating that the lower pachymetry leads to a faster decline in endothelial cells density (ECD). IF pIOL re-enclavation was found in 28% of eyes. 7% of subluxations were caused by trauma. The mean time of nontraumatic re-enclavation was 6 years postoperatively. CONCLUSIONS The study confirmed the advantages of IF pIOL implantation due to rapid visual recovery and stable visual function over the 12-year follow-up and also showed the influence of lower corneal pachymetry regarding EC loss.
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Affiliation(s)
- Iveta Nemcova
- Department of Ophthalmology, Military University Hospital Prague, Prague, Czech Republic
- 1st Faculty of Medicine of Charles University, Prague, Czech Republic
| | - Jiri Pasta
- Department of Ophthalmology, Military University Hospital Prague, Prague, Czech Republic
- 1st Faculty of Medicine of Charles University, Prague, Czech Republic
| | - Katerina Hladikova
- Department of Ophthalmology, Military University Hospital Prague, Prague, Czech Republic
- 1st Faculty of Medicine of Charles University, Prague, Czech Republic
| | - Martin Komarc
- 1st Faculty of Medicine of Charles University, Prague, Czech Republic
| | - Darina Pospisilova
- Department of Ophthalmology, Military University Hospital Prague, Prague, Czech Republic
| | - Pavel Nemec
- Department of Ophthalmology, Military University Hospital Prague, Prague, Czech Republic
- 1st Faculty of Medicine of Charles University, Prague, Czech Republic
| | - Jan Tesar
- Department of Ophthalmology, Military University Hospital Prague, Prague, Czech Republic
- 1st Faculty of Medicine of Charles University, Prague, Czech Republic
| | - Vladimir Kratky
- 1st Faculty of Medicine of Charles University, Prague, Czech Republic
- Health Sciences Centre, Queen's University, Kingston, Canada
| | - Martin Sin
- Department of Ophthalmology, Military University Hospital Prague, Prague, Czech Republic
- 1st Faculty of Medicine of Charles University, Prague, Czech Republic
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Thulasidas M. Retropupillary Iris-Claw Intraocular Lenses: A Literature Review. Clin Ophthalmol 2021; 15:2727-2739. [PMID: 34211261 PMCID: PMC8240859 DOI: 10.2147/opth.s321344] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 06/11/2021] [Indexed: 01/02/2023] Open
Abstract
Retropupillary iris-claw intraocular lenses (ICIOLs) have been increasingly chosen by surgeons nowadays as a primary or secondary procedure of IOL implantation in eyes with insufficient capsular or zonular support. They have gained popularity due to their simple fast technique, favourable functional outcomes, and safety. The transition in the ICIOL fixation from prepupillary to a more biologically appropriate retropupillary position and change in the optic design from biconvex to convex-concave have provided better visual outcomes and improved safety. A peer-reviewed literature search was conducted in Medline (PubMed), Embase, and Cochrane Library using the keywords "retropupillary iris claw" and "iris claw". The search yielded 310 articles that were screened. Forty-three articles on retropupillary ICIOLs were finally found to be relevant and reviewed in full-text versions. The functional outcomes following retropupillary implantation of ICIOLs have been acceptable in eyes with no ocular co-morbidities otherwise. However, the indications for surgery may affect the outcomes. The major postoperative complications directly associated with ICIOLs include pupil ovalization and redislocation. Nevertheless, the rate of disenclavation depends on the experience and skill of the surgeon. This review is based on a literature review, and it focuses on the preoperative evaluation, surgical technique, postoperative outcomes, and associated complications. Prospective randomized trials with a larger sample size and longer follow-up are needed for comparison with other techniques of IOL fixation and confirmation of long-term safety profile.
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Affiliation(s)
- Mithun Thulasidas
- Cataract and Glaucoma services, Sankara Eye Hospital, Coimbatore, Tamil Nadu, 641035, India
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Sumitha CV, Pai V, Thulasidas M. Retropupillary iris-claw intraocular lens implantation in aphakic patients. Indian J Ophthalmol 2021; 68:597-602. [PMID: 32174577 PMCID: PMC7210845 DOI: 10.4103/ijo.ijo_1043_19] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
Purpose: To evaluate the outcomes of implantation of an iris-claw intraocular lens (IC-IOL) in retropupillary position in aphakic patients. Methods: We conducted a prospective interventional study, including 36 aphakic eyes with inadequate capsular support. The postoperative examination included best-corrected visual acuity (BCVA), intraocular pressure (IOP) measurement, central corneal thickness (CCT), and anterior segment examination with emphasis on the anterior chamber reaction and shape of pupil. Follow-up was done for 3 months. Results: Thirty-six eyes of 34 patients, including 22 right eyes and 14 left eyes were included. Indications for surgery were complicated cataract surgery in 38.9% (n = 14), aphakia in 27.8% (n = 10), pseudophakic bullous keratopathy in 16.7% (n = 6), dislocated posterior chamber IOL (PCIOL) in 11.1% (n = 4), IC drop in 2.8% (n = 1), and subluxated PCIOL in 2.8% (n = 1). Postoperatively, the visual acuity improved by at least two lines in 32 (88.9%) and worsened in four (11.1%) eyes at the end of three months. Mean postoperative IOP at the end of the third month was 12.42 mmHg (standard deviation [SD] 2.57; range 11.55–13.29 mmHg). The mean postoperative CCT at the end of the third month was 542.42 microns (SD 13.77; range 537.76–547.07 microns). Sixteen eyes (44.4%) had horizontally oval pupil, eleven eyes (30.6%) had round pupil, and nine eyes (25%) had irregular pupil. Twenty-three eyes (63.9%) presented with significant anterior chamber reaction and seven eyes (19.4%) had corneal stromal edema on postoperative day 1. Conclusion: Our study demonstrated that retropupillary IC-IOL implantation in eyes without adequate capsular support is an effective and safe procedure with a good visual outcome and fewer complications.
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Affiliation(s)
- C V Sumitha
- Department of Ophthalmology, K.S Hegde Charitable Hospital, Deralakatte, Mangalore, Karnataka, India
| | - Vijay Pai
- Department of Ophthalmology, K.S Hegde Charitable Hospital, Deralakatte, Mangalore, Karnataka, India
| | - Mithun Thulasidas
- Centre for Sight Eye Institute, Plot No. 9, Sector 9, Dwarka, New Delhi, India
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Cakir I, Demir G, Yildiz BK, Öcal MC, Yildirim Y, Agca A. Efficacy and safety of iris-supported phakic lenses (Verisyse) for the treatment of high myopia: 5-year results. Int Ophthalmol 2021; 41:2837-2845. [PMID: 33864187 DOI: 10.1007/s10792-021-01841-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Accepted: 04/01/2021] [Indexed: 11/27/2022]
Abstract
PURPOSE Evaluating efficacy and safety of iris-supported phakic lenses (Verisyse) for high myopia treatment. METHODS Patients treated with Verisyse (Abbott Medical Optics, Santa Ana, CA, USA) intraocular lens (IOL) implants were evaluated retrospectively. Patients with follow-up periods of more than 5 years were included in the study. Pre- and postoperative fifth-year spheric equivalent (SE) of manifest refraction values, uncorrected and corrected distance visual acuities (UDVA and CDVA, respectively), and endothelial cell density (ECD) values were recorded. Complications were evaluated. RESULTS Forty-seven eyes of 31 patients were included in the study. Pre- and postoperative fifth year mean SE was - 12.50 ± 3.51D and - 0.72 ± 0.40D, respectively. Pre- and postoperative fifth-year UDVA was 1.56 ± 0.22 and 0.33 ± 0.18 logMAR (p < 0.001), respectively. The safety index (pre- and postoperative CDVA) was 1.39 ± 0.63 at the 5-year follow-up (p > 0,05). The efficacy index (ratio of mean postoperative UDVA to mean preoperative CDVA) of the patients was 1.14 ± 0.60. The mean postoperative endothelial cell loss at 5 years was -7.42%. None of the patients had lost 25% of their preoperative endothelial cells at 5-year follow-up. The mean postoperative endothelial cell loss was -3.05% at 1 year, -1.23% between years one and three, -1.02% between the third and fifth years. CONCLUSION Verisyse IOL implantation is an effective and safe for high myopia surgical treatment. However, the 5-year follow-up period is not sufficient to evaluate the safety profiles in terms of endothelial cells.
