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[PMID]: 29227508
[Au] Autor:Tandogan T; Son HS; Choi CY; Knorz MC; Auffarth GU; Khoramnia R
[Ti] Title:Laboratory Evaluation of the Influence of Decentration and Pupil Size on the Optical Performance of a Monofocal, Bifocal, and Trifocal Intraocular Lens.
[So] Source:J Refract Surg;33(12):808-812, 2017 Dec 01.
[Is] ISSN:1081-597X
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:PURPOSE: To assess the influence of decentration and aperture size on the optical quality of different intraocular lenses (IOLs) of the same material, body design, and refractive power using standardized optical bench testing. METHODS: Using an optical bench set-up, an aspheric monofocal (CT ASPHINA 409M; Carl Zeiss Meditec, Jena, Germany), an aspheric diffractive bifocal (AT LISA 809M; Carl Zeiss Meditec), and an aspheric diffractive trifocal (AT LISA 839M; Carl Zeiss Meditec) intraocular lens (IOL) were evaluated, each with the same distance power, body design, and material. Modulation transfer function (MTF) values were measured at spatial frequencies of 50 lp/mm and aperture sizes of 3 and 4.5 mm. Each IOL was measured while centered, then decentered by 0.25, 0.5, 0.75, and 1 mm. RESULTS: MTF values for the monofocal IOL at far focus with 3- and 4.5-mm aperture size were 0.80/0.80 with maximum reduction to 0.77/0.73 for 1-mm decentration, respectively. Centered IOL MTFs of the bifocal and trifocal IOLs were lower for the far focus at 0.46/0.41 and 0.39/0.26, with reduction at 1-mm decentration to 0.35/0.25 and 0.25/0.18, respectively. Values for near focus of the bifocal and trifocal IOLs reduced from 0.27/0.31 and 0.19/0.18 to 0.2/0.21 and 0.12/0.13, respectively. The trifocal intermediate focus MTF reduced from 0.15/0.10 to 0.12/0.08. MTF values of all three lenses decreased significantly under all conditions with decentration of 0.5 to 0.75 mm. CONCLUSIONS: Monofocal lenses were least negatively affected by decentration, with mean optical quality reduction of less than 10% for 1-mm decentration at physiological pupil sizes. For diffractive bifocal and trifocal lenses, optical quality at all distances was significantly reduced if decentration exceeded 0.75 mm, with intermediate focus showing the least reduction. [J Refract Surg. 2017;33(12):808-812.].
[Mh] MeSH terms primary: Artificial Lens Implant Migration/physiopathology
Iris/anatomy & histology
Lenses, Intraocular
Optics and Photonics
Pseudophakia/physiopathology
Pupil/physiology
Refraction, Ocular/physiology
[Mh] MeSH terms secundary: Humans
Models, Theoretical
Prosthesis Design
Vision, Ocular
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180223
[Lr] Last revision date:180223
[Js] Journal subset:IM
[Da] Date of entry for processing:171212
[St] Status:MEDLINE
[do] DOI:10.3928/1081597X-20171004-02

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[PMID]: 29208827
[Au] Autor:Roop P; Roop
[Ad] Address:Dr. Rajendra Prasad Centre for Ophthalmic Sciences, AIIMS, New Delhi, India.
[Ti] Title:Optimizing optical outcomes of intraocular lens implantation by achieving centration on visual axis.
[So] Source:Indian J Ophthalmol;65(12):1425-1427, 2017 Dec.
[Is] ISSN:1998-3689
[Cp] Country of publication:India
[La] Language:eng
[Ab] Abstract:In existing designs of intraocular lenses (IOLs), optical outcomes are compromised even after perfectly executed surgery. The reason for this is misalignment of optical axis of the eye and its visual axis. There is a need to design an IOL which compensates for this misalignment and hence enhances the optical outcomes of cataract surgery. The present innovation attempts to fulfill this unmet need and optimizes optical outcomes of all IOLs of different optical profiles - spherical, aspheric, toric, and multifocal. In addition, the improvised design of IOL offers other benefits such as delaying the formation of after-cataract and ameliorating negative dysphotopsia.
