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El-Khayat, Abdul R. "Optimizing the intraocular lens formula constant according to intraocular lens diameter." International Journal of Ophthalmology 14, no. 5 (May 18, 2021): 700–703. http://dx.doi.org/10.18240/ijo.2021.05.09.
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AIM: To determine whether the different diameters of a specific intraocular lens (IOL) have significantly different optimized SRK/T A constants and whether these new A constants can improve refractive outcomes. METHODS: Data were collected prospectively from Jan. 2011 to Dec. 2012 on all patients undergoing routine cataract surgery at a district general hospital in the UK. Patients were divided into three groups according to the size of the Akreos AO MI60 IOL used. A constants for the SRK/T formula were optimized according to the size of the IOL. These optimized A constants were then used to select future refractive outcomes. RESULTS: A total of 2398 cataract operations were performed during the study period of which 1131 met the inclusion criteria. The three optimized A constants for the different sized IOLs were 118.98, 119.13, 119.32. The difference between them was highly significant (P≤0.0001). Two optimized A constants for three sizes of IOL led to an improvement in refractive outcomes (from 93.4% to 94.6% of refractive outcomes within 1.00 D of predicted spherical equivalent). The optimized A constant for the largest IOL was based on a small number of cases and was not used. CONCLUSION: Optimizing the A constant for the three distinct sizes of the Bausch & Lomb Akreos MI60 lens lead to three significantly different A constants. In our practice, using two different optimized A constants for three different sized IOLs give the least refractive error, however, using three optimized A constants may give better results with a larger dataset.
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Chan, Chin Sern, Szu May Chua, Siti Zakiah Md Khair, Nor Fadzillah Abdul Jalil, Raja Norliza Raja Omar, and Othmaliza Othman. "Iris-claw intraocular lens, scleral-fixated intraocular lens, and angle-supported anterior chamber intraocular lens in Hospital Melaka: a four-year retrospective analysis." Malaysian Journal of Ophthalmology 2, no. 2 (July 2, 2020): 83–95. http://dx.doi.org/10.35119/myjo.v2i2.71.
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Introduction: Cataract surgery with insufficient capsular support has become an intense challenge to surgeons in intraocular lens (IOL) selection. Anterior chamber IOL (ACIOL), iris-claw (Artisan) IOL, and scleral-fixated IOL (SFIOL) are the three common types of IOL used. However, each type of IOL has its own characteristics and different clinical requirements. IOL selection is important in ensuring good visual outcome.
Purpose: The purpose is to compare the duration or surgery, visual outcomes, and complications among ACIOL, Artisan IOL, and SFIOL.
Study design: Retrospective comparative analysis.
Material and methods: This is a four-year retrospective analysis of patients who underwent either ACIOL, Artisan IOL, or SFIOL implantation between January 2014 and January 2018. Patients were divided into ACIOL, Artisan, and SFIOL groups. Demographic data, duration of surgery, preoperative and postoperative visual acuity, and postoperative complications were identified and compared among the different groups.
Results: Sixty-four eyes from 58 patients were analysed: twenty (31.3%) eyes with ACIOL, 28 (43.8%) eyes with Artisan, and 16 (25%) eyes with SFIOL. Mean surgery times for ACIOL, Artisan, and SFIOL were: 61 ± 27.8, 64 ± 26.9, and 104.1 ± 46.8, respectively. SFIOL showed significantly longer surgery time than the ACIOL and Artisan groups (p < 0.05). There was no significant difference in surgery time between the ACIOL and Artisan groups (p > 0.05). The Artisan group showed significantly better visual recovery at postoperative 1 week than both the ACIOL and SFIOL groups (Artisan vs ACIOL: 6/18 vs 6/24, p < 0.05; Artisan vs SFIOL: 6/18 vs 6/60, p < 0.05). However, final best-corrected visual acuity (BCVA) at two months was comparable among all three groups with a median BCVA of 6/9. Elevated intraocular pressure occurred in all IOL groups, retinal detachment developedin the Artisan and SFIOL groups, epiretinal membrane developed in the ACIOL and SFIOL groups, corneal decompensation developed in the ACIOL group only. Cystoid macular oedema and IOL tilt occurred in SFIOL only.
Conclusions: All three groups of IOL showed comparable good visual outcomes. The decision of IOL selection should be based on patients’ clinical condition and availability of surgical skill and resources.
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Mano, Yuko, Kei Mizobuchi, Tomoyuki Watanabe, Akira Watanabe, and Tadashi Nakano. "Minimally Invasive Surgery for Intraocular Lens Removal and Intrascleral Intraocular Lens Fixation with Trabeculectomy in a Patient with Dislocated Intraocular Lens and Elevated Intraocular Pressure." Case Reports in Ophthalmology 12, no. 2 (June 11, 2021): 538–42. http://dx.doi.org/10.1159/000511593.
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A 88-year-old female who was being treated for end-stage pseudoexfoliation syndrome was referred to our hospital for treatment of dislocated intraocular lens (IOL) and the elevated intraocular pressure (IOP) and in the right eye (RE). At the first visit to our hospital, best-corrected visual acuity (BCVA) was 0.2 in the RE and 0.02 in the left eye (LE). IOP was 47 mm Hg in the RE and 21 mm Hg in the LE. Slit-lamp examination showed no abnormalities in anterior segments and dislocated IOL in the RE. Fundus photograph showed optic disc pallor in both eyes. We performed the combined therapy of flanged intrascleral IOL fixation with the double-needle technique and trabeculectomy. Throughout the follow-up period, BCVA slightly improved from 0.2 to 0.4 in the RE. The angle of tilt of the IOL was 6.6, 7.9, and 8.7° as measured by swept-source optical coherence tomography at 1, 4, and 6 months after the surgery, respectively. The IOP remained less than 10 mm Hg without having to administer any other glaucoma medications. Furthermore, any complications associated with the surgery were not confirmed.
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Egorova, E. V., A. S. Nesterenko, V. V. Chernykh, and L. V. Shcherbakova. "Late intraocular lens dislocation. Retrospective study." Fyodorov journal of ophthalmic surgery, no. 1 (March 20, 2021): 17–21. http://dx.doi.org/10.25276/0235-4160-2021-1-17-21.
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Purpose. To analyze the frequency, terms and risk factors of late IOL dislocation. Material and methods. A retrospective cohort study was conducted based on archival data of 70 787 cases of the senile cataracts phacoemulsifications performed in 2002–2019 years. Statistical processing of the results and Kaplan–Meier analysis were performed using the SPSS 11.0 program (STATA). Results. 320 patients in the study group were treated for late IOL dislocation at various postoperative periods. The average age of the patients was 76.2±12.5 years at the moment of reconstruction procedure. The periods from the moment of IOL implantation to its dislocation varied from 4 months to 17.58 years, the average term was 6.95±3.67 years. IOL reposition was performed in 272 cases (85.0%) and IOL change – in 48 cases (15.0%). The leading risk factor was pseudoexfoliation syndrome detected in 239 patients (74.7%). Among other factors there was high myopia (72 patients; 22.5%), in 78 cases there were the surgery procedures between cataract surgery and IOL dislocation: glaucoma surgeries – 27 cases (8.4%), vitreal surgeries – 9 cases (2.8%), laser discission of secondary cataract – 42 cases (13.1%). The cumulative 5-, 10-, 15-, and 18- year risk of late IOL dislocation was estimated using Kaplan–Meier analysis. Conclusion. The dynamics of the number of reconstructive operations at late IOL dislocations has a tendency to increase. The average term from the IOL implantation to its dislocation was 6,95±3,67 years. The leading risk factor was pseudoexfoliation syndrome. The cumulative 5-, 10-, 15-, and 18-year risk of late IOL dislocation was 0.2; 0.7; 1.15; and 1.4%, respectively. Key words: intraocular lens, dislocation, phacoemulcification.
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Osawa, Ryoko, Tetsuro Oshika, Masahiko Sano, Takuma Yuguchi, and Tadayoshi Kaiya. "Rotational stability of modified toric intraocular lens." PLOS ONE 16, no. 3 (March 1, 2021): e0247844. http://dx.doi.org/10.1371/journal.pone.0247844.
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We evaluated the rotational stability of a new toric intraocular lens (IOL), HOYA XY-1 toric IOL that is an improved version of HOYA 355 toric IOL, with longer overall length (13.0 mm vs. 12.5 mm), shortened unfolding time, and texture processing of the surface of haptics. Data from 193 eyes of 165 patients (76.4 ± 8.3 years old) with preoperative corneal astigmatism exceeding 0.75 diopters who had undergone phacoemulsification and toric IOL implantation were collected and analyzed. Corneal astigmatism, refractive astigmatism, and uncorrected (UDVA) and corrected distance visual acuity (CDVA) were evaluated before and 1 day, 1 week, and 1 month after surgery. The degree of IOL decentration, IOL tilt, and toric axis misalignment was assessed at 1 day and 1 month postoperatively. Fifty eyes received AcrySof toric IOL, 51 eyes TECNIS toric IOL, 46 eyes HOYA 355 toric IOL, and 46 eyes HOYA XY-1 toric IOL. The amount of axis misalignment from the intended axis was significantly different among IOLs (p = 0.004, one-way ANOVA), and HOYA XY-1 showed significantly less amount of axis misalignment than TECNIS (p = 0.020, Tukey’s multiple comparison) and HOYA 355 (p = 0.010). The proportion of eyes that showed axis misalignment <10° at 1 month postoperatively was significantly higher with HOYA XY-1 toric IOL than with other toric IOLs (χ2 test, p = 0.020). HOYA XY-1 toric IOL, the modified version of HOYA 355 toric IOL, showed excellent rotational stability in comparison with other models of toric IOLs.
