Secondary IOL Implantation without Capsular Support: A Laser Flare Cell Meter Study

Cellini, Mauro; Strobbe, Ernesto; Toschi, P. G.; Campos, Emilio C.

doi:10.5402/2011/653246

Cited by 10 publications

(16 citation statements)

References 34 publications

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“…The best method is one that offers best visual outcome with lowest complication in an already delicate situation. Each of the available options has its own risks and complications: transscleral fixation of posterior chamber IOLs has the advantage of posterior position of IOL, but it is a time-consuming procedure with known complications 9,10…”

Section: Discussionmentioning

confidence: 99%

Retropupillary iris claw intraocular lens implantation in aphakia for dislocated intraocular lens

Faria

Ferreira

Pinto

et al. 2016

IMCRJ

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BackgroundNowadays, dislocated intraocular lenses (IOLs) and inadequate capsular support are becoming a challenge for every ophthalmic surgeon. Explantation of dislocated IOL and iris claw IOL (ICIOL) are the techniques that have been used in our ophthalmic department. The aim of this study is to report our technique for retropupillar ICIOL.MethodsThis study is a retrospective case series. A total of 105 eyes with dislocated IOL from the patients at the Department of Ophthalmology in Santa Maria Hospital, a tertiary reference hospital in Lisbon, Portugal, from January 2012 until January 2016, had been analyzed. Of these 105 eyes, 66 eyes had dislocated one-piece IOL and 39 eyes had dislocated three-piece IOL. The latter underwent iris suture of the same IOL and were excluded from this study. The remaining 66 eyes with dislocated one-piece IOL underwent pars plana vitrectomy, that is, explantation of dislocated IOL through corneal incision and an implantation of retropupillary ICIOL. Operative data and postoperative outcomes included best corrected visual acuity, IOL position, intraocular pressure, pigment dispersion, clinical signs of endothelial cell loss, and anterior chamber depth.ResultsThe mean follow-up was 23 months (range: 6–48 months). The mean preoperative best corrected visual acuity was 1.260±0.771 logMAR, and postoperative best corrected visual acuity was 0.352±0.400 logMAR units. Mean vision gain was 0.909 logMar units. The patients had the following complications: 1) retinal detachment was found in one patient, 2) corneal edema was found in three patients, 3) high intraocular pressure was observed in twelve patients, 4) subluxation of the IOL was observed in one patient, and 5) macular edema was found in three eyes.ConclusionThe results demonstrate that retropupillary ICIOL is an easy and effective method for the correction of aphakia in patients not receiving capsule support. The safety of this procedure must be interpreted in the context of a surgery usually indicated in complicated cases.

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Section: Discussionmentioning

confidence: 99%

Retropupillary iris claw intraocular lens implantation in aphakia for dislocated intraocular lens

Faria

Ferreira

Pinto

et al. 2016

IMCRJ

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“…The elevated IOP might be directly caused by prolonged inflammation or indirectly due to prolonged corticosteroid use. The Laser Flare Cell Meter Study by Cellini et al 29 compared the severity of intraocular inflammation among ACIOL, SFIOL, and iris-fixated IOL using a laser cell flare meter, which is a more objective and quantitative measurement. The results demonstrated that SFIOL had significantly more severe subclinical intraocular inflammation than the other two IOLs up to 90 days.…”

Section: Resultsmentioning

confidence: 99%

“…The results demonstrated that SFIOL had significantly more severe subclinical intraocular inflammation than the other two IOLs up to 90 days. 29 The eye that underwent glaucoma drainage device implantation was diagnosed preoperatively as primary angle-closure suspect. The narrowed anterior chamber angle might be further compromised in subclinical intraocular inflammation after surgery, causing persistent IOP elevation.…”

Section: Resultsmentioning

confidence: 99%

Iris-claw intraocular lens, scleral-fixated intraocular lens, and angle-supported anterior chamber intraocular lens in Hospital Melaka: a four-year retrospective analysis

