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LoBue SA, Saba N, Catapano TM, Martin CR, Shelby CL, Coleman WT. Potential role of the light-adjustable lens in flanged intrascleral haptic fixation. J Cataract Refract Surg 2024; 50:754-759. [PMID: 38595175 DOI: 10.1097/j.jcrs.0000000000001455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Accepted: 04/01/2024] [Indexed: 04/11/2024]
Abstract
PURPOSE To compare maximum tensile strength between commonly used 3-piece intraocular lens (IOL) for flanged intrascleral haptic fixation (FISHF). SETTING Willis-Knight Eye Institute, Shreveport, Louisiana. DESIGN Laboratory investigation. METHODS Haptic tensile strength was compared with MA60AC, CT Lucia 602, AR40E, and the light-adjustable lens (LAL). Haptic strength with a 24-diopter (D) IOL was compared across all lenses, as well as across a range of 10 to 30 D with the MA60AC. A custom device was created to hold the IOL in correct haptic orientation. The maximum tension (mean ± SD) was recorded in Newtons (N) when the haptic lost tension or broke. RESULTS CT Lucia was the strongest at 1.53 ± 0.11 N vs 1.00 ± 0.15 (MA60AC), 0.87 ± 0.19 (AR40E), and 0.83 ± 0.14 N (LAL) ( P < .001). The LAL and AR40E were similar to a 9-0 polypropylene suture while being significantly stronger than 10-0 polypropylene suture ( P < .001). No difference in haptic tension for the MA60AC from 10 to 30 D ( P > .05). High magnification revealed the highest haptic fractures for MA60AC at 40% compared with LAL, AR40E, and CT Lucia at 0%. CT Lucia and AR40E had 100% of haptics disinserted from the IOL without any damage compared with 60% LAL and 60% MA60AC. CT Lucia, AR40E, and LAL have a flatter haptic angulation at 5 degrees. CONCLUSIONS Haptic strength, durability, and angulation of the LAL may support the possibility of FISHF in the hands of experienced surgeons. However, further testing is strongly recommended to verify whether physiologic conditions or light treatments may compromise long-term haptic stability.
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Affiliation(s)
- Stephen A LoBue
- From the Department of Ophthalmology, Willis-Knighton Medical Center, Shreveport, Louisiana (LoBue, Martin, Shelby, Coleman); Department of Ophthalmology, SUNY Downstate Medical Center, Brooklyn, New York (Saba); St. Georges University School of Medicine, Grenada, West Indies (Catapano)
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Fernández-Vigo JI, Fernández-Aragón S, Burgos-Blasco B, Ly-Yang F, De-Pablo-Gómez-de-Liaño L, Almorín-Fernández-Vigo I, Martínez-de-la-Casa JM, Fernández-Vigo JÁ. Comparison in conjunctival-Tenon's capsule thickness, anterior scleral thickness and ciliary muscle dimensions between Caucasians and Hispanic by optical coherence tomography. Int Ophthalmol 2023; 43:3969-3977. [PMID: 37405569 DOI: 10.1007/s10792-023-02798-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 06/22/2023] [Indexed: 07/06/2023]
Abstract
PURPOSE To investigate the differences in the dimensions of the anterior ocular segment, and specifically in conjunctival-Tenon's capsule thickness (CTT), anterior scleral thickness (AST) and ciliary muscle thickness (CMT), between Caucasian and Hispanic subjects using swept-source optical coherence tomography (SS-OCT). METHODS Cross-sectional study including 53 Hispanic and 60 Caucasian healthy participants, matched by age, sex and refractive error, who underwent a complete ophthalmological examination. CTT, AST and CMT were manually measured in the temporal and nasal quadrants at 0, 1, 2 and 3 mm from the scleral spur using SS-OCT. RESULTS Mean age and refractive error were 38.7 ± 12.3 years and -1.05 ± 2.6 diopters, and 41.8 ± 11.7 years and -0.50 ± 2.6 diopters for the Hispanic and Caucasians, respectively (p = 0.165 and p = 0.244). The CTT was increased in the temporal quadrant in the Hispanic group in the three studied regions (CTT1, CTT2 and CTT3; being the means 223.0 ± 68.4, 215.3 ± 66.4 and 203.8 ± 67.1 µm versus 190.8 ± 51.0, 189.4 ± 53.2 and 187.4 ± 55.3 µm respectively; p < 0.001). Larger AST values were observed in the temporal quadrant in the Hispanic group (AST2: 559.8 ± 80.8 µm and AST3: 591.6 ± 83.0 µm) compared to the Caucasian group (520.7 ± 50.1 and 558.9 ± 54.7 respectively; p ≤ 0.022). No differences were observed in the nasal quadrant for CTT, AST1 and AST3 (p ≥ 0.076). No differences emerged in the CM dimensions (p ≥ 0.055). CONCLUSION CTT and AST measurements were thicker in the temporal quadrant of Hispanic patients compared to Caucasians. This could have implications for the pathogenesis of different ocular diseases.