[Mh] MeSH terms primary: Artificial Lens Implant Migration/prevention & control
Lens Implantation, Intraocular/methods
Lenses, Intraocular
Models, Theoretical
Refraction, Ocular
[Mh] MeSH terms secundary: Humans
Prosthesis Design
Treatment Outcome
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1712
[Cu] Class update date: 180103
[Lr] Last revision date:180103
[Js] Journal subset:IM
[Da] Date of entry for processing:171207
[St] Status:MEDLINE
[do] DOI:10.4103/ijo.IJO_653_17

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[PMID]: 28573991
[Au] Autor:Rishi P; Rishi E; Maitray A
[Ad] Address:Department of Vitreoretinal Services, Sankara Nethralaya, Chennai, Tamil Nadu, India.
[Ti] Title:Surgical refixation of posteriorly dislocated intraocular lens with scleral-tuck technique.
[So] Source:Indian J Ophthalmol;65(5):365-370, 2017 May.
[Is] ISSN:1998-3689
[Cp] Country of publication:India
[La] Language:eng
[Ab] Abstract:PURPOSE: To report the outcomes of surgical refixation of posteriorly dislocated intraocular lens (IOL) using scleral-tuck method, and to compare the "scleral groove" and the "scleral flap" techniques used. STUDY DESIGN: Single-center, retrospective, interventional, comparative study. METHODS: Medical records of patients undergoing closed globe scleral refixation of posteriorly dislocated posterior chamber IOL (PCIOLs) by scleral-tuck method using two different techniques ("scleral groove" vs. "scleral flap" technique) were reviewed. This approach involved retrieving the dislocated PCIOL, externalizing the haptics through 2 sclerotomies created in paralimbal lamellar scleral grooves, or under lamellar scleral flaps and tucking the haptics into limbus-parallel scleral tunnels. No specific haptic architecture, haptic suturing, or large incisions were needed. Main outcome measures included best-corrected visual acuity (BCVA), final mean refractive error, and intra- and post-operative complications. RESULTS: Thirteen eyes of 13 patients (scleral groove, n = 6; scleral flap, n = 7 eyes) with a mean follow-up of 20.6 months were included. BCVA in all eyes was maintained or improved postoperatively, with three eyes (23%) showing ≥2 line improvement. Median astigmatic error at 6-week follow-up was -1.25 D cylinder (range: -0.5 D--2.0 D) which remained stable till final follow-up. All IOLs remained stable and well centered. None of the eyes had a recurrent dislocation, retinal detachment, endophthalmitis, or glaucoma. Both techniques were comparable in terms of postoperative BCVA, and refraction. CONCLUSION: Intrascleral haptic fixation by scleral-tuck method is reliable and effective for secure IOL refixation of posteriorly dislocated IOLs, providing good IOL centration and stability with minimal surgically-induced astigmatism. Both techniques (scleral groove and scleral flap) appear to have similar outcomes in the short term.
[Mh] MeSH terms primary: Artificial Lens Implant Migration/surgery
Posterior Eye Segment/surgery
Postoperative Complications
Sclera/surgery
Surgical Flaps
Suture Techniques
Visual Acuity
[Mh] MeSH terms secundary: Adult
Aged
Aged, 80 and over
Artificial Lens Implant Migration/diagnosis
Female
Follow-Up Studies
Humans
Male
Middle Aged
Retrospective Studies
Treatment Outcome
[Pt] Publication type:COMPARATIVE STUDY; JOURNAL ARTICLE
[Em] Entry month:1709
[Cu] Class update date: 170919
[Lr] Last revision date:170919
[Js] Journal subset:IM
[Da] Date of entry for processing:170603
[St] Status:MEDLINE
[do] DOI:10.4103/ijo.IJO_960_16

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[PMID]: 28345572
[Au] Autor:Ganesh SK; Sen P; Sharma HR
[Ad] Address:Sankara Nethralaya Medical Research Foundation, Chennai, Tamil Nadu, India.
[Ti] Title:Late dislocation of in-the-bag intraocular lenses in uveitic eyes: An analysis of management and complications.
[So] Source:Indian J Ophthalmol;65(2):148-154, 2017 Feb.