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Affiliation(s)
- Ihsan Cakir
- University of Health Sciences, Beyoglu Eye Training and Research Hospital, Bereketzade Street Number:2, Beyoglu, Istanbul, Turkey.
| | - Gökhan Demir
- University of Health Sciences, Beyoglu Eye Training and Research Hospital, Bereketzade Street Number:2, Beyoglu, Istanbul, Turkey
| | - Burcin Kepez Yildiz
- University of Health Sciences, Beyoglu Eye Training and Research Hospital, Bereketzade Street Number:2, Beyoglu, Istanbul, Turkey
| | - Mevlüt Celal Öcal
- University of Health Sciences, Beyoglu Eye Training and Research Hospital, Bereketzade Street Number:2, Beyoglu, Istanbul, Turkey
| | - Yusuf Yildirim
- University of Health Sciences, Beyoglu Eye Training and Research Hospital, Bereketzade Street Number:2, Beyoglu, Istanbul, Turkey
| | - Alper Agca
- University of Health Sciences, Beyoglu Eye Training and Research Hospital, Bereketzade Street Number:2, Beyoglu, Istanbul, Turkey
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Nam M, Kang DSY, Kim SW. Five-year Change in Corneal Endothelial Cell Density after Foldable Iris-fixed Lens Insertion. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2021. [DOI: 10.3341/jkos.2021.62.4.479] [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]
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Luo W, Tong J, Shen Y. Rigid gas‐permeable contact lens for visual rehabilitation in aphakia following trauma. Clin Exp Optom 2021; 95:499-505. [PMID: 22804911 DOI: 10.1111/j.1444-0938.2012.00764.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2010] [Revised: 10/25/2011] [Accepted: 01/31/2012] [Indexed: 01/08/2023] Open
Affiliation(s)
- Wei‐ling Luo
- Department of Ophthalmology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
- Department of Ophthalmology, Jiaxing Traditional Chinese Medical Hospital, Jiaxing, Zhejiang, China
| | - Jian‐ping Tong
- Department of Ophthalmology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Ye Shen
- Department of Ophthalmology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
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Liu J, Fan W, Lu X, Peng S. Sutureless Intrascleral Posterior Chamber Intraocular Lens Fixation: Analysis of Clinical Outcomes and Postoperative Complications. J Ophthalmol 2021; 2021:8857715. [PMID: 33510907 PMCID: PMC7826223 DOI: 10.1155/2021/8857715] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 12/22/2020] [Accepted: 01/06/2021] [Indexed: 11/29/2022] Open
Abstract
PURPOSE To report a technique for performing sutureless intrascleral fixation of a posterior chamber intraocular lens (PC-IOL) and analyzing the clinical outcomes and postoperative complications. Study Design. 68 eyes of 66 patients who received the technique were studied retrospectively. METHODS The best-corrected visual acuity (BCVA), intraocular pressure (IOP), anterior chamber depth (ACD), IOL tilt and decentration, corneal topography (K1 and K2), and postoperative complications were determined at 3 months. RESULTS The mean preoperative BCVA was 1.63 ± 1.24 logMAR units, and the mean postoperative BCVA was 0.74 ± 0.59 logMAR units at 3 months (P < 0.05). The mean preoperative IOP was 21.9 ± 12.6 mmHg, and the mean postoperative IOP was 16.9 ± 4.5 mmHg at 3 months (P = 0.001). The mean preoperative corneal topography (K1 and K2) was K1 = 42.14 ± 1.91 and K2 = 43.54 ± 1.51; the mean postoperative corneal topography (K1 and K2) was K1 = 43.03 ± 2.18 and K2 = 43.40 ± 1.71 at 3 months (P = 0.678 and 0.468, respectively). The mean preoperative spherical equivalent was +11.00 ± 13.19 diopters (D), and the mean postoperative spherical equivalent was +0.06 ± 0.86 D (P < 0.005). The mean IOL tilt was 2.4 ± 1.7°, and the mean decentration was 0.35 ± 0.21 mm. The mean ACD was 4.31 ± 0.29 mm. CONCLUSIONS The 27-gauge sutureless intrascleral PC-IOL implantation technique minimizes intraoperative injury, simplifies procedure, and provides good PC-IOL fixation with few postoperative complications.
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Affiliation(s)
- Jiannan Liu
- Aier School of Ophthalmology, Central South University, Changsha, China
| | | | - Xinyu Lu
- Harbin Aier Eye Hospital, Harbin, China
| | - Shaomin Peng
- Aier School of Ophthalmology, Central South University, Changsha, China
- Harbin Aier Eye Hospital, Harbin, China
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Hipólito-Fernandes D, Elisa-Luís M, Vieira M, Crisóstomo S, Alves N, Maduro V, Feijão J. Long-term results of Descemet-stripping automated endothelial keratoplasty for endothelial failure caused by phakic intraocular lenses. Eur J Ophthalmol 2020; 31:1688-1694. [PMID: 32783469 DOI: 10.1177/1120672120950936] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE To describe the surgical approach and long-term outcomes of Descemet-stripping automated endothelial keratoplasty (DSAEK) for endothelial failure secondary to phakic intraocular lenses (pIOL). METHODS Retrospective, interventional case series of 18 eyes of 13 patients who developed endothelial failure secondary to pIOL implant. Patients were submitted to pIOL explant and DSAEK for visual rehabilitation, with or without phacoemulsification plus posterior-chamber intraocular lens implant. The minimum follow-up time was 3 years and the main outcome measures were best-corrected visual acuity (BCVA), endothelial cell density (ECD) and percentage of endothelial cell loss (ECL), intraoperative and postoperative complications. RESULTS Patients' mean age was 47.44 (7.86) years with a mean follow-up time of 55.61 (14.13) months. Sixteen eyes (88.9%) had an angle-supported pIOL. The mean pIOL implant-to explant time was 8.17 (2.73) years. BCVA improved from 1.00 (0.36) logMAR preoperatively to 0.29 (0.36) logMAR at 1 year of follow-up (p < 0.001), remaining stable over the entire follow-up period (p > 0.05). At the last visit, all corneas were clear, with a mean ECD of 724.74 (325.57) cells/mm2. During the follow-up, two eyes (11.1%) required a re-DSAEK due to early graft failure (<3 months). CONCLUSION Our outcomes reveal that an individualized and careful approach may result in a stable visual rehabilitation in young patients with corneal decompensation following pIOL implant.
