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Yang X, Fan Q, Zhang Y, Chen X, Jiang Y, Zou H, Li M, Li L, Wang Y. Changes in Refractive Error Under COVID-19: A 3-Year Follow-up Study. Adv Ther 2022; 39:2999-3010. [PMID: 35508845 PMCID: PMC9067555 DOI: 10.1007/s12325-022-02150-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 03/25/2022] [Indexed: 11/01/2022]
Abstract
INTRODUCTION To investigate changes in refractive error in schoolchildren before and during the coronavirus disease 2019 (COVID-19) pandemic. METHODS This study included 2792 students, who underwent a 3-year follow-up from 2018 to 2020. All participants underwent yearly noncycloplegic refraction and ocular examinations. Time-related changes in sphere, cylinder, and spherical equivalent (SE) measurements in both genders were analyzed. RESULTS The myopic sphere (- 0.78 ± 1.83 vs. - 1.03 ± 1.91 D; P = 0.025) and SE (- 1.04 ± 1.90 vs. - 1.32 ± 1.99 D; P = 0.015) progressed significantly from 2018 to 2019. Female participants had a significantly greater change in SE than male participants (P < 0.05), and the low hyperopia, emmetropia, and mild myopia groups significantly deteriorated (P < 0.001) from 2018 to 2019. Significant differences in sphere change (- 0.21 ± 0.97 vs. - 0.36 ± 0.96 D; P < 0.001) and SE change (- 0.23 ± 0.99 vs. - 0.38 ± 0.98 D; P < 0.001) were noted between 2019-2018 and 2020-2019, respectively. The respective changes in cylinder were statistically similar (- 0.03 ± 0.53 vs. - 0.05 ± 0.62 D; P = 0.400). CONCLUSIONS The refractive status of schoolchildren showed an increasing myopic shift trend before and during the COVID-19 pandemic. The low hyperopia, emmetropia, and mild myopia groups were more sensitive to environmental changes during COVID-19 than before. The myopic shift was greater in female participants than male participants.
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Affiliation(s)
- Xiaoyan Yang
- Tianjin Key Lab of Ophthalmology and Visual Science, Tianjin Eye Institute, Tianjin Eye Hospital, Nankai University Affiliated Eye Hospital, Tianjin, China
- Clinical College of Ophthalmology, Tianjin Medical University, Tianjin, China
- Tianjin Eye Hospital Optometric Center, Tianjin, China
| | - Qian Fan
- Tianjin Key Lab of Ophthalmology and Visual Science, Tianjin Eye Institute, Tianjin Eye Hospital, Nankai University Affiliated Eye Hospital, Tianjin, China
- Nankai Eye Institute, Nankai University, Tianjin, China
- Clinical College of Ophthalmology, Tianjin Medical University, Tianjin, China
| | - Yue Zhang
- Tianjin Key Lab of Ophthalmology and Visual Science, Tianjin Eye Institute, Tianjin Eye Hospital, Nankai University Affiliated Eye Hospital, Tianjin, China
- Clinical College of Ophthalmology, Tianjin Medical University, Tianjin, China
- Tianjin Eye Hospital Optometric Center, Tianjin, China
| | - Xiaoqin Chen
- Tianjin Key Lab of Ophthalmology and Visual Science, Tianjin Eye Institute, Tianjin Eye Hospital, Nankai University Affiliated Eye Hospital, Tianjin, China
- Clinical College of Ophthalmology, Tianjin Medical University, Tianjin, China
- Tianjin Eye Hospital Optometric Center, Tianjin, China
| | - Yanglin Jiang
- Tianjin Key Lab of Ophthalmology and Visual Science, Tianjin Eye Institute, Tianjin Eye Hospital, Nankai University Affiliated Eye Hospital, Tianjin, China
- Clinical College of Ophthalmology, Tianjin Medical University, Tianjin, China
- Tianjin Eye Hospital Optometric Center, Tianjin, China
| | - Haohan Zou
- Tianjin Key Lab of Ophthalmology and Visual Science, Tianjin Eye Institute, Tianjin Eye Hospital, Nankai University Affiliated Eye Hospital, Tianjin, China
- Clinical College of Ophthalmology, Tianjin Medical University, Tianjin, China
| | - Mengdi Li
- Tianjin Key Lab of Ophthalmology and Visual Science, Tianjin Eye Institute, Tianjin Eye Hospital, Nankai University Affiliated Eye Hospital, Tianjin, China
- Clinical College of Ophthalmology, Tianjin Medical University, Tianjin, China
- Tianjin Eye Hospital Optometric Center, Tianjin, China
| | - Lihua Li
- Tianjin Key Lab of Ophthalmology and Visual Science, Tianjin Eye Institute, Tianjin Eye Hospital, Nankai University Affiliated Eye Hospital, Tianjin, China.
