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Mogil RS, Ferenchak K, Starr MR. GORE-TEX SUTURE-ASSOCIATED ENDOPHTHALMITIS IN A SCLERAL-SUTURED INTRAOCULAR LENS. Retin Cases Brief Rep 2024; 18:293-295. [PMID: 36603161 DOI: 10.1097/icb.0000000000001400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
PURPOSE To describe a unique case of Gore-Tex (Gore Medical, AZ) suture-associated delayed-onset endophthalmitis in a patient with a history of scleromalacia, pathologic myopia, multiple prior vitrectomies in the setting of a scleral-sutured intraocular lens (IOL). METHODS A 69-year-old man complained of blurry vision and eye pain 21 months after implantation of a scleral-sutured IOL and was found to have an exposed Gore-Tex suture with scleromalacia, vision loss to hand motion, a hypopyon, and vitritis. He was diagnosed with culture-positive endophthalmitis. He had a previous history of a rhegmatogenous retinal detachment repair and subsequent dislocated IOL in this eye treated with a scleral-sutured IOL. A vitreous tap and injection of broad-spectrum antibiotics and suture removal at the slit lamp were performed at the time of presentation. One week later, he underwent pars plana vitrectomy and removal of the IOL. RESULTS After the tap and inject and subsequent lens removal, his vision has returned to his preoperative vision of 20/100 with refraction. DISCUSSION Gore-Tex suture is a nonabsorbable and flexible option with great tensile strength that has emerged as a favored alternative to polypropylene for the use in transscleral fixated IOLs. Although endophthalmitis and suture erosion are known complications of this procedure, this report describes one of the first cases of Gore-Tex suture-associated endophthalmitis.
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Affiliation(s)
- Rachel S Mogil
- Department of Ophthalmology, Mayo Clinic, Rochester, Minnesota
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Ortega-Prades G, Pérez-Torregrosa VT, Carot-Sanmillán H, Cifre-Fabra Y, Ruíz-Del Río N, Duch-Samper AM. Citrobacter koseri, an unusual exogenous endoftalmitis. ARCHIVOS DE LA SOCIEDAD ESPANOLA DE OFTALMOLOGIA 2024; 99:82-86. [PMID: 38211828 DOI: 10.1016/j.oftale.2024.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Accepted: 11/12/2023] [Indexed: 01/13/2024]
Abstract
Citrobacter koseri is a bacillus that causes infrequent endophthalmitis. 6% of cultures in endophthalmitis are Gram -, and as in these, C. koseri is associated with a poor visual prognosis. We present a 65-year-old man who works in an animal laboratory. He went to emergencies with loss of vision in his left eye due to a vitreous hemorrhage. A vitrectomy was performed and 3 days later, endophthalmitis was diagnosed. Vancomycin and Ceftazidime were applied in eye drops and in two intravitreal injections. 24 h later he returned with a lens extrusion. Due to the severity of the condition, an evisceration was performed. Subsequently, the samples confirm the microorganism. We assume that the entry point for the bacterium was the sclerotomies through the exposed suture material, after handling rodent feces.
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Affiliation(s)
- G Ortega-Prades
- Servicio de Oftalmología, Hospital Clínico Universitario de Valencia, Valencia, Spain.