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Simanjuntak, Gilbert W. S. "Reimplantasi Lensa Setelah Komplikasi Operasi Katarak." Kesmas: National Public Health Journal 6, no. 4 (February 1, 2012): 168. http://dx.doi.org/10.21109/kesmas.v6i4.95.
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Ada keterbatasan laporan implementasi lensa intraokuler sekunder di Indonesia. Penelitian ini bertujuan untuk melaporkan hasil implementasi lensa intraokuler sekunder di Rumah Sakit Communion of Churches in Indonesia (CCI) Cikini, Fakultas Kedokteran Universitas Kristen IndonesiaJakarta. Penelitian dengan sumber data sekunder rekam medis pasien dengan bedah inclusi eventful dengan atau tanpa implementasi lensa dan setiap komplikasi post operasi, termasuk penurunan penglihatan dan inflamasi katarak. Segmen anterior dan posterior diperiksa secara menyeluruh dan dicatat. Sinechiolisis dilakukan 360o dan viskoelastik disuntikkan untuk membuka ruangan antara iris dan kapsul rensi remain. Remain vitreous di depan chamber dipotong dan diangkat. Intraocular lens (IOL) ditanam di sulkus. Hasilnya yaitu ada 8 pasien yang memenuhi kriteria inklusi yang kemudian dievaluasi (50% adalah pria), 6 pasien underwent extracapsular catarac extraction (ECCE), dan 2 pasien underwent phacoemulsification before. Semua pasien mempunyai kornea sentral yang jernih. Ada 5 pasien denganuveitis dan opasitas vitreous. Ada 1 pasien dengan (AC IOL), 2 pasien dengan (PCIOL) terdislokasi sebagian pada rongga vitreous dan sisanya aphakic. Semua prosedur bedah dikerjakan dengan anastesi lokal retrobulbar dan diimplementasi IOL pada sulkus tanpa fiksasi. Rata-rata umuradalah 56,3 + 18,5 tahun. Rata-rata best corrected visual acuity (BCVA) sebelum operasi 0,33 + 0,26 dan setelah operasi 0,89 + 0,16 (p = 0,000). Rata-rata intraocular pressure (IOP) adalah 20,25 + 8,2 dan 15,25 + 3,5 mmHg sebelum dan sesudah operasi secara berurutan (p = 0,140). Pemantauan dilakukan 1 - 60 bulan. Implementasi IOL sekunder dapatmemperbaiki penglihatan dan mengurangi subjektif dan temuan klinik setelah operasi katarak sebelumnya.Kata kunci: Intraokuler, implementasi, katarakAbstractThere are limited reports of secondary intraocular lens implantation in Indonesia. The purpose of study is to report the result of secondary intraocular lens implantation in Cikini Communion of Churches in Indonesia (CCI) Hospital/Faculty of Medicine University Universitas Kristen Indonesia Jakarta. Retrospective study of medical records of patients with inclusioneventful cataract surgery with or without lens implantation with any complications postoperatively, including reduced vision and inflammation. Anterior and posterior segment findings were examine thoroughly and recorded. Synechiolysis done 360 degree and viscoelastic injected to open space between iris and remain lens capsule. Remain vitreous in anterior chambercut and removed. Intraocular lens (IOL) implanted in the sulcus. There are 8 patients that fulfills inclusion criteria which then evaluated (50% are men), 6 patients underwent extracapsular catarac extraction (ECCE), and 2 patientsunderwent phacoemulsification before. All patient have clear central cornea. There are 5 patients with uveitis and vitreous opacity. There are 1 patients with (AC IOL), 2 patients with (PC IOL) dislocated some part to vitreous cavity and the rest aphakic. All surgical procedures were done under local retrobulbar anesthesia and IOL implanted in the sulcus withoutfixation. Mean age were 56,3 + 18,5 years. Mean best corrected visual acuity (BCVA) preoperatively 0,33 + 0,26 and postoperatively 0,89 + 0,16 (p = 0,000). Mean intraocular pressure (IOP) were 20,25 + 8,2 and 15,25 + 3,5 mmHg pre and post operative respectively (p = 0,140). Follow up was 1 - 60 months. Secondary IOL implantation can improve vision and reduce subjective and clinical findings after remarkable cataract surgery.Key words: Intraocular, implementation, cataract
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Thanathanee, Onsiri, Tanapat Ratanapakorn, and Olan Suwan-apichon. "Postoperative opacification of polymethylmethacrylateintraocular lens." Asian Biomedicine 4, no. 3 (June 1, 2010): 457–62. http://dx.doi.org/10.2478/abm-2010-0056.
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Abstract Background: Opacification of ophthalmic devices has been previously reported in silicone scleral buckle, Molteno implant, and intraocular lens opacification. However, there is no report on polymethyl methacrylate (PMMA) intraocular lens (IOL) calcification. Objective: Report the clinical feature, histopathologic and spectrophotometer analysis of opacified three-piece PMMA IOL. Method: A 60-year-old diabetic patient reported decreased visual acuity in her right eye, which had undergone phacoemulsification with PMMA IOL implantation. The ophthalmic examination revealed a white homogeneous opacification of posterior surface of the IOL. The explanted IOL was analyzed using scanning electron microscopy, energy dispersive spectroscopy, and alizarin red staining. Results: The scanning electron microscope analysis showed granular deposits on posterior surface of the IOL. Using energy dispersive spectroscopy analysis, calcium and phosphate peaks were revealed, which was confirmed by positive for alizarin red staining. Conclusion: This case report provided evidence of PMMA IOL calcification caused by calcium and phosphate deposits. The possible etiologies were extrinsic and/or intrinsic factors.
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Haigis, Wolfgang. "Intraocular Lens Calculation After Refractive Surgery." European Ophthalmic Review 06, no. 01 (2012): 21. http://dx.doi.org/10.17925/eor.2012.06.01.21.
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More and more patients who have had corneo-refractive surgery present for intraocular lens (IOL) implantation. IOL calculation in these patients is still a challenge. After refractive surgery, if eyes are treated as normal eyes, high hyperopic errors can occur in previously myopic eyes and moderate myopic errors in formerly hyperopic eyes. Three main sources for these errors can be identified: the radius measurement error, the keratometer index error and the IOL formula error. The literature presents a confusing variety of procedures and formulas to cope with this situation. An analysis of the available literature reveals the different methods used to address the individual error contributions, the magnitude of which is assessed by model calculations. The most relevant formulas for clinical practice are the no-history procedures, which require no previous patient data. Using these methods to calculate IOL power after refractive surgery makes it possible to obtain clinical outcomes of a similar quality to that for normal eyes.
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Amon, Michael, and Guenal Kahraman. "Enhancement of Refractive Results after Intraocular Lens Implantation." European Ophthalmic Review 05, no. 01 (2011): 59. http://dx.doi.org/10.17925/eor.2011.05.01.59.
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Summary:An overview on polypseudophakia (‘piggyback’ intraocular lens [IOLs]) is given. Requirements on a sulcus-supported supplementary IOL are defined. Two-year results of a new IOL (Sulcoflex®) are presented and indications for this IOL are defined.Methods:The IOL is especially designed for implantation into the ciliary sulcus in pseudophakic eyes (piggyback). It is a single-piece implant made of hydrophilic acrylic. Optic- and haptic-edges are round. The optic has a diameter of 6.5mm and a concave/convex shape for perfect fit on the anterior convex surface of the primary IOL. The haptic is angulated, and has an undulated design to preclude IOL rotation. A monofocal, a multifocal or a toric version of the sulcoflex IOL were implanted into the ciliary sulcus of pseudophakic eyes. All IOLs were implanted by injector through a 3mm clear cornea incision. After surgery near and far uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA) and eye pressure were assessed. Inflammation was measured by laser flare/cell meter. Position and rotational stability of the IOL were documented regularly at all control visits. Furthermore, Scheimpflug photography and ultrasound biomicroscopy were performed.Results:Surgery was performed without any complication in all cases. Two years after surgery there were no severe intra- or post-operative complications detected. Emmetropia was achieved in all cases (±0.25dpt) and the refraction was stable. Flare values were lower than the values measured after standard cataract procedures. Rotational stability and centration were excellent. Intraocular pressure was within the normal range at all visits. After one year of follow-up no iris-chafing was documented. In all cases, a good distance was found between iris and the Sulcoflex-IOL and primary implant and the Sulcoflex-IOL. In those cases with the multifocal IOL-version all patient achieved independency from glasses.Conclusion:Surgery with implantation of a sulcus-IOL is safe and less traumatic than IOL-exchange. The material and design of the Sulcoflex IOL ensure that the implants are well tolerated within the eye. The implant can be used at the same time with the primary implant or as secondary implant. Indications for implantation of this IOL are the correction of ‘post-surgical’ ametropia, of astigmatism (toric IOL) of higher order aberrations (aspherical IOL) and of ‘pseudophakic presbyopia’ (multifocal IOL). In the future, other potential indications will be established.
