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Ma M, Xiao Q, Wang A, Zheng Z. A posterior chamber phakic refractive lens dislocated into the vitreous. Eur J Ophthalmol 2023; 33:NP21-NP24. [PMID: 36314418 DOI: 10.1177/11206721221135911] [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] [Indexed: 08/31/2023]
Abstract
SIGNIFICANCE We present a unique cause for zonular dehiscence, which provides a pathway for subsequent dislocation of an implanted phakic refractive lens (PRL) into the vitreous cavity. PURPOSE To determine the cause of zonular dehiscence and to avoid similar complications after PRL implantation in the future. CASE REPORT A 37-year-old highly myopic patient with refraction of -24.0 DS in both eyes received PRL implantation in both eyes. In the 14-month postoperative follow-up, it was found that the PRL dislocated into the vitreous cavity. The patient then underwent phacoemulsification and vitrectomy. The patient was treated successfully. No ocular complication was found. The visual acuity of the left eye was 20/40, two weeks after surgery. CONCLUSIONS We report a unique cause for zonular dehiscence, and the clarification of its detailed characteristics may contribute to prevention of such a complication in the future.
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Affiliation(s)
- Mingming Ma
- Department of Ophthalmology, Shanghai General Hospital, Shanghai, China
- National Clinical Research Center for Eye Diseases, Shanghai, China
- Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai, China
- Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, China
- Shanghai engineering center for precise diagnosis and treatment of eye diseases, Shanghai, China
| | - Qirui Xiao
- Shanghai Bright Eye Hospital, Shanghai, China
| | - Aijun Wang
- Shanghai Bright Eye Hospital, Shanghai, China
| | - Zhi Zheng
- Department of Ophthalmology, Shanghai General Hospital, Shanghai, China
- National Clinical Research Center for Eye Diseases, Shanghai, China
- Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai, China
- Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, China
- Shanghai engineering center for precise diagnosis and treatment of eye diseases, Shanghai, China
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Yaşa D, Köse B, Ağca A. Rotational Stability of a New Posterior Chamber Toric Phakic Intraocular Lens. J Ophthalmol 2020; 2020:1624632. [PMID: 32351717 PMCID: PMC7171658 DOI: 10.1155/2020/1624632] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2019] [Accepted: 03/12/2020] [Indexed: 11/17/2022] Open
Abstract
PURPOSE To evaluate the refractive results and rotational stability of Eyecryl toric phakic intraocular lens (pIOL). METHODS In this retrospective single-surgeon case series, manifest refraction, visual acuities, endothelial cell density (ECD), and pIOL rotation were evaluated over 6 months. RESULTS 43 eyes from 23 patients were included. At 6 months, the SE was within ±0.50 D of emmetropia in 30 (70%) eyes and within ±1.00 D of emmetropia in 39 (91%) eyes. The efficacy and safety indices were 1.25 ± 0.38 and 1.41 ± 0.34, respectively. Mean ECD was 2719 ± 296 cells/mm2 at the preoperative visit and 2779.42 ± 422 cells/mm2 at the 6-month visit (p > 0.05). The mean value of absolute axis orientation error was 4.95 ± 5.28°. Mean absolute change in axis orientation between visits was less than 3° for all visit intervals. Ninety percent or more of lenses were found to rotate 5° or less between all visit intervals. None of the patients experienced a vision-threatening complication, and no patient required secondary IOL repositioning. CONCLUSION The pIOL appears to effectively reduce subjective manifest astigmatism and provide good visual acuity. Its position was found to be stable throughout the follow-up.
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Affiliation(s)
- Dilek Yaşa
- Beyoğlu Eye Training and Research Hospital, Bereketzade Mah, No. 2, Beyoglu, Istanbul, Turkey
| | - Bülent Köse
- Aritmi Osmangazi Hospital, Ulu Mah, Ulubatlı Hasan Bulvarı, No. 48-62, Bursa, Turkey
| | - Alper Ağca
- Beyoğlu Eye Training and Research Hospital, Bereketzade Mah, No. 2, Beyoglu, Istanbul, Turkey
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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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Abstract
Implantation of phakic intraocular lenses (pIOLs) is a reversible refractive procedure, preserving the patient's accommodative function with minimal induction of higher order aberrations compared with corneal photoablative procedures. Despite this, as an intraocular procedure, it has potential risks such as cataracts, chronic uveitis, pupil ovalization, corneal endothelial cell loss, pigmentary dispersion syndrome, pupillary block glaucoma, astigmatism, or endophthalmitis. Currently, only two models of posterior chamber pIOLs are commercially available, the implantable collammer lens (STAAR Surgical Co.) and the phakic refractive lens (PRL; Zeiss Meditec). The number of published reports on the latter is very low, and some concerns still remain about its long-term safety. The present article reviews the published literature on the outcomes after PRL implantation in order to provide a general overview and evaluate its real potential as a surgical refractive option.