| | - V-T Pérez-Torregrosa
- Servicio de Oftalmología, Hospital Clínico Universitario de Valencia, Valencia, Spain
| | - H Carot-Sanmillán
- Servicio de Oftalmología, Hospital Clínico Universitario de Valencia, Valencia, Spain
| | - Y Cifre-Fabra
- Servicio de Oftalmología, Hospital Clínico Universitario de Valencia, Valencia, Spain
| | - N Ruíz-Del Río
- Servicio de Oftalmología, Hospital Clínico Universitario de Valencia, Valencia, Spain
| | - A-M Duch-Samper
- Servicio de Oftalmología, Hospital Clínico Universitario de Valencia, Valencia, Spain
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Citrobacter koseri: A Cause of Silicone Oil Related Endophthalmitis after Post Pars Plana Vitrectomy. Case Rep Ophthalmol Med 2023; 2023:3494521. [PMID: 36974070 PMCID: PMC10039805 DOI: 10.1155/2023/3494521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 02/08/2023] [Accepted: 02/17/2023] [Indexed: 03/19/2023] Open
Abstract
Purpose. We present a rare case of Citrobacter koseri culture-positive endophthalmitis in a postvitrectomy silicone oil-filled eye. Case report. A 64-year-old male patient presented to our ophthalmology emergency room with representative symptoms of acute endophthalmitis. He underwent a plana vitrectomy oil-filled tamponade previously. Preoperative and postoperative findings of the case were reported. Results. Culture tests of aqueous, silicone oil, and vitreous taps were positive for Citrobacter koseri. Conclusions. Culture-positive endophthalmitis in a silicone oil-filled eye has very rarely been in the literature. The described cases were caused by acute inflammatory reactions to silicone oil and were culture-negative. The postvitrectomy culture-positive endophthalmitis caused by Citrobacter is a very rare condition, and its management is not so smooth. Approaching with silicone oil removal, intraoperative intravitreal antibiotic injection, and silicone oil reinjection was performed in our case with good outcomes.
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Silva N, Ferreira A, Ferreira N, Pessoa B, Meireles A. Intrascleral Knotless Zigzag Suture Fixation of Four-Haptic Hydrophilic Acrylic Foldable IOL: Clinical Outcomes. Clin Ophthalmol 2022; 16:33-41. [PMID: 35023899 PMCID: PMC8747796 DOI: 10.2147/opth.s340039] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 10/22/2021] [Indexed: 11/23/2022] Open
Abstract
Background The main options for intraocular lens (IOL) placement without capsular bag support and/or zonular weakness are iris-fixated IOL and scleral-fixated IOL (SFIOL). Purpose To describe the surgical technique and the outcomes of intrascleral knotless zigzag suture fixation of Akreos AO60 foldable IOL. Methods Retrospective cohort study of consecutive cases. Results Ninety-nine eyes of 92 patients were retrospectively studied. The mean age was 72.1±15.2 years (range 18–94), and the median follow-up duration was 19.5 months (range 3–81). The best-corrected visual acuity improved from a mean±SD of 1.34±0.70 logarithm of the minimum angle of resolution (logMAR) units at baseline to 0.49±0.56 logMAR at the end of follow-up (p<0.001). The mean±SD final SE was −1.24±1.82 diopters. The mean±SD prediction error was −0.51±1.16 diopters. The overall perioperative complications rate was 44.4% (n=44). The rate of complications requiring invasive treatment was 19.2% (n=19). The most common perioperative complications were ocular hypertension (OHT, 20.2%, n=20), and cystoid macular edema (CME, 15.2%, n=15). The rate of IOL dislocation was 7% (n=7). Conclusion This knotless technique avoids the risks of haptics fixation but is more prone to IOL dislocation in cases of suture deterioration. Past ophthalmic history needs to be carefully considered in candidates who underwent SFIOL implantation.
