Choices in Correction of Aphakia during Vitrectomy

Bastawrous, Andrew; Parkes, Craig; Prasad, Somdutt

doi:10.1159/000328210

Cited by 9 publications

(4 citation statements)

References 31 publications

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“…There are limited number of clinical trials comparing AC-IOL with scleral-fixated IOL, but the results show no significant superiority of one design over other, and therefore the choice of lens and method of fixation is still open to personal preference, availability and the individual surgeon's skill set. 12 In our study, 40% in group early vitrectomy had vision 0.5 or better, 50% in group moderate vitrectomy had vision 0.5 or better, and 33% in group late vitrectomy had vision 0.5 or better. Over all we have 42% patients had visual acuity 0.5 or better.…”

Section: Discussionsupporting

confidence: 47%

Outcome of Vitrectomy Surgery in Dropped Nucleus at Jakarta Eye Center

Agustiawan¹,

Elvioza²,

Sjamsoe³

et al. 2018

IJRetina

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Introduction: To report management and outcome of dropped nucleus in Jakarta Eye Center Methods: Retrospective review of the records of 19 consecutive patients who underwent pars plana vitrectomy for retain lens fragments at Jakarta Eye Center from January 2010 to September 2012. Result: The mean age of the patient was 57 years (range 48-79). There were 10 males (53%) and 9 females (47%). 10 patients (53%) had vitrectomy within 1 day of phacoemulsification, 6(32%) within 1 week and 3(15%) after more than 1 week. Eight patients (42%) achieved a final visual acuity of 0.5 or better, only 3 patients (15%) had final visual acuity 1-meter finger counting or worse. 74% patient achieved final acuity better than pre-op (14 patients). Early vitrectomy group has 3 patients (30%) with complication, intermediate vitrectomy group has 33% complication and late vitrectomy has 33 % complication. Posterior chamber IOL were implanted in 12 patients (63%), 2 patients had scleral fixation IOL, anterior chamber IOL in 2 patients, and only 3 patients (16%) were left aphakic. Conclusion: Surgical management in cases of nucleus drop in JEC showed good result with very limited complications. In most cases, vitrectomy was performed immediately after cataract surgery. Early vitrectomy has no significant differences in complications and visual outcome than 1 week vitrectomy and late vitrectomy after cataract surgery.

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Section: Discussionsupporting

confidence: 47%

Outcome of Vitrectomy Surgery in Dropped Nucleus at Jakarta Eye Center

Agustiawan¹,

Elvioza²,

Sjamsoe³

et al. 2018

IJRetina

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“…Secondary IOL implantation is widely used in the management of IOL dislocation, and various surgical techniques have been employed including anterior chamber IOL, iris fixation IOL, and sutured scleral fixation (SF) of posterior chamber IOL [5][6][7][8][9]. Of these approaches, transscleral fixation, with 10-0 polypropylene sutures, displays an advantage over the other techniques, with a decreased incidence of corneal endothelial cell loss, iritis, secondary glaucoma, and cystoid macular edema being reported [10][11][12].…”

Section: Introductionmentioning

confidence: 99%

A 1-Year Prospective Comparative Study of Sutureless Flanged Intraocular Lens Fixation and Conventional Sutured Scleral Fixation in Intraocular Lens Dislocation

et al. 2020

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Purpose: To compare surgical outcomes of sutureless flanged intraocular lens (IOL) fixation and conventional sutured scleral fixation (SF) for secondary IOL implantation in patients with IOL dislocation. Methods: This is a prospective, comparative cohort study on 103 consecutive patients (103 eyes) with IOL dislocation who underwent vitrectomy with IOL removal and sutured SF (53 eyes) or flanged IOL fixation (50 eyes). Operating time, best-corrected visual acuity (BCVA), refractive difference, IOL tilt and decentration using swept-source anterior segment OCT, and postoperative complications were measured for 12 months. Results: Operating time was significantly shorter for the flanged IOL fixation than for sutured SF (19.4 ± 4.6 vs. 48.9 ± 5.2 min, p < 0.001). BCVA in both groups improved at 1, 3, 6, and 12 months postoperatively (p < 0.05). BCVA in the 2 groups was similar during the 12 months of observation. The refractive difference, IOL tilt, IOL decentration, and incidence of postoperative complications were also not different in the 2 groups. Conclusion: Sutured SF and flanged IOL fixation had similar visual outcomes and IOL stability in patients with IOL dislocation. However, the operating time for flanged IOL fixation was less than half that of the sutured SF. This technique is an efficient alternative for treating IOL dislocation.

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“…1,2 The gold standard method has yet to be defined, and usually the decision depends on the pre-operatory status of the eye, IOL availability, and individual surgeon's personal preference and skills. 3 At present, little is known in the Western world about practice patterns in the surgical management of aphakia or correction of in-the-bag dislocation of the IOL. In a comprehensive prospective project studying the latter situation, repositioning of the present IOL or exchange to a retropupillary iris-claw IOL (RICI) implantation were compared.…”

mentioning

confidence: 99%

Retropupillary Iris-Claw Intraocular Lens and Pars Plana Vitrectomy in Aphakia Management

Bernal-Morales¹,

Hernández-Martínez

Navarro-Angulo

et al. 2021

Retina

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To evaluate the outcomes and safety of retropupillary iris-claw intraocular lens implantation and associated pars plana vitrectomy.Methods: Multicenter, national audit of 325 eyes (325 patients). Demographics, surgical details, and complications are described. Visual acuity, intraocular pressure, and central retinal thickness assessed by optical coherence tomography were collected at 1, 3, 6, and 12 months after surgery. Kaplan-Meier curves were created to assess the cumulative probability of postoperative visual acuity and intraocular pressure levels, macular edema development, and corneal decompensation.Results: The cumulative probability of the final visual acuity #0.3 logarithm of the minimum angle of resolution ($20/40 Snellen) was 75.6% at 12-month follow-up. The probability of intraocular pressure .21, $25, and $30 mmHg was 48.1%, 33.1%, and 19.0%, and the probability of intraocular pressure-lowering drops was 50.9% at 12 months. Glaucoma surgery was required in 4.3% of the eyes (14/325). The cumulative probability of macular edema was 20.5% at 12 months and was greater in complicated cataract surgery than in intraocular lens-luxation eyes (26% vs. 16.7%, P = 0.04). Corneal transplantation was required in 2.8% of the eyes (9/325).Conclusion: This study on 325 eyes with aphakia or intraocular lens dislocation managed with the retropupillary iris-claw intraocular lens technique provides clinical outcomes in a real-world scenario, reporting relevant data for patient counseling and preoperative discussions.

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Choices in Correction of Aphakia during Vitrectomy

Cited by 9 publications

References 31 publications

Outcome of Vitrectomy Surgery in Dropped Nucleus at Jakarta Eye Center

Outcome of Vitrectomy Surgery in Dropped Nucleus at Jakarta Eye Center

A 1-Year Prospective Comparative Study of Sutureless Flanged Intraocular Lens Fixation and Conventional Sutured Scleral Fixation in Intraocular Lens Dislocation

Retropupillary Iris-Claw Intraocular Lens and Pars Plana Vitrectomy in Aphakia Management

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