Secondary implantation of scleral-fixated intraocular lenses

Uthoff, Detlef; Teichmann, Klaus D.

doi:10.1016/s0886-3350(98)80048-5

Cited by 92 publications

(72 citation statements)

References 36 publications

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“…[9][10][11][12][13][14] The retinal detachment rate in this study is comparable to the rate of 3.2% found in a previous study in eyes that underwent complete pars plana vitrectomy at the time of SPCIOL implantation. 8 Comparison of these two series may, however, be misleading, the previous series being largely eyes with uncomplicated ectopia lentis or aphakia following trauma unlike the more heterogeneous aetiology of aphakia in the current study.…”

Section: Discussionsupporting

confidence: 87%

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Scleral-fixated posterior chamber intraocular lenses in nonvitrectomised eyes

Yang

Bunce

Dart

et al. 2005

Eye

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Objective To assess the long-term outcome of scleral-fixated sutured posterior chamber intraocular lens (SPCIOL) implantation in non pars plana vitrectomised eyes (1) to evaluate the long-term visual outcome, (2) to identify preoperative risk factors for poor visual outcomes, and (3) to identify the incidence of vitreoretinal complications. Method A retrospective review of 65 eyes, which had not undergone pars plana vitrectomy prior to scleral-fixated SPCIOL implantation. Results In all, 65 eyes of 61 patients were analysed. The median follow-up period was 16 months (range 1-68 months). At final follow-up, 43 (66%) eyes had unchanged or improved BCVA at final follow-up. A total of 20 (31%) eyes had at least a two line improvement and eight (12%) eyes had at least a two line deterioration in final BCVA. No significant preoperative risk factors for a poor visual outcome were identified. In all, 24 eyes (37%) had per-and postoperative adverse events. These eyes were significantly more likely to have a poor visual outcome. Three eyes (4.6%) had a retinal detachment in the postoperative period, all of which had no perception of light at final follow-up. Conclusions This study confirmed that while scleral-fixated SPCIOL intraocular lens implantation might be beneficial, there is a significant risk of per-and postoperative complications leading to loss of best-corrected vision in some eyes.

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Section: Discussionsupporting

confidence: 87%

“…All three eyes had no light perception at final follow-up. In the reports of SPCIOL implantation where the outcome of retinal detachment was included, [8][9][10][11]14,15 the reattachment rate was 79% (23/ 29). PVR was reported as the cause of failure in almost all cases.…”

Section: Discussionmentioning

confidence: 99%

Scleral-fixated posterior chamber intraocular lenses in nonvitrectomised eyes

Yang

Bunce

Dart

et al. 2005

Eye

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“…However, the IOP levels were within normal limits at last follow-up in both groups. 34 Uthoff et al 35 showed suture erosion (17.9%), cystoid macular edema (5.8%), retinal detachment (1.4%), vitreous hemorrhage (1.0%), and uveitis (0.5%) in a 1-year postoperative outcome of scleral-fixated IOL. Kumar et al 28 reported that late complications were pigment dispersion (3.7%), healed macular edema (7.5%), and 5.23 ± 3.4% loss of endothelial cells, but results obtained at 1 year showed a good visual outcome, with minimal complications in eyes with deficient capsular support.…”

Section: Discussionmentioning

confidence: 98%

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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“…Discussion SFIOL has been used in both adults and children with success, either as a single procedure or combined with penetrating keratoplasty and other vitreoretinal procedures. 3,[8][9][10][11] There are many variations of the technique and a range of complications of varying frequencies, which include suture and knot erosions, lens tilt, dislocation or decentration, infection, glaucoma, cystoid macula oedema, corneal decompensation, retinal detachment, and suprachoroidal haemorrhage. 3,[8][9][10][11][12][13][14][15] The maintenance of ocular tension and the avoidance of globe collapse would be technically demanding in cases with low scleral rigidity, small palpebral fissures (eg oriental eyes), poor exposure, and high vitreous pressure.…”

Section: Resultsmentioning

confidence: 99%

“…3 One of the common problems encountered by surgeons performing SFIOL is the tendency for globe collapse during the procedure. The maintenance of globe integrity is particularly difficult in eyes with low scleral rigidity and small palpebral fissures (eg oriental eyes).…”

Section: Introductionmentioning

confidence: 99%