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Affiliation(s)
- Nisa Silva
- Department of Ophthalmology, Centro Hospitalar Universitário do Porto, Porto, 4099-001, Portugal
| | - André Ferreira
- Department of Ophthalmology, Centro Hospitalar Universitário do Porto, Porto, 4099-001, Portugal.,Unit of Anatomy, Department of Biomedicine, Faculty of Medicine of University of Porto, Porto, 4200-319, Portugal
| | - Natália Ferreira
- Department of Ophthalmology, Centro Hospitalar Universitário do Porto, Porto, 4099-001, Portugal
| | - Bernardete Pessoa
- Department of Ophthalmology, Centro Hospitalar Universitário do Porto, Porto, 4099-001, Portugal.,Department of Ophthalmology, Instituto de Ciências Biomédicas Abel Salazar, University of Porto, Porto, 4050-313, Portugal
| | - Angelina Meireles
- Department of Ophthalmology, Centro Hospitalar Universitário do Porto, Porto, 4099-001, Portugal.,Department of Ophthalmology, Instituto de Ciências Biomédicas Abel Salazar, University of Porto, Porto, 4050-313, Portugal
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Kim KW, Park UC, Ahn J, Kim JH, Lee SJ, Nam KY, Kim M, Woo SJ. INFECTIOUS ENDOPHTHALMITIS AFTER SCLERAL FIXATION OF AN INTRAOCULAR LENS. Retina 2021; 41:2310-2317. [PMID: 33782364 DOI: 10.1097/iae.0000000000003176] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE To determine the mechanism of infection, clinical features, and risk factors of endophthalmitis after scleral fixation of an intraocular lens. METHODS We included 15 patients with infectious endophthalmitis after scleral fixation of an intraocular lens between April 2004 and December 2017, as well as four patients found through a literature search. Thus, a total of 19 patients were analyzed. RESULTS Among 19 eyes, infectious endophthalmitis developed at a mean of 23 months (range: 1 day-10 years) after scleral fixation surgery. Nine eyes (47.4%) had early-onset endophthalmitis (≤6 weeks), and 10 eyes (52.6%) had delayed-onset endophthalmitis (>6 weeks). Eleven eyes (57.9%) had presumed microbial influx due to suture exposure. Those with delayed-onset endophthalmitis showed a higher rate of suture-related infection (80.0% vs. 33.3%) and culture of gram-negative bacteria (70.0% vs. 12.5%) than did those with early-onset endophthalmitis. CONCLUSIONS Infectious endophthalmitis can develop late after scleral fixation of an intraocular lens, usually related to the exposed sutures, and the visual prognosis is poor. Eyes that have sutured scleral fixation should be monitored regularly, and preventive measures should be performed if an exposed suture is found.
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Affiliation(s)
- Kyung Won Kim
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Korea
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Korea
| | - Un Chul Park
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Korea
| | - Jeeyun Ahn
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Korea
| | - Jae Hui Kim
- Department of Ophthalmology, Kim's Eye Hospital, Konyang University College of Medicine, Seoul, Korea
| | - Sang Joon Lee
- Department of Ophthalmology, College of Medicine, Kosin University, Gospel Hospital, Busan, Korea ; and
| | - Ki Yup Nam
- Department of Ophthalmology, College of Medicine, Kosin University, Gospel Hospital, Busan, Korea ; and
| | - Min Kim
- Department of Ophthalmology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Se Joon Woo
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
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Nah SK, Kim JW, Kim CG, Kim JH. Outcomes of Re-fixation after the First Intraocular Lens Scleral Fixation. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2021. [DOI: 10.3341/jkos.2021.62.9.1189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Purpose: To investigate the outcomes of re-fixation after the first intraocular lens (IOL) scleral fixation. Methods: We retrospectively reviewed the charts of patients who underwent second IOL scleral fixation and vitrectomy for dislocation of IOL after the first IOL scleral fixation. We compared the best-corrected visual acuity (BCVA) and spherical equivalent (SE) after 1 month of the first and second surgery, and noted the complications. Results: We included 21 eyes that underwent second IOL scleral fixation: 13 eyes (61.9%) with IOL exchange and eight (38.1%) with one-haptic fixation. Mean BCVAs (LogMAR) were 0.17 ± 0.25 and 0.11 ± 0.23 after the first and second surgery, respectively (<i>p</i> = 0.073); mean SEs were -0.94 ± 1.69 and -0.58 ± 1.46 diopters after the first and second surgery, respectively (<i>p</i> = 0.076). Postoperative complications occurred in eight eyes (38.1%), including temporarily increased intraocular pressure and suture knots exposure. However, none of the complications required re-operation. Conclusions: The outcomes of primary and secondary IOL fixation were similar, and there were no serious complications of the second surgery.
