Clinical analysis of the factors contributing to pupillary optic capture after transscleral fixation of posterior chamber intraocular lens for dislocated intraocular lens

Kang, Dong Jin; Kim, Hong Kyun

doi:10.1016/j.jcrs.2016.05.006

Cited by 19 publications

(13 citation statements)

References 12 publications

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“…No pupillary capture was seen in all cases of four-point scleral suture fixation of the Akreos Adapt IOL. In some series, pupillary capture of the IOL optic has occurred in 7.9–14.3% of cases after scleral fixated sutured posterior chamber IOL implantation [ 18 ], but patients with MFS tended to have a higher rate of pupillary capture of the IOL [ 19 ]. IOL pupillary capture is usually transient, but it might cause complications such as pupillary block with secondary glaucoma, pigmentary dispersion glaucoma and iritis as well as refractive change [ 20 , 21 ].…”

Section: Discussionmentioning

confidence: 99%

Outcomes of Transscleral Two-Point Fixation Versus Closed Continuous-Loop Four-Point Fixation of Intraocular Lens in Subluxated Lens Secondary to Marfan Syndrome

et al. 2022

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Introduction To compare the outcome of two different transscleral fixation approaches for posterior chamber intraocular lens (IOL) implantation, a two-point fixation of the Sensar (Allergan) or CZ70BD (Alcon) IOL and a four-point fixation of the Akreos Adapt (Bausch & Lomb) foldable IOL, for treatment of subluxated lenses in Marfan syndrome (MFS). Methods Fifty-three eyes of 33 consecutive patients with subluxated lenses secondary to MFS were studied. Eighteen patients with MFS (30 eyes) received two-point fixation of the Sensar (16 patients, 26 eyes) or CZ70BD (2 patients, 4 eyes) IOL, and 15 patients with MFS (23 eyes) received four-point fixation of the Akreos Adapt IOL. Preoperative and postoperative ophthalmologic examinations were performed. A primary outcome measure of postoperative complication was studied. Results The mean preoperative best corrected visual acuity (BCVA) in the two-point group was 0.68 ± 0.38 logarithm of the minimum angle of resolution (logMAR), and it improved to 0.30 ± 0.32 logMAR at the final follow-up ( p < 0.05). The mean preoperative BCVA in the four-point group was 0.68 ± 0.45 logMAR, and it improved to 0.28 ± 0.28 logMAR at the final follow-up ( p < 0.05). The BCVA results did not differ significantly between groups. The intraocular pressure was increased at the final follow-up in the two-point group ( p < 0.05). Transscleral two-point fixation of IOL has relatively high incidences of pupillary capture of the IOL. Conclusion The closed continuous-loop transscleral four-point fixation of the Akreos Adapt foldable IOL is more suitable than two-point fixation of a two-haptic IOL in treating subluxated lenses due to MFS.

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Section: Discussionmentioning

confidence: 99%

Outcomes of Transscleral Two-Point Fixation Versus Closed Continuous-Loop Four-Point Fixation of Intraocular Lens in Subluxated Lens Secondary to Marfan Syndrome

et al. 2022

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“…2,3 Thus, patients with floppy iris syndrome, asymmetric lens fixation, or an abnormal anterior chamber depth may be more prone to developing postoperative pupillary capture. 2,4 Patients with a longer anterior chamber depth may have a more posteriorly placed pupil margin in relation to the limbus and thus decreased distance between the scleral-fixated IOL and iris 4 ; in cases with shallow anterior chambers, turbulent fluid mechanics may increase posterior bowing forces and the chance of pupillary capture. 2 Patients with floppy iris syndrome are more prone to posterior bowing of the iris from anterior chamber fluid mechanics.…”

Section: Discussionmentioning

confidence: 99%

Intraocular Lens Imbrication for Recurrent Pupillary Capture After Sutureless Intrascleral Fixation

Patel

Stem

Todorich

2022

RETINAL Cases &Amp; Brief Reports

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Supplemental Digital Content is Available in the Text.We demonstrate a novel surgical technique to address persistent postoperative pupillary capture in a patient who underwent sutureless scleral intraocular fixation. The intraocular lens is imbricated with a suture to prevent reverse pupillary block and subsequent intraocular lens capture and to stabilize the anterior–posterior movement of the intraocular lens.

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“…Dong Jin Kang et al have reported that five eyes (7.8%) had pupillary capture after transscleral IOL fixation. Other complications after transscleral fixation were vitreous hemorrhage in 5 eyes (7.8%) and IOP elevation in 8 eyes (12%) [ 11 ]. Besides, suturing of the haptics to the sclera may result in suture erosion, delayed IOL dislocation owing to suture breakage, or suture exposure-induced endophthalmitis [ 4 , 12 ].…”

Section: Discussionmentioning

confidence: 99%

Capture of intraocular lens optic by residual capsular opening in secondary implantation: long-term follow-up

Tian¹,

Chen²,

Jin³

et al. 2018

BMC Ophthalmol

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BackgroundTo introduce a novel surgical technique for optic capture by residual capsular opening in secondary intraocular lens (IOL) implantation and to report the outcomes of a long follow-up.MethodsTwenty patients (20 eyes) who had received secondary IOL implantation with the optic capture technique were retrospectively reviewed. We used the residual capsular opening for capturing the optic and inserted the haptics in the sulcus during surgery. Baseline clinical characteristics and surgical outcomes, including best-corrected visual acuity (BCVA), refractive status, and IOL position were recorded. The postoperative location and stability of IOL were evaluated using the ultrasound biomicroscopy.ResultsOptic capture technique was successfully performed in all cases, including 5 cases with large area of posterior capsular opacity, 6 cases with posterior capsular tear or rupture,and 9 cases with adhesive capsules. BCVA improved from 0.60 logMAR at baseline to 0.36 logMAR at the last follow-up (P < 0.001). Spherical equivalent changed from 10.67 ± 4.59 D at baseline to 0.12 ± 1.35 D at 6 months postoperatively (P < 0.001). Centered IOLs were observed in all cases and remained captured through residual capsular opening in 19 (95%) eyes at the last follow-up. In one case, the captured optic of IOL slid into ciliary sulcus at 7 months postoperatively. No other postoperative complications were observed in any cases.ConclusionsThis optic capture technique by using residual capsule opening is an efficacious and safe technique and can achieve IOL stability in the long follow-up.

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Clinical analysis of the factors contributing to pupillary optic capture after transscleral fixation of posterior chamber intraocular lens for dislocated intraocular lens

Abstract: Neither author has a financial or proprietary interest in any material or method mentioned.

Cited by 19 publications

References 12 publications

Outcomes of Transscleral Two-Point Fixation Versus Closed Continuous-Loop Four-Point Fixation of Intraocular Lens in Subluxated Lens Secondary to Marfan Syndrome

Outcomes of Transscleral Two-Point Fixation Versus Closed Continuous-Loop Four-Point Fixation of Intraocular Lens in Subluxated Lens Secondary to Marfan Syndrome

Intraocular Lens Imbrication for Recurrent Pupillary Capture After Sutureless Intrascleral Fixation

Capture of intraocular lens optic by residual capsular opening in secondary implantation: long-term follow-up

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