Evaluation of functional outcome and stability of sutureless scleral tunnel fixated IOLs in children with ectopia lentis

Rastogi, Anju; Kumar, Prateek; Dhiman, Shweta; Mishra, Manisha; Anand, Kamlesh; Bhardwaj, Ankita

doi:10.18240/ijo.2020.01.10

Cited by 9 publications

(8 citation statements)

References 18 publications

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“…Moreover, it is a contact inspection method and the deformation of the eyeball extruded by water in bath cup may affect the measured results [ 27 ]. Given the above limitations and its ability to clearly depict ocular structure posterior to the pupillary plane, UBM has been more frequently used to assess the IOL stability in scleral fixated, [ 14 , 32 , 33 , 34 ] iris fixated [ 35 ] and sulcus IOLs [ 36 , 37 ] rather than a routine modality in evaluation of tilt and decentration via validated quantitative measurements. Marianelli et al [ 14 ] used this technique to compare the IOL tilt between two groups of sutureless and sutured scleral fixated IOL groups.…”

Section: Measurement Of Iol Tilt and Decentrationmentioning

confidence: 99%

Effect of Intraocular Lens Tilt and Decentration on Visual Acuity, Dysphotopsia and Wavefront Aberrations

Ashena

Maqsood

Ahmed

et al. 2020

Vision

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Tilt and decentration of intraocular lenses (IOL) may occur secondary to a complicated cataract surgery or following an uneventful phacoemulsification. Although up to 2–3° tilt and a 0.2–0.3 mm decentration are common and clinically unnoticed for any design of IOL, larger extent of tilt and decentration has a negative impact on the optical performance and subsequently, the patients’ satisfaction. This negative impact does not affect various types of IOLs equally. In this paper we review the methods of measuring IOL tilt and decentration and focus on the effect of IOL tilt and decentration on visual function, in particular visual acuity, dysphotopsia, and wavefront aberrations. Our review found that the methods to measure the IOL displacement have significantly evolved and the available studies have employed different methods in their measurement, while comparability of these methods is questionable. There has been no universal reference point and axis to measure the IOL displacement between different studies. A remarkably high variety and brands of IOLs are used in various studies and occasionally, opposite results are noticed when two different brands of a same design were compared against another IOL design in two studies. We conclude that <5° of inferotemporal tilt is common in both crystalline lenses and IOLs with a correlation between pre- and postoperative lens tilt. IOL tilt has been noticed more frequently with scleral fixated compared with in-the-bag IOLs. IOL decentration has a greater impact than tilt on reduction of visual acuity. There was no correlation between IOL tilt and decentration and dysphotopsia. The advantages of aspheric IOLs are lost when decentration is >0.5 mm. The effect of IOL displacement on visual function is more pronounced in aberration correcting IOLs compared to spherical and standard non-aberration correcting aspherical IOLs and in multifocal versus monofocal IOLs. Internal coma has been frequently associated with IOL tilt and decentration, and this increases with pupil size. There is no correlation between spherical aberration and IOL tilt or decentration. Although IOL tilt produces significant impact on visual outcome in toric IOLs, these lenses are more sensitive to rotation compared to tilt.

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Section: Measurement Of Iol Tilt and Decentrationmentioning

confidence: 99%

Effect of Intraocular Lens Tilt and Decentration on Visual Acuity, Dysphotopsia and Wavefront Aberrations

Ashena

Maqsood

Ahmed

et al. 2020

Vision

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“…In their study, 5 of 45 eyes developed a significant IOL tilt of more than 5° based on UBM. 33 Three of our patients had IOL decentration and IOL tilt. However, none of them had significant decentration leading to the bisection of the mesopic pupillary area.…”

Section: Discussionmentioning

confidence: 67%

“…The mean endothelial cell loss and change in IOP were comparable with other similar studies. 25,28,29,33 One of the limitations of our study is the retrospective nature of the study.…”

Section: Discussionmentioning

confidence: 98%

Long-term Outcomes of Fibrin Glue–Assisted Intrascleral Haptic Fixation of Posterior Chamber Intraocular Lenses in Children