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Affiliation(s)
- Diogo Hipólito-Fernandes
- Department of Ophthalmology, Centro Hospitalar Universitário de Lisboa Central, Alameda Santo António dos Capuchos, Lisbon, Portugal
| | - Maria Elisa-Luís
- Department of Ophthalmology, Centro Hospitalar Universitário de Lisboa Central, Alameda Santo António dos Capuchos, Lisbon, Portugal
| | - Miguel Vieira
- Department of Ophthalmology, Centro Hospitalar Universitário de Lisboa Central, Alameda Santo António dos Capuchos, Lisbon, Portugal
| | - Sara Crisóstomo
- Department of Ophthalmology, Centro Hospitalar Universitário de Lisboa Central, Alameda Santo António dos Capuchos, Lisbon, Portugal
| | - Nuno Alves
- Department of Ophthalmology, Centro Hospitalar Universitário de Lisboa Central, Alameda Santo António dos Capuchos, Lisbon, Portugal
| | - Vitor Maduro
- Department of Ophthalmology, Centro Hospitalar Universitário de Lisboa Central, Alameda Santo António dos Capuchos, Lisbon, Portugal
| | - João Feijão
- Department of Ophthalmology, Centro Hospitalar Universitário de Lisboa Central, Alameda Santo António dos Capuchos, Lisbon, Portugal
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Artisan iris-claw intraocular lens implantation in vitrectomised eyes. Eye (Lond) 2020; 35:1393-1397. [PMID: 32555519 DOI: 10.1038/s41433-020-1022-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2019] [Revised: 06/03/2020] [Accepted: 06/04/2020] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVES To present the visual acuity (VA) results and complication rates following Artisan intraocular lens (IOL) insertion in vitrectomised eyes. METHODS Outcome data were collected for all vitrectomised patients who had undergone Artisan IOL insertion between January 2014 and May 2019 at Moorfields Eye Hospital. All those with follow-up greater than 2 months were included in the analysis. RESULTS Sixty-nine eyes from 61 patients were included. Average follow up was 2 years. Fifty-five (80%) eyes had at least one ocular comorbidity prior to Artisan IOL insertion. At final follow up 46 (67%) eyes had best-corrected VA better than 6/12. Sixty-three eyes (91%) either gained or maintained VA. Mean post-operative spherical equivalent was -0.2D. Two (3%) lenses became de-enclavated requiring further surgery. Two (3%) eyes developed acute post-operative cystoid macular oedema. Two (3%) required additional topical IOP-lowering therapy to their pre-operative glaucoma regimen. One eye had mild corneal oedema, which persisted for 1 year following surgery and subsequently resolved. CONCLUSIONS Artisan IOL insertion is a safe and effective option for the surgical correction of aphakia in vitrectomised eyes lacking capsular support. Refractive results comparable to posterior chamber IOL placement can be achieved with these lenses.
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Galvis V, Villamil JF, Acuña MF, Camacho PA, Merayo-Lloves J, Tello A, Zambrano SL, Rey JJ, Espinoza JV, Prada AM. Long-term endothelial cell loss with the iris-claw intraocular phakic lenses (Artisan®). Graefes Arch Clin Exp Ophthalmol 2019; 257:2775-2787. [DOI: 10.1007/s00417-019-04506-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Revised: 08/19/2019] [Accepted: 10/07/2019] [Indexed: 10/25/2022] Open
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13
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Irisfixierte phake Intraokularlinse. SPEKTRUM DER AUGENHEILKUNDE 2019. [DOI: 10.1007/s00717-019-00434-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Rezar-Dreindl S, Stifter E, Neumayer T, Papp A, Gschliesser A, Schmidt-Erfurth U. Visual outcome and surgical results in children with Marfan syndrome. Clin Exp Ophthalmol 2019; 47:1138-1145. [PMID: 31325202 PMCID: PMC6973035 DOI: 10.1111/ceo.13596] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Revised: 07/05/2019] [Accepted: 07/15/2019] [Indexed: 12/28/2022]
Abstract
IMPORTANCE To determine visual and surgical results in children with Marfan syndrome. BACKGROUND Marfan syndrome involves ocular complications which can lead to visual disturbance and amblyopia. Data about the visual and surgical results in children with Marfan syndrome is vital for the clinical management of these patients. DESIGN Retrospective data analysis. PARTICIPANTS Eighty-two eyes of 41 patients with a genetically proved diagnosis of Marfan syndrome. METHODS Medical records of patients with Marfan syndrome were reviewed between 2007 and 2017. Ocular complications, visual acuity (VA) of patients with/without lensectomy and surgical method were evaluated. MAIN OUTCOME MEASURES VA outcomes of patients with Marfan syndrome with/without surgical repair of ectopia lentis. RESULTS In 27 (66%) of the 41 patients a bilateral subluxation of the lens was visible and 14 (52%) patients received lensectomy. The mean age at initial presentation was 12.3 ± 9 years and mean follow-up was 3 years (range 1-7). VA varied from 1.2 to -0.1 logMAR at first examination. At initial presentation, mean VA was 0.1 ± 0.7 logMAR in patients with a normal lens status (n = 14) and 0.3 ± 0.5 logMAR in patients with subluxation of the lens (n = 27) (P < .01). VA improved from 0.2 ± 0.5 logMAR to 0.1 ± 0.5 logMAR (P = .06) in children with subluxation of the lens who did not need a lensectomy (n = 12) and from 0.5 ± 0.5 logMAR to 0.2 ± 0.5 logMAR (P = .02) in patients who were referred to lensectomy with/without secondary lens implantation. CONCLUSIONS AND RELEVANCE In Marfan syndrome subluxation of the lens was found in the majority of children. Improvement of VA resulted in children with subluxation of the lens and following lensectomy.
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Affiliation(s)
- Sandra Rezar-Dreindl
- Department of Ophthalmology and Optometry, Medical University of Vienna, Vienna, Austria
| | - Eva Stifter
- Department of Ophthalmology and Optometry, Medical University of Vienna, Vienna, Austria
| | - Thomas Neumayer
- Department of Ophthalmology and Optometry, Medical University of Vienna, Vienna, Austria
| | - Andrea Papp
- Department of Ophthalmology and Optometry, Medical University of Vienna, Vienna, Austria
| | - Andreas Gschliesser
- Department of Ophthalmology and Optometry, Medical University of Vienna, Vienna, Austria
| | - Ursula Schmidt-Erfurth
- Department of Ophthalmology and Optometry, Medical University of Vienna, Vienna, Austria
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Changes in Endothelial Cell Count Up to Three Years After Implantation of Toric Implantable Collamer Lenses. Cornea 2019; 38:873-879. [PMID: 31170105 DOI: 10.1097/ico.0000000000001914] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To determine the temporal effect of toric implantable collamer lens (TICL) implantation and location on corneal endothelial cell density (ECD) over a period of 36 months after surgery. METHODS ECD [number of cells per square millimeter estimated using the Specular Microscope SP-1P (Topcon Europe Medical B.V., Netherlands)] data were collected from cases deemed suitable for the TICL (VTICMO, VTICM5; STAAR Surgical, Nidau, Switzerland). The preoperative refractive error (sphere and cylinder) ranged from -1.00 to -22.25 diopter sphere and from -0.50 to -5.50 diopter cylinder. ECD was evaluated at preoperative and all postoperative sessions. RESULTS Key findings were as follows: the mean ECD (±SD, 95% confidence interval) was 2720 cells/mm (±272, 2620-2820 cells/mm) preoperatively, which was reduced to 2372 cells/mm (±325, 2250-2490 cells/mm) at 36 months postoperatively (P < 0.001). Linear regression revealed the following significant correlations between the (1) log of the change in ECD (y1) and log of preoperative ECD (x1) at 2 years postoperatively, y1 = 2.513x1-6.2816 (n = 62, r= 0.3503, P = 0.005); (2) mean ECD (y2) and log time (in months, x2), y2= 2543.7-36.997x2-38.99x2 (r=-0.9654, n = 7, P = 0.0004); and (3) mean axial distance between the front surface of the crystalline lens and the TICL back surface (y3) and time postoperatively (in months, x3), y3 = 0.1035x3-5.2808x3 +473.18 (r = 0.8512, n = 7, P = 0.015). CONCLUSIONS Expected ECD loss after TICL implantation by 2 years postoperatively is predictable. On average, over 3 years after implantation, there is (1) an initial rapid decline in ECD, followed by a gradual fall in the rate of cell loss, and (2) a gradual fall in the distance between the TICL and the crystalline lens by 2 years postoperatively, followed by a reversal by the third year.