- Clinical College of Ophthalmology, Tianjin Medical University, Tianjin, China.
- Tianjin Eye Hospital Optometric Center, Tianjin, China.
| | - Yan Wang
- Tianjin Key Lab of Ophthalmology and Visual Science, Tianjin Eye Institute, Tianjin Eye Hospital, Nankai University Affiliated Eye Hospital, Tianjin, China.
- Nankai Eye Institute, Nankai University, Tianjin, China.
- Clinical College of Ophthalmology, Tianjin Medical University, Tianjin, China.
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Fernández Berdasco K, Castro Navarro J, González Castaño CN, Rodríguez Villa S, García Fernández M. Retrospective study of secondary implantation of retroiridial fixation lenses in patients without capsular support: functional results and complications. ARCHIVOS DE LA SOCIEDAD ESPANOLA DE OFTALMOLOGIA 2022; 97:317-322. [PMID: 35676024 DOI: 10.1016/j.oftale.2021.06.002] [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: 02/18/2021] [Accepted: 06/13/2021] [Indexed: 06/15/2023]
Abstract
INTRODUCTION The correction of aphakia when there is no adequate capsular support remains a therapeutic challenge. The use of retroiridial fixation lenses has been extended given their lower complication rate compared to other available options. MATERIAL AND METHODS Retrospective study including all cases operated with an Artisan® retropupillary aphakia implant. RESULTS 33 eyes were included out of a total of 28 patients. The follow-up period has been 38.55 months (1-96). 32.3% had a lens dislocation and 67.7% had an intraocular lens dislocation. The previous mean best corrected visual acuity (BCVA) was 1.18 ± 0.79 logMAR and post-intervention 0.36 ± 0.62 (p < 0.01). 93.8% of the patients presented a final BCVA equal to or better and 62.5% an improvement of 3 or more lines. The most frequent complication was corectopia (31.3%) and hypotony in the immediate postoperative period (21.9%). An epiretinal membrane (ERM) developed in 18.8% and cystic macular oedema (CME) in 9.4%. The presence of complications in the postoperative period did not statistically influence the final BCVA. CONCLUSIONS The retropupillary Artisan® lens allows the correction of aphakia with satisfactory visual results and a low rate of complications.
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Affiliation(s)
- K Fernández Berdasco
- Servicio de Oftalmología, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain.
| | - J Castro Navarro
- Servicio de Oftalmología, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain
| | - C N González Castaño
- Servicio de Oftalmología, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain
| | - S Rodríguez Villa
- Servicio de Oftalmología, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain
| | - M García Fernández
- Servicio de Oftalmología, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain
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Thulasidas M. Comments on: Comparative study of secondary implantation of iris–claw lens and scleral-fixated intraocular lens in terms of visual outcome and complications. JOURNAL OF CLINICAL OPHTHALMOLOGY AND RESEARCH 2022. [DOI: 10.4103/jcor.jcor_3_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Supporting IOL'S in a Deficient Capsular Environment: The Tale of No "Tails". J Ophthalmol 2021; 2021:9933486. [PMID: 34557313 PMCID: PMC8455193 DOI: 10.1155/2021/9933486] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 08/18/2021] [Indexed: 11/18/2022] Open
Abstract
Purpose To evaluate the efficacy and safety of the following three distinct surgical procedures for secondary IOL implantation without capsular support: Iris-claw lens, flanged transscleral fixated IOLs (Yamane technique), and sutureless transscleral hook IOL fixation (Carlevale IOL). Materials and Methods In this retrospective comparative study, three different sutureless IOL implantation techniques were compared in patients without any capsular support. Visual acuity and outcomes were analyzed in 24 eyes of 23 patients (14 male and 9 female). Study included 13 iris-claw lenses (Artisan Ophtec), 6 flanged transscleral fixated IOLs (Yamane technique using a MA60MA Alcon Inc IOL), and 5 transscleral Carlevale IOLS (Carlevale IOL, Soleko, Italy). Results logMAR mean best-corrected visual acuity (BCVA) improved from 0.49 ± 0.19 to 0.19 ± 0.10 at three months after surgery (p < 0.05). Postoperative BCVA was similar in all three groups, and no intergroup difference was noted. Three eyes (12.5%) had a raised IOP >25 mmHg, 2 eyes (8%) presented a subluxated/dislocated IOL, 4 eyes (16%) had corneal edema longer than 7 days, 3 eyes (12.5%) had irregular pupil profile, 2 eyes (8%) had vitreous hemorrhage, 7 eyes had (29%) corneal astigmatism over 3 diopters, and one patient (4%) developed cystoid macular edema (CME). Conclusions All three surgical procedures can be considered adequate to correct aphakia in patients without capsular support with significant improvement in visual acuity and low complication.
