All the tested IOLs provided good visual outcome, reading performance, and spectacle independence after cataract surgery. While trifocal IOLs gave better near visual acuity results, the ERV IOL provided better contrast sensitivity.
Purpose:
To assess the surgical and refractive outcomes of a new technique of sutureless scleral fixation (SSF) using a single-piece foldable acrylic intraocular lens (IOL) (Carlevale).
Setting:
Department of Translational Surgery and Medicine, Ophthalmology, University of Florence, Careggi, Florence, Italy.
Design:
Prospective observational case series.
Methods:
Thirty-two eyes of 32 patients with aphakia, dislocated IOL, or subluxated lens who underwent SSF with a novel single-piece hydrophilic acrylic IOL were studied. Preoperative and postoperative refractive status and complications during and after surgery were recorded. The IOL tilt was evaluated using anterior segment optical coherence tomography (AS-OCT).
Results:
Twenty-two eyes were IOL/bag luxations, 9 were aphakia, and 3 were subluxated crystalline lens. Mean preoperative corrected distance visual acuity was 0.46 ± 0.29 logarithm of the minimum angle of resolution (logMAR) and improved to 0.13 ± 0.12 logMAR (P < .05) at the 8-month follow-up, with a predictive error spherical equivalent of −0.24 ± 0.81 diopters (D); the IOL tilt was 2.08 ± 1.19 degrees. One patient (3.1%) experienced transient cystoid macular edema, and 1 (3.1%) experienced vitreous hemorrhage; pigment dispersion with AS-OCT findings of reverse pupillary block was found in 2 (6.2%) eyes. IOL dislocation, conjunctival erosion, and plug externalization were not observed in any eye during the follow-up.
Conclusions:
SSF using the novel IOL could be a viable option for the management of aphakia, lens subluxation, and IOL–bag complex dislocation with unique characteristics of stability. The advantages of this technique were the absence of haptic manipulation, self-centration, and firm fixation of the IOL.
The ability of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2′s) to cause multi-organ ischemia and coronavirus-induced posterior segment eye diseases in mammals gave concern about potential sight-threatening ischemia in post coronavirus disease 2019 patients. The radial peripapillary capillary plexus (RPCP) is a sensitive target due to the important role in the vascular supply of the peripapillary retinal nerve fiber layer (RNFL). Eighty patients one month after SARS-CoV-2 infection and 30 healthy patients were selected to undergo structural OCT (optical coherence tomography) and OCTA (optical coherence tomography angiography) exams. Primary outcome was a difference in RPCP perfusion density (RPCP-PD) and RPCP flow index (RPCP-FI). No significant difference was observed in age, sex, intraocular pressure (IOP) and prevalence of myopia. RPCP-PD was lower in post SARS-CoV-2 patients compared to controls. Within the post-COVID-19 group, patients with systemic arterial hypertension had lower RPCP-FI and age was inversely correlated to both RPCP-FI and RPCP-PD. Patients treated with lopinavir + ritonavir or antiplatelet therapy during admission had lower RPCP-FI and RPCP-PD. RNFL average thickness was linearly correlated to RPCP-FI and RPCP-PD within post-COVID-19 group. Future studies will be needed to address the hypothesis of a microvascular retinal impairment in individuals who recovered from SARS-CoV-2 infection.
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