Iris-claw intraocular lens implantation in children with ectopia lentis

Çevik, Sadık Görkem; Çevik, Muhammer Özgür; Özmen, Ahmet

doi:10.5935/0004-2749.20170027

Cited by 10 publications

(18 citation statements)

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“… 30 , 70 The risk of redislocation tends to be more among young patients (<55 years of age) and those with a trauma history. 15 , 34 , 43 Three randomized clinical trials by Dalby et al, Kristianslund et al, and Helvaci et al, involving patients >55 years of age, observed redislocation at a rate of 3%, 2%, and 0%, respectively. 14 , 16 , 24 Shuaib et al reported a disenclavation rate of 20% (mean follow-up of 6 months), and Cevik et al experienced a disenclavation rate of 37% (mean follow-up of 38 months).…”

Section: Postoperative Outcomesmentioning

confidence: 99%

“…The frequency of CME following ICIOL implantation depends on the indication for surgery and ranges from 0%-25%. 14–18 , 20–32 , 34–39 , 41–44 , 46–56 The duration of follow-up, sample size, and investigative method for CME in different studies also affect the CME rates. Use of OCT at regular follow-ups after cataract surgery might be useful in detecting non-clinical CME (<20/40 change in CDVA).…”

Section: Postoperative Outcomesmentioning

confidence: 99%

“… 14 , 16 , 24 Shuaib et al reported a disenclavation rate of 20% (mean follow-up of 6 months), and Cevik et al experienced a disenclavation rate of 37% (mean follow-up of 38 months). 15 , 34 However, these two studies with the highest dislocation rate reported in literature included children between 2 and 16 years of age, and had a small sample size. Two retrospective studies by Toro et al, and Forlini et al, with the longest follow-up periods of around 5 years, observed haptic disenclavation at a rate of 2% and 1%, respectively.…”

Section: Postoperative Outcomesmentioning

confidence: 99%

“…Only three studies have reported an RD incidence of more than 5% with retropupillary ICIOLs, all of which included paediatric cases and had a sample size ≤30 eyes. 15 , 34 , 43 …”

Section: Postoperative Outcomesmentioning

confidence: 99%

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Retropupillary Iris-Claw Intraocular Lenses: A Literature Review

Thulasidas¹

2021

OPTH

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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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Section: Postoperative Outcomesmentioning

confidence: 99%

Section: Postoperative Outcomesmentioning

confidence: 99%

Section: Postoperative Outcomesmentioning

confidence: 99%

“…Only three studies have reported an RD incidence of more than 5% with retropupillary ICIOLs, all of which included paediatric cases and had a sample size ≤30 eyes. 15 , 34 , 43 …”

Section: Postoperative Outcomesmentioning

confidence: 99%

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Retropupillary Iris-Claw Intraocular Lenses: A Literature Review

Thulasidas¹

2021

OPTH

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“…They concluded that Artisan provides good results in terms of improving uncorrected and corrected vision, but involves a high incidence of postoperative complications, especially lens dislocation and retinal detachment. [35]…”

Section: Introductionmentioning

confidence: 99%

Management strategies of ocular abnormalities in patients with marfan syndrome: Current perspective

Esfandiari

Ansari

Mohammad-Rabei

et al. 2019

J Ophthalmic Vis Res

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Marfan syndrome is an autosomal dominant genetic connective tissue disorder that results from mutations in the fibrillin-1 gene located on chromosome band 15q15–21. Fibrillin, a glycoprotein, is widely expressed throughout the body and contributes to the elasticity and force-bearing capacity of connective tissue. In the eye, fibrillin is a key constituent of the ciliary zonules, which suspend the crystalline lens in place. The zonular defect leads to ectopia lentis, which is a hallmark of Marfan ocular abnormalities and occurs in 60% to 80% of cases. Other less common ocular features of Marfan syndrome are increased axial length, astigmatism, and flat cornea. Visual function in Marfan syndrome could be affected in several ways: ectopia lentis, refractive error, amblyopia, retinal detachment, cataract, and glaucoma. Management of a subluxated lens starts with the correction of refractive error with eyeglasses in mild cases. In more severe cases, especially when the lens bisects the pupil, complete correction of refractive error is impossible without removing the subluxated lens. The best method for visual rehabilitation after lens extraction is still debated. Aphakic Artisan lens implantation at the time of subluxated lens removal results in good visual outcomes with an acceptable safety profile. Studies with longer term follow-up and larger sample populations are needed to evaluate the safety of this procedure in patients with Marfan syndrome.

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Rhegmatogenous retinal detachment in paediatric patients after pars plana vitrectomy and sutured scleral-fixated intraocular lenses

Sen

Shaikh

Sreelakshmi

2017

Eye

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PurposeTo report the incidence rate, management, and surgical outcomes of rhegmatogenous retinal detachment (RRD) in children who underwent pars plana vitrectomy (PPV) with sutured scleral-fixated intraocular lens implantation (SSFIOL).Patients and methodsOf the 279 eyes of 230 children who underwent PPV with SSFIOL at a tertiary eye care centre, 16 eyes of 15 children developed RRD. Retrospective analysis of the surgical details of RRD, the structural and functional outcomes was done.ResultsOf the 279 eyes of 230 children who underwent PPV with SSFIOL, RRD was seen in 5.7% of the eyes. Average age was 10.7 years (range 4-15 years). Indication for SSFIOL implantation was congenital subluxation of lens (8 eyes) and traumatic aphakia or lens subluxation (4 eyes each). PPV was done in 15 of the 16 eyes, and 1 patient underwent scleral buckling. Retina was attached at the last follow-up visit in 87.5% of the eyes with median number of surgeries being 1. BCVA at the time of retinal detachment, multiple surgeries, and PVR at presentation were associated with poor visual outcome.ConclusionSurgery for SSFIOL in our series of paediatric eyes was complicated by vision-threatening RRD in 5.7% of cases. Surgical outcome in eyes with RRD without PVR was better (100%) than that in those, where PVR had already set in (75%). Need for regular follow-up and self-monitoring of vision should be emphasized and discussed with the parents before surgical intervention.

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Iris-claw intraocular lens implantation in children with ectopia lentis

Cited by 10 publications

References 0 publications

Retropupillary Iris-Claw Intraocular Lenses: A Literature Review

Retropupillary Iris-Claw Intraocular Lenses: A Literature Review

Management strategies of ocular abnormalities in patients with marfan syndrome: Current perspective

Rhegmatogenous retinal detachment in paediatric patients after pars plana vitrectomy and sutured scleral-fixated intraocular lenses

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