Outcomes of anterior chamber intraocular lenses placed by surgeons in training

Brunin, Greg; Khandelwal, Sumitra; Coffee, Robert E.; Orengo-Nania, Silvia; Biggerstaff, Kristin

doi:10.1016/j.jcrs.2015.11.006

Cited by 3 publications

(3 citation statements)

References 16 publications

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“…Corneal decompensation has been a theoretical concern with ACIOL placement since they were first introduced. The relatively low number of patients developing decompensation in this study is similar to that in nonvitrectomised eyes, 2,4,5,7 and is reassuring that with openloop anterior chamber lenses corneal problems only rarely occur, even in patients who have had multiple previous vitreoretinal procedures. Given that some patients had only 3 months of follow-up, a limitation of this study is that we may have underestimated the true rate of corneal decompensation.…”

Section: Discussionsupporting

confidence: 76%

“…Most recent studies looking at the outcome of ACIOL insertion have tended to look at outcomes following primary insertion after complicated cataract surgery/ intracapsular extraction 7,8 or they have compared secondary scleral-fixated lenses to ACIOLs, thus limiting the numbers in the ACIOL arm. 2,3 This study, looking at a large cohort of patients with long follow-up, demonstrates how effective ACIOL insertion can be as a secondary procedure, after vitrectomy, in patients aphakic for multiple different reasons.…”

Section: Discussionmentioning

confidence: 99%

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Anterior chamber lens implantation in vitrectomised eyes

Negretti

Lai

Petrou

et al. 2017

Eye

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PurposeTo investigate long-term visual acuity (VA) outcomes and complication rates in vitrectomised eyes undergoing anterior chamber intraocular lens (ACIOL) insertion.Patients and methodsA single-centre, retrospective case series including all patients who had undergone ACIOL placement at the time of vitrectomy surgery or having had previous vitrectomy, between January 2007 and January 2013. Patients were identified using an electronic database and paper casefile notes were analysed for all patients. Patients were excluded if they had <3 months follow-up.ResultsTwo hundred and seventy-one patients were included in the analysis. Mean follow-up was 27 months. One hundred and forty-eight patients were vitrectomised before ACIOL placement. One hundred and twenty-three patients underwent vitrectomy at the time of ACIOL placement. Mean best-corrected visual acuity (BCVA) before ACIOL placement was 1.27 LogMar (SD 0.95). Mean BCVA at final follow-up was 0.51 LogMar (SD 0.66) (paired-sample T-test P<0.001). Forty (15%) patients developed postoperative cystoid macular oedema (CMO). Eighty-seven (32%) patients had an intraocular pressure (IOP) rise acutely post ACIOL insertion. Fifteen (6%) patients developed corneal decompensation. Five subsequently required corneal grafting. Sixteen patients had ACIOL displacement or instability requiring further surgery.ConclusionsACIOL insertion after vitrectomy is effective. Ninety-two per cent of patients maintained or gained VA, comparable to previous studies of ACIOL insertion post complicated cataract surgery. Raised IOP was the most frequent complication: 61 patients were on topical therapy at most recent follow-up. CMO tended to be acute. Corneal decompensation was infrequent.

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Section: Discussionsupporting

confidence: 76%

Section: Discussionmentioning

confidence: 99%

Anterior chamber lens implantation in vitrectomised eyes

Negretti

Lai

Petrou

et al. 2017

Eye

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“…Corneal decompensation has been a theoretical concern with ACIOL placement since they were first introduced. There are relatively less number of patients developing corneal decompensation[ 5 11 19 30 ] particularly if it is performed along with PPV as done in our study and it is reassuring that with open loop anterior chamber lenses corneal problems occur rarely, even in patients with multiple previous vitreoretinal procedures. Many also argue, conversely, that ACIOL surgery results in increased endothelial cell count loss, a substantial shortcoming for the procedure.…”

Section: Discussionmentioning

confidence: 53%

Anterior chamber intraocular lens - An effective alternative in traumatic and surgical aphakia in the era of scleral-fixated intraocular lens

Mahapatra

Mannem

2021

Indian Journal of Ophthalmology

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Purpose: To evaluate outcomes of anterior chamber intraocular lens (ACIOL) implantation with vitrectomy in eyes with surgical or traumatic aphakia, and subluxated or dislocated lens. Methods: In this retrospective study, we evaluated patients who underwent pars plans vitrectomy with ACIOL implantation from April 2016 to March 2019. Patients with minimum follow-up period of 1 year and operated by single surgeon were included. Ophthalmic history, indication for surgery, BCVA, IOP, slit-lamp examination, and fundus assessment findings were noted. Postoperatively best-corrected visual acuity (BCVA), intraocular pressure (IOP) and complications if any were noted. Results: Ninety eyes of 88 patients were included in the study. The mean age of the patients was 60.2 ± 10.2 yrs. Majority (75.6%) were males and 24.4% were females. Indications for pars-plana vitrectomy (PPV) with ACIOL implantation were nucleus drop in 16.6%, IOL drop in 25.5%, large posterior capsular rupture (PCR) with vitreous disturbance or zonular dehiscence (ZD) during cataract surgery in 33.3%, more than 180° subluxation of lens in 10% and traumatic lens or intraocular lens (IOL) drop in 14.4% cases. Preoperative and postoperative mean Log MAR visual acuity was 1.59 ± 0.44 and 0.36 ± 0.33 respectively, with few complications like cystoid macular edema (CME) in 8.8%, persistently raised IOP in 4.4%, persistent uveitis in 2.2%, retinal detachment (RD) in 2.2%, and tilted IOL in 1.1% cases. Conclusion: Out of different options available for secondary IOL implantation in patients with poor capsular support ACIOL has the advantages of cost-effectiveness, small learning curve, faster surgical time with a lesser rate of complications like IOL tilt, vitreous hemorrhage, and suture erosion as compared to scleral-fixated IOL (SF-IOL). Comparable visual outcome can be obtained by proper patient selection in these cases.

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