Angle-Closure Glaucoma after Piggyback Intraocular Lens Implantation

Garcia-Feijó, Julian; Sáenz-Francés, F.; Martinez-de-la-Casa, José M.; Méndez-Hernández, Carmen; Fernandez-Vidal, Ana; Elías-De-Tejada, M; Reche-Frutos, J; García–Sánchez, J.

doi:10.1177/112067210801800528

Cited by 11 publications

(4 citation statements)

References 16 publications

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“…17 More recent techniques have included the use of a secondary IOL or implantation in the ciliary sulcus of the same lens material (as the primary IOL) which resolved the ILO issue but was associated with significant and specific complications, such as transillumination defects of the iris and pigmentary dispersion glaucoma, pupillary block, intraocular hemorrhage, cystoid macular edema, and dysphotopsia. 5–9…”

Section: Discussionmentioning

confidence: 99%

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Outcomes of refractive error correction in pseudophakic patients using a sulcus piggyback intraocular lens

Levinger

Finkelman

Yatziv

et al. 2020

European Journal of Ophthalmology

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Purpose: The purpose of this study was to assess the results of a sulcus intraocular lens (Sulcoflex) for pseudophakic refractive errors following phacoemulsification cataract surgery. Methods: This retrospective clinical observational cohort study included consecutive eyes in which a Sulcoflex was implanted. Uncorrected distance visual acuity and corrected distance visual acuity as well as refractive outcomes were assessed. The minimum follow-up time required for inclusion was 3 months. Results: In total, 15 eyes ( n = 15) were evaluated. The mean follow-up was 14 months (range: 3–18 months). The Sulcoflex aspheric (653L) was implanted in 13 eyes and the Sulcoflex toric (653T) in two eyes. The preoperative mean logMAR (Snellen) uncorrected distance visual acuity and corrected distance visual acuity were 0.88 (20/150) and 0.27 (20/40), respectively. The postoperative mean logMAR (Snellen) corrected distance visual acuity was 0.15 (20/30). The preoperative mean spherical equivalent was −0.22 ± 5.95 D and the postoperative mean spherical equivalent was −1.59 ± 1.45 D. There was a significant and strong correlation ( r = 0.64, p < 0.001) between the attempted and the achieved spherical equivalent. Conclusion: The Sulcoflex is a safe and viable option for patients with residual refractive error following cataract surgery.

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Section: Discussionmentioning

confidence: 99%

“…Moreover, sulcus-implanted IOLs that were not specifically designed for the sulcus lead to several complications including pigmentary dispersion glaucoma, pupillary block, and cystoid macular edema. 5–9…”

Section: Introductionmentioning

confidence: 99%

Outcomes of refractive error correction in pseudophakic patients using a sulcus piggyback intraocular lens

Levinger

Finkelman

Yatziv

et al. 2020

European Journal of Ophthalmology

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“…An advantage of the supplementary IOLs (also known as secondary or additional IOLs) is their position in the sulcus in contrast to the classic piggyback technique, which requires implantation of both the primary and secondary IOLs into the capsular bag. The classic piggyback technique was associated with a number of complications, namely, interlenticular opacification (ILO) [9][10][11][12], postoperative elevation of intraocular pressure, pupillary optic capture after mydriasis [13,14], iris chafing, pigment dispersion syndrome [15,16], and secondary pigmentary glaucoma [15,16]. The implantation of these IOLs in the ciliary sulcus increases the distance between the 2 IOLs significantly, thereby reducing (but not eradicating) lens-lens contact and the possibility of ILO.…”

Section: Discussionmentioning

confidence: 99%

Clinical and Surgical Outcome of a Supplementary Multifocal Intraocular Lens Implanted with a Bag-In-the-Lens Intraocular Lens: 5-Year Follow-Up

Verdonck

Werner²,

Dhubhghaill

et al. 2020

Ophthalmic Res

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Introduction: To assess the postoperative outcome and patient-reported satisfaction, spectacle independence, and dysphotopsia after implantation with the mutifocal Rayner Sulcoflex supplementary intraocular lens (sIOL). Materials and Methods: We analyzed the outcome of all patients implanted with a multifocal sIOL between 2009 and 2011. In all cases, the sIOL was the Rayner Sulcoflex IOL (type 653F) and the primary IOL was a bag-in-the-lens (BIL) IOL. The data were obtained through a retrospective analysis of the patient records and by means of a questionnaire, 5 years after sIOL implantation. Results: This study included 31 eyes of 20 patients. In 13 eyes, the sIOL needed explantation (n = 13, 41.94%). Dysphotopsia is a frequent complaint (12/15 patients: 80.0%) after sIOL implantation. In 13 out of 31 eyes (41.94%), pigment deposits were found on the sIOL with variable clinical complaints. Five eyes required additional surgery because of clinically significant deposits. Discussion/Conclusion: Patients with a multifocal sIOL in combination with a BIL implantation have a higher incidence of dysphotopsia compared to previously published studies. Dysphotopsia was the main complaint and reason for explantation. We encountered a high incidence of pigmented IOL deposits. The sIOLs can be safely removed even years after implantation.

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“…The contact between the IOL and the iris endothelium led to pigmentary dispersion and glaucoma in many cases. [2][3][4] The modified design of the former piggyback IOLs led to a new generation of sulcus-fixated additional IOLs. Among other improvements, the design of the add-on IOL changed from biconvex to convex-concave (meniscus) geometry, which prevents contact with the primary implanted IOL and therefore prevents interlenticular opacification.…”

mentioning

confidence: 99%

Effect of interface reflection in pseudophakic eyes with an additional refractive intraocular lens

Schrecker¹,

Zoric²,

Messner³

et al. 2012

Journal of Cataract and Refractive Surgery

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Angle-Closure Glaucoma after Piggyback Intraocular Lens Implantation

Abstract: Ahmed valve implantation is a good option in angle closure glaucoma due to piggyback. The placement of the valve's tube between the two IOLs is a good option to protect corneal endothelium.

Cited by 11 publications

References 16 publications

Outcomes of refractive error correction in pseudophakic patients using a sulcus piggyback intraocular lens

Outcomes of refractive error correction in pseudophakic patients using a sulcus piggyback intraocular lens

Clinical and Surgical Outcome of a Supplementary Multifocal Intraocular Lens Implanted with a Bag-In-the-Lens Intraocular Lens: 5-Year Follow-Up

Effect of interface reflection in pseudophakic eyes with an additional refractive intraocular lens

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