Comparison of secondary implantation of flexible open-loop anterior chamber and scleral-fixated posterior chamber intraocular lenses

Evereklioğlu, Cem; Er, Hamdi̇; Bekir, Necdet; Borazan, Mehmet; Zorlu, Ferhat

doi:10.1016/s0886-3350(02)01526-2

Cited by 154 publications

(133 citation statements)

References 23 publications

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“…Evereklioglu et al (2003) reported that secondary implantation of the SFIOL will provide more favorable outcome and a lower complication rate than the open-loop ACIOL in complicated cataract cases. In a study by Lee et al (2003) secondary implantation of SFIOL after cataract extraction had a lower early complication rate than primary implantation in complicated cataract extraction although the final visual acuity and late complication rate were not significantly different.…”

Section: Discussionmentioning

confidence: 99%

Visual outcome and early complications of sutureless and glueless scleral fixated intraocular lens

Agarwal

Gurung

et al. 2016

Nep J Oph

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Introduction: In the absence of capsular support, anterior chamber intraocular lens (IOL), iris fixated IOL and sutured scleral fixated intraocular lens (SFIOL) implantation have been performed for many years. Recently sutureless glued SFIOL have been used as a primary or secondary procedure to correct aphakia. In this study we have used sutureless and glueless technique of SFIOL implantation. Methodology: An interventional case series was conducted. Aphakic patients without capsular support, sub-luxated lens (>180˚), dislocated lens and dislocated IOL were the inclusion criteria. The patients with hazy cornea, non-dilating pupil, macular scar and glaucoma were not enrolled in the study. Results: Of 62 eyes who completed 1 month followup, 48 were men and 14 women. There was a significant improvement in uncorrected distance visual acuity after surgery (p<0.001). One month postoperative best corrected distance visual acuity was 6/18 or better in 45 eyes (72.6%). The common early postoperative complications were hypotony, corneal edema. No serious complications such as endophthalmitis and retinal detachment were seen. Conclusion: Our technique of sutureless and glueless SFIOL implantation showed good visual outcome in the absence of serious complications. SFIOL will be the only choice in eyes that have anatomic contraindications like non constricting pupil, large sectoral iridectomy and peripheral anterior synechia in which other types of lens are not suitable.

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Section: Discussionmentioning

confidence: 99%

Visual outcome and early complications of sutureless and glueless scleral fixated intraocular lens

Agarwal

Gurung

et al. 2016

Nep J Oph

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“…In patient 2, she had right eye ACIOL implantation. Various studies had compare the outcome of the both technique, both with its own pros and cons (11,12). ACIOL are associated with complication like post-operative corneal decompensation and raised intra-ocular pressure, due to the close contact of the lens with the corneal and angle structures (11,12).…”

Section: Discussionmentioning

confidence: 99%

“…Different techniques had been described for PSFIOL, including continuous-loop fixation, four points fixation, transcleral fixation through sclerotomy, scleral tunnel technique, etc (13). The complication includes intraocular haemorrhage, retinal detachment, suture erosion and subsequent IOL decenteration (11,12). Some studies have reported higher complications in PSFIOL compare to ACIOL (12).…”

Section: Discussionmentioning

confidence: 99%

Dislocated Posterior Chamber Intraocular Lens (PCIOL) in Patients with Retinitis Pigmentosa (RP)

Lam¹,

Bastion²

2017

JSA

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Subluxation or dislocation of PCIOL is one of the complications of cataract operation in RP patients. This paper reports the presentation of PCIOL dislocation and subluxation and the management and outcome in 3 eyes of 2 RP patients. Two medical records of patients with RP who developed dislocated or subluxated PCIOL and subsequently underwent explantation of the dropped IOL were evaluated. Two patients had bilateral eye cataract operation done and had PCIOL implanted. Patient 1 developed left eye subluxated PCIOL inferiorly after 2 years of the cataract operation and right eye dislocated PCIOL anteriorly 4 years after cataract operation. Patient 2 develop right eye subluxated PCIOL inferiorly after 12 years of the cataract operation. Patient 1 with right eye dislocated PCIOL underwent intraocular lens (IOL) explantation and was left aphakic as her visual prognosis was poor due to advanced RP. The left IOL remained within the visual axis despite subluxation and no intervention has been done. Patient 2 with right eye subluxated PCIOL underwent IOL explantation and anterior chamber intraocular lens (ACIOL) implantation. ACIOL remained stable and visual acuity improved post-operation. Both the operations were uneventful. Post-operatively, there was no elevated intraocular pressure and no prolonged ocular inflammation, which required prolonged anti-inflammatory and no retinal detachment was seen. Both patient and surgeon should be aware of potential PCIOL subluxation or dislocation in RP. The presentation may be as late as more than a decade after the cataract operation.