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Affiliation(s)
- José Ignacio Fernández-Vigo
- Centro Internacional de Oftalmología Avanzada, Zurbano 71 Street, 28010, Madrid, Spain.
- Department of Ophthalmology, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria (IdISSC), Madrid, Spain.
| | | | - Bárbara Burgos-Blasco
- Department of Ophthalmology, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria (IdISSC), Madrid, Spain
| | - Fernando Ly-Yang
- Department of Ophthalmology, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria (IdISSC), Madrid, Spain
| | - Lucía De-Pablo-Gómez-de-Liaño
- Centro Internacional de Oftalmología Avanzada, Zurbano 71 Street, 28010, Madrid, Spain
- Department of Ophthalmology, Hospital 12 de Octubre, Madrid, Spain
| | | | | | - José Ángel Fernández-Vigo
- Centro Internacional de Oftalmología Avanzada, Zurbano 71 Street, 28010, Madrid, Spain
- Department of Ophthalmology, Universidad de Extremadura, Badajoz, Spain
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Wei W, Lin H, Zheng X, Wang S, Bai S, Zhao Z. Refractive outcomes of scleral-sutured posterior chamber intraocular lenses in post-traumatic eyes. Int Ophthalmol 2023; 43:423-429. [PMID: 35997929 DOI: 10.1007/s10792-022-02439-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 07/05/2022] [Indexed: 10/15/2022]
Abstract
PURPOSE To evaluate the refractive outcomes of scleral-sutured IOL 2 mm posterior to the limbus in post-traumatic eyes using SRK/T formula. METHODS This single-center retrospective case series included 35 eyes from 35 post-traumatic patients undergoing scleral-suture of ErgomaX IOLs by a single experienced surgeon. Preoperative predicted refraction, procedure-related complications, and postoperative spherical equivalent (SE) at least 1 month after surgery were recorded. The prediction error (PE) was calculated as the difference between the postoperative SE and preoperative predicted refraction. RESULTS Of the 35 post-traumatic patients, 28 patients were aphakia without capsular support, and 7 patients were traumatic lens dislocation or subluxation. The mean age at surgery was 56.03 ± 14.56 years and 28 patients were men (80%). The mean postoperative spherical equivalent (SE) and postoperative astigmatism were - 1.23 ± 0.82 D and 1.57 ± 1.14 D, respectively. The mean prediction error (ME) of SRK/T formula was - 0.17 D. The mean absolute error (MAE) was 0.48D. The prediction accuracy was 60.0% for refractive errors of ± 0.50 D and 85.7% for refractive errors of ± 1.00D. Multiple linear regression analyses revealed that IOL power has positive correlation with PE. CONCLUSION Assumption of in-the-bag IOL position when calculating IOL (52501TY, ErgomaX) power for standardizing scleral-sutured IOL 2 mm posterior to the limbus demonstrates acceptable refractive outcomes. The accuracy of IOL power calculation using the SRK/T formula for eyes needing low IOL power or high IOL power may be affected by the uncertain position of postoperative IOL and further studies are needed.