Chan¹,

Chua²,

Khair³

et al. 2020

MyJO

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Introduction: Cataract surgery with insufficient capsular support has become an intense challenge to surgeons in intraocular lens (IOL) selection. Anterior chamber IOL (ACIOL), iris-claw (Artisan) IOL, and scleral-fixated IOL (SFIOL) are the three common types of IOL used. However, each type of IOL has its own characteristics and different clinical requirements. IOL selection is important in ensuring good visual outcome. Purpose: The purpose is to compare the duration or surgery, visual outcomes, and complications among ACIOL, Artisan IOL, and SFIOL. Study design: Retrospective comparative analysis. Material and methods: This is a four-year retrospective analysis of patients who underwent either ACIOL, Artisan IOL, or SFIOL implantation between January 2014 and January 2018. Patients were divided into ACIOL, Artisan, and SFIOL groups. Demographic data, duration of surgery, preoperative and postoperative visual acuity, and postoperative complications were identified and compared among the different groups. Results: Sixty-four eyes from 58 patients were analysed: twenty (31.3%) eyes with ACIOL, 28 (43.8%) eyes with Artisan, and 16 (25%) eyes with SFIOL. Mean surgery times for ACIOL, Artisan, and SFIOL were: 61 ± 27.8, 64 ± 26.9, and 104.1 ± 46.8, respectively. SFIOL showed significantly longer surgery time than the ACIOL and Artisan groups (p < 0.05). There was no significant difference in surgery time between the ACIOL and Artisan groups (p > 0.05). The Artisan group showed significantly better visual recovery at postoperative 1 week than both the ACIOL and SFIOL groups (Artisan vs ACIOL: 6/18 vs 6/24, p < 0.05; Artisan vs SFIOL: 6/18 vs 6/60, p < 0.05). However, final best-corrected visual acuity (BCVA) at two months was comparable among all three groups with a median BCVA of 6/9. Elevated intraocular pressure occurred in all IOL groups, retinal detachment developedin the Artisan and SFIOL groups, epiretinal membrane developed in the ACIOL and SFIOL groups, corneal decompensation developed in the ACIOL group only. Cystoid macular oedema and IOL tilt occurred in SFIOL only. Conclusions: All three groups of IOL showed comparable good visual outcomes. The decision of IOL selection should be based on patients’ clinical condition and availability of surgical skill and resources.

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“…However, they are technically challenging to insert, with an increased risk of IOL tilt, intraocular hemorrhage, suture breakage, and endophthalmitis. [ 13 ]…”

Section: Discussionmentioning

confidence: 99%

Retropupillary iris-claw intraocular lens for the surgical correction of aphakia in cases with microspherophakia

Fouda

Aswad

Ibrahim

et al. 2016

Indian J Ophthalmol

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Purpose:This study aimed to evaluate the safety and efficacy of retropupillary fixation of an iris-claw intraocular lens (IOL; Verisyse polymethyl methacrylate IOL, Abbott Medical Optics [AMO], Netherlands) for the surgical correction of aphakia in microspherophakic eyes without sufficient capsular support.Design:This was a prospective, interventional, noncomparative case series.Methods:This interventional case series comprised 17 eyes of 9 microspherophakic patients. Retropupillary fixation of the Verisyse iris-claw IOL (AMO) was performed in all cases. The surgical time was measured. Corrected distance visual acuity, astigmatism, intraocular pressure (IOP), tissue reaction, pigment dispersion, and stability of the IOL were studied 1 day, 3 days, 1 week, 2 weeks, 1 month, and 6 months postoperatively.Results:Eight patients had familial microspherophakia and one patient had Marfan's syndrome. Eighty-two percent of the cases achieved a visual acuity of 0.3 or better. There was no significant postoperative inflammatory reaction. Transient elevation of IOP was recorded in two cases in the 1st week only. One IOL developed disengagement of one of the haptics from the iris and was successfully re-engaged. All the other IOLs were well centered and stable. The mean surgical time was 18.0 ± 4.5 min.Conclusions:Retropupillary fixation of an iris-claw IOL is a safe and effective procedure that provides early visual recovery. It is also a time-saving method for correcting aphakia in microspherophakic eyes without sufficient capsular support.

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Secondary IOL Implantation without Capsular Support: A Laser Flare Cell Meter Study

Cited by 10 publications

References 34 publications

Retropupillary iris claw intraocular lens implantation in aphakia for dislocated intraocular lens

Retropupillary iris claw intraocular lens implantation in aphakia for dislocated intraocular lens

Iris-claw intraocular lens, scleral-fixated intraocular lens, and angle-supported anterior chamber intraocular lens in Hospital Melaka: a four-year retrospective analysis

Retropupillary iris-claw intraocular lens for the surgical correction of aphakia in cases with microspherophakia

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