[Is] ISSN:1998-3689
[Cp] Country of publication:India
[La] Language:eng
[Ab] Abstract:AIM: An analysis of late in-the-bag dislocation of intraocular lenses (IOL), in uveitic eyes. SETTING: Referral uveitis clinic. DESIGN: Retrospective case series. MATERIALS AND METHODS: All case records of eyes with chronic uveitis that had phacoemulsification with IOL implantation, at a referral uveitis clinic between February 1997 and January 2015 were retrieved and analyzed. Only those eyes with no documented intraoperative complication and no predisposing risks to IOL dislocation, such as pseudoexfoliation, high myopia, trauma, and prior VR surgery were included in this study. RESULTS: A total of 581 eyes with chronic uveitis underwent phacoemulsification with IOL implantation under steroid cover from February 1997 to December 2015. Out of these 581 eyes, 10 patients (11 eyes) had experienced late in-the-bag IOL dislocation (1.89%). All 11 eyes had chronic intermediate uveitis. The mean duration from the time of cataract surgery to IOL dislocation was 11.24 years. 5 out of 11 eyes had pars plana vitrectomy (PPV) with IOL removal with 4-point sutured scleral fixated IOL. Two out of 11 eyes had PPV with in-the-bag IOL re-fixation. Out of 11, 2 eyes had PPV with IOL removal only. Remaining 2 eyes of 2 patients did not opt for surgery. Out of 11, 8 eyes had improved vision at last follow-up. CONCLUSIONS: In-the-bag dislocation of IOL is a rare late complication in uveitic eyes. With tight perioperative inflammatory control, scleral-fixated posterior chamber intraocular lens or IOL re-fixation are good options of restoring vision in these high-risk eyes.
[Mh] MeSH terms primary: Artificial Lens Implant Migration/diagnosis
Device Removal/methods
Disease Management
Lenses, Intraocular/adverse effects
Phacoemulsification/adverse effects
Postoperative Complications
Uveitis/complications
[Mh] MeSH terms secundary: Adult
Artificial Lens Implant Migration/etiology
Artificial Lens Implant Migration/surgery
Cataract/complications
Chronic Disease
Female
Follow-Up Studies
Humans
Male
Middle Aged
Retrospective Studies
Time Factors
Uveitis/diagnosis
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1708
[Cu] Class update date: 170816
[Lr] Last revision date:170816
[Js] Journal subset:IM
[Da] Date of entry for processing:170328
[St] Status:MEDLINE
[do] DOI:10.4103/ijo.IJO_938_16

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[PMID]: 28254116
[Au] Autor:Hung JH; Wang SH; Teng YT; Hsu SM
[Ad] Address:Department of Ophthalmology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
[Ti] Title:Motorized injector-assisted intrascleral intraocular lens fixation.
[So] Source:Kaohsiung J Med Sci;33(3):137-143, 2017 Mar.
[Is] ISSN:1607-551X
[Cp] Country of publication:China (Republic : 1949- )
[La] Language:eng
[Ab] Abstract:For eyes with deficient capsular support, intraocular lens (IOL) implantation has long been a technical challenge. Recently, intrascleral fixation of the haptics of a three-piece posterior chamber IOL has become a popular option. In this procedure, externalization of the leading haptic during IOL injection is a stressful step. We present a modified technique to improve the ease and safety of this step. Our modified technique involves IOL injection with a motorized injector with several important modifications described here. With these modifications, a surgeon can easily maintain the correct orientation of the IOL in a well-controlled manner during IOL injection. The records of 13 patients who underwent this technique were retrospectively evaluated. Corrected-distance visual acuity improved significantly after surgery (p<0.05). No postoperative retinal detachment, endophthalmitis, IOL decentration, or vitreous hemorrhage was noted during the follow-up period. In conclusion, the motorized injector-assisted intrascleral IOL fixation technique is a safe and effective alternative to the conventional procedure. This technique makes the process of leading haptic externalization easier and more controllable.