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Affiliation(s)
- Wenlong Wei
- The Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, 325027, China
| | | | - Xuanli Zheng
- Wenzhou Medical University, Wenzhou, 325027, China
| | - Siyi Wang
- The Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, 325027, China
| | - Shengsheng Bai
- The Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, 325027, China
| | - Zhenquan Zhao
- The Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, 325027, China.
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Kim Y, Choi EY, Lee CS, Kim SS, Byeon SH. Clinical Characteristics of recurrent intraocular lens dislocation after scleral-fixated sutured intraocular lens and long-term outcomes of intraocular lens re-fixation. Graefes Arch Clin Exp Ophthalmol 2022; 260:3267-3273. [PMID: 35588329 DOI: 10.1007/s00417-022-05692-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 04/08/2022] [Accepted: 04/27/2022] [Indexed: 11/29/2022] Open
Abstract
PURPOSE This study aimed to investigate the clinical characteristics of patients with recurrent intraocular lens (IOL) dislocation after scleral-fixated sutured IOL implantation and evaluate the long-term outcomes of scleral re-fixation of IOL. METHODS The medical records of patients who underwent surgery for IOL dislocation between January 2011 and January 2021 were reviewed. The study included 164 patients (male: 131, female: 33) (176 eyes). Patient demographics, preoperative, intraoperative and postoperative data, and the ocular and systemic conditions associated with IOL re-dislocation were analyzed. RESULTS The study included 176 consecutive cases of scleral-fixated sutured IOL. Twenty-six eyes (14.8%) showed re-dislocation of IOL after the initial IOL scleral fixation and underwent reoperation (mean 75.5 ± 62.5 months after the first surgery); three (11.5%) of them required a third surgery. Younger adults (aged less than 40 years), and patients who underwent IOL scleral fixation in complicated cataract surgery or aphakic state had a higher risk of re-dislocation. Diabetes mellitus (DM) was the only statistically significantly higher risk factor in the re-dislocated group (p = 0.041). The complication rate with scleral re-fixation was higher than that in the non-re-dislocated group. No statistically significant differences were observed, except for vitreous hemorrhage (p = 0.024). CONCLUSIONS Caution should be exercised when performing sutured scleral fixation of IOL in younger patients, cases of complicated cataract surgery and aphakia, and patients with DM to prevent IOL re-dislocation. Scleral-fixated sutured IOL in eyes with recurrent IOL dislocation seems to be a safe and effective procedure with a relatively low complication rate.
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Affiliation(s)
- Yeji Kim
- Department of Ophthalmology, Institute of Vision Research, Severance Hospital, Yonsei University College of Medicine, 50-1, Yonseiro, Seodaemun-gu, Seoul, Republic of Korea
| | - Eun Young Choi
- Department of Ophthalmology, Institute of Vision Research, Severance Hospital, Yonsei University College of Medicine, 50-1, Yonseiro, Seodaemun-gu, Seoul, Republic of Korea
| | - Christopher Seungkyu Lee
- Department of Ophthalmology, Institute of Vision Research, Severance Hospital, Yonsei University College of Medicine, 50-1, Yonseiro, Seodaemun-gu, Seoul, Republic of Korea
| | - Sung Soo Kim
- Department of Ophthalmology, Institute of Vision Research, Severance Hospital, Yonsei University College of Medicine, 50-1, Yonseiro, Seodaemun-gu, Seoul, Republic of Korea
| | - Suk Ho Byeon
- Department of Ophthalmology, Institute of Vision Research, Severance Hospital, Yonsei University College of Medicine, 50-1, Yonseiro, Seodaemun-gu, Seoul, Republic of Korea.