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Toro MD, Longo A, Avitabile T, Nowomiejska K, Gagliano C, Tripodi S, Choragiewicz T, Kaminska A, Figus M, Posarelli C, Forlini M, Jünemann AGM, Reibaldi M, Rejdak R. Five-year follow-up of secondary iris-claw intraocular lens implantation for the treatment of aphakia: Anterior chamber versus retropupillary implantation. PLoS One 2019; 14:e0214140. [PMID: 30970023 PMCID: PMC6457484 DOI: 10.1371/journal.pone.0214140] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2018] [Accepted: 03/07/2019] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Though several procedures of IOL implantation have been described (sutured scleral fixation, intra-scleral fixation, angle-supported anterior chamber, and anterior chamber or retropupillary iris-claw IOLs), there are no randomized trials which are comparing different techniques. Hence, the surgical treatment of aphakia still remains controversial and challenging. The purpose of this study was to compare the long-term efficacy and the rate of complications of anterior versus posterior Iris-claw intraocular lenses (IOL) implantation to correct for the treatment of aphakia without sufficient capsule support. METHODS AND FINDINGS Consecutive eyes having secondary implantation of aphakic iris-fixated IOLs with a follow-up of at least 5 years were considered. Mean correct distance visual acuity (CDVA) changes, percentage of eyes with CDVA improvement, mean corneal endothelial cell density (CECD) loss and the rate of other complications were used for statistical analysis. The study evaluated a total of 180 eyes (Group A: 87 anterior chamber iris-claw fixation, Group B: 93 retropupillary iris-claw implantation) of 180 consecutive different patients, with aphakia of various reasons. CDVA improved significantly in both groups after surgery (P<0.001, ANOVA), and was remarkably higher than baseline in both groups from first week and during the entire follow-up (P<0.001, Tukey's Honest Significant Difference). There was no statistically significant difference in CDVA between the two groups during each follow-up visits (P = NS, unpaired t-test) and in the CDVA improvement percentage between the two groups (P = 0.882, Chi-square test). No significant changes in CECD were noted after surgery in both groups (ANOVA Group A: P = 0.067, Group B: P = 0.330P). No intra-operative complications occurred in both groups. There was no statistically significant difference in the rate of complications between the two groups (P = NS, Chi-square test), except for pigment precipitates which were higher in Group A (P<0.05, Chi-square test). CONCLUSIONS Five-year follow-up shows that secondary implantation of aphakic IOLs is effective and safe for the correction treatment of aphakia in eyes without capsule support.
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Affiliation(s)
- Mario Damiano Toro
- Department of Ophthalmology, University of Catania, Catania, Italy
- Department of General Ophthalmology, Medical University of Lublin, Lublin, Poland
- * E-mail:
| | - Antonio Longo
- Department of Ophthalmology, University of Catania, Catania, Italy
| | | | - Katarzyna Nowomiejska
- Department of General Ophthalmology, Medical University of Lublin, Lublin, Poland
- Institute for Ophthalmic Research, University Eye Hospital, Tuebingen, Germany
| | | | - Sarah Tripodi
- Department of Ophthalmology, University of Catania, Catania, Italy
| | - Tomasz Choragiewicz
- Department of General Ophthalmology, Medical University of Lublin, Lublin, Poland
| | - Agnieszka Kaminska
- Faculty of Medicine, Collegium Medicum, Cardinal Stefan Wyszynski University, Warsaw, Poland
| | - Michele Figus
- Department of Surgical, Medical, Molecular Pathology and of the Critical Area, University of Pisa, Pisa, Italy
| | - Chiara Posarelli
- Department of Surgical, Medical, Molecular Pathology and of the Critical Area, University of Pisa, Pisa, Italy
| | - Matteo Forlini
- Institute of Ophthalmology, University of Parma, Parma, Italy
| | | | - Michele Reibaldi
- Department of Ophthalmology, University of Catania, Catania, Italy
| | - Robert Rejdak
- Department of General Ophthalmology, Medical University of Lublin, Lublin, Poland
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Shajari M, Scheffel M, Koss MJ, Kohnen T. Dependency of endothelial cell loss on anterior chamber depth within first 4 years after implantation of iris-supported phakic intraocular lenses to treat high myopia. J Cataract Refract Surg 2018; 42:1562-1569. [PMID: 27956282 DOI: 10.1016/j.jcrs.2016.08.027] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Revised: 07/15/2016] [Accepted: 08/09/2016] [Indexed: 10/20/2022]
Abstract
PURPOSE To evaluate the effect of the anterior chamber depth (ACD) on the central corneal endothelial cell density (ECD) in eyes after implantation of an iris-fixated phakic intraocular lens (pIOL). SETTING Department of Ophthalmology, Goethe-University, Frankfurt, Germany. DESIGN Retrospective nonrandomized case series. METHODS An Artisan pIOL was implanted in eyes of highly myopic patients. Follow-up examinations at 1, 12, 24, 36, and 48 months included evaluation of ECD and adverse events. Three cohorts based on the ACD were established and their ECDs compared. All eyes had 1-year and 4-year postoperative ECD measurements available. Statistical analysis included linear regression analysis to evaluate the influence of ACD on ECD. RESULTS The study comprised 95 eyes (52 patients). Four years after surgery the mean spherical equivalent changed from -11.06 diopters (D) ± 4.77 (SD) to -0.42 ± 0.47 D. Severe adverse events were not detected. There was a significantly higher ECD loss after 4 years in patients with an ACD of less than 3.00 mm than in those with an ACD greater than 3.40 mm (-224 cells/mm2) (P < .01). There was no significant difference in ECD between eyes with an ACD of 3.00 to 3.39 mm and eyes with an ACD less than 3.00 mm (P = .23) or more than 3.40 mm (P = .08). CONCLUSIONS The iris-claw pIOL precisely and safely corrected high myopia. However, the loss in ECD can be considerable. Establishing stricter exclusion criteria for ACD might reduce this loss. FINANCIAL DISCLOSURE Proprietary or commercial disclosures are listed after the references.
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Affiliation(s)
- Mehdi Shajari
- From the Department of Ophthalmology, Goethe-University, Frankfurt am Main, Germany
| | - Magdalena Scheffel
- From the Department of Ophthalmology, Goethe-University, Frankfurt am Main, Germany
| | - Michael Janusz Koss
- From the Department of Ophthalmology, Goethe-University, Frankfurt am Main, Germany
| | - Thomas Kohnen
- From the Department of Ophthalmology, Goethe-University, Frankfurt am Main, Germany.
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Jirásková N, Rozsíval P, Kohout A. A Survey of Intraocular Lens Explantation: A Retrospective Analysis of 23 IOLs Explanted during 2005. Eur J Ophthalmol 2018; 17:579-87. [PMID: 17671934 DOI: 10.1177/112067210701700416] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose To evaluate the indications, lens styles, perioperative findings, and results of intraocular lens (IOL) explantation or exchange performed in the authors department in 2005. Methods The retrospective analysis comprised 22 patients (23 eyes). Twenty-one eyes had previous phacoemulsification and IOL implantation, one eye secondary aphakic IOL, and one eye phakic IOL implantation. The indications for IOL explantation/exchange and perioperative complications were evaluated. The best-corrected visual acuity (BCVA) before and after surgery was compared. Results Time from initial surgery to explantation/exchange varied from 1 to 121 months, median value was 46 months. The IOLs were explanted using local anesthesia and in 21 eyes replaced with new lens. Indications for IOL removal were opacification of the IOL in 12 eyes, malposition of the IOL in 5 eyes, postoperative refractive error in 2 eyes, recurrent toxic anterior segment syndrome in 1 eye, pseudophakic dysphotopsia in 1 eye, endothelial cell loss in phakic anterior chamber IOL in 1 eye, and visual discomfort with intraocular telescopic lens in 1 eye. The mean BCVA (decimal scale) before and after IOL explantation/exchange was 0.562±0.279 and 0.627±0.276, respectively. There was no significant difference in visual acuity before and after IOL exchange (Wilcoxon test). Conclusions The most frequent indications for IOL explantation/exchange were opacification of the IOL and IOL malposition. Surgeries were uneventful in most cases. Final visual results have been largely good. Long-term follow-up of patients with various types of IOLs should be maintained.
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Affiliation(s)
- N Jirásková
- Department of Ophthalmology, Faculty of Medicine and University Hospital, Charles University, Sokolská 581, 500 05 Hradec Králové, Czech Republic.
