Secondary IOLs: ACIOL vs Iris Sutured vs Scleral Fixated vs Phakic IOL in Aphakic Settings

Khan, Mahmood; Al-Mohtaseb, Zaina; Kim, Dooho Brian

doi:10.1007/s40135-018-0184-1

Cited by 4 publications

(1 citation statement)

References 67 publications

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“…Due to rotation or dislocation, a smalldiameter IOL could damage corneal endothelium and anterior chamber angle, while a large-diameter IOL gives too much pressure to the root of the iris leading to damage of the anterior chamber angle, the formation of peripheral anterior synechiae, and an increase in intraocular pressure. The complication that may occur in AC-IOL implantation including chronic inflammation, corneal decompensation, cystoid macular edema, and hyphema (Brunin et al, 2017;Khan et al, 2018;Tejero et al, 2007;Woo et al, 2022).…”

Section: Discussionmentioning

confidence: 99%

Management of aphakia with low corneal endothelial cell count after complicated cataract surgery in a middle-age patient

Putri,

Dharmawidiarini

2023

SMJ IDI Surabaya

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Background: secondary intraocular lens implantation becomes more challenging due to pre-existing conditions. Objective: To report the outcome of retropubic iris-claw intraocular lens (RP-ICIOL) to corrects aphakia with low corneal endothelial cell count following previous complicated cataract surgery. Case: A 32-year-old male was referred to Undaan Eye Hospital with a chief complaint of blurred vision in his left eye (LE). Previously, the patient was diagnosed with a mature subluxated cataract and has undergone cataract extraction on the LE. Visual acuity of LE was 1/60 with raised intraocular pressure (31,8 mmHg with Schiotz Tonometry). On anterior segment examination, there was a clear cornea with an oval pupil and aphakia. The examination of the posterior segment was within normal limits. Specular microscopy of LE was 1140 cells/mm2. After IOP was controlled by medication, the patient then underwent retropubic iris-claw intraocular lens implantation. Post-operatively, the visual acuity of the LE was 2/10 and the IOP was 11 mmHg using non-contact tonometry. Six weeks post-op, the best visual acuity (BCVA) was 9/10 and the IOP was 15 mmHg and the CECD was 1110 cells/mm2 on the LE. Discussion: The RP-ICIOL was maintaining the physiological condition of the IOL location posteriorly, thus minimizing the risk of corneal decompensation and increased postoperative intraocular pressure, while at the same time trying to achieve a good refractive outcome. Conclusion: The implantation of RP-ICIOL is safe and effective management of aphakia with a low corneal endothelial cell coun secondary intraocular lens implantation becomes more challenging.

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Section: Discussionmentioning

confidence: 99%

Management of aphakia with low corneal endothelial cell count after complicated cataract surgery in a middle-age patient

Putri,

Dharmawidiarini

2023

SMJ IDI Surabaya

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Secondary Intraocular Lenses (IOLs)

Brown,

Hirabayashi,

Ginsburg

2024

Advances in Ophthalmology and Optometry

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A Modified Four-point Scleral Fixation of Intraocular Lens in Aphakic Eyes without Adequate Capsular Support

Pao,

Chen,

Chang

2024

Journal of Medical Sciences

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Background: Polypropylene is a commonly used suturing material for intraocular lens (IOL) scleral fixation, but a high breakage rate after several years of follow-up is reported. Meanwhile, Gore-Tex has been a popular artificial material in ophthalmic surgery. Aim: This pilot study investigated the safety and efficacy of a modified surgical technique for scleral fixation of a four-point, close-loop haptic IOL using Gore-Tex as the suture material for aphakic patients without adequate capsular support. Methods: A modified IOL scleral fixation technique was developed using a four-point, close-loop haptic IOL and Gore-Tex as the suture material. Patients undergoing the operation between March 2018 and May 2019 at one center were included in the study. The preoperative uncorrected distance visual acuity (UDVA) with spectacles and postoperative UDVA with an IOL were compared as the main outcome. Follow-up time was 17–43 months. Results: A total of 10 eyes of 10 patients were enrolled, including 3 with iatrogenic IOL dislocation, 3 with iatrogenic lens drop, 2 with traumatic lens dislocation, and 2 with late in-the-bag IOL dislocation. The mean age was 70.8 ± 12.11 years. The mean UDVA, evaluated by the logarithm of the minimum angle of resolution, was decreased from preoperative 1.89 ± 0.28 to postoperative 0.58 ± 0.70 (P < 0.001). No complications were reported except in one case with a postoperative corneal ulcer which healed after antibiotic treatment. Conclusions: The favorable outcome suggests Gore-Tex sutures as a safe and stable material for IOL scleral fixation. Prospective studies with a larger sample size would be necessary for more details on the safety and efficacy of the Gore-Tex suture in IOL scleral fixation.

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Secondary IOLs: ACIOL vs Iris Sutured vs Scleral Fixated vs Phakic IOL in Aphakic Settings

Cited by 4 publications

References 67 publications

Management of aphakia with low corneal endothelial cell count after complicated cataract surgery in a middle-age patient

Management of aphakia with low corneal endothelial cell count after complicated cataract surgery in a middle-age patient

Secondary Intraocular Lenses (IOLs)

A Modified Four-point Scleral Fixation of Intraocular Lens in Aphakic Eyes without Adequate Capsular Support

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