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Massa, Horace F., Iona Gobej, Paul Jacquier, Christian Jonescu-Cuypers, and Olivier Le Quoy. "Cystoid macular oedema and iris-fixated intraocular lens treated with intraocular lens exchange: A case series and review." Journal of International Medical Research 47, no. 1 (October 1, 2018): 188–95. http://dx.doi.org/10.1177/0300060518799004.
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This series of case reports describes six eyes from five patients that underwent intraocular lens (IOL) exchange with scleral-fixated IOLs for cystoid macular oedema associated with iris-fixated IOLs between 2005 and 2015. Macular oedema was assessed using ocular coherence tomography (OCT). The six eyes in this series were treated by IOL removal and implantation of a scleral -sutured IOL with four points of fixation in the sulcus. Visual acuity improved in all six eyes. On OCT, macular oedema resolved after 3 months in all eyes. There were no surgical complications from the IOL exchange. One eye had a pupilloplasty and another had a diaphragm IOL to treat a major iris impairment from prior surgeries. The cause of cystoid macular oedema in these cases remains controversial but has been well recognized in eyes with iris-sutured IOLs. The absence of sutures with posterior fixation of an iris claw IOL prevents progressive corneal endothelial cell loss but does not prevent macular oedema, even in vitrectomized eyes. In conclusion, macular oedema resolved and visual acuity improved after implant exchange with a secondary scleral-fixated IOL in these cases. This procedure should be considered as a solution to persistent symptomatic cystoid macular oedema from an iris-fixated implant.
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Portaliou, Dimitra M., George D. Kymionis, and Ioannis G. Pallikaris. "The WIOL-CF Accommodative Intraocular Lens." European Ophthalmic Review 03, no. 01 (2009): 54. http://dx.doi.org/10.17925/eor.2009.03.01.54.
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A few years ago, the goal of cataract surgery was simply removal of an opaque crystalline lens. Nowadays, clear lens extraction is used in everyday clinical practice in order to correct refractive errors, especially presbyopia. Different intaocular lens (IOL) designs have been proposed, such as monofocal IOLs with monovision or multifocal IOLs. Accommodative IOLs are considered one of the greatest accomplishments in ophthalmology today. The WIOL-CF is an accommodative IOL with unique design and properties that guarantee excellent uncorrected vision at all distances, glare-free optics, position stability and posterior capsule opacification resistance. The WIOL-CF IOL can combine the advantages of other accommodative intraocular lenses regarding spectacle-free near vision, while at the same time its main technical parameters can overcome the major problems that other accommodative IOLs present.
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Batkov, E. N., T. F. Artemyeva, N. P. Pashtayev, and N. A. Pozdeyeva. "First Clinical Results of Modular Intraocular Lens Implantation." Ophthalmology in Russia 18, no. 2 (July 5, 2021): 240–44. http://dx.doi.org/10.18008/1816-5095-2021-2-240-244.
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Introduction. Recent population studies reveal steady growth in intraocular lens (IOL) exchanges including those for refractive and other optical reasons. To lower complication risks related to IOL exchange, we introduced a modular IOL model with replaceable optical part.Purpose: preliminary analysis of modular IOL implantation clinical results.Patients and methods. From August 2018 to February 2020, five patients as part of their surgical treatment for various forms of cataract received newly designed modular IOLs. The modular IOL is composed of two separate parts — haptic and optic, manufactured from the same elastic acrylic material with hydrophobic properties. The haptic includes a closed ring and a pair of open equally distant loops in a unified design. The haptic ring with projections serves as a base for optical disk. The current study evaluated characteristics of the IOL implantation and assembly process, as well as possible development of intra- and early postoperative complications.Results. First implantations of the modular IOL accomplished using standard surgical instrumentation and disposables passed without complications. We did not observe scratches, breaks or any other mechanical damage to neither haptic, nor optical parts. During simultaneous implantation, optical disks fixated in haptic rings preserved their due positioning after transiting through slender injector channel. There were no specific, modular-IOL related complications in the early postoperative period. The optical disk maintained correct location, delimited by fixation leaflets of the haptic ring.Conclusion. Early results for clinical application of the novel modular IOL demonstrated feasibility of its safe implantation in disassembled and preassembled modes.
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Muñoz, Gonzalo, César Albarrán-Diego, Ma Ángeles Galotto, Javier Pascual, and Teresa Ferrer-Blasco. "Lack of Effect of Intraocular Lens Asphericity on Visual Performance with Acrylic Intraocular Lenses." European Journal of Ophthalmology 21, no. 6 (November 2011): 723–31. http://dx.doi.org/10.5301/ejo.2011.6356.
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Purpose. To determine whether implantation of acrylic intraocular lens (IOL) with aspheric design (Tecnis Z9003, AMO) results in improved visual acuity or contrast sensitivity compared with conventional spherical acrylic IOL (AR40e, AMO). Methods. In an intraindividual randomized prospective study of 60 patients with bilateral cataract, the Tecnis Z9003 IOL was compared with the AR40e IOL. Ocular aberrations for a 4.0-mm pupil and 6.0-mm pupil were measured with a Hartmann-Shack aberrometer. Quality of vision was measured using visual acuity and contrast sensitivity under mesopic and photopic conditions. Results. Eyes with the Tecnis Z9003 IOL had significantly less spherical aberration and greater Strehl ratio after surgery, showing a better optical quality in comparison with the standard spherical IOL. However, visual acuity and both mesopic and photopic contrast sensitivity were not significantly different between the groups. Conclusions. The significantly better optical quality achieved with the aspheric acrylic IOL design did not result in improved visual acuity or contrast sensitivity in comparison with a conventional spherical acrylic IOL.
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Wong, Ching-Lin, T. V. N. Karunakar, Ming-Yueh Lee, and K. S. Sendhil. "Opacification of intraocular lens implant after uncomplicated cataract surgery: A case series." Asian Journal of Ophthalmology 14, no. 1 (August 4, 2015): 43–47. http://dx.doi.org/10.35119/asjoo.v14i1.30.
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Opacification of intraocular lens implant after successful cataract surgery is an important issue with the introduction of new intraocular lens. The complexity of the problem is not merely associated with visual impairment, but also lies in the difficulty in diagnosis and management of the case. We report 3 cases of late postoperative opacification of IOL implants warranted IOL exchange.
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Shiba, Takuya, and Hiroshi Tsuneoka. "Prewound Assisted Technique for Hydrophobic Foldable Intraocular Lens Implantation." European Journal of Ophthalmology 27, no. 5 (July 4, 2017): 569–72. http://dx.doi.org/10.5301/ejo.5000967.
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Purpose To describe a technique for intraocular lens (IOL) implantation that lessens the degree of surgical invasiveness by implanting a tightly rolled IOL through a small incision without touching the eye with the cartridge tip. Methods An IOL was inserted through an incision by first allowing the leading haptic to protrude slightly from the cartridge tip. It was then injected through the incision without allowing any part of the cartridge to touch the eye during IOL implantation. In one eye, the entire circumference of the beveled portion of the cartridge tip was inserted into the anterior chamber to implant the IOL, whereas in the other eye, the IOL was inserted through the incision by first allowing the leading haptic to protrude slightly from the cartridge tip. It was then injected through the incision without allowing any part of the cartridge to touch the eye during IOL implantation. We analyzed the incision width before and after IOL implantation and the degree of surgically induced astigmatism on the day after surgery and at 1 and 3 months after surgery. Results Using our technique, both the amount by which the wound was enlarged and the hydration rate were significantly lower compared with conventional IOL implantation. Our method enables IOL implantation to be carried out through a small incision at a width that was only previously possible with forcible insertion. Conclusions Our IOL implantation technique can be performed using both hands with no need to immobilize the eyeball.
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Weil, Natalie, and Scott R. Lambert. "Comparison of Contact Lens and Intraocular Lens Correction of Monocular Aphakia During Infancy." US Ophthalmic Review 8, no. 1 (2015): 21. http://dx.doi.org/10.17925/usor.2015.8.1.21.
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The Infant Aphakia Treatment Study recommended primary intraocular lens (IOL) implantation be reserved for infants with parents unable to manage contact lenses. The best baseline predictor of a good visual outcome was private health insurance. IOL implantation was associated with more adverse events, but lower direct costs to parents.
