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Sejournet L, Elbany S, Serrar Y, Loria O, Bontemps J, Mathis T, Burillon C, Kodjikian L. FIL SSF intraocular lens opacification after gas tamponade: A case series. Eur J Ophthalmol 2024; 34:NP34-NP38. [PMID: 38233368 DOI: 10.1177/11206721241226743] [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: 01/19/2024]
Abstract
PURPOSE To report three cases of postoperative opacification of sutureless scleral-fixed hydrophilic intraocular lens (FIL SSF IOL, Soleko, Italy) after gas tamponade. Two cases occurred after pars plana vitrectomy and one case after Descemet membrane endothelial keratoplasty. CASE REPORT Two diabetic patients underwent a FIL SSF IOL implantation after posterior capsular rupture during cataract surgery. Rhegmatogenous retinal detachment (RRD) was observed in one patient during the initial surgery. A second patient developed a RRD five months after surgery. Both RRDs were treated with pars plana vitrectomy and perfluoroethane (C2F6) gas tamponade. A few days after the surgery, C2F6 was observed in the anterior chamber of both patients. Two months after gas tamponade, opacification of the anterior surface of the IOL was observed. The third patient was a 74-year-old woman, who underwent a combined Descemet membrane endothelial keratoplasty (DMEK) and FIL SSF IOL implantation. Two rebubblings with sulfur hexafluoride (SF6) retreatments were required due to corneal graft detachment. One month later, an opacification of the anterior surface of the IOL was observed. Explantation with implantation of iris-claw IOL was decided, which resulted in an improvement of BVCA. Analysis of the IOL showed a positive Von Kossa staining, indicating calcification of the IOL. We performed a review of all the cases of FIL SSF IOL implantation in our centers. The overall rate of FIL SSF IOL opacification was 2.1% (3/140). Amongst patients treated with gas tamponade, the rate of opacification was 27.3% (3/11). Although FIL SSF IOL implantation appears to be an effective option for the treatment of aphakia, caution should be exercised regarding the risk of opacification following gas tamponade, especially since these patients are at risk of retinal detachment.
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Affiliation(s)
- L Sejournet
- Department of Ophthalmology, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France
| | - S Elbany
- Department of Ophthalmology, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France
| | - Y Serrar
- Department of Ophthalmology, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France
| | - O Loria
- Department of Ophthalmology, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France
| | - J Bontemps
- Department of Ophthalmology, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France
| | - T Mathis
- Department of Ophthalmology, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France
- Laboratoire MATEIS, UMR-CNRS 5510, INSA, Université Lyon 1 69100 Villeurbanne, France
| | - C Burillon
- Department of Ophthalmology, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France
| | - L Kodjikian
- Department of Ophthalmology, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France
- Laboratoire MATEIS, UMR-CNRS 5510, INSA, Université Lyon 1 69100 Villeurbanne, France
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Vaiano AS, Greco A, Greco A, Toro ME, Leto MG, Savini G. Efficacy and safety of UT-DSAEK combined with Carlevale's sutureless scleral fixation IOL. Eur J Ophthalmol 2023; 33:2201-2209. [PMID: 36976933 DOI: 10.1177/11206721231166558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/30/2023]
Abstract
PURPOSE To evaluate a novel surgical combination of ultrathin Descemet stripping automated endothelial keratoplasty (UT-DSAEK) and sutureless scleral fixation for Carlevale intraocular lens (SSF-Carlevale IOL) implantation to manage corneal endothelial decompensation when there is a concomitant need for secondary IOL fixation. METHODS Clinical data collected from 10 eyes of 9 patients with bullous keratopathy (BK) who underwent combined UT-DSAEK and SSF-Carlevale IOL implantation in a single procedure were retrospectively analyzed. Anterior chamber IOL (4 cases), aphakia (4 cases, 1 of which associated with PEX), and previous trauma (2 cases) were the conditions responsible for BK. Corrected distance visual acuity (CDVA), intraocular pressure (IOP), endothelial cell density (ECD), central corneal thickness (CCT), graft thickness (GT) and complications were recorded over a 12-month follow-up period. RESULTS In 90% (9/10) of eyes graft clarity was maintained during follow-up. The mean CDVA improved significantly (p < 0.0001) from 1.78 ± 0.76 logMAR preoperatively to 0.53 ± 0.3 logMAR at 12 months. ECD on average decreased from 2575 ± 125.3 cells/mm2 (donor tissue) to 1697 ± 133.3 cells/mm2 in 12 months. The mean CCT decreased from 870 ± 200 µm to 650 µm ± 9 at 12 months (ANOVA, p = 0.0005). CONCLUSIONS Combined UT-DSAEK and SSF-Carlevale IOL implantation was associated with good corneal graft survival and IOP control, with few complications. These findings suggest that this surgical approach is a practical option for patients requiring both treatment for corneal endothelial dysfunction and secondary IOL implantation.