[Mh] MeSH terms primary: Intraoperative Complications/prevention & control
Lens Implantation, Intraocular/instrumentation
Lenses, Intraocular
Postoperative Complications/prevention & control
Sclera/surgery
Surgical Instruments
[Mh] MeSH terms secundary: Adult
Aged
Aged, 80 and over
Equipment Design
Female
Humans
Lens Implantation, Intraocular/methods
Male
Middle Aged
Retrospective Studies
Visual Acuity
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1705
[Cu] Class update date: 170515
[Lr] Last revision date:170515
[Js] Journal subset:IM
[Da] Date of entry for processing:170304
[St] Status:MEDLINE

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[PMID]: 27914839
[Au] Autor:Kristianslund O; Råen M; Østern AE; Drolsum L
[Ad] Address:Department of Ophthalmology, Oslo University Hospital, Oslo, Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway. Electronic address: olav.kristianslund@gmail.com.
[Ti] Title:Late In-the-Bag Intraocular Lens Dislocation: A Randomized Clinical Trial Comparing Lens Repositioning and Lens Exchange.
[So] Source:Ophthalmology;124(2):151-159, 2017 Feb.
[Is] ISSN:1549-4713
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:PURPOSE: To compare the efficacy and safety of 2 operation methods for late in-the-bag intraocular lens (IOL) dislocation. DESIGN: Prospective, randomized, parallel-group surgical trial. PARTICIPANTS: Patients referred to Oslo University Hospital (tertiary referral center). METHODS: We randomly assigned 104 patients (104 eyes) either to IOL repositioning by scleral suturing (n = 54) or to IOL exchange with retropupillary fixation of an iris-claw IOL (n = 50). One surgeon performed all operations. Patients were evaluated comprehensively before surgery, and most patients (82%) attended an examination 6 months after surgery. MAIN OUTCOME MEASURES: Best-corrected visual acuity (BCVA) 6 months after surgery. RESULTS: The mean postoperative BCVA was 0.24±0.29 logarithm of the minimum angle of resolution (logMAR) units (range, -0.18 to 1.16 logMAR) in the repositioning group and 0.35±0.54 logMAR (range, -0.20 to 3.0 logMAR) in the exchange group (P = 0.23). A BCVA of 20/40 or better (Snellen) was reached by 61% and 62% of the patients, respectively (P = 0.99). The mean postoperative corneal cylinder was 1.2±1.0 and 1.2±0.8 diopters, respectively (P = 0.84), and the postoperative endothelial cell density changes were -3±10% (P = 0.07) and -10±14% (P = 0.001), respectively (group difference, P = 0.04). Repositioning had a longer mean surgical time than exchange (P < 0.001). There were 2 (4%) and 0 cases of perioperative fluid misdirection syndrome, respectively. Postoperative complications were intraocular pressure (IOP) increase (n = 12), cystoid macular edema (CME; n = 3), and nonarteritic anterior ischemic optic neuropathy (n = 1) in the repositioning group, and IOP increase (n = 9), pupillary block (n = 1), choroidal effusion (n = 2), CME (n = 4), and redislocation (n = 1) in the exchange group. CONCLUSIONS: We found satisfactory and not significantly different outcomes for BCVA 6 months after surgery in the 2 groups. Both operation methods seemed safe, with low frequencies of serious perioperative and postoperative complications. However, some of the observed differences in complications should be taken into consideration when selecting the most suitable method in clinical practice.
[Mh] MeSH terms primary: Artificial Lens Implant Migration/surgery
Lens Implantation, Intraocular/methods
Lenses, Intraocular
[Mh] MeSH terms secundary: Aged
Aged, 80 and over
Cell Count
Endothelial Cells/cytology
Female
Humans
Iris/surgery
Lens, Crystalline/surgery
Male
Middle Aged
Prospective Studies
Sclera/surgery
Suture Techniques
Visual Acuity
[Pt] Publication type:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Em] Entry month:1707
[Cu] Class update date: 170718
[Lr] Last revision date:170718
[Js] Journal subset:IM
[Da] Date of entry for processing:161205
[St] Status:MEDLINE

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[PMID]: 27811568
[Au] Autor:Sorkin N; Einan-Lifshitz A; Ashkenazy Z; Boutin T; Showail M; Borovik A; Alobthani M; Chan CC; Rootman DS
[Ad] Address:Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, ON, Canada.
