Glued Trans-scleral Intraocular Lens Exchange for Anterior Chamber Lenses in Complicated Eyes: Analysis of Indications and Results

Kumar, Dhivya Ashok; Agarwal, Amar; Jacob, Soosan; Athiya, Agarwal

doi:10.1016/j.ajo.2013.07.013

Cited by 17 publications

(16 citation statements)

References 27 publications

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“…While exchanging the dislocated lens for an anterior chamber IOL (ACIOL) or sulcus IOL remains an option, it requires a large incision and risks corneal endothelial cell loss. 1 Newer techniques like externalizing the haptics of a three-piece IOL cannot be applied to most one-piece PCIOLs. 2 The purpose of the current case series is to demonstrate the adaptability of a previously established scleral suture-fixation technique to one-piece acrylic PCIOLs.…”

Section: Introductionmentioning

confidence: 99%

Scleral Suture Fixation Technique for One-Piece Acrylic Intraocular Lens

Leung

Mohsenin

Smiddy

2018

RETINAL Cases &Amp; Brief Reports

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Section: Introductionmentioning

confidence: 99%

Scleral Suture Fixation Technique for One-Piece Acrylic Intraocular Lens

Leung

Mohsenin

Smiddy

2018

RETINAL Cases &Amp; Brief Reports

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“…В случае децентрации и/или дислокации ИОЛ какое вмешательство будет лучше -репозиция ИОЛ с соответствующей дополнительной фиксацией или реимплантация ИОЛ? [1,3,[5][6][7][8].…”

Section: Information About the Authorsunclassified

“…Развитие хирургических технологий значительно расширило спектр моделей и методов имплантации ИОЛ, но одновременно существенно повысило требования к качеству зрения после хирургического вмешательства, в том числе после повторного по поводу замены ИОЛ. При децентрации и дислокации комплекса «капсульный мешок+ИОЛ» или имплантированных в цилиарную борозду ИОЛ на современном технологическом уровне для замены ИОЛ чаще всего применяют ирис-кло-линзы с ретропупиллярной фиксацией или ретропупиллярные ИОЛ с транссклеральной фиксацией [7,9,18,19]. И тот и другой метод по данным сравнительных исследований дают практически одинаковые функциональные результаты, но соответственно имеют определенные различия по влиянию на внутриглазные структуры и послеоперационные осложнения [8,20].…”

Section: Information About the Authorsunclassified

“…С целью предупреждения контакта ИОЛ с задней поверхностью радужки помимо ангуляции гаптики предложены современные эластичные ИОЛ с конструкцией опорных элементов, которые снижают вероятность развития вращательного момента и соответственно контакта ИОЛ с задней поверхностью радужки. Данные модели ИОЛ также способствуют предупреждению развития синдрома захвата оптики зрачком [7,25,27]. Несмотря на значительное количество публикаций, посвященных преимуществам ретропупиллярной фиксации ирис-кло-линз [9,18,[28][29][30], необходимо отметить, что имплантация данного типа ИОЛ в переднюю камеру сохраняет, согласно различным исследованиям, достаточно высокое и устойчивое число сторонников благодаря простоте и малотравматичности самого хирургического вмешательства [30,31].…”

Section: Information About the Authorsunclassified

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Evolution of IOL exchange. Part 2. Modern problems of IOL exchange

Yusef¹,

Yusef²,

Ivanov³

et al. 2020

Vestn. oftal'mol.

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РЕЗЮМЕ В обзоре представлены современные проблемы реимплантации интраокулярных линз (ИОЛ). Адекватный выбор между репозицией и реимплантацией ИОЛ у пациентов с позиционными осложнениями артифакии остается в значительной степени нерешенным вопросом. Данные литературы показывают заметное увеличение числа сторонников применения ретропупиллярной фиксации ирис-кло-линзы при реимплантации ИОЛ.

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“…14, 15 Agarwal's group has demonstrated promising outcomes in follow-up studies including a recent major review of 735 eyes that underwent scleral glued IOLs for insufficient capsular support with improved visual outcomes along with low rates of optic haptic-related complications. 16,17 The group also discussed the application of the technique in cases of iris prosthesis, corneal transplantation, glued IOL scaffold in complicated cataract surgery, and glued endocapsular hemi-ring segments.…”

Section: Posterior Chamber Scleral Tunnel-glued Intraocular Lensmentioning

confidence: 99%

Review of Surgical Techniques for Posterior Chamber Intraocular Lens Fixation in the Absence of Capsular Lens Support

Ng¹,

Behshad²,

Farid³

2015

US Ophthalmic Review

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An ongoing challenge in complex anterior segment surgery continues to be the safe and effective management of long-term intraocular lens (IOL) fixation in the absence of capsular support. Although anterior chamber IOLs are still an option, especially with improved lens designs and relative ease in placement, complications can still occur including corneal decompensation, iris chaffing, and anterior chamber angle injury, especially when incorrectly sized or in an inadequately shallow anterior chamber.1 Therefore, additional options for posterior chamber IOL fixation in cases of capsular compromise are indicated. Posterior chamber IOLs are not only placed further from the corneal endothelium and anterior chamber angle with less risk for injury to these structures, but are also closer to the nodal point of the eye and may offer a benefit in optical outcomes. Etiology of Loss of Capsular Lens SupportCases of inadequate capsular support for IOL fixation can result from a multitude of causes including trauma, complicated cataract surgery, IOL exchange or replacement, and zonulopathies, such as pseudoexfoliation syndrome and, less commonly, congenital ectopia lentis (see Table 1). 1,2With the many potential causes of loss of capsular support with need for IOL fixation, the ongoing development of improved lens design and surgical techniques continues to be an ongoing challenge for surgeons. Preoperative ConsiderationsGiven the potential complexity of cases requiring IOL fixation when adequate capsular support is lacking, careful preoperative planning is required to determine the most appropriate technique for securing an IOL. A surgeon should also take into account their level of experience and comfort level in attempting potentially surgically demanding techniques in often challenging eyes.A surgeon should consider whether any capsular support is present.Having some capsular support may add additional support to the IOL during manipulation during a complex case. Noting the availability of some capsular support can be particularly useful in cases when an anterior chamber IOL is not appropriate. AbstractThis is a review of surgical options for posterior chamber intraocular lens (IOL) fixation in the absence of adequate capsular support. The indications, techniques, and outcomes for posterior chamber iris-sutured and scleral-fixated IOLs, including trans-scleral sutured and trans-scleral tunnel glued fixation, are reviewed. Iris-sutured IOL fixation may be appropriate in cases in which small corneal incisions with a foldable IOL are desired, but are only possible in cases of adequate iris tissue, and may be complicated by pupil ovaling and iris trauma, which can lead to prolonged inflammation in some studies. Scleral-sutured IOL fixation does not require robust iris tissue and decreases the risk for iris trauma, but is technically more demanding, may require larger incisions, and poses potentially more posterior segment complications.There are also ongoing concerns for suture exposure, erosion, and late suture breakage an...

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Glued Trans-scleral Intraocular Lens Exchange for Anterior Chamber Lenses in Complicated Eyes: Analysis of Indications and Results

Cited by 17 publications

References 27 publications

Scleral Suture Fixation Technique for One-Piece Acrylic Intraocular Lens

Scleral Suture Fixation Technique for One-Piece Acrylic Intraocular Lens

Evolution of IOL exchange. Part 2. Modern problems of IOL exchange

Review of Surgical Techniques for Posterior Chamber Intraocular Lens Fixation in the Absence of Capsular Lens Support

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