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Mirhajianmoghadam H, Piña A, Ostrin LA. Objective and Subjective Behavioral Measures in Myopic and Non-Myopic Children During the COVID-19 Pandemic. Transl Vis Sci Technol 2021; 10:4. [PMID: 34473223 PMCID: PMC8419879 DOI: 10.1167/tvst.10.11.4] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Accepted: 08/09/2021] [Indexed: 12/12/2022] Open
Abstract
Purpose The coronavirus disease 2019 (COVID-19) pandemic required a shift to electronic devices for education and entertainment, with children more confined to home, which may affect eye growth and myopia. Our goal was to assess behaviors during COVID-19 in myopic and non-myopic children. Methods Parents completed a questionnaire for their children (ages 8.3 ± 2.4 years, n = 53) regarding visual activity in summer 2020, during the COVID-19 pandemic, as well as during school time and the summer before COVID-19. Children also wore an Actiwatch for 10 days in summer 2020 for objective measures of light exposure, activity, and sleep. Data were analyzed with repeated-measures analysis of variance. Results Subjective measures showed that during COVID-19, children exhibited increased electronic device use and decreased activity and time outdoors (P < 0.05 for all), while time spent doing near work was not different than during a typical school or summer session before COVID-19 (P > 0.05). Objective measures during COVID-19 showed that myopic children exhibited lower daily light exposure (P = 0.04) and less activity (P = 0.04) than non-myopic children. Conclusions Children demonstrated increased electronic device use and decreased activity and time outdoors during COVID-19, with myopic children exhibiting lower light exposure and activity than non-myopes. Long-term follow-up is needed to understand if these behavioral changes ultimately contribute to myopia progression. Translational Relevance Children's behaviors changed during the COVID-19 pandemic, which may have implications in eye growth and myopia.
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Affiliation(s)
| | - Amanda Piña
- University of Houston College of Optometry, Houston, TX, USA
| | - Lisa A. Ostrin
- University of Houston College of Optometry, Houston, TX, USA
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Aslan F, Sahinoglu-Keskek N. The effect of home education on myopia progression in children during the COVID-19 pandemic. Eye (Lond) 2021; 36:1427-1432. [PMID: 34193982 PMCID: PMC8243061 DOI: 10.1038/s41433-021-01655-2] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 06/05/2021] [Accepted: 06/17/2021] [Indexed: 11/24/2022] Open
Abstract
Objectives To evaluate the effect of the COVID-19 pandemic restrictions on myopia progression (MP) in school age children. Methods A total of 115 children aged 8–17 years with a diagnosis of myopia who had been followed-up for at least three years, were included in this study with a retrospective and single-centre design. The subjects’ age, the history of myopia in the family, the time spent in front of a screen, the digital devices used during home education (computer, tablet, smartphone, television), the time spent in open air (hours/day), the refractive error (RE) (spherical equivalent value) detected before the home education period and the changes in the myopia over the years, were recorded. Results The mean age was 12.06 (±2.29) years. Only the right eyes were included. The glasses use duration was 3.57 (±0.74) years. The annual MP amount 0.49 (±0.26), 0.41 (±0.36) and 0.54 (±0.43) dioptres (D) for the 2017, 2018 and 2019 years before home education, respectively, (p > 0.05), and 0.71 (±0.46) D in 2020, during home education. The increase in MP amount in 2020 compared to the 2019 and 2018 years was statistically significant (p < 0.003). MP was statistically significantly less in children who participated in open-air activities for 2 h a day and those who lived in detached houses (p = 0.004, p = 0.006, respectively). Conclusion During home confinement, education programmes of school children should be designed while taking into account preventive measures for MP, in particular for allowing children to spend at least 2 h of outdoor time per day.
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Affiliation(s)
- Fatih Aslan
- Faculty of Medicine, Department of Ophthalmology, Alanya Alaaddin Keykubat University, Antalya, Turkey.
| | - Nedime Sahinoglu-Keskek
- Faculty of Medicine, Department of Ophthalmology, Alanya Alaaddin Keykubat University, Antalya, Turkey.