[Ti] Title:Enhancing Descemet Membrane Endothelial Keratoplasty in Postvitrectomy Eyes With the Use of Pars Plana Infusion.
[So] Source:Cornea;36(3):280-283, 2017 Mar.
[Is] ISSN:1536-4798
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:PURPOSE: To present a modified surgical technique to perform Descemet membrane endothelial keratoplasty (DMEK) in previously vitrectomized eyes and to analyze its safety and efficacy. METHODS: A retrospective analysis of previously vitrectomized eyes that underwent DMEK at Toronto Western Hospital was performed. The modified DMEK technique that was used included placement of a posterior pars plana infusion to reduce fluctuations in the anterior chamber depth and its excessive deepening. RESULTS: Twelve eyes of 12 patients (5 females and 7 males) aged 65.3 ± 21.5 years were included. Mean best-corrected visual acuity improved significantly from 1.72 ± 0.62 logMAR (mean Snellen ∼20/1040) preoperatively to 1.01 ± 0.64 logMAR (mean Snellen ∼20/200) at 6 months postoperatively (P = 0.017). Mean donor endothelial cell density was 2658 ± 229 cells/mm preoperatively and 1732 ± 454 cells/mm at 6 months after the procedure (mean percentage cell loss of 31.8%) (P = 0.046). There were no significant intraoperative complications, and no graft failures. One eye had graft detachment, which resolved after 2 rebubbling procedures. One eye had retinal detachment, which was corrected surgically. CONCLUSIONS: The use of posterior pars plana infusion in previously vitrectomized eyes stabilizes the anterior segment during DMEK, allowing for performance of DMEK surgery, and can potentially reduce intraoperative and postoperative complications.
[Mh] MeSH terms primary: Acetates/administration & dosage
Anterior Chamber/drug effects
Corneal Diseases/surgery
Descemet Stripping Endothelial Keratoplasty/methods
Minerals/administration & dosage
Sodium Chloride/administration & dosage
Vitrectomy
[Mh] MeSH terms secundary: Aged
Artificial Lens Implant Migration/surgery
Cell Count
Corneal Diseases/physiopathology
Corneal Endothelial Cell Loss/physiopathology
Drug Combinations
Endothelium, Corneal/pathology
Eye Injuries, Penetrating/surgery
Female
Graft Survival/physiology
Humans
Infusions, Parenteral
Intraoperative Complications
Male
Retinal Detachment/surgery
Retrospective Studies
Supine Position
Visual Acuity/physiology
[Pt] Publication type:JOURNAL ARTICLE
[Nm] Name of substance:0 (Acetates); 0 (BSS solution); 0 (Drug Combinations); 0 (Minerals); 451W47IQ8X (Sodium Chloride)
[Em] Entry month:1708
[Cu] Class update date: 170817
[Lr] Last revision date:170817
[Js] Journal subset:IM
[Da] Date of entry for processing:161105
[St] Status:MEDLINE
[do] DOI:10.1097/ICO.0000000000001072

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[PMID]: 27421176
[Au] Autor:Chang PY; Lian CY; Wang JK; Su PY; Wang JY; Chang SW
[Ad] Address:Department of Ophthalmology, Far Eastern Memorial Hospital, Ban-Chiao, New Taipei, Taiwan; Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan.
[Ti] Title:Surgical approach affects intraocular lens decentration.
[So] Source:J Formos Med Assoc;116(3):177-184, 2017 Mar.