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Altinkurt E, Sayar Bilgin G. Scleral fixation of hydrophobic acrylic intraocular lenses using a suture burial technique. Indian J Ophthalmol 2021; 69:1600-1604. [PMID: 34011750 PMCID: PMC8302312 DOI: 10.4103/ijo.ijo_3151_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2020] [Revised: 02/07/2020] [Accepted: 02/14/2021] [Indexed: 11/06/2022] Open
Abstract
The procedure involved an ab-externo scleral fixation technique using a double-armed 10-0 polypropylene suture with straight needles that require no scleral flaps. The IOLs are sutured to the sclera, the free suture ends are tied to the suture loops, and they are buried together under the sclera. Forty eyes of 37 patients were included. Postoperative complications are IOL capture in five eyes (12.5%), a significant IOL tilt in one eye (2.5%), recurrent UGH (uveitis-glaucoma-hyphema) syndrome in two eyes (5%), glaucoma in three eyes (7.5%), suture exposure in two eyes (5%) and IOL drop due to haptic breakage in one eye (2.5%). The technique can be effectively used for the refixation of dislocated hydrophobic acrylic IOLs by temporary haptic externalization through a corneal incision and for the treatment of aphakia with or without penetrating keratoplasty. Surgeons should be aware of the possibility of UGH syndrome due to IOL capture, especially in young eyes.
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Affiliation(s)
- Emre Altinkurt
- Istanbul University, Istanbul Faculty of Medicine, Department of Ophthalmology, Istanbul, Turkey
| | - Gizem Sayar Bilgin
- Istanbul University, Istanbul Faculty of Medicine, Department of Ophthalmology, Istanbul, Turkey
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Kannan NB, Sen S, Mishra C, Lalitha P, Rameshkumar G, Kumar K, Rajan RP, Ramasamy K. Ten-year trends in the incidence, clinical profile and outcomes of acute-onset endophthalmitis following combined pars plana vitrectomy and sutureless, glueless and flapless scleral fixation of intraocular lenses. Int Ophthalmol 2021; 41:1651-1658. [PMID: 33511515 DOI: 10.1007/s10792-021-01715-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Accepted: 01/09/2021] [Indexed: 10/22/2022]
Abstract
PURPOSE To evaluate the frequency and outcomes of acute-onset endophthalmitis following combined pars plana vitrectomy and scleral fixation of intraocular lens. METHODS We evaluated patients undergoing a sutureless, glueless, flapless technique of scleral fixation of intraocular lenses (SFIOL) implantation for various causes of aphakia and documented the clinico-demographic data, microbiological profile and final outcome after acute endophthalmitis in this cohort of eyes. RESULTS The frequency of suspected acute endophthalmitis diagnosed post-surgery was 0.112% (4/3541 eyes), with culture-positive endophthalmitis frequency being 0.028% (1 eye), showing growth of Pseudomonas aeruginosa. Mean age of patients with endophthalmitis was 51.75 ± 9.28 years, and mean interval between surgery and acute endophthalmitis presentation was 10.25 ± 9.6 days. Patients were managed with intravitreal antibiotics with or without core vitrectomy. Visual acuity of patients increased from baseline 1.43 ± 0.32 logMAR (Snellen equivalent = 6/150) to 0.79 ± 0.16 logMAR (Snellen equivalent = 6/36) after an average follow-up of 11 ± 2 weeks. CONCLUSION Endophthalmitis is a rare complication following SFIOL surgery, and all ophthalmic surgeons must be aware of this inadvertent possibility, since SFIOLs are gaining wider acceptability recently. Moreover, these cases of endophthalmitis may show a different pattern of microorganisms than post-cataract surgery endophthalmitis; however, with prompt diagnosis and effective timely management, favorable outcomes can be achieved.