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Kurosaka, Daijiro, Toshiyasu Imaizumi, and Junya Kizawa. "Time Course of Lens Epithelial Cell Behavior in Rabbit Eyes following Lens Extraction and Implantation of Intraocular Lens." Journal of Ophthalmology 2021 (January 16, 2021): 1–8. http://dx.doi.org/10.1155/2021/6659838.
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Background. After cataract surgery, some lens epithelial cells (LECs) transdifferentiate into myofibroblast-like cells, which causes fibric posterior capsule opacification (PCO). Residual LECs differentiate into lens fiber cells, forming Elschnig pearls with PCO. This study was carried out to identify the time course of both types of LEC behavior in rabbit eyes following lens extraction and implantation of an intraocular lens (IOL). Methods. Phacoemulsification and implantation of posterior chamber IOLs were performed in rabbit eyes. Following enucleation, immunohistochemical methods were used to detect α-smooth muscle actin (α-SMA), a marker for myofibroblast-like cells, in the pseudophakic rabbit eyes. A mouse monoclonal antibody against α-SMA was used. Results. Soon after the operation, the LECs migrated and covered the lens capsule. Thereafter, the LECs around the anterior capsular margin were always positive for α-SMA. However, the distributions of these cells were not consistent. In some specimens, α-SMA-positive LECs were present around the IOL optic early after surgery, but most of them had disappeared several weeks after the surgery. The residual cells induced fibrotic PCO. In the other specimens, most LECs around the IOL optic except the anterior capsular margin were negative for α-SMA. In the peripheral region covered by the peripheral anterior and posterior capsules, LECs on the posterior capsule always differentiated into lens fiber cells and formed a Soemmering ring. Thereafter, migration of lens fiber cells from the Soemmering ring and differentiation of LECs in situ on the central posterior capsule consisted of Elschnig pearls type of PCO. Conclusions. Although postoperative LEC behavior is not consistent, residual α-SMA-positive LECs induced fibrotic PCO. The lens fiber cells that migrated from the peripheral capsular bag or that were differentiated in situ covered the central posterior capsule, forming Elschnig pearls with PCO.
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Pérez-Vives, Cari. "Biomaterial Influence on Intraocular Lens Performance: An Overview." Journal of Ophthalmology 2018 (2018): 1–17. http://dx.doi.org/10.1155/2018/2687385.
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There is strong evidence that the IOL material is the factor having the greatest impact on posterior capsule opacification (PCO), anterior capsule opacification (ACO) development, and glistening formation after cataract surgery, even though there are other IOL features—such as haptic material and design and edge and optic design—that also have some influence. We reviewed the published literature describing the adverse events that are mainly related to the intraocular lens (IOL) material, such as PCO, ACO, and the subsequent capsule contraction, as well as glistening formation. The adverse events presented in this overview are the most common ones in clinical practice, and therefore, they are generally included in the clinical protocols for IOL evaluation.
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Wilczyński, Tomasz K., Alfred Niewiem, Rafał Leszczyński, and Katarzyna Michalska-Małecka. "Recurrent Intraocular Lens Dislocation in a Patient with Familial Ectopia Lentis." International Journal of Environmental Research and Public Health 18, no. 9 (April 25, 2021): 4545. http://dx.doi.org/10.3390/ijerph18094545.
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A 36-year-old patient presented to the hospital with recurrent dislocation of the intraocular lens (IOL). The patient with the diagnosis of familial ectopia lentis was first operated on for crystalline lens subluxation in the left eye in 2007 and in the right eye in 2009. In both eyes, lens extraction with anterior vitrectomy and transscleral fixation of a rigid IOL was performed. In 2011, the IOL in the right eye luxated into the vitreous cavity due to ocular trauma. The patient underwent a pars plana vitrectomy with the IOL resuturation to the sclera. Seven years later, a spontaneous vision loss in the right eye was caused by a retinal detachment. The pars plana vitrectomy with silicone oil tamponade and a consequential oil removal three months later were performed in 2018. The follow-up examination revealed recurrent IOL dislocation in the same eye. Due to a history of previous suture-related complications a decision was made to remove the subluxated rigid polymethyl-methacrylate (PMMA) IOL and fixate to sclera a sutureless SOLEKO FIL SSF Carlevale lens. The purpose of this report is to present a single case of a 36-year-old patient who was presented to the hospital with recurrent dislocation of the intraocular lens. In a three-month follow-up period, a good anatomical and functional outcome was finally obtained with transscleral sutureless intraocular lens. This lens is an option worth considering especially in a young patient with a long life expectancy and physically active.
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Potemkin, V. V., S. Yu Astakhov, E. V. Goltsman, and Syao Yu Van. "Assessment of Risk Factors for the Development of Late Intraocular Lens Dislocation." Ophthalmology in Russia 18, no. 1 (April 4, 2021): 103–9. http://dx.doi.org/10.18008/1816-5095-2021-1-103-109.
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Dislocation of intraocular lens is a serious complication of phacoemulsification with implantation of intraocular lens. Among the causes of early dislocation of intraocular lens intraoperative complications predominate, as well as various form of their mixed fixation. In the late postoperative period, dislocation of the capsular bag-intraocular lens complex mainly occurs, the main reasons for which are the zonular weakness and the failure of the capsular bag support or its fibrosis.Purpose: to assess the influence of various factors on the development of late IOL dislocation (both in the capsular bag and without it) requiring surgical correction.Patientes and methods. The study included 78 patients (78 eyes) who were underwent surgical treatment of varying degree of IOL dislocation from October 2018 to April 2020. The control group consisted of 62 patients recruited for surgical treatment of cataract at the same period. The main factors for assessment were the following: axial myopia (≥26 mm), previous vitreoretinal surgery, recurrent uveitis, primary glaucoma, retinitis pigmentosa, and the use of the capsular tension ring during phacoemulsification.Results. Among the factors studied, the following risk factors of late IOL dislocation were revealed: age, gender, the presence of pseudoexfoliation syndrome, axial myopia, primary glaucoma, implantation of the capsular tension ring. Conclusion. Phacoemulsification is the standard surgical treatment of cataract. However, in patients with potential risk factors of developing IOL dislocation, surgeons should consider the use of additional IOL fixation.
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Ferreira, Tiago Bravo. "Multifocal Toric Intraocular Lenses." European Ophthalmic Review 11, no. 01 (2017): 23. http://dx.doi.org/10.17925/eor.2017.11.01.23.
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Meticulous correction of astigmatism during cataract surgery is mandatory in cases of multifocal intraocular lens (IOL) implantation. Toric multifocal IOLs allow predictable astigmatic correction during cataract surgery. In this editorial, we review our investigation on the Tecnis ZMT IOL (Abbott Medical Optics, CA, US) as well as other recent developments in multifocal toric IOLs.
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Joshi, Rajesh S. "Posterior capsular calcification without opacification of intraocular lens." Nepalese Journal of Ophthalmology 8, no. 1 (December 12, 2016): 91–94. http://dx.doi.org/10.3126/nepjoph.v8i1.16145.
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Background: Posterior capsular clarity is important for long-term visual gain. Postoperative visual acuity could be reduced due to posterior capsular or intraocular lens opacification, which occur months or years after cataract surgery. We report early occurrence of posterior capsular calcification without opacification of intraocular lens. Case: We report the case of a 78-year-old male who had undergone phacoemulsification with implantation of hydrophilic intraocular lens (IOL) in the left eye for cataract. The patient was non-diabetic, and the surgical procedure was uneventful. On the third postoperative day, fine granular deposits were found on the mid-peripheral part of the posterior capsule. No deposits were found on IOL. The patient presented with diminished vision four months after surgery. Slit-lamp examination revealed distinct areas of calcification with an early opacification of the posterior capsule and no IOL calcification. Neodymium doped: YAG capsulotomy was done to clear posterior capsular opacification, and the patient regained visual acuity of 20/20. To the best of our knowledge, this report is the first to investigate posterior capsular calcification without opacification of IOL in a patient without any known etiological factors. Conclusion: This case is reported to stimulate future study on the use of BSS plus and the development of posterior capsular or IOL calcification. Nepal J Ophthalmol 2016; 8(15): 91-94
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Trivedi, R. H., L. Werner, D. J. Apple, S. K. Pandey, and A. M. Izak. "Post cataract-intraocular lens (IOL) surgery opacification." Eye 16, no. 3 (May 2002): 217–41. http://dx.doi.org/10.1038/sj.eye.6700066.
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Ibrahim, Hesham A., and Heba Nabil Sabry. "The Balanced Two-String Technique for Sulcus Intraocular Lens Implantation in the Absence of Capsular Support." Journal of Ophthalmology 2015 (2015): 1–5. http://dx.doi.org/10.1155/2015/153963.