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Long-Term Endothelial Cell Loss in Patients with Artisan Myopia and Artisan Toric Phakic Intraocular Lenses: 5- and 10-Year Results. Ophthalmology 2017; 125:486-494. [PMID: 28935401 DOI: 10.1016/j.ophtha.2017.08.011] [Citation(s) in RCA: 58] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2017] [Revised: 07/10/2017] [Accepted: 08/08/2017] [Indexed: 11/22/2022] Open
Abstract
PURPOSE To evaluate the long-term change in endothelial cell density (ECD) after the implantation of 2 types of rigid iris-fixated phakic intraocular lenses (pIOLs) for the treatment of myopia and astigmatism. DESIGN Prospective, clinical cohort study. PARTICIPANTS A total of 507 eyes of 289 patients receiving the Artisan Myopia or Artisan Toric (Ophtec B.V., Groningen, The Netherlands) iris-fixated pIOL for the treatment of myopia or astigmatism at the University Eye Clinic Maastricht as of January 1998. METHODS A total of 381 myopic and 126 toric pIOLs were implanted. Five- and 10-year follow-ups were completed by 193 and 127 eyes implanted with the myopic pIOL and by 40 and 20 eyes implanted with the toric pIOL, respectively. MAIN OUTCOME MEASURES Chronic endothelial cell (EC) loss, percentage of eyes with a decrease of ≥25% in ECD, and percentage of eyes with an ECD <1500 cells/mm2. RESULTS Chronic EC loss was calculated from 6 months postoperatively to the end of follow-up and showed an annual ECD decline of 48 cells/mm2 (standard error, 3.14) and 61 cells/mm2 (standard error, 6.30) in the myopic (P < 0.001) and toric (P < 0.001) groups, respectively, resulting in a total EC loss of 16.6% and 21.5% from 6 months to 10 years postoperatively, respectively. Ten years after implantation, ECD had decreased by ≥25% in 7.9% and 6.3%, whereas ECD was <1500 cells/mm2 in 3.9% and 4.0% in the myopic and toric groups, respectively. Explantation of the pIOL occurred in 6.0% in the myopic group and 4.8% in the toric group. Risk factors for increased EC loss were a shallow anterior chamber depth (ACD) (P ≤ 0.005) and a smaller distance between the central and peripheral pIOL edge to the endothelium (P ≤ 0.005). CONCLUSIONS A significant linear chronic EC loss was reported after implantation with myopic or toric iris-fixated pIOLs. A smaller ACD and smaller distance between pIOL edge and endothelium were risk factors for EC loss. Modification of preoperative age-related ECD thresholds is indicated to maintain an ECD that warrants safe future combined pIOL explantation and cataract surgery.
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Assessment of the safety and efficacy of primary retropupillary fixation of iris-claw intraocular lenses in children with large lens subluxations. Int Ophthalmol 2017; 38:1985-1992. [PMID: 28819785 DOI: 10.1007/s10792-017-0688-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Accepted: 08/07/2017] [Indexed: 10/19/2022]
Abstract
PURPOSE To evaluate whether retropupillary fixation of the iris-claw intraocular lens (IOL) is a safe and effective treatment option in children with large lens subluxations. METHODS Fourteen eyes of children between the ages of 8-17 years with lens subluxations more than 7 clock hours underwent pars plana lensectomy-vitrectomy with implantation of the iris-claw IOL in the retropupillary position as a primary procedure. The best corrected visual acuity (BCVA), intraocular pressure (IOP), corneal endothelial count (EC) and the lens position using ultrasound biomicroscopy (UBM) were assessed pre- and postoperatively. RESULTS Postoperatively, all patients had an increase in the BCVA with a mean of 0.351 ± 0.154 log MAR units which was statistically significant as compared to the preoperative value of 0.771 ± 0.132 log MAR units (p = 0.003). The difference between the mean preoperative IOP (13.642 ± 2.437 mmHg) and the mean postoperative intraocular pressure at the end of 6 months (13.5 ± 2.244 mmHg) was not statistically significant (p = 0.671). The mean EC decreased by 0.99% from 2838.42 ± 474.76 cells/mm2 preoperatively to 2810 ± 461.24 cells/mm2 at the end of 6 months postoperatively (p = 0.117). The lens position was analyzed using UBM and was found to be parallel to the iris plane in all cases at the end of 6 months. CONCLUSIONS Our study shows that primary retropupillary iris-claw IOL implantation can be a safe and efficacious option for children with large (>7 clock hours) lens subluxations that is at least comparable to scleral-fixated PCIOLs.
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Huerva V, Ascaso FJ, Caral I, Grzybowski A. Calculation of iris-claw IOL power for correction of late in-the-bag IOL complex dislocation. BMC Ophthalmol 2017; 17:122. [PMID: 28693457 PMCID: PMC5504750 DOI: 10.1186/s12886-017-0516-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2017] [Accepted: 07/06/2017] [Indexed: 02/05/2023] Open
Abstract
Background To assess the constants and formula for aphakia correction with iris-claw IOLs to achieve the best refractive status in cases of late in-the-bag IOL complex dislocation. Methods A literature search was performed. The following data were obtained: Iris-claw IOL model, Iridal or retroiridal enclavation, A-constant, ultrasound or optical biometry, formula employed and refractive outcomes. Acceptable emmetropia was considered if the resulting spherical equivalent (SE) was within ±1.00 D. Results The majority of the studies used SRK/T formula (66.6%). The 88.9% of the reports obtained a SE within ±1.00 D. Using A-115 for ultrasound biometry and A-115.7 for optical biometry and SRK/T formula, the emmetropia (±1.00 D) of SE, was able to get near 100% of reported cases over the pupil implantation. However, the emmetropia decreased to 80% when the enclavation is retropupilar using the same formula. The A-constant can vary from 116.7 to 117.5 for retropupilar enclavation. Conclusions Using A-115 for ultrasound biometry and A-115.7 for optical biometry and SRK/T formula, ±1.00 D of SE, is able to get near 100% of cases. Nevertheless, ±1.00 D of SE decreased to 80% of the cases when the enclavation is retropupilar.
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Affiliation(s)
- Valentín Huerva
- Department of Ophthalmology, Universitary Hospital Arnau de Vilanova, Avda. Alcade Rovira Roure 80, 25198, Lleida, Spain. .,IRB Lleida, Lleida, Spain.