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Affiliation(s)
| | - Sagnik Sen
- Department of Vitreo-Retina, Aravind Eye Hospital, Madurai, India.
| | | | - Prajna Lalitha
- Department of Microbiology, Aravind Eye Hospital, Madurai, India
| | | | - Karthik Kumar
- Department of Vitreo-Retina, Aravind Eye Hospital, Madurai, India
| | - Renu P Rajan
- Department of Vitreo-Retina, Aravind Eye Hospital, Madurai, India
| | - Kim Ramasamy
- Department of Vitreo-Retina, Aravind Eye Hospital, Madurai, India
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Giansanti F, Tartaro R, Caporossi T, Murro V, Savastano A, Barca F, Bacherini D, Fiore T, Cagini C, Rizzo S. Intraocular lens dislocation: a novel in-situ scleral refixation technique using a 25 Gauge trocar in the anterior chamber. BMJ Open Ophthalmol 2018; 3:e000174. [PMID: 30539150 PMCID: PMC6257374 DOI: 10.1136/bmjophth-2018-000174] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2018] [Accepted: 10/02/2018] [Indexed: 11/12/2022] Open
Abstract
Objective Intraocular lens (IOL) repositioning using a closed-eye approach could be carried out in some selected cases. Our study focuses on the efficacy and safety of a IOL closed-eye repositioning technique using scleral suture, which is performed using a trocar as an intrastromal limbal guide. Methods and analysis Thirty-one eyes of 31 patients with late IOL dislocation operated on between January 2015 and May 2017 were included in this retrospective non-comparative consecutive case series study. The patients had a single-piece in-the-bag dislocation or a 3-pieces in-the-bag or out-of-the-bag dislocation. The patients underwent an anterior vitrectomy and a scleral refixation in a closed chamber using a 10/0 polypropylene suture passed through a 25 Gauge trocar inserted in the anterior chamber. Results The mean follow-up time was 19.54 months. Average preoperative best-corrected visual acuity (BCVA) was 0.73 LogMar (±0.21 SD); while average postoperative BCVA was 0.27 LogMar (±0.23 SD). Fifteen patients underwent anterior pars plana vitrectomy (PPV) while 16 patients did not; moreover, two patients underwent PPV. Six patients had an increase of postoperative intraocular pressure, two patients had postoperative decentration, two patients had postoperative cystoid macular oedema, none of the patients had major complications such as retinal detachment, choroidal detachment, malignant glaucoma, irreversible corneal decompensation and endophthalmitis. Conclusion We can affirm that our technique may be safe and useful in the case of 3-piece in-the bag or out-of the bag dislocated IOLs and also in the case of in-the-bag single-piece dislocated IOLs.
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Affiliation(s)
- Fabrizio Giansanti
- Dipartimento Neuromuscoloscheletrico e Organi di Sensi, Università degli Study di Firenze, Florence, Italy
| | - Ruggero Tartaro
- Dipartimento Neuromuscoloscheletrico e Organi di Sensi, Università degli Study di Firenze, Florence, Italy
| | - Tomaso Caporossi
- Dipartimento Neuromuscoloscheletrico e Organi di Sensi, Università degli Study di Firenze, Florence, Italy
| | - Vittoria Murro
- Dipartimento Neuromuscoloscheletrico e Organi di Sensi, Università degli Study di Firenze, Florence, Italy
| | - Alfonso Savastano
- Dipartimento Neuromuscoloscheletrico e Organi di Sensi, Università degli Study di Firenze, Florence, Italy
| | - Francesco Barca
- Dipartimento Neuromuscoloscheletrico e Organi di Sensi, Università degli Study di Firenze, Florence, Italy
| | - Daniela Bacherini
- Dipartimento Neuromuscoloscheletrico e Organi di Sensi, Università degli Study di Firenze, Florence, Italy
| | - Tito Fiore
- Division of Ophthalmology, Department of Surgery and Biomedical Science, University of Perugia, S Maria della Misericordia Hospital, Perugia, Italy
| | - Carlo Cagini
- Division of Ophthalmology, Department of Surgery and Biomedical Science, University of Perugia, S Maria della Misericordia Hospital, Perugia, Italy
| | - Stanislao Rizzo
- Dipartimento Neuromuscoloscheletrico e Organi di Sensi, Università degli Study di Firenze, Florence, Italy
