Comparision of surgical outcomes of intraocular lens refixation and intraocular lens exchange with perfluorocarbon liquid and fibrin glue-assisted sutureless scleral fixation

Oh, Shin Yeop; Lee, S J; Park, J M

doi:10.1038/eye.2015.22

Cited by 36 publications

(77 citation statements)

References 34 publications

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“…20 In two retrospective studies of IOL dislocation surgery, mean SIAs of 0.6 and 0.7 D after IOL repositioning, and 0.7 and 1.1 D after IOL exchange with a corneal incision was found. 11,14 Also other IOL dislocation studies have shown increased astigmatism after exchange surgery. 10,12 Further- Change from preoperative to postoperative visit SE change,# D À0.68 6 1.14 (P ¼ 0.002) (n ¼ 33) þ0.44 6 1.25 (P ¼ 0.09) (n ¼ 25) 0.001 * Mean for patients with information and that attended the 6-month postoperative visit.…”

Section: Discussionmentioning

confidence: 99%

“…Despite its importance for daily life activities, only a few studies have compared refractive outcomes between different operation methods for late in-the-bag IOL dislocation, 3,[11][12][13][14] and to our knowledge, no previous randomized trial has been conducted. Because a consensus on the surgical technique has not yet been established, nor with regard to refractive outcomes, we considered it of clinical relevance to perform such a comparison.…”

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confidence: 99%

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Astigmatism and Refractive Outcome After Late In-The-Bag Intraocular Lens Dislocation Surgery: A Randomized Clinical Trial

Kristianslund

Østern

Drolsum

2017

Invest. Ophthalmol. Vis. Sci.

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PURPOSE.To compare surgically induced astigmatism (SIA) and refractive outcomes between two operation methods for late in-the-bag IOL dislocation.METHODS. In this prospective, randomized, parallel-group clinical trial, 104 patients (eyes) were assigned to IOL repositioning by scleral suturing 1.5-to 2-mm posterior to limbus (n ¼ 54) or IOL exchange with a retropupillar iris-claw IOL using a 5.5-mm scleral pocket incision (n ¼ 50). The SIA was determined by vector analysis through conversion of corneal cylinders to Cartesian coordinates, and is presented as magnitude in diopters @ direction in degrees (D @ 8). Follow-up was 6 months.RESULTS. The SIA was 0.24 D @ 88 for IOL repositioning and 0.65 D @ 1718 for IOL exchange, which was a nonsignificant group difference (X coordinate: P ¼ 0.08; Y coordinate: P ¼ 0.16). Mean SIA magnitude was 0.60 6 0.50 D and 1.12 6 0.85 D, respectively (P < 0.001). Mean postoperative spherical equivalent was À1.6 6 1.6 D after IOL repositioning and À0.5 6 1.0 D after IOL exchange (P < 0.001). For IOL repositioning, this represented a mean myopic shift of À0.7 6 1.1 D compared with before the IOL dislocation (P < 0.001). For IOL exchange, it was within 61 D of target refraction in 83% of the patients.CONCLUSIONS. Surgically induced astigmatism was modest in both operation groups, albeit with a tendency of being more pronounced for IOL exchange. Repositioning surgery led to a myopic shift, whereas exchange surgery provided good refractive predictability.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Astigmatism and Refractive Outcome After Late In-The-Bag Intraocular Lens Dislocation Surgery: A Randomized Clinical Trial

Kristianslund

Østern

Drolsum

2017

Invest. Ophthalmol. Vis. Sci.

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“… Creation of suture loop around the haptic with surgical maneuvers around the dislocated PCIOL inside the eye – ”Cow-hitch knot” or the “Lasso” technique[ 12 ] Externalization of haptic and fixing it to sclera by the creation of scleral tunnels with or without scleral flaps (scleral tuck). [ 7 8 21 22 23 ] …”

Section: Discussionmentioning

confidence: 99%

“…There are limited studies in literature reporting the management of dislocated IOLs by a sutureless closed globe scleral refixation. [ 7 8 19 20 21 22 23 ] This study analyses the treatment outcomes following scleral refixation of dislocated IOLs using the scleral tuck method and compares the outcomes between the two techniques used.…”

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confidence: 99%

Surgical refixation of posteriorly dislocated intraocular lens with scleral-tuck technique

Rishi

Maitray

2017

Indian J Ophthalmol

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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.

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“…9 IOL explantation and exchange is technically difficult procedure associated with complications like corneal endothelial cell loss, aggravation of refractive error, zonular dehiscence, IOL tilting, and decentration. [10][11][12]…”

Section: Image 4 Haptic Dialed Into Anterior Chamber and Removal Of mentioning

confidence: 99%

Tips and Tricks for Surgical Management of Opacified IOL

Mahesha¹,

Sastry²,

Suryakanth³

2019

jebmh

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The opacification of hydrophilic acrylic IOLs is a serious complication of unknown etiology, with the only effective treatment being lens explantation and replacement, preferably with a lens of some different material. 1 IOL exchange for opacified lens can be difficult and challenging. Surgery may not always go on according to the pre-operative plan and the surgeon must be ready with an alternative during surgery. We present a series of cases of IOL opacification that posed challenges in diagnosis and the various surgical management techniques.

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Comparision of surgical outcomes of intraocular lens refixation and intraocular lens exchange with perfluorocarbon liquid and fibrin glue-assisted sutureless scleral fixation

Cited by 36 publications

References 34 publications

Astigmatism and Refractive Outcome After Late In-The-Bag Intraocular Lens Dislocation Surgery: A Randomized Clinical Trial

Astigmatism and Refractive Outcome After Late In-The-Bag Intraocular Lens Dislocation Surgery: A Randomized Clinical Trial

Surgical refixation of posteriorly dislocated intraocular lens with scleral-tuck technique

Tips and Tricks for Surgical Management of Opacified IOL

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