Anterior Axial Lens Subluxation, Progressive Myopia, and Angle-Closure Glaucoma: Recognition and Treatment of Atypical Presentation of Ectopia Lentis

Dagi, Linda R.; Walton, David S.

doi:10.1016/j.jaapos.2006.01.218

Cited by 24 publications

(18 citation statements)

References 20 publications

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“…[18] were of the opinion that if laser PI failed, surgical peripheral iridectomy could be performed. According to Dagi and Walton,[4] since the primary mechanism of angle closure is angle crowding, peripheral iridectomy may not suffice to control a rise in IOP; these authors opined that early detection and prophylactic lensectomy alone could control IOP, and, thus, could be considered a reliable treatment. Asaoka et al .…”

Section: Discussionmentioning

confidence: 99%

“…[12] Surgical interventions described include pars plana lensectomy with scleral-fixated intraocular lens (SFIOL)[1] implantation, phacoemulsification with removal of the capsular bag and anterior chamber IOL implantation,[1] lenticular aspiration with posterior chamber (PC) IOL implantation[2] and phacoemulsification with acrylic lens implantation. [3] In microspherophakia with subluxation and raised intraocular pressure (IOP), additional glaucoma surgery[1456] is indicated.…”

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confidence: 99%

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Scleral- fixated intraocular lens implantation in microspherophakia

Subbiah

Thomas

Jesudasan

2014

Indian J Ophthalmol

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Background:In microspherophakia, abnormal laxity of the lenticular zonules leads to development of a spherical lens and possible subluxation. We evaluated long-term results of lens removal with scleral-fixated intraocular lens (SFIOL) implantation in microspherophakia.Materials and Methods:Case series. SF IOLs were implanted in four consecutive patients with bilateral microspherophakia (eight eyes [three with pupillary block and secondary glaucoma who underwent immediate surgery and five with only subluxation who underwent elective surgery]). Post-operative best-corrected visual acuity (BCVA), intraocular pressure (IOP) and lens position were evaluated periodically from day 1 to 18 months.Results:All patients were females (mean age 28 ± 7.03 years). In group 1 eyes (three eyes that presented with pupillary block), the mean BCVA improved from 0.008 decimals (preoperative) to 0.50 decimals (final post-operative visit); in group 2 eyes (the other five eyes), the mean BCVA improved from 0.12 ± 0.21 decimals to 0.73 ± 0.14 decimals. The preoperative mean IOP (54.53 ± 7.33 mmHg) in group 1 eyes was significantly (P = 0.03) higher than that (16 ± 4.30 mm Hg) in group 2 eyes. At final post-operative visit, the mean IOP (11.67 ± 2.88 mmHg) in group 1 eyes was not significantly different from that in group 2 eyes (13.0 ± 3.08 mmHg). All SFIOLs were well- centred at the final visit. None of the patients encountered any peroperative or postoperative complications.Conclusions:SFIOLs may be an option for surgical management of microspherophakia.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Scleral- fixated intraocular lens implantation in microspherophakia

Subbiah

Thomas

Jesudasan

2014

Indian J Ophthalmol

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“…The AC IOL has the added benefit of preventing anterior dislocation of the subluxated crystalline lens with its associated morbidity. 13,14 Disadvantages of this approach include the possibility of late crystalline lens dislocation onto the retina and induced astigmatism from larger incisions that would be used for AC IOL insertion.…”

Section: Discussionmentioning

confidence: 99%

Primary anterior chamber intraocular lens for the treatment of severe crystalline lens subluxation

Hoffman

Fine

Packer

2009

Journal of Cataract and Refractive Surgery

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Subluxated cataractous and clear lenses are commonly treated by limbal or pars plana lensectomy followed by primary or secondary intraocular lens (IOL) implantation. Adjunctive capsular prosthetic devices have facilitated lens removal and IOL centration in these challenging cases but have also added complexity and potential complications to the procedure. Although crystalline lens extraction may be required to clear the visual axis in mild to moderate lens subluxations, we propose insertion of a primary anterior chamber IOL without lens extraction in severe subluxations when the eye is optically aphakic or can be made functionally aphakic following neodymium:YAG laser zonulysis. Two cases demonstrating this approach are presented.

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“…Dagi and Walton [20 ] have outlined the two different mechanisms responsible for this progressive myopia: anterior shift of the lens/ iris diaphragm, which moves the focal point of the eye anteriorly, and anterior/posterior thickening of the lens, which increases its refractive power and augments this myopic shift. These two phenomena can be related to a circumferential stretching of the zonule, as opposed to ectopia lentis, in which the stretching is sectorial (Fig.…”

Section: Myopiamentioning

confidence: 99%