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Pérez-Cambrodí RJ, Piñero DP, Blanes-Mompó FJ, Ferrer-Blasco T, Cerviño A. Preliminary in vivo positional analysis of a posterior chamber phakic intraocular lens by optical coherence tomography and its correlation with clinical outcomes. JOURNAL OF OPTOMETRY 2012; 5:121-130. [PMCID: PMC3860978 DOI: 10.1016/j.optom.2012.04.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2012] [Accepted: 03/20/2012] [Indexed: 06/10/2023]
Abstract
Purpose To analyze by spectral-domain optical coherence tomography the anatomical relationship of a specific type of posterior chamber phakic intraocular lens (pIOL) implanted in cases of high to moderate myopia with the adjacent intraocular structures and to correlate it with clinical outcomes. Methods Prospective observational case series including 18 eyes with high to moderate myopia (spherical equivalent between −5.88 and −15.75 D) of 9 patients (age range, 29–49 years) undergoing bilateral Phakic Refractive Lens (PRL, Zeiss) implantation. Postoperative visual acuity, refraction, contrast sensitivity (CS), and ocular higher order aberrations (HOA) were evaluated. Furthermore, the in vivo position of the PRL was analyzed by means of spectral domain optical coherence tomography (3D OCT-1000, Topcon). Central (CENV), temporal (TEMV) and nasal vault (NASV) were measured. Correlation of these anatomical parameters with clinical data was also investigated. Mean follow-up was 47 ± 25 months. Results A statistically significant visual and refractive improvement (p < 0.01) was found postoperatively. Mean postoperative CENV, NASV, and TEMV were 157.88 ± 69.93 μm, 168.29 ± 65.02 μm, and 188.59 ± 55.99 μm, respectively. Significant difference was found between NASV and TEMV (p = 0.01). No significant correlations were found between ocular aberrometric and anatomical parameters (p ≥ 0.12). CENV, NASV and TEMV correlated significantly with 6-cycles per degree (cpd) photopic CS as well as with 18-cpd low mesopic CS (r ≥ 0.57, p ≤ 0.04). Furthermore, NASV also correlated significantly with preoperative anterior chamber depth (r = −0.65, p = 0.01). Conclusions This posterior chamber pIOL shows a trend to nasal position, with potential impact on refractive and visual outcomes, particularly in eyes with deep anterior chambers.
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Affiliation(s)
- Rafael J. Pérez-Cambrodí
- Optometry Research Group, Department of Optics, University of Valencia, Spain
- Alicante Oftalmológica, Oftalmar, Hospital Internacional Medimar, Alicante, Spain
| | - David P. Piñero
- Foundation for the Visual Quality (FUNCAVIS, Fundación para la Calidad Visual), Alicante, Spain
- Departamento de Óptica, Farmacología y Anatomía, Universidad de Alicante, Spain
| | | | | | - Alejandro Cerviño
- Optometry Research Group, Department of Optics, University of Valencia, Spain
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Pérez-Cambrodí RJ, Piñero DP, Madrid-Costa D, Blanes-Mompó FJ, Ferrer-Blasco T, Cerviño A. Medium-term visual, refractive, and intraocular stability after implantation of a posterior chamber phakic intraocular lens to correct moderate to high myopia. J Cataract Refract Surg 2011; 37:1791-8. [PMID: 21930045 DOI: 10.1016/j.jcrs.2011.04.034] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2011] [Revised: 04/28/2011] [Accepted: 04/29/2011] [Indexed: 10/17/2022]
Abstract
PURPOSE To evaluate the medium-term refractive and visual outcomes and the complications after implantation of a silicone posterior chamber phakic intraocular lens (PC pIOL) for moderate to high myopia. SETTING Oftalmar, Medimar International Hospital, Alicante, Spain. DESIGN Retrospective case series. METHODS Uncorrected (UDVA) and corrected (CDVA) distance visual acuities, refraction, and intraocular pressure were evaluated during a medium-term follow-up. Postoperative complications were also studied. RESULTS The study enrolled 35 eyes (mean preoperative spherical equivalent [SE] -10.25 diopters [D] ± 3.19 [SD]) of 20 patients with a mean age of 31.83 ± 8.87 years and a mean follow-up of 57.34 ± 9.24 months. The mean UDVA improved from 2.40 ± 0.20 logMAR preoperatively to 0.08 ± 0.13 logMAR at the last postoperative visit (P<.01). The mean CDVA improved from 0.11 ± 0.09 logMAR to 0.02 ± 0.09 logMAR, respectively (P<.01). The postoperative CDVA was 0.1 or better in 30 eyes (85.71%), with 22 eyes (62.86%) gaining lines of CDVA. The final efficacy index was 1.16 and the final safety index, 1.26. Regarding predictability, 34 eyes (97.14%) had an SE within ± 1.00 D and 33 eyes (94.28%) within ± 0.50 D. The complications were PC pIOL decentration (2 eyes, 5.71%), cortical lens opacification (1 eye, 2.86%), and retinal detachment (1 eye, 2.86%). CONCLUSIONS Implantation of a PC pIOL to correct moderate to high myopia was efficient and predictable in the medium term, with intraocular stability in most cases. New designs and criteria for PC pIOL size selection should be developed. FINANCIAL DISCLOSURE No author has a financial or proprietary interest in any material or method mentioned.
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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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Chen LJ, Chang YJ, Kuo JC, Rajagopal R, Azar DT. Metaanalysis of cataract development after phakic intraocular lens surgery. J Cataract Refract Surg 2008; 34:1181-200. [PMID: 18571089 DOI: 10.1016/j.jcrs.2008.03.029] [Citation(s) in RCA: 105] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2007] [Accepted: 03/24/2008] [Indexed: 11/24/2022]
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Verde CM, Teus MA, Arranz-Marquez E, Cazorla RG. Medennium Posterior Chamber Phakic Refractive Lens to Correct High Myopia. J Refract Surg 2007; 23:900-4. [DOI: 10.3928/1081-597x-20071101-06] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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