| | - Francisco J Ascaso
- Department of Ophthalmology, Hospital Clínico Universitario "Lozano Blesa", Zaragoza, Spain.,Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza, Spain
| | - Isabel Caral
- Department of Ophthalmology, Universitary Hospital Arnau de Vilanova, Avda. Alcade Rovira Roure 80, 25198, Lleida, Spain.,IRB Lleida, Lleida, Spain
| | - Andrzej Grzybowski
- Department of Ophthalmology, Poznań City Hospital, Poznań, Poland.,University of Warmia and Mazury, Olsztyn, Poland
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Park JS, Park BG, Choi BJ, Lee JS. Long Term Corneal Endothelial Cell Density Loss after Iris-fixed Phakic Intraocular Lens Implantation. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2017. [DOI: 10.3341/jkos.2017.58.4.473] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
| | - Byung Gun Park
- Department of Ophthalmology, Pusan National University School of Medicine, Yangsan, Korea
| | | | - Jong Soo Lee
- Department of Ophthalmology, Pusan National University School of Medicine, Yangsan, Korea
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Bohac M, Anticic M, Draca N, Kozomara B, Dekaris I, Gabric N, Patel S. Comparison of Verisyse and Veriflex Phakic Intraocular Lenses for Treatment of Moderate to High Myopia 36 Months after Surgery. Semin Ophthalmol 2016; 32:725-733. [DOI: 10.3109/08820538.2016.1170163] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Affiliation(s)
- Maja Bohac
- Specialty Eye Hospital “Svjetlost,” Zagreb, Croatia, and School of Medicine, University of Rijeka, Rijeka, Croatia
| | - Marija Anticic
- Specialty Eye Hospital “Svjetlost,” Zagreb, Croatia, and School of Medicine, University of Rijeka, Rijeka, Croatia
| | - Natasa Draca
- Specialty Eye Hospital “Svjetlost,” Zagreb, Croatia, and School of Medicine, University of Rijeka, Rijeka, Croatia
| | - Bojan Kozomara
- Eye Hospital “Svjetlost,” Banja Luka, Bosnia and Herzegovina
| | - Iva Dekaris
- Specialty Eye Hospital “Svjetlost,” Zagreb, Croatia, and School of Medicine, University of Rijeka, Rijeka, Croatia
| | - Nikica Gabric
- Specialty Eye Hospital “Svjetlost,” Zagreb, Croatia, and School of Medicine, University of Rijeka, Rijeka, Croatia
| | - Sudi Patel
- Specialty Eye Hospital “Svjetlost,” Zagreb, Croatia, and School of Medicine, University of Rijeka, Rijeka, Croatia
- NHS National Services Scotland, Edinburgh, UK
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Venter JA, Pelouskova M, Schallhorn SC, Collins BM. Visual acuity improvement in adult amblyopic eyes with an iris-fixated phakic intraocular lens: long-term results. J Cataract Refract Surg 2015; 41:541-7. [PMID: 25804581 DOI: 10.1016/j.jcrs.2014.06.037] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2013] [Revised: 06/01/2014] [Accepted: 06/04/2014] [Indexed: 10/23/2022]
Abstract
PURPOSE To evaluate the effect of implantation of iris-fixated phakic intraocular lenses (pIOLs) (Artisan) in adult amblyopic eyes. SETTING Optical Express, London, United Kingdom. DESIGN Retrospective case series. METHODS The study analyzed data from 5 years of follow-up of amblyopic eyes that were implanted with iris-fixated pIOLs and had a preoperative corrected distance visual acuity (CDVA) of 6/15 or worse. Visual acuity, refraction, endothelial cell count, and complications were assessed. RESULTS Data for 103 eyes were analyzed as 2 groups. Group 1 comprised 82 eyes with myopia or myopic astigmatism, and Group 2 contained 21 eyes with hyperopia or hyperopic astigmatism. The mean preoperative sphere in Group 1 was -13.42 diopters (D) ± 5.62 (SD) with a mean cylinder of -2.35 ± 1.75 D. In Group 2, the mean sphere and cylinder were +6.77 ± 1.91 D and -2.63 ± 2.43 D, respectively. The mean CDVA improved from 0.51 ± 0.15 logMAR to 0.34 ± 0.16 logMAR (P<.001) in Group 1 and from 0.54 ± 0.17 logMAR to 0.46 ± 0.14 logMAR in Group 2 (P<.005). The safety index was 1.48 in Group 1 and 1.19 in Group 2. The efficacy index was 1.21 in Group 1 and 1.00 in Group 2. The mean gain in CDVA was statistically significantly greater in Group 1 (0.17 ± 0.14 logMAR) than in Group 2 (0.08 ± 0.11 logMAR). Two or more lines of CDVA were gained by 48.8% of eyes in Group 1 and by 19.0% of eyes in Group 2. CONCLUSION The iris-fixated pIOL was a safe and effective option for improving visual acuity in adult amblyopic eyes. FINANCIAL DISCLOSURE Dr. Schallhorn is a consultant to Abbott Medical Optics, Inc. No other author has a financial or proprietary interest in any material or method mentioned.
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Seong S, Choi CM, Choi TH, Kim SK. Clinical Outcomes of Foldable Iris-Fixed Phakic Intraocular Lens and Change in Corneal Endothelial Cell Density. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2015. [DOI: 10.3341/jkos.2015.56.7.1020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Yaşa D, Ağca A, Alkın Z, Çankaya Kİ, Karaküçük Y, Coşar MG, Yılmaz İ, Yıldırım Y, Demirok A. Two-Year Follow-Up of Artisan Iris-Supported Phakic Anterior Chamber Intraocular Lens for Correction of High Myopia. Semin Ophthalmol 2014; 31:280-4. [PMID: 25412329 DOI: 10.3109/08820538.2014.962164] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE To evaluate the results of Artisan iris-supported phakic anterior chamber intraocular lens (pIOL) implantation in patients with high myopia. METHODS Medical records of patients who underwent Artisan pIOL implantation for surgical correction of myopia were retrospectively reviewed. Only patients with at least a two- year follow-up were included. Spherical equivalent of manifest refractive error (SE), uncorrected visual acuity (UDVA), distance corrected visual acuity (CDVA), and endothelial cell density (ECD) were analyzed at six months, one year, and two years after surgery. RESULTS Sixty-two eyes of 42 patients were included in the study. All patients had a minimum anterior chamber depth of 3.0 mm from the endothelium. At two years, 68% of the patients were within ±0.50 D. Mean ECD was 2723 ± 311 cells/mm(2) preoperatively and 2630 ± 291 cells/mm(2) at six months postoperatively (3.4% loss, p = 0.001). ECD loss from six months postoperatively to two years postoperatively was not statistically significantly different. In three eyes (4.8%) of two patients, a temporary, steroid-induced increase in intraocular pressure (IOP) was detected. CONCLUSION Artisan pIOL implantation is a safe and highly effective procedure for surgical correction of high myopia. ECD loss stabilizes in the early postoperative period.
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Affiliation(s)
- Dilek Yaşa
- a Beyoglu Eye Research and Training Hospital , Istanbul , Turkey and
| | - Alper Ağca
- a Beyoglu Eye Research and Training Hospital , Istanbul , Turkey and
| | - Zeynep Alkın
- a Beyoglu Eye Research and Training Hospital , Istanbul , Turkey and
| | | | - Yalçin Karaküçük
- a Beyoglu Eye Research and Training Hospital , Istanbul , Turkey and
| | | | - İhsan Yılmaz
- a Beyoglu Eye Research and Training Hospital , Istanbul , Turkey and
| | - Yusuf Yıldırım
- a Beyoglu Eye Research and Training Hospital , Istanbul , Turkey and
| | - Ahmet Demirok
- a Beyoglu Eye Research and Training Hospital , Istanbul , Turkey and.,b Istanbul Medeniyet University, Department of Ophthalmology , Istanbul , Turkey
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Labeille E, Burillon C, Cornut PL. Pars plana vitrectomy combined with iris-claw intraocular lens implantation for lens nucleus and intraocular lens dislocation. J Cataract Refract Surg 2014; 40:1488-97. [DOI: 10.1016/j.jcrs.2013.12.025] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2013] [Revised: 12/04/2013] [Accepted: 12/06/2013] [Indexed: 10/24/2022]
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Corneal endothelial cell density after vitrectomy with silicone oil for complex retinal detachments. Retina 2014; 34:228-36. [PMID: 23807185 DOI: 10.1097/iae.0b013e3182979b88] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To evaluate the endothelial cell density changes in eyes with silicone oil tamponade after vitrectomy for complex rhegmatogenous retinal detachment. METHODS A prospective controlled study with 81 eyes with complex rhegmatogenous retinal detachment undergoing vitrectomy and silicone oil tamponade. Fellow eyes that fulfilled specific inclusion criteria served as controls. Endothelial cell density (in cells per square millimeter), coefficient of variance (standard deviation per mean cell area × 100), percentage of hexagonal cells, and corneal thickness were documented preoperatively and compared with values obtained at 3, 6, and 12 months postoperatively. For the purpose of the study analysis, all study eyes were divided into 5 groups, according to their lens status during the follow-up. RESULTS High endothelial cell density loss was found in Group 3, (eyes that underwent an additional phacoemulsification procedure) and Group 4 (eyes that underwent lens and/or intraocular lens removal during the follow-up) at 12 months with a mean cell loss of 19% and 39%, respectively (P < 0.001). CONCLUSION An intact natural or artificial lens-iris diaphragm may provide a protective barrier against corneal endothelial cell damage from long-term silicone oil tamponade.