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Yuan A, Ma K, Sharifi S, Pineda R. Biomechanical Testing of Flanged Polypropylene Sutures in Scleral Fixation. Am J Ophthalmol 2021; 230:134-142. [PMID: 33945819 PMCID: PMC10560604 DOI: 10.1016/j.ajo.2021.04.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 04/18/2021] [Accepted: 04/18/2021] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To optimize the flanged belt-loop technique of scleral fixation through biomechanical testing and report clinical outcomes of resultant modifications. DESIGN Experimental study. METHODS The force to disinsert flanged polypropylene suture from human cadaveric sclera was assessed using a tensile testing machine and compared to the breaking strengths of 9-0 and 10-0 polypropylene. The effects of modifying suture gauge (5-0, 6-0, 7-0, or 8-0), amount of suture cauterized (0.5 or 1.0 mm), and sclerotomy size (27, 30, 32, 33 gauge) were investigated. Belt-loop intrascleral fixation using 6-0 and 7-0 polypropylene with 30 and 32 gauge needles, respectively, was performed in 4 patients. Main outcome measures were flanged suture disinsertion forces in cadaveric sclera. RESULTS The average force to disinsert a flange created by melting 1.0 mm of 5-0, 6-0, 7-0, and 8-0 polypropylene suture from human cadaveric sclera via 27, 30, 32, and 33 gauge needle sclerotomies was 3.0 ± 0.5 N, 2.1 ± 0.3 N, 0.9 ± 0.2 N, and 0.4 ± 0.1 N, respectively. The disinsertion forces for flanges formed by melting 0.5 mm of the same gauges were 72%-79% lower (P < .001). In comparison, the breaking strengths of 9-0 and 10-0 polypropylene were 0.91 ± 0.4 N and 0.52 ± 0.03 N. Belt-loop fixation using 6-0 and 7-0 polypropylene with 30 and 32 gauge sclerotomies demonstrated good outcomes at 6 months. CONCLUSIONS The flanged belt-loop technique is a biomechanically sound method of scleral fixation using 1.0 mm flanges of 5-0 to 7-0 polypropylene paired with 27, 30, and 32 gauge sclerotomies. In contrast, 8-0 polypropylene and 0.5 mm flanges of any suture gauge will likely be unstable with this technique.
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Affiliation(s)
- Amy Yuan
- From the Department of Ophthalmology, University of Washington, Seattle, Washington, USA (A.Y.)
| | - Kevin Ma
- Department of Ophthalmology, Massachusetts Eye and Ear, Boston, Massachusetts, USA (K.M., R.P.)
| | - Sina Sharifi
- Schepens Eye Research Institute of Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts, USA (S.S.)
| | - Roberto Pineda
- Department of Ophthalmology, Massachusetts Eye and Ear, Boston, Massachusetts, USA (K.M., R.P.).
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Jiang B, Dong S, Sun MH, Zhang ZY, Sun DW. Clinical effect of peripheral capsule preservation in eyes with silicone oil tamponade. World J Clin Cases 2021; 9:7729-7737. [PMID: 34621823 PMCID: PMC8462261 DOI: 10.12998/wjcc.v9.i26.7729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 06/16/2021] [Accepted: 07/20/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND At present, silicone oil has been widely used in vitrectomy to deal with complex fundus diseases. Usually, cataract extraction is combined with vitrectomy. However, reducing the complications of silicone oil tamponade and facilitating the secondary implantation of intraocular lens (IOL) are still an urgent problem.
AIM To evaluate the clinical effect of vitrectomy combined with peripheral capsule preservation (PCP) in eyes with silicone oil tamponade.
METHODS This single-center retrospective analysis included 70 patients (73 eyes) who underwent vitrectomy and silicone oil tamponade combined with cataract surgery (stage I) between January 2015 and July 2019. All patients underwent selective reoperation for silicone oil extraction and IOL implantation (stage II) more than 3 mo after stage I. These patients were divided into three groups according to the different lens capsule preservation methods: 28 patients (31 eyes) in a whole capsule preserved (WCP) group, 17 (17 eyes) in a capsule absent (CA) group, and 25 (25 eyes) in a peripheral capsule preserved (PCP) group. Intraocular pressure (IOP), best-corrected visual acuity, surgery time, and other complications were recorded at each time point (1 d, 1 wk, and 1 mo after stages I and II).
