Ultrasound biomicroscopy study of the Verisyse aphakic intraocular lens combined with penetrating keratoplasty in pseudophakic bullous keratopathy

Abstract

Ultrasound biomicroscopy showed that in eyes that had PKP with Verisyse IOL enclavation to the posterior plane of the iris, which involved posterior translation of the iridal plane, the ACD was significantly deeper and the CED and AOD were significantly larger than in eyes with anterior enclavation of the IOL.

Visual outcome and complications after posterior iris-claw aphakic intraocular lens implantation

“…18,19 Retropupillary fixation of an iris-claw IOL has the advantages of true posterior chamber implantation, which results in a deeper anterior chamber and greater distance to the corneal endothelium and has a lower intraoperative and postoperative risk profile than anterior fixation. 20,21 This study reviewed the use of retropupillary irisclaw IOLs to treat aphakia in the absence of capsule support for a wide range of indications; the majority of cases were secondary IOL exchange procedures for dislocated PC IOLs due to pseudoexfoliation syndrome. One hundred thirty-three eyes (97.1%) achieved improved (80 eyes, 58.4%) or unchanged (53 eyes, 38.7%) postoperative CDVA.…”

“…Except at the fixation points under the iris, the IOLs are slightly raised below the iris plane, which prevents them from interfering with the normal physiologic features of the iris. 20 Secondary pupillary block glaucoma was not expected; therefore, we did not perform a peripheral iridectomy.…”

Iris-claw, retropupillary-fixated, aphakic intraocular lens implantation for traumatic aphakia following penetrating keratoplasty

“…6 In the present case, with insufficient capsular support, the refractive correction options were anterior chamber, angle-supported IOL, which was excluded because of possible complications with respect to endothelial cell loss and secondary glaucoma 7,8 ; sclera-fixated posterior chamber IOL, which was also excluded because of possible complications with respect to suture cut, ciliary bogy hemorrhage, and cystoid macular edema 9,10 ; and anterior, iris-fixated IOL, which was excluded on account of possible endothelial cell loss in general 11 and in particular compared to posterior iris-fixated IOL in PKP patients. 12 Artisan iris-claw retropupillary fixated aphakic IOLs have been shown to be safe for aphakia in general 13,14 and in aphakia with keratoplasty. 3 An Artisan iris-claw retropupillary fixated aphakic IOL was implanted in our case after considering its good published results and the future possibility that the patient might have to undergo endothelial keratoplasty, which would be much more difficult in the presence of an anterior chamber IOL.…”

Komparative Analyse von Sicherheits- und Funktions-Outcomes der anterioren versus retropupillaren Irisklauen-IOL-Implantation

“…Irisklauen-IOL-Implantationen sind zwar schon in einigen Studien beschrieben worden, jedoch wird nur in sehr wenigen die Positionierung in der VK im Gegensatz zur HK verglichen [15,16,17]. Der Bedarf an fundierten Vergleichsdaten einschließlich Variablen wie EZD und ZND veranlasste uns zur Durchführung der vorliegenden Studie [18], in der wir langfristige funktions- und sicherheitsbezogene Outcomes bei einer großen Gruppe von Augen untersuchten, bei denen eine VK- oder HK-Irisklauen-IOL-Implantation vorgenommen worden war.…”

“…In einer früheren Studie, in der VK- und HK-Irisklauen-IOL in Kombination mit einer PPV verglichen wurden, zeigte sich nach 3 Monaten ebenfalls kein Unterschied im EZD-Verlust [17]. Eine weitere Studie mit Patienten, die sich einer perforierenden Keratoplastik, IOL-Entfernung und Irisklauen-IOL-Implantation unterzogen, ergab hingegen für die VK-IOL-Platzierung einen vergleichsweise größeren EZD-Verlust zwischen 6 und 12 Monaten nach dem Eingriff [16]. Die kumulative Inzidenz aller anderen erfassten postoperativen Komplikationen war zwischen den beiden Gruppen vergleichbar, wobei ein Trend zu einem höheren Anteil persistierender AID-Erhöhung in der VK- im Vergleich zur HK-IOL-Platzierung bestand ( p = 0,08).…”