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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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Bhatia K, Manaktala R, Sachdev M, Tank N, Saha I, Mishra D. MYX technique: A modified adaptation of Yamane and extraocular needle-guided haptic insertion techniques for scleral-fixated intraocular lens implantation. Indian J Ophthalmol 2021; 69:428-431. [PMID: 33463604 PMCID: PMC7933830 DOI: 10.4103/ijo.ijo_728_20] [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] [Indexed: 11/30/2022] Open
Abstract
Scleral-fixated intraocular lens implantation in an important tool in the armamentarium of an ophthalmologist for managing aphakia. Various techniques have been described in the literature with variable learning curves. Herein, we describe an easy, fast, reproducible technique; the “MYX” technique, which utilizes the advantages of both the Yamane and the X-NIT technique, where the handshaking of the prolene haptic of a 3-piece PMMA IOL into the lumen of a 26-gauge needle is done externally (like in X-NIT technique), and the exteriorized haptic is cauterized to form a flange transconjunctivally, thereby avoiding the scleral pocket tucking (like Yamane technique), to achieve excellent surgical outcomes.
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Affiliation(s)
- Karan Bhatia
- Regional Institute of Ophthalmology, Sitapur Eye Hospital, Sitapur, Uttar Pradesh, India
| | - Ruchita Manaktala
- Regional Institute of Ophthalmology, Sitapur Eye Hospital, Sitapur, Uttar Pradesh, India
| | | | - Nikunj Tank
- Regional Institute of Ophthalmology, Sitapur Eye Hospital, Sitapur, Uttar Pradesh, India
| | - Indranil Saha
- Regional Institute of Ophthalmology, Sitapur Eye Hospital, Sitapur, Uttar Pradesh, India
| | - Deepak Mishra
- Regional Institute of Ophthalmology, Banaras Hindu University, Varanasi, Uttar Pradesh, India
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Sumitha CV, Pai V, Thulasidas M. Reply to comments on: Retropupillary iris-claw intraocular lens implantation in aphakic patients. Indian J Ophthalmol 2021; 69:175-176. [PMID: 33323621 PMCID: PMC7926091 DOI: 10.4103/ijo.ijo_1475_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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
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Mansoori T. Comments on: Retropupillary iris - claw intraocular lens implantation in aphakic patients. Indian J Ophthalmol 2021; 69:175. [PMID: 33323622 PMCID: PMC7926147 DOI: 10.4103/ijo.ijo_578_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Affiliation(s)
- Tarannum Mansoori
- Sita Lakshmi Glaucoma Center, Anand Eye Institute, Hyderabad, Telangana, India
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Choi EY, Lee CH, Kang HG, Han JY, Byeon SH, Kim SS, Koh HJ, Kim M. Long-term surgical outcomes of primary retropupillary iris claw intraocular lens implantation for the treatment of intraocular lens dislocation. Sci Rep 2021; 11:726. [PMID: 33436860 PMCID: PMC7804091 DOI: 10.1038/s41598-020-80292-3] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Accepted: 11/09/2020] [Indexed: 11/16/2022] Open
Abstract
We aimed to investigate the efficacy and safety of primary retropupillary iris claw intraocular lens (R-IOL) implantation in patients with complete intraocular lens (IOL) dislocation. In this single-center retrospective case series, we reviewed the medical records of patients who underwent R-IOL implantation surgery with pars plana vitrectomy for the treatment of IOL dislocation between September 2014 and July 2019. The primary outcome was change in visual acuity (VA) up to 24 months postoperatively. The secondary outcomes included changes in intraocular pressure (IOP), refractive errors, and endothelial cell count (ECC) over the same period. Data of 103 eyes (98 patients) were analyzed. The mean uncorrected VA was significantly improved at one month postoperatively (− 0.69 logMAR, P < 0.001), compared to the preoperative value. IOP (− 2.3 mmHg, P = 0.008) and ECC (− 333.4 cells/mm2, P = 0.027) significantly decreased one month post-surgery and remained stable thereafter. Postoperative mean spherical equivalents were similar to the prediction error throughout the follow-up period. IOP elevation (n = 8, 7.8%), cystoid macular edema (n = 4, 3.9%), and dislocation of the R-IOL (n = 10, 9.7%) were managed successfully. Overall, primary R-IOL implantation with pars plana vitrectomy is effective and safe for correcting IOL dislocation due to various causes.