RESULTS The IOP values were 14.9 ± 8.2 mmHg in the WCP group, 20.3 ± 13.0 mmHg in the CA group, and 14.2 ± 9.7 mmHg in the PCP group (P < 0.05) at 1 mo after stage I operation. Five eyes had IOP higher than 30 mmHg, and one eye in the WCP group appeared to have silicone oil entering the anterior chamber. There was no significant difference in IOP among the three groups at any other time point (P > 0.05). With IOL implantation, visual acuity improved significantly compared to stage I. The incidence rate of posterior capsule opacity was higher in the WCP group than in the other groups (P < 0.001). In the CA group, IOL deviation due to suture relaxation occurred in one case. There was no significant difference in the surgery time among the three groups in stage I (P = 0.618). In stage II, the surgery time of the PCP group and WCP group was significantly shorter than that of the AC group (P = 0.031).
CONCLUSION Preservation of the peripheral capsule in vitrectomy combined with lens removal is a better option. This method has significant advantages in reducing intraoperative and postoperative complications.
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Affiliation(s)
- Bo Jiang
- Department of Ophthalmology, The Second Affiliated Hospital of Harbin Medical University, Harbin 150001, Heilongjiang Province, China
| | - Su Dong
- Department of Ophthalmology, The Second Affiliated Hospital of Harbin Medical University, Harbin 150001, Heilongjiang Province, China
| | - Ming-Hao Sun
- Department of Ophthalmology, The Second Affiliated Hospital of Harbin Medical University, Harbin 150001, Heilongjiang Province, China
| | - Zhong-Yu Zhang
- Department of Ophthalmology, The Second Affiliated Hospital of Harbin Medical University, Harbin 150001, Heilongjiang Province, China
| | - Da-Wei Sun
- Department of Ophthalmology, The Second Affiliated Hospital of Harbin Medical University, Harbin 150001, Heilongjiang Province, China
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Kokame GT, Tanji TT, Omizo JN. Long-Term Stability of Sutured Scleral Fixation of a Posterior Chamber Intraocular Lens With 10-0 Polypropylene for More Than 30 Years. JOURNAL OF VITREORETINAL DISEASES 2021; 5:452-454. [PMID: 37008711 PMCID: PMC9976114 DOI: 10.1177/2474126420978870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Purpose: We report the longest follow-up to our knowledge of stable scleral fixation of a posterior chamber intraocular lens (PC IOL) with 10-0 polypropylene sutures. Methods: A retrospective review is presented of a case with more than 30 years’ follow-up after performing sutured scleral fixation with 10-0 polypropylene suture using 2 sutures tied together under a scleral flap. One suture was a cow-hitch looped around the haptic, and the other suture was passed through the sclera to create the scleral fixation. Results: The scleral fixation with 10-0 polypropylene suture knots for both haptics of the PC IOL allowed central optic positioning with excellent vision for more than 30 years without suture breakage. Conclusions: Polypropylene sutures for scleral fixation of PC IOLs remained stable for more than 30 years with central positioning of the PC IOL, without exposure of the fixation suture knots through the conjunctiva, and without suture breakage.
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Affiliation(s)
- Gregg T. Kokame
- Division of Ophthalmology, Department of Surgery, University of Hawaii School of Medicine, Honolulu, HI, USA
- The Retina Center at Pali Momi, Aiea, HI, USA
- Retina Consultants of Hawaii, Aiea, HI, USA
- Hawaii Macula and Retina Institute, HI, USA
- University of Hawai’i John A. Burns School of Medicine, Honolulu, HI, USA
| | - Tarin T. Tanji
- The Retina Center at Pali Momi, Aiea, HI, USA
- Retina Consultants of Hawaii, Aiea, HI, USA
- Hawaii Macula and Retina Institute, HI, USA
| | - Jase N. Omizo
- The Retina Center at Pali Momi, Aiea, HI, USA
- Retina Consultants of Hawaii, Aiea, HI, USA
- Hawaii Macula and Retina Institute, HI, USA
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Kristianslund O, Sandvik GF, Drolsum L. Long-Term Suture Breakage After Scleral Fixation of a Modified Capsular Tension Ring with Polypropylene 10-0 Suture. Clin Ophthalmol 2021; 15:2473-2479. [PMID: 34163130 PMCID: PMC8214109 DOI: 10.2147/opth.s310648] [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: 03/11/2021] [Accepted: 04/23/2021] [Indexed: 12/17/2022] Open
Abstract
Aim To investigate the long-term risk of suture breakage after implantation of a modified capsular tension ring (MCTR) fixated to the sclera with polypropylene 10–0 suture. Methods Retrospective case series of operations for subluxated phakic lenses in 2007–2015 with implantation of an MCTR secured with a 10–0 polypropylene suture as part of an intraocular lens (IOL)-capsular bag complex. Results We identified 132 eyes (92 patients) operated on with an MCTR. Of these eyes, 26 (20%) had suture breakage requiring re-operation, while another eight eyes (6%) had suture breakage that did not require surgery. The re-operations occurred after a mean 4.8±3.3 years. Suture breakage occurred in patients with a mean age of 34.0±23.3, as compared to 43.2±26.0 years for patients who did not experience this complication (p=0.36). In patients aged 40 years or younger at the time of surgery, 47% experienced suture breakage in one or both eyes, as compared to 19% in the age group 41–69 years and 13% in the age group 70 years and older (p=0.004). Of the 132 eyes that were operated on, we registered one case (0.8%) of possible suture-related late endophthalmitis. Conclusion The long-term risk of suture breakage was quite high after scleral fixation of the MCTR in this patient cohort, and it seems as the risk is increased with young age.
