Methods of fixation of intraocular lenses according to the anatomical structures in trauma eyes

Fiorentzis, Miltiadis; Viestenz, A; Heichel, Jens; Seitz, Berthold; Hammer, Thomas; Viestenz, Arne

doi:10.1002/ca.22898

Cited by 8 publications

(8 citation statements)

References 62 publications

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“…Many studies have shown less postsurgical refractive error following a two-stage intervention [ 3 , 23 ]. A very careful surgical approach should be established for globe reconstruction with secondary IOL implantation [ 10 ].…”

Section: Discussionmentioning

confidence: 99%

“…However, secondary IOL implantation is a challenging surgical procedure and demands suitable ocular conditions. Although the methods and timing of the surgical approach have changed over years, the functional reconstruction of the eye is often more difficult than the original attempt at anatomic reconstruction [ 3 , 10 ]. If there are local or general contraindications for surgery, appropriate contact lens correction can be offered to the patient.…”

Section: Introductionmentioning

confidence: 99%

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Comparison of the Techniques of Secondary Intraocular Lens Implantation after Penetrating Keratoplasty

Krysik¹,

Dobrowolski

Wróblewska‐Czajka

et al. 2018

Journal of Ophthalmology

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Aim To conduct a retrospective analysis of secondary IOL implantation in patients who underwent PK with no simultaneous IOL implantation. Materials and Methods The retrospective study of the secondary implantation of IOLs was conducted in 46 eyes that underwent a primary operation with PK and cataract/lens extraction with no IOL implantation due to capsule rupture or combining corneal or intraocular complications. The minimum period from PK was 12 months. All secondary IOL implantations were performed from January 2011 to August 2017. Aphakic postkeratoplasty patients were treated using one of the surgical techniques for secondary IOL implantation. In-the-bag IOL implantation was possible if the posterior capsule was complete. If the lens capsule remnants were sufficient to provide secure IOL support, an in-the-sulcus IOL implantation was performed. Scleral fixation was offered in eyes with extensive capsular deficiency or the presence of the vitreous body in anterior chamber. BCVA and expected and achieved refraction were evaluated; we included using two biometry devices, and results were compared. Results The corrected distance visual acuity (CDVA) before surgery ranged from 0.1 to 0.8 (mean 0.54 ± 0.17). After secondary IOL implantation, CDVA ranged from 0.2 to 0.8 (mean 0.43 ± 0.14) at postoperative 1 month and from 0.3 to 0.9 (mean 0.55 ± 0.15) at postoperative 6 months (p < 0.05). Comparison of the final refraction using two methods of biometry showed no statistically significant difference in the group that underwent scleral fixation of the IOL, similar to the findings for the in-the-bag and in-the-sulcus IOL implantation groups. In the scleral-fixation group, p=0.55 for the USG biometry technique and p=0.22 for the OB technique. p values for the IOL-implantation group were p=0.49 and p=0.44, respectively. Conclusion Both implantation methods are safe for the patients. Final refraction is depending on the technique and indication to keratoplasty. Both biometry techniques deliver precise data for IOL choice.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Comparison of the Techniques of Secondary Intraocular Lens Implantation after Penetrating Keratoplasty

Krysik¹,

Dobrowolski

Wróblewska‐Czajka

et al. 2018

Journal of Ophthalmology

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“…Intralenticular foreign bodies (ILFBs) are a special subgroup of IOFBs. They are not commonly encountered, and they account for approximately 5% to 10% of all IOFBs [3]. The visual acuity of those patients usually shows some decline due to the aggravation of a traumatic cataract.…”

Section: Introductionmentioning

confidence: 99%

Visual Outcomes and Prognostic Factors of Intralenticular Foreign Bodies in a Tertiary Hospital in North China