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Affiliation(s)
- Eun Young Choi
- Department of Ophthalmology, Institute of Vision Research, Severance Eye Hospital, Yonsei University College of Medicine, 50-1, Yonseiro, Seodaemun-gu, Seoul, 03722, Korea
| | - Chul Hee Lee
- Department of Ophthalmology, Institute of Vision Research, Gangnam Severance Hospital, Yonsei University College of Medicine, 211, Eonjuro, Gangnam-gu, Seoul, 06273, Korea
| | - Hyun Goo Kang
- Department of Ophthalmology, Institute of Vision Research, Gangnam Severance Hospital, Yonsei University College of Medicine, 211, Eonjuro, Gangnam-gu, Seoul, 06273, Korea
| | - Jae Yong Han
- Department of Ophthalmology, Institute of Vision Research, Gangnam Severance Hospital, Yonsei University College of Medicine, 211, Eonjuro, Gangnam-gu, Seoul, 06273, Korea
| | - Suk Ho Byeon
- Department of Ophthalmology, Institute of Vision Research, Severance Eye Hospital, Yonsei University College of Medicine, 50-1, Yonseiro, Seodaemun-gu, Seoul, 03722, Korea
| | - Sung Soo Kim
- Department of Ophthalmology, Institute of Vision Research, Severance Eye Hospital, Yonsei University College of Medicine, 50-1, Yonseiro, Seodaemun-gu, Seoul, 03722, Korea
| | - Hyoung Jun Koh
- Department of Ophthalmology, Institute of Vision Research, Severance Eye Hospital, Yonsei University College of Medicine, 50-1, Yonseiro, Seodaemun-gu, Seoul, 03722, Korea
| | - Min Kim
- Department of Ophthalmology, Institute of Vision Research, Gangnam Severance Hospital, Yonsei University College of Medicine, 211, Eonjuro, Gangnam-gu, Seoul, 06273, Korea.
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Watane A, Botsford BW, Sood AB, Williams AM, Xu D, Gupta RR, Conner IP, Sivalingam A, Gupta OP, Ward MS, Mehta S, Cid MD, Crossan A, Sierpina DI, Hwang FS, Rachitskaya A, Ehmann DS, Kovacs KD, Orlin A, Zhang AY, Patel U, Dubovy S, Klufas MA, Patel NA, Sridhar J, Yannuzzi NA. Scleral-Sutured Intraocular Lens Dislocations Secondary to Eyelet Fractures. Am J Ophthalmol 2021; 221:273-278. [PMID: 32777376 DOI: 10.1016/j.ajo.2020.07.049] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 07/22/2020] [Accepted: 07/24/2020] [Indexed: 12/11/2022]
Abstract
OBJECTIVE To report clinical features and visual outcomes following eyelet fractures of scleral-sutured enVista MX60 (Bausch + Lomb) intraocular lenses (IOL). DESIGN Retrospective, multi-center, multi-surgeon, observational case series. METHODS Study Population: Patients with scleral-sutured enVista MX60 IOLs that experienced either an intraoperative or post-operative eyelet fracture associated with dislocation or subluxation. PROCEDURES All records were reviewed for patients with a dislocated or subluxed scleral-sutured enVista MX60 IOL. Clinical features and outcomes were gathered. Main Outcome Measures: Clinical setting, surgical technique, complications, and visual acuity. RESULTS A total of 25 scleral-sutured enVista MX60 IOLs displacements secondary to eyelet fractures in 23 eyes of 23 patients were included. There were 20 IOLs that sustained a postoperative fracture and 5 IOLs that sustained an intraoperative fracture. Of the postoperative fractures, 7 were dislocated and 13 were subluxed. Gore-Tex was the suture of choice for 19 of the postoperative fractures and all 5 of the intraoperative fractures, and Prolene was used for 1 postoperative fracture. The mean time until postoperative fracture was 96 ± 125 days, and the median time was 61 (IQR 48-144) days. Of the postoperative fractures, new MX60s were sutured in 10 patients, and 2 of them experienced repeat displacements due to a new eyelet fracture. In the intraoperative fracture group, new MX60s were sutured in 4 patients and an Akreos AO60 lens was placed in the 5th patient. The mean preoperative best-corrected logMAR visual acuity for all patients improved from 1.2 ± 0.8 (20/317 Snellen equivalent) to 0.5 ± 0.5 (20/63 Snellen equivalent) at most recent follow-up after lens replacement. CONCLUSIONS Scleral-sutured MX60 intraocular lenses can experience intraoperative or postoperative eyelet fractures, resulting in lens subluxation or dislocation. Surgeons should be aware of this complication when evaluating secondary intraocular lens options.
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