Vitrectorhexis and lens aspiration with posterior chamber intraocular lens implantation in spherophakia

Al‐Haddad, Christiane; Khatib, Lama

doi:10.1016/j.jcrs.2012.05.001

Cited by 8 publications

(14 citation statements)

References 8 publications

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“…The anterior chamber maintainer, which facilitates ophthalmological surgical procedures and reduces iatrogenic damage to the iris, corneal endothelium, and lens, has been used in the management of hard nuclear cataract lens [ 3 ], subluxation in young patients [ 4 ], endoscopic goniotomy [ 5 ], traumatic hyphaemas [ 6 ], congenital pupillary-iris-lens membrane [ 7 ], and spherophakia [ 8 ]. As compared to extracapsular cataract extraction (ECCE) with the protection of viscoelastics, anterior chamber might be more unstable when nucleus extraction was performed during phacoemulsification when posterior capsular was ruptured.…”

Section: Discussionmentioning

confidence: 99%

Management of Traumatic Cataract with Posterior Capsular Rupture: A Case Report and In Vitro Model Study

Wan

et al. 2017

Case Reports in Ophthalmological Medicine

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Purpose To investigate the optimal strategy for surgical management of traumatic cataract with posterior capsular rupture. Methods We describe four cases of traumatic cataract with posterior capsular rupture and an in vitro model built to evaluate the optimal infusion pressure during surgery. Results All patients underwent cataract surgery. By using an anterior chamber maintainer to elevate infusion pressure, we safely performed cataract extraction without phacoemulsification. At 3 days after surgery, visual acuity was greater than 20/25 in all patients, without any complications. Phacoemulsification would also be feasible under anterior chamber maintainer infusion in a similar case of traumatic cataract with posterior capsular rupture during intravitreal injection. In addition, an in vitro model that we established using pig's eyes revealed that the anterior chamber remained stable when the height of infusion bottle was 50–90 mmHg, whereas shallowing of the anterior chamber occurred when the height of infusion bottle was reduced to 40 mmHg, and corneal edema occurred when the height of infusion bottle was raised to 100 mmHg. Conclusions During management of traumatic cataract with posterior capsular rupture, using an anterior chamber maintainer to maintain optimal infusion pressure may reduce the risk of anterior hyaloid membrane breakup and vitreous loss.

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Section: Discussionmentioning

confidence: 99%

Management of Traumatic Cataract with Posterior Capsular Rupture: A Case Report and In Vitro Model Study

Wan

et al. 2017

Case Reports in Ophthalmological Medicine

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“…However, lensectomy is usually required to lower the intraocular pressure (IOP) and preserve vision (Yasar T, 2003;Willoughby Case report CE et al, 2002). No standard surgical technique has been adopted because of the variable laxity of the zonular ¿ bers (Al-Haddad C et al, 2012).The different surgical procedures used in management of these cases are intracapsular extraction, phacoemulsi¿ cation or lensectomy with a limbal approach or pars plana lensectomy and vitrectorhexis with lens aspiration. Intraocular lens (IOL) implantation is not always feasible in the absence of a stable capsule support, especially after complicated surgery (Al-Haddad C et al, 2012;Kaushik S et al, 2006;Wu-Chen WY et al, 2005;Kanamori A et al, 2004).…”

Section: Introductionmentioning

confidence: 99%

“…No standard surgical technique has been adopted because of the variable laxity of the zonular ¿ bers (Al-Haddad C et al, 2012).The different surgical procedures used in management of these cases are intracapsular extraction, phacoemulsi¿ cation or lensectomy with a limbal approach or pars plana lensectomy and vitrectorhexis with lens aspiration. Intraocular lens (IOL) implantation is not always feasible in the absence of a stable capsule support, especially after complicated surgery (Al-Haddad C et al, 2012;Kaushik S et al, 2006;Wu-Chen WY et al, 2005;Kanamori A et al, 2004). Also, in the bag implantation of IOL is questionable due to unstable bag postoperatively, non-availability of a small capsular tension ring (CTR) and high rate of bag contraction (Al-Haddad C et al, 2012; Behndig A, 2002;Dufay-Dupar B et al, 2007).…”

Section: Introductionmentioning

confidence: 99%

Management of bilateral microspherophakia with secondary angle closure glaucoma

et al. 2015

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This case demonstrates that microspherophakia should be ruled out even in middle aged patients presenting as angle closure glaucoma. The possibility of thickened cornea must be kept in mind requiring an IOP correction. Lensectomy with scleral fixation of posterior chamber IOL provides a satisfactory recovery of visual acuity and IOP control. Though in this patient, the lens was held in position by posterior synechiae in the left eye, future stability of zonules needs to be monitored.

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“…1 , is attributed to the underdeveloped zonules of Zinn, which do not exert enough force on the lens to maintain its usual oval shape. [ 1 2 3 4 ] This condition is the result of a homozygous mutation to the LTBP2 gene. Parental consanguinity was present in the reported families.…”

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confidence: 99%

Retropupillary iris-claw intraocular lens for the surgical correction of aphakia in cases with microspherophakia

Fouda

Aswad

Ibrahim

et al. 2016

Indian J Ophthalmol

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Purpose:This study aimed to evaluate the safety and efficacy of retropupillary fixation of an iris-claw intraocular lens (IOL; Verisyse polymethyl methacrylate IOL, Abbott Medical Optics [AMO], Netherlands) for the surgical correction of aphakia in microspherophakic eyes without sufficient capsular support.Design:This was a prospective, interventional, noncomparative case series.Methods:This interventional case series comprised 17 eyes of 9 microspherophakic patients. Retropupillary fixation of the Verisyse iris-claw IOL (AMO) was performed in all cases. The surgical time was measured. Corrected distance visual acuity, astigmatism, intraocular pressure (IOP), tissue reaction, pigment dispersion, and stability of the IOL were studied 1 day, 3 days, 1 week, 2 weeks, 1 month, and 6 months postoperatively.Results:Eight patients had familial microspherophakia and one patient had Marfan's syndrome. Eighty-two percent of the cases achieved a visual acuity of 0.3 or better. There was no significant postoperative inflammatory reaction. Transient elevation of IOP was recorded in two cases in the 1st week only. One IOL developed disengagement of one of the haptics from the iris and was successfully re-engaged. All the other IOLs were well centered and stable. The mean surgical time was 18.0 ± 4.5 min.Conclusions:Retropupillary fixation of an iris-claw IOL is a safe and effective procedure that provides early visual recovery. It is also a time-saving method for correcting aphakia in microspherophakic eyes without sufficient capsular support.

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Vitrectorhexis and lens aspiration with posterior chamber intraocular lens implantation in spherophakia

Abstract: Neither author has a financial or proprietary interest in any material or method mentioned.

Cited by 8 publications

References 8 publications

Management of Traumatic Cataract with Posterior Capsular Rupture: A Case Report and In Vitro Model Study

Management of Traumatic Cataract with Posterior Capsular Rupture: A Case Report and In Vitro Model Study

Management of bilateral microspherophakia with secondary angle closure glaucoma

Retropupillary iris-claw intraocular lens for the surgical correction of aphakia in cases with microspherophakia

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