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Affiliation(s)
- Olav Kristianslund
- Department of Ophthalmology, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Gunhild F Sandvik
- Department of Ophthalmology, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Liv Drolsum
- Department of Ophthalmology, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
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Caporossi T, Tartaro R, Albani G, Barca F, Giansanti F, Rizzo S. Via pars plana anterior iris enclavation IOL fixation. Int J Ophthalmol 2021; 14:774-776. [PMID: 34012895 DOI: 10.18240/ijo.2021.05.20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Accepted: 11/26/2020] [Indexed: 11/23/2022] Open
Abstract
AIM To describe a via pars plana anterior iris enclavation intraocular lens (IOL) fixation technique. METHODS A total of 35 consecutive aphakic vitrectomised patients (average age 71.12±10.12y) underwent pars plana vitrectomy (PPV) and via pars plana anterior iris enclavation IOL fixation. RESULTS The mean preoperative best corrected visual acuity (BCVA) was 0.11±0.14 logMAR, the mean postoperative BCVA was 0.07±0.11 logMAR. The preoperative mean spherical equivalent was 7.22±4.21 D. The final mean spherical equivalent was -0.25±0.15 D. No eyes had hypotony, retinal or choroidal detachment or endophthalmitis. CONCLUSION This technique may be a safe and useful in the case of aphakia, and a prospective study would be useful to confirm this findings.
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Affiliation(s)
- Tomaso Caporossi
- Department of Surgical and Translational Medicine, Eye Clinic, University of Florence, Azienda Ospedaliera Universitaria Careggi, Florence 50139, Italy
| | - Ruggero Tartaro
- Department of Surgical and Translational Medicine, Eye Clinic, University of Florence, Azienda Ospedaliera Universitaria Careggi, Florence 50139, Italy
| | - Giancarlo Albani
- Department of Surgical and Translational Medicine, Eye Clinic, University of Florence, Azienda Ospedaliera Universitaria Careggi, Florence 50139, Italy
| | - Francesco Barca
- Department of Surgical and Translational Medicine, Eye Clinic, University of Florence, Azienda Ospedaliera Universitaria Careggi, Florence 50139, Italy
| | - Fabrizio Giansanti
- Department of Surgical and Translational Medicine, Eye Clinic, University of Florence, Azienda Ospedaliera Universitaria Careggi, Florence 50139, Italy
| | - Stanislao Rizzo
- Department of Surgical and Translational Medicine, Eye Clinic, University of Florence, Azienda Ospedaliera Universitaria Careggi, Florence 50139, Italy.,Department of Ophthalmology, Catholic University of Sacred-Heart Foundation "Policlinico Universitario A. Gemelli" IRCCS, Rome 00168, Italy
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Kokame GT. Outcomes and Complications of Concurrent Pars Plana Vitrectomy and Scleral-Fixated Intraocular Lens Placement Using Gore-Tex Suture. JOURNAL OF VITREORETINAL DISEASES 2021; 5:163-164. [PMID: 37009088 PMCID: PMC9979049 DOI: 10.1177/2474126420947046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Gregg T. Kokame
- Division of Ophthalmology, Department of Surgery, University of Hawaii School of Medicine, Honolulu, HI, USA
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11