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Affiliation(s)
- Agostino S Vaiano
- Institute of Ophthalmology, Santa Croce e Carle Hospital, Cuneo, Italy
| | - Antonio Greco
- Institute of Ophthalmology, Santa Croce e Carle Hospital, Cuneo, Italy
| | - Andrea Greco
- Institute of Ophthalmology, Santa Croce e Carle Hospital, Cuneo, Italy
| | - Maria E Toro
- Institute of Ophthalmology, Santa Croce e Carle Hospital, Cuneo, Italy
| | - Marco G Leto
- Institute of Ophthalmology, Santa Croce e Carle Hospital, Cuneo, Italy
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Coco G, Ferrara M, Borgia A, Romano D, Romano V. Carlevale intraocular lens opacification after Descemet stripping automated endothelial keratoplasty. Eur J Ophthalmol 2023; 33:NP60-NP62. [PMID: 36163691 DOI: 10.1177/11206721221128669] [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: 11/15/2022]
Abstract
PURPOSE To report a case of sutureless scleral-fixated (SSF) Carlevale intraocular lens (IOL) opacification following Descemet stripping automated endothelial keratoplasty (DSAEK) surgery. METHODS An 82-year-old man underwent combined SSF Carlevale IOL implant and DSAEK surgery for aphakic endothelial decompensation. Surgery was uneventful, while the postoperative period was complicated by multiple graft detachments requiring re-bubbling. After four re-bubbling procedures, the corneal graft attached and cleared over time. RESULTS 29 months after combined SSF IOL implant and DSAEK surgery, the patient presented with decreased vision due to IOL opacification affecting the visual axis. CONCLUSION Although combined SSF IOL and DSAEK surgery is an overall safe and effective procedure for aphakic endothelial decompensation, risk of IOL opacification due to anterior chamber air injection is higher when using hydrophilic IOLs and in cases requiring multiple re-bubbling, therefore, intraocular lens material should be chosen after considering the risks and benefits.
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Affiliation(s)
- Giulia Coco
- St. Paul's Eye Unit, Royal Liverpool University Hospital, Liverpool, UK
- Department of Clinical Science and Translational Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Mariantonia Ferrara
- Newcastle Eye Centre, Royal Victoria Infirmary, Newcastle upon Tyne NE1 4LP, UK
| | - Alfredo Borgia
- St. Paul's Eye Unit, Royal Liverpool University Hospital, Liverpool, UK
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090, Pieve Emanuele, Milan, Italy
| | - Davide Romano
- St. Paul's Eye Unit, Royal Liverpool University Hospital, Liverpool, UK
- Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, Ophthalmology Clinic, University of Brescia, Viale Europa 15, 25123 Brescia, Italy
| | - Vito Romano
- St. Paul's Eye Unit, Royal Liverpool University Hospital, Liverpool, UK
- Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, Ophthalmology Clinic, University of Brescia, Viale Europa 15, 25123 Brescia, Italy
- Department of Eye and Vision Science, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK
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Grzybowski A, Zemaitiene R, Markeviciute A, Tuuminen R. Should We Abandon Hydrophilic Intraocular Lenses? Am J Ophthalmol 2022; 237:139-145. [PMID: 34843687 DOI: 10.1016/j.ajo.2021.11.021] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 11/02/2021] [Accepted: 11/16/2021] [Indexed: 11/18/2022]
Abstract
PURPOSE To characterize the features of hydrophilic intraocular lenses (IOLs) important in the clinical context of expected prolonged duration time of the IOL within the eye. DESIGN Perspective. METHODS Discussion includes possible factors and mechanisms associated with hydrophilic IOLs' susceptibility to calcification and posterior capsule opacification (PCO) formation. RESULTS Results of recently reported studies show that particular surgeries, such as pars plana vitrectomy, Descemet stripping (automated) endothelial keratoplasty, and Descemet membrane endothelial keratoplasty with intraocular gas or air injection, might predispose the calcification process of hydrophilic IOLs, leading to a significant decrease in visual quality and possibly explantation of the IOL. Hydrophilic IOLs are more susceptible than hydrophobic IOLs to PCO formation, which is the most common of late postoperative complications that are associated with significant side effects. CONCLUSIONS We believe that all patients should be informed about the higher risk of calcification and PCO associated with hydrophilic IOLs. We also recommend limiting the use of hydrophilic acrylic IOLs during cataract surgery, especially when it is combined with pars plana vitrectomy or endothelial keratoplasty, and in patients with endothelial diseases who will probably require operation on it in the future.