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Moran S, Kirwan C, O'Keefe M, Leccisotti A, Moore T. Incidence of dislocated and subluxed iris-fixated phakic intraocular lens and outcomes following re-enclavation. Clin Exp Ophthalmol 2014; 42:623-8. [DOI: 10.1111/ceo.12310] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2013] [Accepted: 01/06/2014] [Indexed: 11/26/2022]
Affiliation(s)
- Sarah Moran
- Eye Laser Department; Mater Private Hospital; Dublin Ireland
| | | | - Michael O'Keefe
- Eye Laser Department; Mater Private Hospital; Dublin Ireland
| | - Antonio Leccisotti
- School of Biomedical Sciences; University of Ulster; Coleraine UK
- Siena Eye Laser; Monteriggioni Siena Italy
| | - Tara Moore
- School of Biomedical Sciences; University of Ulster; Coleraine UK
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Kwitko S, Stolz AP. Iris-claw (Artisan®/Artiflex®) phakic intraocular lenses for high myopia and high hyperopia. EXPERT REVIEW OF OPHTHALMOLOGY 2014. [DOI: 10.1586/eop.11.57] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Na KS, Jeon S, Joo CK. Effect of intraoperative manipulation during iris-claw phakic IOL implantation on endothelium. Can J Ophthalmol 2013; 48:259-64. [DOI: 10.1016/j.jcjo.2013.02.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2012] [Accepted: 02/11/2013] [Indexed: 12/13/2022]
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Torun N, Bertelmann E, Klamann MKJ, Maier AK, Liekfeld A, Gonnermann J. Posterior chamber phakic intraocular lens to correct myopia: long-term follow-up. J Cataract Refract Surg 2013; 39:1023-8. [PMID: 23664355 DOI: 10.1016/j.jcrs.2013.01.041] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2012] [Revised: 01/19/2013] [Accepted: 01/22/2013] [Indexed: 10/26/2022]
Abstract
PURPOSE To evaluate the long-term safety and efficacy of a refractive phakic intraocular lens (pIOL) (PRL) to correct moderate to high myopia. SETTING Department of Ophthalmology, University Medicine Charité Berlin, Berlin, Germany. DESIGN Retrospective cohort study. METHODS Uncorrected (UDVA) and corrected (CDVA) distance visual acuities, refraction, intraocular pressure, endothelial cell loss, and adverse events were evaluated. RESULTS The study enrolled 53 eyes (mean spherical equivalent [SE] -12.17 diopters [D] ± 4.12 [SD]) of 29 patients. The mean age was 34.6 ± 9.2 years and the mean follow-up, 86 ± 21.2 months. The mean UDVA improved from 1.37 ± 0.28 logMAR preoperatively to 0.14 ± 0.19 logMAR at the last postoperative visit (P<.05). The mean CDVA improved from 0.10 ± 0.18 logMAR to -0.01 ± 0.09 logMAR (P<.05). The overall mean efficacy index and mean safety index were 0.9 and 1.21, respectively, at the last follow-up visit. The mean endothelial cell loss at the last follow-up was 6.4%. The complications were slight posterior chamber (PC) pIOL decentration (5 eyes, 9.4%), severe PC pIOL decentration resulting in pIOL removal (1 eye, 1.8%), glaucoma (4 eyes, 7.5%), clinically significant cortical lens opacification resulting in cataract surgery (4 eyes, 7.5%), clinically asymptomatic anterior subcapsular cataract formation (6 eyes, 11.3%), and retinal detachment (2 eyes, 3.8%). CONCLUSIONS Posterior chamber phakic pIOL implantation to correct moderate to high myopia provided predictable and stable refractive results but with a high rate of serious complications over the long term. FINANCIAL DISCLOSURE No author has a financial or proprietary interest in any material or method mentioned.
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Affiliation(s)
- Necip Torun
- Departments of Ophthalmology, University Medicine Charité Berlin, Berlin, Germany.
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Gonnermann J, Klamann MK, Maier AK, Rjasanow J, Joussen AM, Bertelmann E, Rieck PW, Torun N. Visual outcome and complications after posterior iris-claw aphakic intraocular lens implantation. J Cataract Refract Surg 2012; 38:2139-43. [PMID: 23036355 DOI: 10.1016/j.jcrs.2012.07.035] [Citation(s) in RCA: 92] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2012] [Revised: 07/28/2012] [Accepted: 07/31/2012] [Indexed: 10/27/2022]
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Chen Y, Liu Q, Xue C, Huang Z, Chen Y. Three-year follow-up of secondary anterior iris fixation of an aphakic intraocular lens to correct aphakia. J Cataract Refract Surg 2012; 38:1595-601. [PMID: 22906445 DOI: 10.1016/j.jcrs.2012.04.037] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2012] [Revised: 04/19/2012] [Accepted: 04/27/2012] [Indexed: 02/06/2023]
Abstract
PURPOSE To evaluate the efficacy, predictability, stability, safety, and complications of secondary anterior iris fixation of the Artisan iris-fixated intraocular lens (IOL) to correct aphakia in eyes without sufficient capsule support. SETTING Department of Ophthalmology, Jinling Hospital, School of Medicine, Nanjing University, Nanjing, China. DESIGN Cohort study. METHODS Eyes having implantation of aphakic iris-fixated IOLs for aphakia correction were followed for 3 years. RESULTS The study evaluated 72 eyes (72 patients). After 3 years, the uncorrected distance visual acuity improved in all eyes (P<.05); 53 eyes (73.6%) reached 20/40 or better. Two eyes had a postoperative corrected distance visual acuity (CDVA) worse than the preoperative CDVA due to postoperative ischemic optic neuropathy and retinal detachment, respectively. The mean spherical equivalent (SE) decreased from 11.65 diopters (D) ± 1.21 (SD) to -0.58 ± 0.56 D (P<.05); the SE at the last follow-up was within ±1.00 D of the target refraction in 63 eyes (87.5%). The mean endothelial cell loss 3 years postoperatively was 9.78%. There was no significant postoperative intraocular pressure increase throughout the follow-up. Twelve patients (16.7%) reported glare and halos during night driving. Iris pigment precipitates on the IOLs occurred in 4 eyes (5.6%) 3 years postoperatively. No other serious complications occurred. CONCLUSIONS Three-year results indicate that secondary implantation of aphakic IOLs is effective, predictable, and safe for the correction of aphakia in eyes without capsule support. However, longer follow-up with a larger cohort is necessary to confirm these conclusions.
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Affiliation(s)
- Yueqin Chen
- Department of Ophthalmology, Jinling Hospital, School of Medicine, Nanjing University, Nanjing, China
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36
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Iris-fixated intraocular lens implantation to correct moderate to high myopia in Asian-Indian eyes: Five-year results. J Cataract Refract Surg 2012; 38:1446-52. [DOI: 10.1016/j.jcrs.2012.03.029] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2010] [Revised: 03/04/2011] [Accepted: 03/06/2012] [Indexed: 11/20/2022]
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Kim WK, Kim HS, Cho EY, Kim JK, Yang H. Effects of Prone Positioning on Critical Distance in Iris-Claw Phakic Intraocular Lens-Implanted Eyes. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2012. [DOI: 10.3341/jkos.2012.53.9.1254] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Wook Kyum Kim
- B&VIIT Eye Center, Seoul, Korea
- KAIST GSMSE, Daejeon, Korea
| | | | | | - Jin Kook Kim
- B&VIIT Eye Center, Seoul, Korea
- KAIST GSMSE, Daejeon, Korea
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Hara S, Borkenstein AF, Ehmer A, Auffarth GU. Retropupillary Fixation of Iris-claw Intraocular Lens Versus Transscleral Suturing Fixation for Aphakic Eyes Without Capsular Support. J Refract Surg 2011; 27:729-35. [DOI: 10.3928/1081597x-20110623-01] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2010] [Accepted: 05/27/2011] [Indexed: 11/20/2022]
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Woodward MA, Edelhauser HF. Corneal endothelium after refractive surgery. J Cataract Refract Surg 2011; 37:767-77. [PMID: 21420604 DOI: 10.1016/j.jcrs.2011.01.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2010] [Revised: 10/28/2010] [Accepted: 10/29/2010] [Indexed: 11/25/2022]
Abstract
UNLABELLED The endothelium is vital to the health and optical clarity of the human cornea. The safety of procedures to correct refractive errors depends on preservation of an intact corneal endothelium. Disease states and genetic and environmental factors affect the corneal endothelium; an unstable corneal endothelium can impact the success of refractive surgery. Technological advances and recent laboratory findings have improved the ability to assess the endothelium. The status of the corneal endothelium after laser in situ keratomileusis, photorefractive keratectomy, phakic intraocular lenses, and adjuvants to these treatments has been the topic of numerous clinical trials. Safety guidelines for refractive surgery procedures should be followed to minimize deleterious effects on the corneal endothelium. FINANCIAL DISCLOSURE Neither author has a financial or proprietary interest in any material or method mentioned.