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Hayashi T, Yasutsugu I, Shimizu T, Kuroki T, Kobashigawa Y, Iijima Y, Yuda K. Pars plana vitrectomy combined with penetrating keratoplasty and transscleral-sutured intraocular lens implantation in complex eyes: a case series. BMC Ophthalmol 2020; 20:369. [PMID: 32928189 PMCID: PMC7491070 DOI: 10.1186/s12886-020-01639-y] [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: 06/09/2020] [Accepted: 09/09/2020] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND The aim of this study was to evaluate the clinical outcomes of pars plana vitrectomy (PPV) combined with penetrating keratoplasty (PKP) and transscleral-sutured intraocular lens (IOL) implantation (IOL-suture) in complex eyes. METHODS In this prospective, consecutive interventional case series, patients who underwent PKP combined with PPV and IOL implantation from July 2014 to March 2018 at Yokohama Minami Kyosai Hospital were enrolled. The postoperative best corrected visual acuity (BCVA) (converted to logarithm of the minimal angle of resolution [logMAR] units), intraocular pressure (IOP, mmHg), endothelial cell density (ECD, cells/mm2), graft survival, complications, astigmatism, and spherical equivalent (dioptres [D]) were evaluated. RESULTS This study included 11 eyes of 11 patients (three females and eight males; mean age, 61.8 ± 13.9 years) with an injury (n = 6) or bullous keratopathy (n = 5). The BCVA significantly improved from 1.50 ± 0.66 logMAR preoperatively to 0.78 ± 0.59 logMAR (p < 0.001) postoperatively. The baseline ECD significantly decreased from 2396 ± 238 cells/mm2 preoperatively to 1132 ± 323 cells/mm2 (p < 0.001) postoperatively. Despite two rejection episodes, graft survival rates were 100%. The mean follow-up period was 38.0 ± 20.5 months. Two patients required combined glaucoma surgery, and three patients underwent subsequent glaucoma surgery. Postoperative astigmatism and spherical equivalent were 3.9 ± 3.2 D and 0.29 ± 2.18 D, respectively. CONCLUSION The combination of PKP, PPV, and IOL-suture implantation could be a safe and effective approach for eyes requiring anterior segment surgery; however, these eyes are associated with a higher incidence of glaucoma surgery.
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Affiliation(s)
- Takahiko Hayashi
- Department of Ophthalmology, Yokohama Minami Kyosai Hospital, 1-21-1, Mutsuura Higashi, Yokohama, Kanagawa, 236-0037, Japan. .,Department of Ophthalmology, University of Cologne, Cologne, Germany. .,Department of Ophthalmology, Jichi Medical University, Tochigi, Shimotsuke, Japan. .,Department of Ophthalmology, Yokohama City University School of Medicine, Yokohama, Kanagawa, Japan. .,Department of Technology and Design Thinking for Medicine (DT2M), Hiroshima University, Hiroshima, Japan.
| | - Ida Yasutsugu
- Department of Ophthalmology, Yokohama Minami Kyosai Hospital, 1-21-1, Mutsuura Higashi, Yokohama, Kanagawa, 236-0037, Japan.,Department of Ophthalmology, Yokohama City University School of Medicine, Yokohama, Kanagawa, Japan
| | - Toshiki Shimizu
- Department of Ophthalmology, Yokohama City University School of Medicine, Yokohama, Kanagawa, Japan
| | - Tsubasa Kuroki
- Department of Ophthalmology, Yokohama Minami Kyosai Hospital, 1-21-1, Mutsuura Higashi, Yokohama, Kanagawa, 236-0037, Japan
| | | | | | - Kentaro Yuda
- Department of Ophthalmology, Yokohama City University School of Medicine, Yokohama, Kanagawa, Japan.,Angiogenesis Laboratory, Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, USA.,Kikuna Yuda Eye Clinic, Yokohama, Kanagawa, Japan
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