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Affiliation(s)
- Andrzej Grzybowski
- From the Department of Ophthalmology, University of Warmia and Mazury, (A.G.), Olsztyn; Institute for Research in Ophthalmology (A.G.), Poznan, Poland.
| | - Reda Zemaitiene
- Department of Ophthalmology, Medical Academy, Lithuanian University of Health Sciences (R.Z., A.M.), Kaunas, Lithuania
| | - Agne Markeviciute
- Department of Ophthalmology, Medical Academy, Lithuanian University of Health Sciences (R.Z., A.M.), Kaunas, Lithuania
| | - Raimo Tuuminen
- Helsinki Retina Research Group, University of Helsinki (R.T.), Helsinki; Department of Ophthalmology, Kymenlaakso Central Hospital (R.T.), Kotka, Finland
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Abstract
PURPOSE OF REVIEW Phacoemulsification cataract surgery is one of the most commonly performed surgical procedure worldwide. In the majority of cases, intraocular lenses (IOLs) are implanted. Due to the increasing life expectancy and the fact that cataract surgery is performed in earlier stages, the anticipated IOL duration in the eye has increased over the last decades. The aim of this study was to review the types and describe the characteristics of late intraocular lens opacifications. RECENT FINDINGS Calcification was the most commonly reported type of opacification in hydrophilic IOLs; it usually negatively impacted the visual function and required IOL explantation. Glistening manifested in hydrophobic acrylic lenses and was frequent in some IOL models. In most cases glistening and subsurface nanoglistenigs do not lead to a decline in visual acuity or require IOL exchange. Current studies indicate that fluid-related phenomena may induce straylight, leading to a decrease of comfort and quality of vision. SUMMARY Several reports on late IOL opacifications have been published in recent years. In some cases, particularly in glistening, the development of the opacifications might be related to IOL aging. The influence of the fluid-related microvacuoles on the quality of vision requires further research.
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Affiliation(s)
- Piotr Kanclerz
- Department of Ophthalmology, Hygeia Clinic, Gdańsk, Poland
| | - Timur M Yildirim
- David J. Apple International Laboratory for Ocular Pathology and International Vision Correction Research Centre (IVCRC), Department of Ophthalmology, University of Heidelberg, Heidelberg, Germany
| | - Ramin Khoramnia
- David J. Apple International Laboratory for Ocular Pathology and International Vision Correction Research Centre (IVCRC), Department of Ophthalmology, University of Heidelberg, Heidelberg, Germany
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Grzybowski A, Markeviciute A, Zemaitiene R. A narrative review of intraocular lens opacifications: update 2020. ANNALS OF TRANSLATIONAL MEDICINE 2020; 8:1547. [PMID: 33313292 PMCID: PMC7729367 DOI: 10.21037/atm-20-4207] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The opacifications of intraocular lenses (IOLs) can significantly impact patients visual quality. Despite the identification of specific risk factors, manufacturing changes, opacifications are not eliminated. Likewise, more attention in recent studies was paid to possible new risk factors, however one of the most important purposes of the studies remains opacifications effect on visual performance, which could be disturbed in different aspects. The aim of this review is to discuss the main risk factors of IOLs opacification in particular IOL types, and its impact on vision quality. Different risk factors were discussed in the study, including the material of IOLs, the impact of the breakdown of blood-aqueous barrier (BAB), and certain surgeries that can be associated with opacification formation. Glistenings occur more often in a hydrophobic material, however, the changes in water content of the IOLs can significantly reduce the formation of glistenings. The studies showed a significant effect of intraocular injection of exogenous air or gas during Descemet-stripping endothelial keratoplasty, Descemet-stripping automated endothelial keratoplasty, Descemet membrane endothelial keratoplasty, and pars plana vitrectomy on calcification formation. It raises a concern, as the incidence of these surgeries is increasing. Visual acuity decreases significantly after the calcification in IOLs occurs, and it usually causes IOLs exchange. However, disability glare seems to be more affected in patients with IOLs, which were affected by glistenings than visual acuity. Disability glare is associated with increased levels of straylight, which was widely evaluated in recent studies and it was reported to be a susceptible measurement to detect the presence of IOLs pathology. For future researches, it should be noticed that disability glare and straylight are more appropriate in evaluating IOLs opacification effect on visual quality than visual acuity. While reviewing the main risk factors of IOLs opacifications particular attention must be paid on calcification occurrence in hydrophilic acrylic IOLs after surgeries with intraocular injection of exogenous air or gas.
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Affiliation(s)
- Andrzej Grzybowski
- Department of Ophthalmology, University of Warmia and Mazury, Olsztyn, Poland.,Institute for Research in Ophthalmology, Poznan, Poland
| | - Agne Markeviciute
- Department of Ophthalmology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Reda Zemaitiene
- Department of Ophthalmology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
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