Long-term corneal endothelial cell changes in pediatric intraocular lens reposition and exchange cases

Wang, Yan; Wu, Mingxing; Zhu, Liping; Liu, Yizhi

doi:10.1007/s00417-011-1837-z

Cited by 9 publications

(4 citation statements)

References 35 publications

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“…Severe endothelial cell loss and morphologic changes were seen in patients who received AC IOLs compared with PC IOLs, 23 and the density of corneal endothelial cells conspicuously decreased after IOL repositioning or exchange procedures, although there was no significant difference in the decrease between the two groups. 33 In our study, the mean percentage change in endothelial cell density from preoperatively to postoperatively decreased significantly, by 5.09% in IOL refixation and 5.93% in IOL exchange, but there was no significant difference between the two groups. Nd : YAG capsulotomy can be a trigger factor by weakening the zonules, in addition to their effect on the capsule.…”

Section: Discussioncontrasting

confidence: 49%

Comparision of surgical outcomes of intraocular lens refixation and intraocular lens exchange with perfluorocarbon liquid and fibrin glue-assisted sutureless scleral fixation

Lee

Park

2015

Eye

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Aim The purpose of this study was to compare the surgical outcomes of intraocular lens (IOL) refixation with intraocular lens exchange using perfluorocarbon liquid (PFCL) and fibrin glue-assisted sutureless scleral fixation surgery in patients with dislocation of the IOL. Methods Twenty-five eyes of 25 patients who underwent surgery for dislocated IOLs with PFCL and fibrin glue-assisted scleral fixation were studied; 13 eyes experienced IOL refixation (in-the-bag and out-of-the-bag), and 12 eyes experienced IOL exchange. Preoperative and postoperative clinical features from patient charts and 25 eyes with 46 months' follow-up information were reviewed and analyzed. Results At postoperative 6 months, best-corrected visual acuity (BCVA) and spherical equivalent of IOL refixation and exchange were significantly improved (P = 0.042, P = 0.001), and endothelial cell density was significantly decreased in the two groups with no significant difference between them. Surgically induced astigmatism of IOL refixation improved from 0.90 ± 0.47 to 0.61 ± 0.37 (P = 0.012), and IOL exchange improved from 1.17 ± 0.64 to 0.73 ± 0.37 (P = 0.037) at postoperative 6 months, with no significant difference between the two groups. Complications occurred in four eyes in the IOL refixation group and in three eyes in the IOL exchange group.Conclusion PFCL and fibrin glue-assisted IOL sutureless scleral refixation or exchanged fixation was an effective surgical treatment for IOL dislocation. Also, because postoperative BCVA, surgical outcomes, and complications did not differ significantly between IOL refixation and exchange surgery, if IOL exchange surgery is not indicated, IOL refixation surgical techniques should be considered.

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Section: Discussioncontrasting

confidence: 49%

Comparision of surgical outcomes of intraocular lens refixation and intraocular lens exchange with perfluorocarbon liquid and fibrin glue-assisted sutureless scleral fixation

Lee

Park

2015

Eye

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“…Surgically induced astigmatism was not evaluated in this study, but postoperative astigmatism was comparable between the groups. Recent retrospective studies reported a significant decrease in corneal ECD after both refixation and exchange of a dislocated IOL, and reported no significant differences in corneal ECD at 6 months after surgery or in the ECD decrease between the groups [19,20,24]. However, ECD change in the present study was remarkably consistent with a prospective randomized trial by Kristianslund et al that compared IOL reposition by scleral suture and exchange with retropupillary fixation of an iris-claw IOL [22].…”

Section: Discussionsupporting

confidence: 90%

Surgical Outcome of Refixation versus Exchange of Dislocated Intraocular Lens: A Retrospective Cohort Study