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Purpose. To describe and explore an alternative approach for sulcus intraocular lens (IOL) implantation in the absence of capsular support.Methods. The commonly available one-piece poly(methyl methacrylate) (PMMA) lens is stabilized in the sulcus by two intraocular horizontal strings of 10/0 polypropylene suture passed through the lens dialing holes in opposite directions to achieve a mechanical balance. The horizontal strings of 10/0 polypropylene work as a rail track for the IOL optics, allowing some side to side lens adjustment even following wound closure. The stability of the IOL was tested in vitro. Six aphakic patients underwent in-sulcus IOL secondary implantation using the balanced two-string technique. Patients were followed up for a minimum of six months. Best spectacle corrected vision was assessed. Lens centration and lens tilt were measured by anterior segment optical coherence tomography (AS-OCT).Results. All patients had successful lens insertion. Best spectacle corrected visual acuity (BSCVA) improved in all patients. Lens decentration ranged between 0.21 mm and 0.9 mm (average 0.53 mm). Lens tilt ranged between 1.2° and 2.8° (average 2.17°).Conclusion. The mechanically balanced two-string technique is an alternative option for sulcus IOL implantation in absence of capsular support, allowing lens centration adjustment with no additional risks.
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Chaudhry, Mrindu, Keerti Mundey, Shikha Baisakhiya, and Sumita Sethi. "Intra-ocular lens opacification in the anterior chamber leading to loss of vision in an adolescent." Nepalese Journal of Ophthalmology 6, no. 1 (July 22, 2014): 102–4. http://dx.doi.org/10.3126/nepjoph.v6i1.10780.
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Objective: To report a rare case of intraocular lens (ACIOL) opacification in the anterior chamber in an adolescent and to discuss the possible mechanism of its occurrence and the ways of its prevention. Case: A 16-year-old male underwent cataract surgery for developmental cataract with placement of a foldable posterior chamber IOL in the anterior chamber. There was subsequent opacification of the IOL, which was replaced by a scleral fixated posterior chamber intraocular lens. The post-operative visual acuity improved to 6/18. Conclusion: The posterior chamber IOL implanted in the anterior chamber can get opacified possibly due to postoperative intraocular inflammation. DOI: http://dx.doi.org/10.3126/nepjoph.v6i1.10780 Nepal J Ophthalmol 2014; 6 (2): 102-104
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Lertjirachai, Itsara, Maxwell S. Stem, Bozho Todorich, Jeremy D. Wolfe, and Antonio Capone. "Intraocular Lens Repositioning With Polypropylene Suture to Reduce Optic Tilt." Journal of VitreoRetinal Diseases 2, no. 1 (November 22, 2017): 48–50. http://dx.doi.org/10.1177/2474126417744673.
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Purpose: To describe a technique to reduce intraocular lens (IOL) tilt after sutureless intrascleral (SIS) fixation. Methods: Case report with review of surgical technique. Results: We report a technique that can be used to correct IOL tilt that may rarely accompany SIS IOL fixation. The procedure involves placing pupil-spanning polypropylene sutures on either side of the IOL optic to keep the optic parallel to the plane of the iris. Conclusion: Sutureless intrascleral IOL tilt correction can be achieved using polypropylene suture, thus obviating the need for more invasive surgical maneuvers, such as IOL exchange.
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Loh, Huey Peng, Dirk Frans de Korne, Soon Phaik Chee, and Ranjana Mathur. "Reducing wrong intraocular lens implants in cataract surgery." International Journal of Health Care Quality Assurance 30, no. 6 (August 14, 2017): 492–505. http://dx.doi.org/10.1108/ijhcqa-06-2016-0095.
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Purpose Wrong lens implants have been associated with the highest frequency of medical errors in cataract surgery. The purpose of this paper is to explore the use of the Systems Engineering Initiative for Patient Safety (SEIPS) framework to sustainably reduce wrong intraocular lens (IOL) implants in cataract surgery. Design/methodology/approach In this mixed-methods study, the SEIPS framework was used to analyse a series of (near) misses of IOL implants in a national tertiary specialty hospital in Singapore. A series of interventions was developed and applied in the case hospital. Risk assessment audits were done before the interventions (2012; n=6,111 surgeries), during its implementation (n=7,475) and in the two years post-interventions (2013-2015; n=39,390) to compare the wrong IOL-rates. Findings Although the absolute number of incidents was low, the incident rate decreased from 4.91 before to 2.54 per 10,000 cases after. Near miss IOL error decreased from 5.89 before to 3.55 per 1,000 cases after. The number of days between two IOL incidents increased from 35 to an initial peak of 385 before stabilizing on 56. The large variety of available IOL types and vendors was found as the main root cause of wrong implants that required reoperation. Practical implications The SEIPS framework seems to be helpful to assess components involved and develop sustainable quality and safety interventions that intervene at different levels of the system. Originality/value The SEIPS model is supportive to address differences between person and system root causes comprehensively and thereby foster quality and patient safety culture.
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Çaça, I., K. Ünlü, S. Ari, and I. Aksit. "Spontaneous Fracture of an Implanted Posterior Chamber Intraocular Lens." European Journal of Ophthalmology 15, no. 4 (July 2005): 507–9. http://dx.doi.org/10.1177/112067210501500416.
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Purpose Spontaneous fracture of an intraocular lens (IOL) haptic is a rare complication of cataract surgery. The authors report a case of spontaneous fracture of an implanted posterior chamber IOL. Case Five years ago, a 12-year-old patient underwent linear lens extraction, posterior capsulotomy, and anterior vitrectomy due to traumatic cataract and received a polymethyl methacrylate (PMMA) biconvex posterior chamber IOL implanted in ciliary sulcus. Five years later, IOL optic was found in anterior chamber with its haptics broken from the optic-haptic junction. Discussion The broken haptic was examined with scanning electron microscopy. The fracture site of the haptic was on the optic-haptic junction. The fractured surface had a regular appearance. Conclusions To our knowledge, this is the fourth report of spontaneous fracture of an implanted posterior chamber IOL.
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Spierer, Oriel, and Terrence P. O’Brien. "Spontaneous Scleral Perforation of an Anterior Chamber Intraocular Lens." Case Reports in Ophthalmology 7, no. 1 (May 9, 2016): 249–52. http://dx.doi.org/10.1159/000445880.
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A routine eye examination of a 69-year-old man revealed a scleral perforation of one of the haptics of the anterior chamber intraocular lens (AC IOL) which had been implanted many years ago. The patient was asymptomatic with good visual acuity. His history was negative for any trauma, eye rubbing, topical corticosteroid use, or autoimmune disease. The horizontal and vertical white-to-white diameters of the cornea in the right eye were 11.5 and 10.5 mm, respectively. Anterior segment optical coherence tomography showed the anterior chamber length to be 12.28 mm horizontally and 10.63 mm vertically. The patient underwent an IOL exchange, and the length of the explanted AC IOL was measured to be 12 mm. We speculate that the AC IOL, which was vertically aligned, was oversized. This case demonstrates the need for proper sizing and positioning of an AC IOL. In complex cases where AC IOL may be used, measuring the horizontal and vertical lengths of the anterior chamber by anterior segment optical coherence tomography prior to surgery may be useful.
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Gupta, Nishant, Jagat Ram, Manish Chaudhary, Jaspreet Singh Sukhija, and Jaidrath Kumar. "Late Opacification of Foldable Intraocular Lenses." Journal of Postgraduate Medicine, Education and Research 46, no. 2 (2012): 95–97. http://dx.doi.org/10.5005/jp-journals-10028-1020.
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ABSTRACT Objective To report opacification of hydrophilic acrylic and silicone foldable intraocular lenses (IOL). Designs Case series. Participants Five patients with IOL opacification. Results We report five eyes of five patients with late opacification of the intraocular lens (IOL). Three patients had hydrophilic acrylic (SC60B-OUV-MDR, Inc), two had silicone IOL (Allergan SI30NB). Two out of the three patients with opacified hydrophilic acrylic IOLs had diabetes mellitus. Three eyes with opacified acrylic IOL underwent IOL exchange with hydrophobic acrylic IOL. Two silicone IOL patients had no visually significant opacification and were managed conservatively. Conclusion IOL optic opacification in hydrophilic acrylic and silicone IOL may be due to defective material, manufacturing process, storage. How to cite this article Ram J, Gupta N, Chaudhary M, Sukhija JS, Gupta A, Kumar J. Late Opacification of Foldable Intraocular Lenses. J Postgrad Med Edu Res 2012;46(2):95-97.
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Fan, Qi, Xiaoyan Han, Xiangjia Zhu, Lei Cai, Xiaodi Qiu, Yi Lu, and Jin Yang. "Clinical Characteristics of Intraocular Lens Dislocation in Chinese Han Populations." Journal of Ophthalmology 2020 (April 27, 2020): 1–8. http://dx.doi.org/10.1155/2020/8053941.