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Sen P, S. VK, Bhende P, Rishi P, Rishi E, Rao C, Ratra D, Susvar P, Kummamuri S, Shaikh S, Gopal L. Surgical outcomes and complications of sutured scleral fixated intraocular lenses in pediatric eyes. Can J Ophthalmol 2018; 53:49-55. [DOI: 10.1016/j.jcjo.2017.07.015] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2017] [Revised: 07/08/2017] [Accepted: 07/19/2017] [Indexed: 11/24/2022]
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Stem MS, Todorich B, Woodward MA, Hsu J, Wolfe JD. Scleral-Fixated Intraocular Lenses: Past and Present. ACTA ACUST UNITED AC 2017; 1:144-152. [PMID: 29104957 DOI: 10.1177/2474126417690650] [Citation(s) in RCA: 74] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Intraocular lenses (IOLs) can have inadequate support for placement in the capsular bag as a result of ocular trauma, metabolic or inherited conditions such as Marfan's syndrome or pseudoexfoliation, or complicated cataract surgery. Surgical options for patients with inadequate capsular support include alternative placement in the anterior chamber (ACIOLs), fixation to the iris, or fixation to the sclera. The surgical techniques for each of these approaches have improved considerably over the last several decades resulting in improved visual and ocular outcomes. If no capsular or iris support exists, the surgeon can fixate an IOL to the sclera or the patient can remain aphakic. IOLs can be fixated to the sclera using sutures or by tunneling the IOL haptics into the sclera without sutures. This review summarizes the pre-operative considerations, surgical techniques, outcomes, and unique complications associated with implantation of scleral-fixated IOLs.
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Affiliation(s)
- Maxwell S Stem
- Associated Retinal Consultants, Oakland University William Beaumont School of Medicine, Royal Oak, MI
| | - Bozho Todorich
- Associated Retinal Consultants, Oakland University William Beaumont School of Medicine, Royal Oak, MI
| | | | - Jason Hsu
- Mid Atlantic Retina, The Retina Service of Wills Eye Hospital, Thomas Jefferson University, Philadelphia, PA
| | - Jeremy D Wolfe
- Associated Retinal Consultants, Oakland University William Beaumont School of Medicine, Royal Oak, MI
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Cong'En JH, Miah M, Sünkel-Laing B, Emmanuel J. Endogenous endophthalmitis caused by Citrobacter koseri originating from a renal abscess. BMJ Case Rep 2014; 2014:bcr-2014-204095. [PMID: 25096654 DOI: 10.1136/bcr-2014-204095] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
We present a rare case of endogenous endophthalmitis caused by Citrobacter koseri. A 69-year-old woman with a history of poorly controlled diabetes and a protracted urinary tract infection (UTI) presented with a painful swollen left eye. There was no history of eye surgery or trauma. Imaging revealed an abscess in the right kidney. Although endophthalmitis is very rare in healthy patient, it is more common in the immunocompromised. In this patient, several multiple system illnesses including poorly controlled diabetes appear to have worked synergistically to make endophthalmitis a realistic complication of an otherwise isolated and remote source of infection, in this case pyelonephritis. Endophthalmitis, in the absence of an obvious exogenous cause, should be investigated thoroughly to exclude metastatic microbial spread. In addition, chronic features of UTI in a patient with poorly controlled diabetes or who is otherwise immunosuppressed warrant the exclusion of an underlying renal abscess.
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Deveci A, Coban AY. Optimum management of Citrobacter koseri infection. Expert Rev Anti Infect Ther 2014; 12:1137-42. [DOI: 10.1586/14787210.2014.944505] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Affiliation(s)
- Aydin Deveci
- Department of Infectious Disease and Clinical Microbiology, Medical School, Ondokuz Mayis University,
55139, Samsun, Turkey
| | - Ahmet Yilmaz Coban
- Department of Medical Microbiology, Medical School, Ondokuz Mayis University,
55139, Samsun, Turkey
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