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Karimian F, Sadoughi MM. Air-assisted Descemet-stripping automated endothelial keratoplasty with posterior chamber iris-fixation of aphakic iris-claw intraocular lens. J Cataract Refract Surg 2011; 37:224-8. [DOI: 10.1016/j.jcrs.2010.11.021] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2010] [Revised: 09/14/2010] [Accepted: 09/23/2010] [Indexed: 10/18/2022]
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Izquierdo L, Henriquez MA, McCarthy M. Artiflex phakic intraocular lens implantation after corneal collagen cross-linking in keratoconic eyes. J Refract Surg 2011; 27:482-7. [PMID: 21210571 DOI: 10.3928/1081597x-20101223-02] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2010] [Accepted: 11/09/2010] [Indexed: 01/13/2023]
Abstract
PURPOSE To evaluate the safety, efficacy, and stability of the Artiflex (Ophtec BV) foldable anterior iris-claw phakic intraocular lens (PIOL) following corneal collagen cross-linking (CXL) in select cases of progressive keratoconus. METHODS This prospective, comparative study, conducted between March 2007 and June 2008, involved 11 eyes with progressive keratoconus. Inclusion criteria were progressive keratoconus (Amsler-Krumeich classification grades I and II) with no corneal opacities, corneal thickness >450 μm, endothelial cell count >2500 cells/mm(2), anterior chamber depth >3.2 mm, spherical equivalent refraction >4.50 diopters (D) (with a cylinder component <2.00 D), and no other treatment for keratoconus other than contact lens. Each patient underwent CXL in the keratoconic eye with implantation of the Artiflex IOL 6 months thereafter. Uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), and refraction and topographic profiles were examined at 1, 6, and 12 months after the CXL procedure. RESULTS All eyes achieved UDVA of 0.3 logMAR or better. Final spherical and cylindrical error ranged from 0 to -1.50 D and 0 to -1.75 D, respectively. No eyes lost lines of preoperative CDVA. Statistically significant reductions in mean maximum (2.14 D, P<.001) and minimum (1.17 D, P=.02) keratometry values were present 12 months after the CXL procedure. No complications were observed. CONCLUSIONS Combined CXL and Artiflex implantation was a safe and effective treatment in this subset of eyes with progressive keratoconus. Good results in terms of visual acuity, postoperative residual refractive error, and keratometry values were identified.
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Affiliation(s)
- Luis Izquierdo
- Research Department, Instituto de Ojos Oftalmosalud Lima, Peru
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43
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Park DH, Lane SS. Phakic Myopic Intraocular Lenses. Cornea 2011. [DOI: 10.1016/b978-0-323-06387-6.00178-1] [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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45
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Kohnen T, Kook D, Morral M, Güell JL. Phakic intraocular lenses. J Cataract Refract Surg 2010; 36:2168-94. [DOI: 10.1016/j.jcrs.2010.10.007] [Citation(s) in RCA: 141] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2010] [Revised: 09/01/2010] [Accepted: 09/01/2010] [Indexed: 11/29/2022]
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46
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Güell JL, Morral M, Kook D, Kohnen T. Phakic intraocular lenses. J Cataract Refract Surg 2010; 36:1976-93. [PMID: 21029908 DOI: 10.1016/j.jcrs.2010.08.014] [Citation(s) in RCA: 111] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2009] [Accepted: 03/10/2010] [Indexed: 11/28/2022]
Affiliation(s)
- Jose Luis Güell
- Instituto Microcirugia Ocular, Autonoma University of Barcelona, Barcelona, Spain
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47
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Liu A, Manche EE. Late-onset nontraumatic dislocation of anterior chamber phakic intraocular lens. J Cataract Refract Surg 2010; 36:854-6. [PMID: 20457382 DOI: 10.1016/j.jcrs.2010.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2009] [Revised: 11/11/2009] [Accepted: 11/11/2009] [Indexed: 10/19/2022]
Abstract
Long-term stability of the position of phakic intraocular lenses (pIOLs) is important in maintaining visual acuity as well as avoiding injury to the local tissues. We report a case of late nontraumatic dislocation of an iris-fixated pIOL, with subsequent successful repositioning.
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Affiliation(s)
- Anthony Liu
- Department of Ophthalmology, Stanford University School of Medicine, Palo Alto, California 94305, USA
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Titiyal JS, Sharma N, Mannan R, Pruthi A, Vajpayee RB. Outcomes of reenclavation of subluxated iris-fixated phakic intraocular lenses: Comparison with primary surgery outcomes. J Cataract Refract Surg 2010; 36:577-81. [DOI: 10.1016/j.jcrs.2009.11.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2009] [Revised: 11/02/2009] [Accepted: 11/03/2009] [Indexed: 11/30/2022]
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Secondary iris claw intraocular lens implantation for the correction of aphakia after pars plana vitrectomy. Retina 2010; 30:131-9. [PMID: 19834354 DOI: 10.1097/iae.0b013e3181b32eef] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE The purpose of this study was to evaluate the safety and efficacy of iris claw intraocular lens implantation for correction of aphakia in vitrectomized eyes without capsular support. METHODS This was a prospective interventional case series. Twelve aphakic vitrectomized eyes without capsular support underwent iris claw intraocular lens implantation. The main outcome measures were changes in uncorrected visual acuity, best-corrected visual acuity, spheric equivalent, corneal endothelial cell density, corneal thickness, central macular thickness, and complications. RESULTS Mean follow-up was 15.58 +/- 3.80 months with no intraoperative complications. Postoperatively, uncorrected visual acuity increased significantly at all follow-up visits (P < 0.05). Mean best-corrected visual acuity increased 10 letters/2 lines at the final follow-up visit (P = 0.023). Mean postoperative spheric equivalent at the last visit was -1.68 +/- 063 D, and the spheric equivalent was within +/-2.00 D of emmetropia in 9 (75%) eyes. Mean central macular thickness increased only at postoperative Month 3 (P = 0.043). Mean endothelial cell density loss was 23.87% at the last visit. Mean corneal thickness did not change during follow-up (P > 0.05). No corneal edema was observed. Complications were transient intraocular pressure increase (n = 1), cystoid macular edema (n = 1), and haptic dislocation replaced by surgery (n = 1). Retinas remained attached in all eyes. CONCLUSION Secondary iris claw intraocular lens implantation is clinically safe and effective to correct aphakia in vitrectomized eyes without capsular support. Larger studies with longer follow-up are warranted.
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Needle-guided intrascleral fixation of posterior chamber intraocular lens for aphakia correction. J Cataract Refract Surg 2009; 35:2051-3. [DOI: 10.1016/j.jcrs.2009.06.044] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2009] [Revised: 06/20/2009] [Accepted: 06/22/2009] [Indexed: 10/20/2022]
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