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“…There have not been many head-to-head studies between techniques to suggest a superior approach, and reviews comparing methods suggests that the effectiveness and safety profiles among the different techniques may be comparable. [24][25][26][27] The approach to addressing these complex surgeries should therefore be evaluated on a case-by-case approach as no one technique may be suitable in all cases. Furthermore,…”

Section: Discussionmentioning

confidence: 99%

Review of Surgical Techniques for Posterior Chamber Intraocular Lens Fixation in the Absence of Capsular Lens Support

Ng¹,

Behshad²,

Farid³

2015

US Ophthalmic Review

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An ongoing challenge in complex anterior segment surgery continues to be the safe and effective management of long-term intraocular lens (IOL) fixation in the absence of capsular support. Although anterior chamber IOLs are still an option, especially with improved lens designs and relative ease in placement, complications can still occur including corneal decompensation, iris chaffing, and anterior chamber angle injury, especially when incorrectly sized or in an inadequately shallow anterior chamber.1 Therefore, additional options for posterior chamber IOL fixation in cases of capsular compromise are indicated. Posterior chamber IOLs are not only placed further from the corneal endothelium and anterior chamber angle with less risk for injury to these structures, but are also closer to the nodal point of the eye and may offer a benefit in optical outcomes. Etiology of Loss of Capsular Lens SupportCases of inadequate capsular support for IOL fixation can result from a multitude of causes including trauma, complicated cataract surgery, IOL exchange or replacement, and zonulopathies, such as pseudoexfoliation syndrome and, less commonly, congenital ectopia lentis (see Table 1). 1,2With the many potential causes of loss of capsular support with need for IOL fixation, the ongoing development of improved lens design and surgical techniques continues to be an ongoing challenge for surgeons. Preoperative ConsiderationsGiven the potential complexity of cases requiring IOL fixation when adequate capsular support is lacking, careful preoperative planning is required to determine the most appropriate technique for securing an IOL. A surgeon should also take into account their level of experience and comfort level in attempting potentially surgically demanding techniques in often challenging eyes.A surgeon should consider whether any capsular support is present.Having some capsular support may add additional support to the IOL during manipulation during a complex case. Noting the availability of some capsular support can be particularly useful in cases when an anterior chamber IOL is not appropriate. AbstractThis is a review of surgical options for posterior chamber intraocular lens (IOL) fixation in the absence of adequate capsular support. The indications, techniques, and outcomes for posterior chamber iris-sutured and scleral-fixated IOLs, including trans-scleral sutured and trans-scleral tunnel glued fixation, are reviewed. Iris-sutured IOL fixation may be appropriate in cases in which small corneal incisions with a foldable IOL are desired, but are only possible in cases of adequate iris tissue, and may be complicated by pupil ovaling and iris trauma, which can lead to prolonged inflammation in some studies. Scleral-sutured IOL fixation does not require robust iris tissue and decreases the risk for iris trauma, but is technically more demanding, may require larger incisions, and poses potentially more posterior segment complications.There are also ongoing concerns for suture exposure, erosion, and late suture breakage an...

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Comparison of secondary implantation of flexible open-loop anterior chamber and scleral-fixated posterior chamber intraocular lenses

Cited by 154 publications

References 23 publications

Visual outcome and early complications of sutureless and glueless scleral fixated intraocular lens

Visual outcome and early complications of sutureless and glueless scleral fixated intraocular lens

Dislocated Posterior Chamber Intraocular Lens (PCIOL) in Patients with Retinitis Pigmentosa (RP)

Review of Surgical Techniques for Posterior Chamber Intraocular Lens Fixation in the Absence of Capsular Lens Support

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