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Purpose. To investigate the clinical characteristics of patients with intraocular lens (IOL) dislocation after IOL implantation in Chinese Han populations. Methods. The medical records of patients with IOL dislocation were retrospectively reviewed from January 2007 to December 2017, and a total of 312 patients (male: 231, female: 97) (328 eyes) were included in this study. The axial length (AL), IOL power, and the time interval between cataract surgery and IOL dislocation as well as the ocular conditions associated with IOL dislocation were recorded. The IOL dislocation was classified and graded based on its relationship with the capsule and the position of the dislocated IOL. Results. The mean time between original cataract surgery and IOL dislocation was 5.63 ± 5.13 years; IOL dislocation occurred in up to 56.1% (184 eyes) of the eyes within 5 years. Trauma was found in 136 eyes (41.5%); pars plana vitrectomies were performed in 61 eyes (18.6%), and high myopia was detected in 108 eyes (32.9%). A total of 243 eyes (74.1%) had out-of-the-bag IOL dislocations, while 85 eyes (25.9%) had in-the-bag IOL dislocations. There was a statistically significant difference in the constituent ratio of trauma between in-the-bag dislocation and out-of-the-bag dislocation (Pearson’s chi2 = 33.3992, P<0.001); ocular blunt traumas were significantly higher in in-the-bag dislocations, while open-globe injuries were significantly higher in out-of-the-bag dislocations. A statistically significant difference was found for the ratio of patients with AL longer than 30 mm between in-the-bag dislocation and out-of-the-bag dislocation (Pearson’s chi2 = 9.7355, P<0.002). Conclusions. In Chinese Han populations, the most common IOL dislocation is out-of-the-bag dislocation; the most common risk factors were trauma, long axial length, and eyes undergoing pars plana vitrectomy; a minimum follow-up of 5 years is suggested for IOL dislocation-predisposed eyes undergoing cataract surgery.
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Potemkin, Vitaly V., and Elena V. Goltsman. "METHODS OF SURGICAL CORRECTION OF INTRAOCULAR LENS DISLOCATION AND APHACIA (review of literature)." Scientific Notes of the Pavlov University 26, no. 1 (August 23, 2019): 20–28. http://dx.doi.org/10.24884/1607-4181-2019-26-1-20-28.
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Over the last several decades, there has been breakthrough in cataract surgery. The rate of intraoperative complications was minimized. One of the most common complications remained the intraocular lens (IOL) dislocations due to inadequate capsular bag support. Thus, the search for an effective and safe method of the IOL fixation in the absence of adequate support of the lens capsule continued to be one of the major problems in anterior segment surgery. This review was devoted to the main methods of correction of intraocular lens dislocation and aphacia.
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Bonafonte Marquez, Elena, and Sergio Bonafonte Royo. "Bilateral Pseudoexfoliation Deposits on Intraocular Lens Implants." Case Reports in Ophthalmological Medicine 2015 (2015): 1–3. http://dx.doi.org/10.1155/2015/560508.
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We present a rare case of bilateral pseudoexfoliative deposits on both intraocular lens (IOL) implants in an 83-year-old woman with no other associated pathology, 5 years after cataract surgery. Pseudoexfoliation syndrome is the most common cause of secondary open-angle glaucoma worldwide and these deposits are usually found on the natural lens. The fact that pseudoexfoliative deposits have been found on IOL implants implies the need for a thorough examination in pseudophakic patients, for it could be the only sign of secondary glaucoma.
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Jirásková, N., P. Rozsíval, and A. Kohout. "A Survey of Intraocular Lens Explantation: A Retrospective Analysis of 23 IOLs Explanted during 2005." European Journal of Ophthalmology 17, no. 4 (July 2007): 579–87. http://dx.doi.org/10.1177/112067210701700416.
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Purpose To evaluate the indications, lens styles, perioperative findings, and results of intraocular lens (IOL) explantation or exchange performed in the authors department in 2005. Methods The retrospective analysis comprised 22 patients (23 eyes). Twenty-one eyes had previous phacoemulsification and IOL implantation, one eye secondary aphakic IOL, and one eye phakic IOL implantation. The indications for IOL explantation/exchange and perioperative complications were evaluated. The best-corrected visual acuity (BCVA) before and after surgery was compared. Results Time from initial surgery to explantation/exchange varied from 1 to 121 months, median value was 46 months. The IOLs were explanted using local anesthesia and in 21 eyes replaced with new lens. Indications for IOL removal were opacification of the IOL in 12 eyes, malposition of the IOL in 5 eyes, postoperative refractive error in 2 eyes, recurrent toxic anterior segment syndrome in 1 eye, pseudophakic dysphotopsia in 1 eye, endothelial cell loss in phakic anterior chamber IOL in 1 eye, and visual discomfort with intraocular telescopic lens in 1 eye. The mean BCVA (decimal scale) before and after IOL explantation/exchange was 0.562±0.279 and 0.627±0.276, respectively. There was no significant difference in visual acuity before and after IOL exchange (Wilcoxon test). Conclusions The most frequent indications for IOL explantation/exchange were opacification of the IOL and IOL malposition. Surgeries were uneventful in most cases. Final visual results have been largely good. Long-term follow-up of patients with various types of IOLs should be maintained.
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Joshi, Vineet Pramod, and Pravin Krishna Vaddavalli. "Corneal oedema with in situ implantable collamer lens: a challenging scenario for descemet membrane endothelial keratoplasty." BMJ Case Reports 14, no. 5 (May 2021): e240709. http://dx.doi.org/10.1136/bcr-2020-240709.
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A 27-year-old woman had foggy vision and photophobia since 10 months after implantation of implantable collamer lens (ICL STAAR Surgical AG, Nidau, Switzerland) with evidence of corneal decompensation and no cataract formation. Descemet membrane endothelial keratoplasty in phakic eyes is challenging, considering presence of posterior chamber phakic intraocular lens (IOL), decreasing the space available in anterior chamber to manoeuvre the graft. Need of inferior peripheral iridotomy in presence of central hole technology in ICL depends on the dynamics of full chamber air bubble. At 8 months, vision had improved to 20/20 and normal IOP with well-attached graft, stable phakic IOL and clear lens.
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Shrestha, Chunu, Sabina Shrestha, and Aparajita Manoranjan. "Visual outcome following scleral fixated intraocular lens implantation." Medical Journal of Shree Birendra Hospital 16, no. 2 (December 23, 2017): 63–68. http://dx.doi.org/10.3126/mjsbh.v16i2.18478.
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Introduction: Scleral fixated intraocular lens(SFIOL) implantation to correct aphakia offers superior visual rehabilitation in comparison to aphakic spectacles or contact lens. This study was done to evaluate a simplified technique of scleral fixation of posterior chamber intra-ocular lens (IOL) in terms of visual outcome and complications.Methods: This was a prospective study enrolling 23 eyes of 23 patients who underwent anterior vitrectomy followed by ab-externo sclera fixation of posterior chamber IOL using 10.0 polypropylene sutures from January 2016 to February 2017 in Nepal Eye Hospital.Scleral flap was made at 3 and 9'o clock meridian to cover the knots which prevent erosion of the knots through conjunctiva. Main outcome measures were post-operative best corrected visual acuity and post-operative complications.Result: Best corrected visual acuity were 6/6 - 6/18 in 86.9% (n=20), 6/24 - 6/60 in 8.7% (n=2) and worse than 6/60 in 4.3% (n=1)at six months followup. The mean spherical equivalent before surgery was +10.60 diopter and -1.14 diopter post-surgery. The common indicationsfor scleral fixated intraocular lens weretrauma in 60.86% (n=14), surgical aphakia in21.73% (n=5), spontaneous posterior dislocation of lens in 13.0% (n=3) and subluxated intraocular lens in 4.34% (n=1). The common complications were astigmatism in 91.30% (n=21), decentered IOL in 4.34% (n=1) and uveitis in 4.35% (n=1).Conclusion: Ab-externosclerated fixated intraocular lens is a safe and effective method for visual rehabilitation with low post-operative risk.
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El-Massry, Ahmed, Eiman Abdellatif, and Mohamed Ahmed El-Massry. "Refractive Lens Exchange." European Ophthalmic Review 09, no. 01 (2015): 17. http://dx.doi.org/10.17925/eor.2015.09.01.17.
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Refractive lens exchange (RLE) still has a role in young age with anisometropia, or in an eye that is anatomically not suitable for phakic intraocular lens (IOL) implantation or in high hypermetropia. Furthermore, in the presence of water vacuoles in the crystalline lens above the age of 40, it is recommended to perform RLE rather than phakic IOL implantation. Multifocal refractive IOLs are designed with several optical zones on the IOL. Apodised diffractive multifocal IOL has gradual diffractive steps on the IOL implant that create a smooth transition between focal points. RLE is a surgery with the same risks of a cataract surgery. Complications do occur in RLE. The mean incidence of retinal detachment is 1 % while the mean incidence of cystoid macular oedema is 0.1 %. Contraindications include unstable refraction, amblyopia and the presence of certain eye pathologies as age-related macular degeneration, glaucoma, diabetic retinopathy and a high risk of retinal detachment.
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Egorova, E. V. "Anatomical and Topographical Relations between the Posterior Lens Capsule and the Intraocular Lens in Pseudoexfoliation Syndrome." Ophthalmology in Russia 15, no. 2S (July 28, 2018): 134–39. http://dx.doi.org/10.18008/1816-5095-2018-2s-134-139.