Sinha

Asif²,

Kalra³

et al. 2021

Eye &Amp; Contact Lens: Science &Amp; Clinical Practice

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Objectives: To evaluate the long-term outcomes of intrascleral haptic fixation of posterior chamber intraocular lens (PCIOL) with fibrin glue in children. Methods: This is a retrospective case study conducted in a tertiary eye institute in North India. A total of 118 eyes of 82 children who underwent glued intrascleral haptic fixation of PCIOLs were retrospectively analyzed. Detailed analysis of the indication for surgery and ocular and systemic associations was performed. The outcome measures included intraoperative complications, final visual and refractive outcomes, and postoperative complications.Results: The mean age of the patients was 10.1663.94 years. Fifty-one patients (62.2%) were male and 31 (37.8%) were female. The mean followup period was 31.28613.22 months. The mean preoperative corrected distance visual acuity was 1.1860.63 Logarithm of Mean angle of resolution (logMAR) which improved to 0.6060.58 logMAR postoperatively at 6 weeks (P,0.001). The mean preoperative and 6 weeks postoperative endothelial cell density were 3,176.086318.6 and 2,9366289.9 cells/mm 2 , respectively (P¼0.23). In the immediate postoperative period, corneal edema (19 eyes; 16.1%), decentered IOL/tilt (3 eyes; 2.54%), vitreous hemorrhage (3 eyes; 2.54%), optic capture (4 eyes; 3.38%), and hypotony (2 eyes; 1.69%) were seen. In the late postoperative period (.6 weeks), retinal detachment was observed in two eyes that had associated Marfan syndrome. Cystoid macular edema was seen in four eyes (3.38%), and glaucoma was seen in five eyes (4.23%). Conclusions: Fibrin glue-assisted intrascleral haptic fixation of a PCIOL is a safe and effective method to manage aphakia with inadequate capsular support in children.

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“…22 Other complications found in the patients of this study include vitreous bleeding and corneal imbibition. Other studies on SFIOL reported five eyes with transient anterior uveitis less than 1 month after surgery, 27 and another reported one eye with uveitis-glaucoma-hyphema syndrome. 28 Sen et al reported one eye after SFIOL implant with uncontrolled glaucoma that developed ciliary staphyloma and progressed to hypotonic maculopathy.…”

Section: Discussionmentioning

confidence: 95%

Management of paediatric ectopia lentis at an Indonesian referral hospital: A retrospective review

Barliana

Yulia

Soeharto

2022

Afr. vis. eye health

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Background: Ectopia lentis in children is rare and often associated with systemic conditions. Left untreated, it can lead to visually debilitating complications. Although there are various techniques available, no current consensus for treatment of paediatric ectopia lentis exists.Aim: To describe the management and visual outcomes of paediatric ectopia lentis in an academic referral hospital.Setting: This study was conducted at Cipto Mangunkusumo National Central General Hospital, Jakarta, Indonesia.Methods: A retrospective review was conducted on the medical records of all paediatric ectopia lentis patients treated at our hospital, from 2011 to 2020. Primary outcomes include uncorrected visual acuity (UCVA), best-corrected visual acuity (BCVA), treatment, surgical technique, selection of intraocular lens (IOL), and postoperative complications.Results: This study included 66 eyes of 39 patients. Average age at initial presentation was 7.8 (2–17) years. Aetiology was mostly non-traumatic, whilst four were secondary to trauma. All eyes except one underwent surgery, and IOLs were inserted in 57.4% of the non-traumatic cohort, with iris-claw IOL as the most popular choice (85.7%). Uncorrected visual acuity and BCVA significantly improved in pseudophakic and aphakic groups (p 0.05). Nearly 60% achieved a BCVA of 6/12 or greater, and the proportion was higher amongst pseudophakic group. Ten eyes had post-operative complications, with a median onset of 393 (1–1095) days after surgery.Conclusion: With varied techniques used to manage paediatric ectopia lentis, the choice of technique was dependent on individual patient condition and surgeon preference. Whilst the proportion of eyes with BCVA of ≥ 6/12 was higher amongst the pseudophakic eyes than aphakic eyes, IOL implantation entails the risk of complications, whereas no complications occurred in those left aphakic. Therefore, no particular technique can be considered marginally superior to the other, and larger studies are needed.

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Evaluation of functional outcome and stability of sutureless scleral tunnel fixated IOLs in children with ectopia lentis

Cited by 9 publications

References 18 publications

Effect of Intraocular Lens Tilt and Decentration on Visual Acuity, Dysphotopsia and Wavefront Aberrations

Effect of Intraocular Lens Tilt and Decentration on Visual Acuity, Dysphotopsia and Wavefront Aberrations

Long-term Outcomes of Fibrin Glue–Assisted Intrascleral Haptic Fixation of Posterior Chamber Intraocular Lenses in Children

Management of paediatric ectopia lentis at an Indonesian referral hospital: A retrospective review

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