Han

Wang

Jia

et al. 2019

Journal of Ophthalmology

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Purpose The aim of this study is to describe the epidemiological and visual outcomes and to identify the main prognostic factors of intralenticular foreign body (ILFB) injuries. Methods We performed a retrospective review of 21 patients (21 eyes) referred to Hebei Eye Hospital in North China from January 2012 to December 2017, who underwent surgical removal of ILFBs and associated ocular trauma repairs. Data regarding the patient demographics, cause of the injury, nature of the ILFB, clinical features, time interval between the injury and the ILFB removal, time interval between the presentation and the surgery, and the initial and final best-corrected visual acuities (BCVAs) were analyzed, and the main prognostic factors were identified. Results Male adults were most affected by ILFBs (90.5%). The mean age of the patients was 41.5 years (median: 46 years, range: 21 to 60 years). None of the patients were wearing goggles at the time of the injury. The most common ILFB cause was hammering the metal (57.1%), and most of the ILFBs were metallic (71.4%). After medical treatment, the final BCVA was improved significantly (Z = 2.49, P=0.015). There was a significant association between the ILFBs with posterior segment injuries and the final BCVA (χ2 = 10.03, P=0.01). Those factors showing no statistical association with the final BCVA included the age (χ2 = 0.36, P=1.0), gender (χ2 = 0.52, P=1.0), nature of the ILFB (χ2 = 1.11, P=0.54), entrance wound location (χ2 = 2.85, P=0.25), and time interval between the injury and the ILFB removal (χ2 = 1.87, P=0.23). Conclusion This is the first local study to explore the epidemiology of ILFB injuries and to identify the main prognostic factors. There was a significant association between the ILFBs with posterior segment injuries and the final BCVA. Improved public awareness and strengthened education regarding safety are the key approaches to reduce the incidence of eye injuries.

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“…

We have read the article by Fiorentzis et al (2017) with an interest; however, we believe that some comments and discussion is required. The authors present a review article on the methods of intraocular lens (IOL) fixation in trauma eyes.

The authors describe different surgical methods for placing IOL in the sulcus in eyes with the presence of capsular bag support.

…”

mentioning

confidence: 99%

“…We have read the article by Fiorentzis et al (2017) with an interest; however, we believe that some comments and discussion is required. The authors present a review article on the methods of intraocular lens (IOL) fixation in trauma eyes.…”

mentioning

confidence: 99%

Clarifying the methods of fixation of intraocular lenses

Grzybowski

Kanclerz

2017

Clinical Anatomy

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We have read the article by Fiorentzis et al. (2017) with an interest; however, we believe that some comments and discussion is required. The authors present a review article on the methods of intraocular lens (IOL) fixation in trauma eyes.The authors describe different surgical methods for placing IOL in the sulcus in eyes with the presence of capsular bag support. This approach is presented as leading to complications, such as pigment dispersion, uveitis-glaucoma-hyphema syndrome, and recurrent vitreous hemorrhage. The reference analysis reveals that these complications arise from sulcus placement single-piece acrylic IOL. With that, the reader is not informed about such a significant issue as the recommended IOL types in this specific clinical situation. The ASCRS Cataract Clinical Committee has presented a statement (Chang et al., 2009) that sulcus placement of intraocular lenses designed solely for the capsular bag is associated with complications and is contraindicated. The use of 3-piece IOLs with angulated haptics was recommended with capturing the optic within a well-centered capsulorhexis whose diameter must be slightly smaller than that of the optic. Lacking optic capture with a capsulorhexis, the overall haptic diameter must be sufficiently long to avoid lateral subluxation within the sulcus space. Such dedicated foldable lenses with a 13.5 mm overall length are currently available commercially.With that, the authors claim that in aphakic eyes fixation of the iris-claw lens behind the iris should be preferred. We believe that both anterior and posterior iris-fixation can be considered. De Silva et al. (2011) have conducted a study on anterior iris-fixation of iris-claw IOLs revealing good visual outcome and safety for a wide range of indications including aphakia. The most common complications were wound leakage and lens dislocation, due to slippage of one of the iris-claw haptics. Thus, the correct implantation technique was found to be critical in avoiding postoperative IOL subluxation. These problems are likewise reported after retropupillary implantation, and lens repositioning in these cases can be more challenging. We ought to mention that in the majority of cases, iris-claw IOL implantation requires a 5-6 mm incision with subsequent suturing, however it was recently shown that sutureless approach is also possible (Choragiewicz et al., 2016).Finally, the authors state that in aphakic eyes with cystoid macula edema the patient should preferably receive a posterior chamber (PC) IOL rather than an anterior chamber (AC) IOL. Furthermore, implantation of ACIOLs in aphakic eyes is claimed to be associated with cystoid macular edema, ovalization of the pupil, secondary glaucoma, and vitreous herniation anterior to the optic, or epithelial invasion. We should emphasize that with the development of open-loop haptic ACIOLs have significantly improved their safety profile. Chan et al. (2015) have reported no long-term differences in the visual outcomes after primary open-loop ACIOL or secondary scleral-fi...

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Methods of fixation of intraocular lenses according to the anatomical structures in trauma eyes

Cited by 8 publications

References 62 publications

Comparison of the Techniques of Secondary Intraocular Lens Implantation after Penetrating Keratoplasty

Comparison of the Techniques of Secondary Intraocular Lens Implantation after Penetrating Keratoplasty

Visual Outcomes and Prognostic Factors of Intralenticular Foreign Bodies in a Tertiary Hospital in North China

Clarifying the methods of fixation of intraocular lenses

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