Purpose To assess Uveitis‐Glaucoma‐Hyphaema syndrome (UGH syndrome) with focus on resolution, glaucoma development and risk factors. Methods This retrospective case–control study with a cross‐sectional component was performed to compare three groups with 71 patients each: UGH syndrome, dislocated intraocular lens (IOL) without UGH syndrome and ordinary pseudophakia. Main outcome measures were resolution of the UGH syndrome, best‐corrected visual acuity (BCVA) and the need of glaucoma therapy. We also assessed the IOL‐iris contact signs and the use of blood thinners. Results Uveitis‐Glaucoma‐Hyphaema (UGH) syndrome resolved in 77 % of patients who underwent various kind of IOL surgery. Intraocular pressure (IOP) decreased and BCVA improved in the operated cases (p = 0.02 and p < 0.001, respectively), but not in the cases treated conservatively. Intraocular pressure (IOP) ≥22 mmHg at the first haemorrhage predicted the need of glaucoma therapy after UGH syndrome resolution (p = 0.002, area under the curve = 0.8). Fifty‐one per cent of patients without preexisting glaucoma needed glaucoma therapy after UGH syndrome resolution. Pseudophacodonesis was seen more frequently in the UGH group than in the ordinary pseudophakia group (p = 0.001). Iris defects were not more frequent in the UGH group than in the Dislocated group but the types of defects differed (p < 0.0001). Blood thinners were not more frequent in UGH. Conclusion In UGH syndrome, the results are better with surgical intervention than with conservative treatment, but surgery does not guarantee resolution. Pseudophacodonesis is a risk factor for UGH syndrome, but blood thinners are not, and iris defects are not specific to UGH syndrome. A high IOP at the first haemorrhage increases the risk for needing subsequent IOP‐lowering therapy.
Purpose: To evaluate the efficacy and safety of iris suture fixation of out-of-thebag dislocated three-piece intraocular lenses (IOL). Methods: In a retrospective interventional consecutive case series, a chart review was performed in two groups of patients: fourteen patients with a dislocated outof-the-bag three-piece IOL that underwent IOL fixation to the iris using the Siepser sliding knot technique (Iris group) and 18 patients with in-the-bag dislocation that underwent IOL exchange with a new scleral-sutured IOL (Exchange group). The Iris and Exchange groups were compared regarding surgical safety and efficacy. The median follow-up time was 13.5 months [interquartile range (IQR), 10-20] in the Iris group and 12.5 (IQR, 10-14) in the Exchange group. Results: The best corrected visual acuity (BCVA) improved significantly in both groups (p = 0.005 and 0.00006, respectively). No difference in final BCVA was seen between the groups. Significantly less surgically induced astigmatism (p = 0.03) and a lower number of postoperative visits (p = 0.0006) was noted in the Iris group. Considering the type of surgery, there were few complications in the present material. Conclusion: In the study, suturing dislocated three-piece IOLs to the iris appeared to be an acceptable surgical management with less surgically induced corneal astigmatism and fewer postoperative visits than IOL exchange. A larger study with a longer follow-up time would be desirable to confirm the results.The study results were in part presented at the annual meeting of Swedish Ophthalmological Society in 2017. Fig. 3. Firstly, the first knot of prolene suture is tied, then intraocular lenses optics is luxated behind the iris. Pupil is made round with two capsulorhexis forceps. After that final knotting of remaining two knots is done.
Introduction: To evaluate IOL tilt, IOL-induced astigmatism (IIA), refractive change and impact of capsular fibrosis on IOL position after scleral fixation of dislocated IOL using two methods: Ab Externo Scleral Suture Loop Fixation (Group A) and a modification, Embracing the Continuous Curvilinear Capsulorhexis (Group B). Methods: In this prospective randomized clinical trial conducted at St. Erik Eye Hospital, 117 patients with dislocated IOL were randomized to Group A (n = 61) or B (n = 56). Patients with ordinary pseudophakia (n = 60) served as controls. IOL tilt was measured three-dimensionally with anterior segment optical coherence tomography (AS-OCT). Results: The median IOL tilt was similar with both methods (A: 7.8°; B: 8.3°; p=0.51), but higher than in ordinary pseudophakia (5.4°; p<0.001). Both groups showed a myopic shift, p<0.001. In cases without capsular fibrosis, the median IOL tilt was 15.5° in Group A (n = 7) and 7.0° in Group B (n = 5), p=0.19. For each degree of IOL tilt, IIA increased by 0.075D (p<0.001). IOL position could be measured with AS-OCT in all patients given that the IOL was visible in the pupil. Discussion/Conclusion: After IOL fixation surgery, IOL tilt is higher than in normal pseudophakia. A study involving more patients without capsular fibrosis could clarify whether IOL position is better with method B in this subgroup. IOL-induced astigmatism is low, but myopic shift is common. AS-OCT is useful for IOL tilt assessment after IOL fixation surgery. Trial registration number: NCT04150263
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.