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Purpose— to study the relations between the posterior capsule (PC) and intraocular lens (IOL) after cataract surgery in pseudoexfoliation syndrome (PEX).Patients and methods. We examined 46 eyes of 37 patients with PEX who underwent a standard and uncomplicated phacoemulsification. The age of patients was 60–94 years. Postoperative period ranged from 1 day to 10 years. An optical coherence tomography (OCT) (RTVue XR Avanti, “Optovue”) was used to image the IOL-PC space in early and late postoperative period.Results. In the first days full contact PC-IOL was not observed in any case. The maximum of space PC-IOL was noted on the first day postoperatively. Posterior capsule had a wavy or folded profile on the scans. In the next two weeks we observed a decrease of the distances between posterior capsule and IOL. After 1 month we noted the formation of capsular bend around optic edge, the full adhesion of posterior capsule to IOL was not detected. In the late postoperative period the fibroplastic and proliferative capsular changes with secondary discontact PC-IOL was noted. Primary inadhesion of a posterior capsule to IOL was recorded in half of the cases.и. High resolution OCT was suitable for quantitative analysis of IOL-PC space. Involution changes in structures of anterior segment in the eyes with PEX had a role in closure of the IOL-PC space. Complete adhesion of posterior capsule to IOL was not observed in the majority of eyes with PEX.
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Veronese, Chiara, Chiara Maiolo, Grayson W. Armstrong, Laura Primavera, Carlo Torrazza, Livia Della Mora, and Antonio P. Ciardella. "New surgical approach for sutureless scleral fixation." European Journal of Ophthalmology 30, no. 3 (January 30, 2020): 612–15. http://dx.doi.org/10.1177/1120672120902020.
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Purpose: The aim of this article is to describe a novel surgical technique for sutureless scleral fixation of an intraocular lens using the newly developed FIL SSF Carlevale IOL (Soleko, Italy). Methods: Four eyes of four patients with poor capsular support were recruited to our study, three resulting from intraocular lens subluxation and one case resulting from traumatic cataract. A novel sutureless sclera-fixated intraocular lens was implanted into the posterior chamber of each eye with sclerocorneal plugs fixating the lens to the wall of the eye. Results: Mean age of patients was 52 ± 16 years, ranging from 35 to 70 years. Mean follow-up was 6.50 ± 1.29 months (range: 5–7 months). Mean preoperative best-corrected visual acuity was 0.50 ± 0.33 logMAR (range: 1–0.3 logMAR). Postoperative best-corrected visual acuity improved to 0.08 ± 0.08 logMAR (range: 0.2–0 logMAR). There was no significant change in the mean intraocular pressure and there were no postoperative complications, such as iatrogenic distortion or breakage of the intraocular lens haptic, intraocular lens decentration, endophthalmitis, or retinal detachment. Discussion: To the best of our knowledge, this is the first report of outcomes using the novel sutureless sclera-fixated FIL SSF Carlevale IOL. This new surgical technique offers a simplified and effective approach for sutureless scleral intraocular lens fixation with good refractive outcomes.
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Terauchi, Gaku, Celso Soiti Matsumoto, Kei Shinoda, Harue Matsumoto, and Atsushi Mizota. "Effect of Intraocular Lens Diameter Implanted in Enucleated Porcine Eye on Intraocular Pressure Induced by Scleral Depression." BioMed Research International 2014 (2014): 1–5. http://dx.doi.org/10.1155/2014/586060.
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The effect of the diameter of an intraocular lens (IOL) implanted in enucleated porcine eyes on the intraocular pressure induced by scleral depression was investigated. Two IOLs of 6 mm and 7 mm optic diameter were implanted. The intraocular pressure (IOP) was monitored during scleral depression by a transducer placed in the midvitreous through a sclerotomy at 6 o’clock. The area under the curve (AUC) of the IOP changes from the beginning of the indentation to the point when the peripheral retinal surface was observed through the IOL optics was measured. The AUC was significantly larger in eyes with a 6 mm IOL than in eyes with a 7 mm IOL (p<0.05). The IOP elevation at the endpoint was higher in eyes with the 6 mm IOL than in eyes with the 7 mm IOL. We conclude that the AUC may represent the degree of stress induced by scleral depression. The higher AUC value with the X-60 may be because of the longer distance from the peripheral retina to the edge of the IOL optics.
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Gonde, Payal P., and Sagar Aghadate. "Safety and efficacy of glued intraocular lens implantation in eyes with inadequate capsular support." International Journal of Research in Medical Sciences 8, no. 4 (March 26, 2020): 1419. http://dx.doi.org/10.18203/2320-6012.ijrms20201335.
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Background: Aim of the study was to analyze the postoperative visual outcomes, complication rate of fibrin glue-assisted, suture-less posterior chamber (PC) intraocular lens (IOL) implantation technique in eyes with inadequate capsule support at a tertiary eye care hospital.Methods: This is a retrospective, nonrandomized case series. This study analyzes 50 eyes which underwent PC-IOL implantation by fibrin glue-assisted, suture-less technique. All patients who had IOL implants by the fibrin glue-assisted PC-IOL technique from 2017 to 2019 were included in the study. Intra- and post-operative complications were analyzed. The postoperative best corrected visual acuity (BCVA) was evaluated and recorded at the end of 6 months.Results: Mean age of distribution are 42.94 years in glued IOL implantation. Among 50 cases 30 are males and 20 are females. There is significant difference in BCVA between preoperatively and postoperatively, p value for pre-operative to post-operative vision in glued intraocular lens group is <0.0001 i.e. there is definite improvement in vision in glued intraocular group. BCVA ≥6/24 was 18 (48%) in Glued IOL subjects.Conclusions: Glued IOL implantation is a feasible option in rehabilitating patients with aphakia without adequate capsular support.
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Chui, Juanita Noeline, and Keith Ong. "Improving the prediction of effective lens position for intraocular lens power calculations." Asian Journal of Ophthalmology 17, no. 2 (April 30, 2020): 233–42. http://dx.doi.org/10.35119/asjoo.v17i2.585.
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Purpose: Achieving the desired post-operative refraction in cataract surgery requires accurate calculations for intraocular lens (IOL) power. Latest-generation formulae use anterior-chamber depth (ACD)—the distance from the corneal apex to the anterior surface of the lens—as one of the parameters to predict the post-operative IOL position within the eye, termed the effective lens position (ELP). Significant discrepancies between predicted and actual ELP result in refractive surprise. This study aims to improve the predictability of ELP. We hypothesise that predictions based on the distance from the corneal apex to the mid-sagittal plane of the cataractous lens would more accurately reflect the position of the principal plane of the non-angulated IOL within the capsular bag. Accordingly, we propose that predictions derived from ACD + ½LT (length thickness) would be superior to those from ACD alone.
Design: Retrospective cohort study, comparing ELP predictions derived from ACD to aproposed prediction parameter.
Method: This retrospective study includes data from 162 consecutive cataract surgery cases, with posterior-chamber IOL (AlconSN60WF) implantation. Pre- and postoperative biometric measurements were made using the IOLMaster700 (ZEISS, Jena, Germany). The accuracy and reliability of ELP predictions derived from ACD and ACD + ½LT were compared using software-aided analyses.
Results: An overall reduction in average ELP prediction error (PEELP) was achieved using the proposed parameter (root-mean-square-error [RMSE] = 0.50 mm), compared to ACD (RMSE = 1.57 mm). The mean percentage PEELP, comparing between eyes of different axial lengths, was 9.88% ± 3.48% and −34.9% ± 4.79% for predictions derived from ACD + ½LT and ACD, respectively. A 44.10% ± 5.22% mean of differences was observed (p < 0.001).
Conclusion: ACD + ½LT predicts ELP with greater accuracy and reliability than ACD alone; its use in IOL power calculation formulae may improve refractive outcomes.
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Ong, Keith, and Linda Feng. "Prevalence of variation in predicted refraction between different intraocular lens formulae." Asian Journal of Ophthalmology 16, no. 2 (November 18, 2018): 60–61. http://dx.doi.org/10.35119/asjoo.v16i2.389.
Full textAbstract:
Variations of 0.5 D in predicted refraction between the different intraocular lens (IOL) calculation formulae may occur in 19.4% cases. This has implications when reporting refractive surprise. It also shows that it is beneficial to consider more than one IOL formula when choosing IOL power for cataract surgery.
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Hassan, Alahmady Hamad Alsmman, Khulood M. Sayed, Mohammed ElAgooz, and Ashraf Mostafa Elhawary. "Refractive Results: Safety and Efficacy of Secondary Piggyback Sensar™AR40 Intraocular Lens Implantation to Correct Pseudophakic Refractive Error." Journal of Ophthalmology 2016 (2016): 1–5. http://dx.doi.org/10.1155/2016/4505812.