[Is] ISSN:0929-6646
[Cp] Country of publication:Singapore
[La] Language:eng
[Ab] Abstract:BACKGROUND/PURPOSE: This study aims to quantify and identify risk factors for intraocular lens (IOL) tilt and decentration early after surgery using Scheimpflug imaging. METHODS: We prospectively included 268 eyes of 253 patients who underwent uneventful cataract surgery and one-piece IOL implantation using a superior or temporal approach. Scheimpflug imaging was used to evaluate the tilt and decentration of IOLs at 1 week, 1 month, and 3 months postoperatively. Differences in IOL tilt and decentration between the approaches were examined. Correlations of age and axial length with the magnitudes of IOL decentration and tilt were also examined. RESULTS: In total, 139 right and 129 left eyes were included. IOL displacement averaged 150 µm upward and 150 µm to the nasal side of the pupil. Over 50% of the eyes were tilted upward and approximately 90% to the temporal side. The surgical approach was significantly associated with horizontal decentration in both eyes, but significantly associated with only vertical decentration in the right eye 1 week postoperatively. In the left eyes, IOLs were shifted to the nasal side in 57.1% and 36.8% of the eyes that received the temporal and the superior approach, respectively, compared with 75.8% and 50% in the right eyes. The differences were significant only at 1-week follow-up (p = 0.035 and p = 0.003, respectively). Age or axial length was not associated with IOL tilt or decentration in either eye. CONCLUSION: Scheimpflug imaging can be used as a quantitative tool to evaluate IOL position. The incision site affected the IOL position, this finding was significant at 1 week postoperatively only.
[Mh] MeSH terms primary: Artificial Lens Implant Migration/diagnostic imaging
Lenses, Intraocular
Phacoemulsification/methods
[Mh] MeSH terms secundary: Aged
Female
Humans
Male
Middle Aged
Multivariate Analysis
Photography
Postoperative Complications/diagnostic imaging
Prospective Studies
Regression Analysis
Risk Factors
Taiwan
Visual Acuity/physiology
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1708
[Cu] Class update date: 170816
[Lr] Last revision date:170816
[Js] Journal subset:IM
[Da] Date of entry for processing:160717
[St] Status:MEDLINE

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[PMID]: 27338117
[Au] Autor:Faria MY; Ferreira NP; Canastro M
[Ad] Address:Department of Ophthalmology, Hospital Santa Maria, Lisbon - Portugal.
[Ti] Title:Management of dislocated intraocular lenses with iris suture.
[So] Source:Eur J Ophthalmol;27(1):45-48, 2017 Jan 19.
[Is] ISSN:1724-6016
[Cp] Country of publication:Italy
[La] Language:eng
[Ab] Abstract:PURPOSE: Subluxated or malpositioned intraocular lenses (IOLs) and inadequate capsular support is a challenge for every ophthalmic surgeon. Iris suture of an IOL seems to be an easy technique for the management of dislocated 3-piece IOL, allowing the IOL to be placed behind the iris, far from the trabecular meshwork and corneal endothelium. The purpose of this study is to assess the results of pars plana vitrectomy (PPV) and iris suture of dislocated 3-piece acrylic IOLs. METHODS: In this retrospective, nonrandomized, interventional case consecutive study, of a total of 103 dislocated IOLs, 36 eyes were considered for analysis. All 36 eyes had subluxated or totally luxated 3-piece IOL and underwent iris suture at the Ophthalmology Department of Santa Maria Hospital-North Lisbon Hospital Center, Portugal, from January 2011 until November 2015. All patients underwent 3-port 23-G PPV. The optic zone of the dislocated IOL was placed anterior to the iris with the haptics behind, in the posterior chamber. Haptics were sutured to iris followed by placement of the optics behind iris plane. Postoperative measures included best-corrected visual acuity (BCVA), IOL position, intraocular pressure, pigment dispersion, clinical signs of endothelial cell loss, and development of macular edema. RESULTS: A total of 36 eyes of 36 patients were included. All underwent successful iris fixation of dislocated 3-piece IOL. Mean overall follow-up was 15.9 months (range 3-58 months). At presentation, 16 eyes (44.4%) had a luxated IOL and 20 eyes (55.6%) a subluxated IOL. As underlying cause, 17 eyes (47.2%) had a history of complicated cataract surgery, 5 eyes (13.9%) had a traumatic dislocation of the IOL, and 6 eyes (16.7%) had a previous vitreoretinal surgery. A total of 8 eyes (22.2%) had late spontaneous IOL dislocation after uneventful cataract surgery. The mean preoperative BCVA was 1.09 ± 0.70 logarithm of the minimal angle of resolution (logMAR) units and mean postoperative BCVA was 0.48 ± 0.58 of logMAR units. The mean visual acuity improvement was 4.08 ± 5.33 lines on the logMAR scale. In this study, every IOL was stable at the last follow-up. As late complications, macular edema occurred in 1 patient and retinal detachment occurred in 2 patients. There were no cases of endophthalmitis. CONCLUSIONS: Iris suture fixation of subluxated IOL is a good treatment option for eyes with dislocated IOLs, leading to long-term stability of the IOL. The advantage of this procedure is using the same IOL in a closed eye surgery. No astigmatic difference is expected as no large corneal incision is needed.
