Late spontaneous in-the-bag intraocular lens and capsular tension ring dislocation in pseudoexfoliation syndrome

Scherer, Matthias; Bertelmann, Eckart; Rieck, Peter

doi:10.1016/j.jcrs.2006.01.041

Cited by 35 publications

(19 citation statements)

References 15 publications

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“…Creep is usually increased by temperature. Several studies have shown standard PMMA CTRs failing to prevent capsular bag shrinkage or late dislocation [6][7][8][9]. Capsular shrinkage and dislocation is known to be multi-factorial, being influenced by: progression of zonular damage, fibrous metaplasia of residual lens epithelial cells, IOL material and insufficient resistance to compression by the CTR.…”

Section: Discussionmentioning

confidence: 99%

“…Despite the force exerted by the CTR, several cases of capsular bag shrinking have been published, some of them leading to capsular bag-IOL-CTR complex dislocations [6][7][8][9]. In this study we have measured the deformation of a CTR when submitted to a certain pressure "in vitro" and to ascertain if commercially available CTR's remain within the elastic region when the compression is maintained overtime.…”

Section: Introductionmentioning

confidence: 99%

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Resistance to Compression of the Capsular Tension Ring over Time

Aragon¹,

Villada²,

Ruiz–Moreno³

2017

AOVS

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Purpose: To evaluate the resistance to compression of commercially available capsular tension rings (CTRs) when submitted "in vitro" to a constant pressure over a period of time.Setting: Research Unit. CHU Albacete. University of Castilla La Mancha. Spain.Method: Four samples of 3 different CTR manufacturers were evaluated for resistance to compression over time while being exposed to a constant tension. The 13 millimetres CTRs were placed in a round rigid container with an 11 millimetres diameter and submerged in BSS at body temperature (37 degrees Celsius). CTRs were divided into two groups. Two samples of each model were introduced in the containers and removed and evaluated at 1 month, while the other two samples of each model were introduced in the containers and removed and evaluated at three months. Size and shape of the CTRs were measured at baseline, at 1 month and 3 months. Every measurement was repeated 3 times by two different observers. Results:The mean decrease in CTRs diameter of the 1 month compression group was 1, 5 millimetres. The mean decrease in CTRs diameter of the 3 month compression group was 1, 63 millimetres. The differences in diameter between baseline and 1 month, as well as baseline and 3 months were statistically significant. There was no statistical significance when comparing the final size between the 1 month and 3 months groups. Conclusion:All the commercially available CTRs studied have shown a decrease in diameter when exposed to a constant compression at body temperature. This could explain some of the published reports of capsular bag shrinkage or even dislocation of the entire IOL-CTR complex despite the implantation of a CTR.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Resistance to Compression of the Capsular Tension Ring over Time

Aragon¹,

Villada²,

Ruiz–Moreno³

2017

AOVS

View full text Add to dashboard Cite

show abstract

“…[6][7][8] Some surgeons advocate large capsulorrhexis and capsular tension ring as intraoperative measure to reduce zonular stress. One should be aware about delayed spontaneous dislocation of IOL with capsular bag years after uncomplicated cataract surgery in these patients.…”

Section: Discussionmentioning

confidence: 99%

Spontaneous late dislocation of IOL in a case of Pseudoexfoliation Syndrome

Kulariya¹

2012

Delhi Journal of Ophthalmology

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We report a case of pseudo exfoliation (PEX) Pseuoexfoliation Sundrome (PEX) syndrome is relatively common but easily over looked condition of eye. It predisposes the eye to open angle glaucoma. There is deposition of grey-white, extra cellular material in anterior chamber (trabeculum, lens capsule, iris, pupil, ciliary body). It is produced by abnormal basement membranes of aging epithelial cells. Cataract surgery is more hazardous in these cases due to poorly dilating pupil, weak zonules and vitreous loss.1 The zonulopathy in PXF is diffuse and progressive, so dislocation of IntraOcular Lens (IOL) may be seen years after cataract surgery. Case historyA 60 year old male patient presented with sudden diminution of vision in Left eye (LE). There was no history of trauma to eye. On slit lamp examination his Right eye (RE) had decentred IOL (Figure 1) and LE was aphakic (Figure 2). His iris and pupil had grey-white material deposited over it. His cataracts were operated with IOL in 1988 with good postoperative visual recovery. (History regarding capsulotomy or capsulorhexis was not available). So we further investigated him with indirect ophthalmoscopy, his IOL in LE was found to be dropped in vitreous cavity. Patient gave history of early maturation of cataract at the age of 40 years. He was high myopic before cataract surgery (-6D Sph Both eyes). Patient was a regular follow up for glaucoma treatment He Dr S N Medical College, Jodhpur. Correspondence to : Dr.Anand Kumar Kulariya E-mail : anandkulariya@yahoo.co.in had been putting Timolol 0.5% since last 10 years .On direct ophthalmoscopy both eyes had glaucomatous cupping (RE>LE). RE had glaucomatous optic atrophy. His IOP by applanation tonometer found in RE and LE were 17 and 18 mm Hg respectively. On pachymetry reading of his cornea was found to be thin (RE 490 micron and LE 480 micron). His visual field reports and OCT revealed progressive glaucoma damage to eyes. After refraction his vision improved to 1/60 (-2.0D Sph with-1 at 90) in RE and 6/9 (+6D sph with +1.25 at 165) in LE. His visual status has remained stable during subsequent follow-up. As patient was myopic and had glaucoma, removal of dropped IOL and secondary IOL implant was not advised by vitreoretinal surgeons as LE was only seeing eye. So we did not remove IOL and give aphakic

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“…In eyes with PEX, zonular weakness is a well-described clinical feature [2,4,11,12] , and there is a dehiscence of the zonular fibers noted histologically [1]. In addition, the zonules in these eyes become weak due to a degenerative process at the interface of the ciliary processes [13].…”

Section: Discussionmentioning

confidence: 99%