Shin

Park

2020

JCM

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We compared the surgical outcomes and complications of refixation vs. exchange of dislocated intraocular lenses (IOLs) in patients who underwent transscleral suture fixation combined with pars plana vitrectomy for the treatment of IOL dislocation. A total of 83 eyes (n = 83 patients) with postoperative follow-up of ≥6 months were evaluated: 40 received refixation of dislocated IOL (refixation group) while 43 received IOL exchange (exchange group) treatment. Treatment outcomes, including best-corrected visual acuity (BCVA), spherical equivalent, corneal cylinder, intraocular pressure (IOP), central macular thickness (CMT), and corneal endothelial cell density (ECD), and postoperative complications were retrospectively reviewed. BCVA improvement at 6 months after surgery was comparable between the groups. Postoperative decrease in corneal ECD was significantly greater in the exchange group than in the refixation group, but no significant differences were found in spherical equivalent, corneal cylinder, IOP, or CMT changes. The exchange group experienced significantly more frequent postoperative vitreoretinal complications, such as retinal detachment, choroidal effusion, cystoid macular edema, and secondary epiretinal membrane, than the refixation group. Without any reason to extract the dislocated IOL, reuse of the dislocated IOL would be a better surgical option for transscleral suture fixation to protect corneal endothelial cells and prevent postoperative vitreoretinal complications.

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“…Notably, the most common postoperative complication was a significant decrease in endothelial cell density in both the IOL exchange and the IOL refixation groups. Wang et al [ 16 ] reported that corneal endothelial cell density decreased remarkably after IOL exchange or refixation surgery without a significant difference in the decrease between the two groups. We initially predicted that the IOL refixation group would have less decrease in endothelial cell density than the IOL exchange group because the smaller incision would cause less trauma to the corneal endothelium.…”

Section: Discussionmentioning

confidence: 99%

A Comparison of Clinical Outcomes of Dislocated Intraocular Lens Fixation between In Situ Refixation and Conventional Exchange Technique Combined with Vitrectomy

Eum

Kim

2016

Journal of Ophthalmology

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Purpose. To evaluate surgical efficacy of in situ refixation technique for dislocated posterior chamber intraocular lens (PCIOL). Methods. This was a single-center retrospective case series. 34 patients (34 eyes) who underwent sclera fixation for dislocated IOLs combined with vitrectomy were studied. Of 34 eyes, 17 eyes underwent IOL exchange and the other 17 eyes underwent in situ refixation. Results. Mean follow-up period was 6 months. Mean logMAR best corrected visual acuity (BCVA) was not significantly different between the groups 6 months after surgery (0.10 ± 0.03 in the IOL exchange group and 0.10 ± 0.05 in the refixation group; p = 0.065). Surgically induced astigmatism (SIA) was significantly lower in the refixation group (0.79 ± 0.41) than in the IOL exchange group (1.29 ± 0.46) (p = 0.004) at 3 months, which persisted to 6 months (1.13 ± 0.18 in the IOL exchange group and 0.74 ± 0.11 in the refixation group; p = 0.006). Postoperative complications occurred in 3 eyes in the IOL exchange group (17.6%) and 2 eyes in the refixation group (11.8%). However, all of the patients were well managed without additional surgery. Conclusion. The in situ refixation technique should be preferentially considered if surgery is indicated since it seemed to produce a sustained less SIA compared to IOL exchange.

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Long-term corneal endothelial cell changes in pediatric intraocular lens reposition and exchange cases

Abstract: The density of corneal endothelial cells was conspicuously decreased after IOL reposition or exchange procedures in childhood cases. Longer follow-up must be conducted in these cases.

Cited by 9 publications

References 35 publications

Comparision of surgical outcomes of intraocular lens refixation and intraocular lens exchange with perfluorocarbon liquid and fibrin glue-assisted sutureless scleral fixation

Comparision of surgical outcomes of intraocular lens refixation and intraocular lens exchange with perfluorocarbon liquid and fibrin glue-assisted sutureless scleral fixation

Surgical Outcome of Refixation versus Exchange of Dislocated Intraocular Lens: A Retrospective Cohort Study

A Comparison of Clinical Outcomes of Dislocated Intraocular Lens Fixation between In Situ Refixation and Conventional Exchange Technique Combined with Vitrectomy

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