[Mh] MeSH terms primary: Artificial Lens Implant Migration/surgery
Iris/surgery
Lens Implantation, Intraocular
Suture Techniques
[Mh] MeSH terms secundary: Adult
Aged
Aged, 80 and over
Artificial Lens Implant Migration/etiology
Cataract Extraction
Endothelium, Corneal/surgery
Female
Follow-Up Studies
Humans
Lenses, Intraocular
Male
Middle Aged
Polymethyl Methacrylate
Portugal
Postoperative Complications
Retrospective Studies
Visual Acuity/physiology
Vitrectomy/methods
[Pt] Publication type:JOURNAL ARTICLE
[Nm] Name of substance:9011-14-7 (Polymethyl Methacrylate)
[Em] Entry month:1703
[Cu] Class update date: 170817
[Lr] Last revision date:170817
[Js] Journal subset:IM
[Da] Date of entry for processing:160625
[St] Status:MEDLINE
[do] DOI:10.5301/ejo.5000823

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[PMID]: 27598732
[Au] Autor:Tandogan T; Holzer MP; Choi CY; Auffarth GU; Gerten G; Khoramnia R
[Ti] Title:Material Analysis of Spontaneously Subluxated Iris-Fixated Phakic Intraocular Lenses.
[So] Source:J Refract Surg;32(9):618-25, 2016 Aug 01.
[Is] ISSN:1081-597X
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:PURPOSE: To conduct a material analysis of spontaneously subluxated iris-fixated phakic intraocular lenses (IOLs) using light and scanning electron microscopy. METHODS: Six explanted Artisan/Verisyse and Artiflex/Veriflex IOLs (Ophtec, Groningen, Netherlands/AMO, Santa Ana, CA) were analyzed in a laboratory using light and scanning electron microscopy. Four of the IOLs had been explanted after spontaneous subluxation leading to a decrease in visual acuity, whereas the remaining two IOLs did not demonstrate signs of disenclavation but had been explanted in the course of planned cataract surgery and thus served as the control in this study. RESULTS: Light microscopy enabled the detection of clear deformations of the fixation arms on one or both haptics of the lens that had subluxated, and scanning electron microscopy revealed micro-cracks in the material. The deformations, which appeared to have been caused by some form of manipulation of the fixation arms, meant that adequate closure of the fixation arms was no longer possible and a reliable fixation in the iris stroma was unattainable. At least three of the lenses had been implanted with the use of an IOL haptic expander for enclavation, which may have contributed to the malformation of the haptics. The two control lenses exhibited no signs of material deformation or subsequent disenclavation. CONCLUSIONS: Deformations of the haptics of iris-fixated phakic IOLs can cause irreversible damage leading to disenclavation and inadequate re-enclavation. In such cases, explantation appears to be the only therapeutic option. It is important to adhere to an appropriate implantation technique to reduce the risk of spontaneous subluxation. [J Refract Surg. 2016;32(9):618-624.].
[Mh] MeSH terms primary: Artificial Lens Implant Migration/etiology
Equipment Failure Analysis
Iris/surgery
Phakic Intraocular Lenses
Prosthesis Failure
[Mh] MeSH terms secundary: Adult
Aged
Artificial Lens Implant Migration/surgery
Biocompatible Materials
Device Removal
Female
Humans
Microscopy, Electron, Scanning
Middle Aged
Myopia/surgery
Reoperation
Visual Acuity/physiology
[Pt] Publication type:JOURNAL ARTICLE
[Nm] Name of substance:0 (Biocompatible Materials)
[Em] Entry month:1708
[Cu] Class update date: 170831
[Lr] Last revision date:170831
[Js] Journal subset:IM
[Da] Date of entry for processing:160907
[St] Status:MEDLINE
[do] DOI:10.3928/1081597X-20160601-01


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