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In this study we evaluate the visual outcomes, safety, efficacy, and stability of implanting of second sulcus intraocular lens (IOL) to correct unsatisfied ametropic patients after phacoemulsification.Methods.Retrospective study of 15 eyes (15 patients) underwent secondary intraocular lens implanted into the ciliary sulcus. The IOL used was a Sensar IOL three-piece foldable hydrophobic acrylic IOL. The first IOL in all patients was acrylic intrabagal IOL implanted in uncomplicated phacoemulsification surgery.Results.Fifteen eyes (15 patients) were involved in this study. Preoperatively, meanlogMARUDVA and CDVA were 0.88 ± 0.22 and 0.19 ± 0.13, respectively, with a mean follow-up of 28 months (range: 24 to 36 months). At the end of the follow-up, all eyes achievedlogMARUDVA of 0.20 ± 0.12 with postoperative refraction ranging from 0.00 to −0.50 D of attempted emmetropia.Conclusions.Implantation of the second sulcus SensarAR40 IOL was found to be safe, easy, and simple technique for management of ametropia following uncomplicated phacoemulsification.
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Turczynowska, Magdalena, Katarzyna Koźlik-Nowakowska, Magdalena Gaca-Wysocka, and Andrzej Grzybowski. "Effective Ocular Biometry and Intraocular Lens Power Calculation." European Ophthalmic Review 10, no. 02 (2016): 94. http://dx.doi.org/10.17925/eor.2016.10.02.94.
Full textAbstract:
Since the introduction of phacoemulsification, cataract surgery has evolved remarkably. The use of premium intraocular lenses (IOLs) (aspheric, toric, multifocal), refractive lens exchange and patients after refractive surgery procedures require extremely precise clinical measurements and IOL calculation formulas to achieve desired postoperative refraction. For many years, ultrasound biometry has been the standard for measurement of ocular parameters. The introduction of optical biometry (fast and non-invasive) has replaced ultrasound methods and is now considered as the clinical standard for ocular biometry. Recently, several modern optical instruments have been commercially launched and there are new methods available, including the empirical, analytical, numerical or combined methods to determine IOL power. The aim of this review is to present current techniques of ocular biometry and IOL power calculation formulas, which will contribute to achieve highly accurate refractive outcomes.
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Verdonck, Thomas, Liliana Werner, Sorcha Ní Dhubhghaill, and Marie-José Tassignon. "Clinical and Surgical Outcome of a Supplementary Multifocal Intraocular Lens Implanted with a Bag-In-the-Lens Intraocular Lens: 5-Year Follow-Up." Ophthalmic Research 64, no. 3 (December 16, 2020): 503–11. http://dx.doi.org/10.1159/000513790.
Full textAbstract:
<b><i>Introduction:</i></b> To assess the postoperative outcome and patient-reported satisfaction, spectacle independence, and dysphotopsia after implantation with the mutifocal Rayner Sulcoflex supplementary intraocular lens (sIOL). <b><i>Materials and Methods:</i></b> We analyzed the outcome of all patients implanted with a multifocal sIOL between 2009 and 2011. In all cases, the sIOL was the Rayner Sulcoflex IOL (type 653F) and the primary IOL was a bag-in-the-lens (BIL) IOL. The data were obtained through a retrospective analysis of the patient records and by means of a questionnaire, 5 years after sIOL implantation. <b><i>Results:</i></b> This study included 31 eyes of 20 patients. In 13 eyes, the sIOL needed explantation (<i>n</i> = 13, 41.94%). Dysphotopsia is a frequent complaint (12/15 patients: 80.0%) after sIOL implantation. In 13 out of 31 eyes (41.94%), pigment deposits were found on the sIOL with variable clinical complaints. Five eyes required additional surgery because of clinically significant deposits. <b><i>Discussion/Conclusion:</i></b> Patients with a multifocal sIOL in combination with a BIL implantation have a higher incidence of dysphotopsia compared to previously published studies. Dysphotopsia was the main complaint and reason for explantation. We encountered a high incidence of pigmented IOL deposits. The sIOLs can be safely removed even years after implantation.
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Lan, Xiaorong, Yang Lei, Zhoukun He, Anlin Yin, Linhua Li, Zhonglan Tang, Meiling Li, and Yunbing Wang. "A transparent hydrophilic anti-biofouling coating for intraocular lens materials prepared by “bridging” of the intermediate adhesive layer." Journal of Materials Chemistry B 9, no. 17 (2021): 3696–704. http://dx.doi.org/10.1039/d1tb00065a.
Full textAbstract:
The attachment of bio-foulants can lead to implantation failure of intraocular lens (IOL). A facile strategy is provided to prepare a hydrophilic anti-biofouling coating on IOL. A “bridge” can increase the adhesion between the coating and IOL.
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Kuznetsov, S. L. "Light Reflection from the Intraocular Lens and a Way to Reduce It. Theoretical Study." Ophthalmology in Russia 15, no. 3 (October 5, 2018): 318–24. http://dx.doi.org/10.18008/1816-5095-2018-3-318-324.
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The purposeof the study was to examine the effect of the intraocular lens (IOL) position in the probability of occurrence of the phenomenon of light reflection from its surface and to justify the method of its reduction from the standpoint of the optics laws and eye anatomical parameters.Methods.Based on the laws of physical optics, the reflection of light from the surfaces of the IOL was calculated. The phenomenon of light reflection from the IOL was analyzed, in particular, influence such factors as the lens position in the eye and pupil diameter on its occurrence.Results.It was found that with increasing of distance from the iris to posterior chamber IOL, the angle of appearance of the phenomenon of light reflection from the lens decreases significantly, with the most significant change (angle narrowing from 80° to 19°, i.e., 4.21 times) with increasing of the distance from 1 to 3 mm, which is quite achievable at the present stage of intraocular correction. It was shown that the pupil diameter is less influences by appearance of the phenomenon of light reflection from the lens: it is significant only at a minimum distance from the iris to the IOL (the position of the standard posterior chamber IOL) and insignificant when the IOL is removed from the iris. The obtained results demonstrate the optimality of the method for preventing the appearance of the phenomenon of light reflection from the IOL by removing the intraocular lens from the iris at a distance corresponding to the position of posterior capsule of native lens.Conclusions.In this study, on the basis of the laws of physical optics and mathematical calculations, the leading role of such factor as the IOL position in the eye in appearance and intensity of the phenomenon of light reflection from the lens is substantiated for the first time. The proposed method for reducing the appearance of the phenomenon of light reflection from the IOL, which manifests itself in the form of glare in the eye, visible to others, on the basis of increasing the distance from the iris to the IOL is the optimal solution to the important problem of improving the quality of life of patients with pseudophakia.
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Nah, Seung Kwan, Jong Woo Kim, Chul Gu Kim, and Jae Hui Kim. "Outcomes of Re-fixation after the First Intraocular Lens Scleral Fixation." Journal of the Korean Ophthalmological Society 62, no. 9 (September 15, 2021): 1189–97. http://dx.doi.org/10.3341/jkos.2021.62.9.1189.
Full textAbstract:
Purpose: To investigate the outcomes of re-fixation after the first intraocular lens (IOL) scleral fixation. Methods: We retrospectively reviewed the charts of patients who underwent second IOL scleral fixation and vitrectomy for dislocation of IOL after the first IOL scleral fixation. We compared the best-corrected visual acuity (BCVA) and spherical equivalent (SE) after 1 month of the first and second surgery, and noted the complications. Results: We included 21 eyes that underwent second IOL scleral fixation: 13 eyes (61.9%) with IOL exchange and eight (38.1%) with one-haptic fixation. Mean BCVAs (LogMAR) were 0.17 ± 0.25 and 0.11 ± 0.23 after the first and second surgery, respectively (<i>p</i> = 0.073); mean SEs were -0.94 ± 1.69 and -0.58 ± 1.46 diopters after the first and second surgery, respectively (<i>p</i> = 0.076). Postoperative complications occurred in eight eyes (38.1%), including temporarily increased intraocular pressure and suture knots exposure. However, none of the complications required re-operation. Conclusions: The outcomes of primary and secondary IOL fixation were similar, and there were no serious complications of the second surgery.
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Schempf, Tadgh, and Hoon C. Jung. "Off-Label Use of Phakic Intraocular Lens with a “Piggyback” Technique." Case Reports in Ophthalmology 9, no. 3 (November 21, 2018): 465–72. http://dx.doi.org/10.1159/000494712.
Full textAbstract:
Purpose: We report a case of a highly myopic pseudophakic patient who received off-label placement of a phakic intraocular lens (pIOL) via a “piggyback” technique, allowing the placement of an intraocular lens (IOL) in his fellow eye, resulting in improved visual acuity and emmetropia. Case Report: A 66-year-old, highly myopic, pseudophakic male with an IOL implant in his left eye was referred for second opinion for surgical options for his phakic right eye. Given the severe myopic status of both eyes, he received off-label placement of a posterior chamber pIOL with a piggyback technique for the pseudophakic left eye followed by standard cataract surgery and intraocular lens implantation in the right eye. For the left eye, uncorrected best visual acuity improved from 20/70 to 20/25. Conclusion: This case demonstrates the successful off-label use of a phakic IOL in a pseudophakic, highly myopic patient with a piggyback technique, resulting in improved visual acuity and ultimately allowing IOL placement in the fellow eye for emmetropia. This off-label use of pIOL can offer ophthalmologists an alternative option for pseudophakic patents with severe refractive error.