Jagat and Bala intraocular lens supporting system: An artificial platform for intraocular lens implantation in an aphakic patient with inadequate capsular support.
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ABSTRACT:
SUBMITTER: Balamurugan R
PROVIDER: S-EPMC8302291 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:BackgroundThis paper describes a modified surgical technique for intraocular lens implantation in aphakic eyes with no capsular support.MethodsRetrospective case series. Seventeen eyes of 17 aphakic patients with no capsule support underwent intraocular lens (IOL) implantation using a standardized technique in which a net was created at the ciliary sulcus plane with two threads forming a net pattern. The net was used as support for the IOL. Follow-up ranged from 6 to 38 months, with an average of 23 months.ResultsIn all cases, the IOL was safely implanted and remained stable during the follow-up. In 16 eyes, the IOL remained well centered; in one eye, slight decentration was observed. Distance-corrected visual acuity improved by a mean of 4 lines, from 1.13 (LogMAR) to 0.52 (P = 0.01).ConclusionThis technique might be especially useful in cases of insufficient capsular support associated with tissue loss or iris atrophy. In these cases, iris fixation is not feasible; thus, the only surgical alternative is IOL scleral fixation.
| S-EPMC5572154 | biostudies-literature
Project description:We present a case of posterior capsular defect with traumatic cataract after blunt trauma in which an extended focal length intraocular lens (IOL) was implanted in the bag after conventional phacoemulsification and anterior vitrectomy. Anterior segment optical coherence tomography performed preoperatively aided in the confirmation and documentation of the capsular integrity. Intraoperative trocar anterior chamber (AC) maintainer allowed AC maintenance without further complications. IOL was well centered postoperatively at 6 months, and the unaided visual acuity was 20/20 for distance and N8 for near. The report showed that an extended depth of focus IOL can be placed in eyes with ruptured posterior capsule for good visual outcome in posttraumatic young eyes and it may not be considered as a relative contraindication for it.
| S-EPMC5939171 | biostudies-literature
Project description:To assess the safety and outcome of single-piece posterior chamber intraocular lens (PC-IOL) implantation in the ciliary sulcus following posterior capsular rupture during cataract surgery.Patients with posterior capsular rupture during cataract surgery with a single-piece acrylic IOL implanted into the ciliary sulcus were studied. Complete ocular examinations were performed after 6 months postoperatively.Twenty-four eyes were included. Mean follow-up duration was 8.33 ± 2.33 months. There was no significant difference between preoperative and postoperative keratometric cylinder or intraocular pressure. Visual acuity of 87.50% of patients was ≥20/40 after surgery. Complications included foveopathy (10 eyes), iris transillumination defect (4 eyes), iris chafing (2 eyes), pigmented keratic precipitate (KP) (4 eyes), clinical IOL tilt (6 eyes), endothelial pigment dusting (14 eyes), IOL pigment dusting (17 eyes), iris bowing (6 eyes), IOL decentration (4 eyes), and IOL tilt detected with ultrasonography biomicroscopy (UBM) (4 eyes). IOL pigment dusting was significantly higher in eyes with short axial lengths, high IOL power, small sulcus-to-sulcus (STS) diameter, large STS IOL diameter mismatch, and small anterior chamber depth and angle. Significant relationships were observed between pigmented KP with small STS diameter and large STS IOL diameter mismatch, UBM and clinical IOL tilt with large anterior chamber depth and between iris transillumination defect and STS IOL diameter mismatch.This implantation is associated with higher incidence of complications. Single-piece acrylic IOLs are not designed for sulcus implantation. However, they may be used in eyes with longer axial length if the 3-piece IOL is not available.
| S-EPMC5525496 | biostudies-other
Project description:Among 20 million cataract surgeries being performed worldwide every year, approximately 5% are being complicated by posterior capsule rent or zonular dialysis. Intraocular lens (IOL) implantation in such cases with intraoperative complications is quite challenging. Our next course of action is to place the IOL in the ciliary sulcus, however, there is a risk of IOL drop into the vitreous in cases of inadequate support. We have described a novel idea of using a suture material through the dialling hole of a three-piece rigid IOL which can be used as a leash to reduce the risk of IOL drop during implantation in such cases. This technique could also be used during sutureless scleral fixated IOL and retro-pupillary iris claw lens implantation. We found that in 90 consecutive patients where this technique was used, there was no incidence of IOL drop or retinal detachment.
| S-EPMC7210857 | biostudies-literature
Project description:PurposeThe objective was to evaluate the effect of co-implantation of a preloaded capsular tension ring (CTR) and aberration-free monofocal intraocular lens (IOL) on clinical outcomes and visual quality after cataract surgery.Materials and methodsPatients who underwent cataract surgery were randomized into two groups that were implanted with a CTR and IOL (group 1, 26 eyes) or an IOL only (group 2, 26 eyes). At 1 and 3 months after surgery, visual acuity, refractive errors, refractive prediction errors, ocular aberrations, and modulation transfer function (MTF) were analyzed. At 3 months postoperatively, anterior chamber depth (ACD) and contrast sensitivity were evaluated.ResultsGroup 1 showed greater hyperopic shift, which caused the refractive prediction error at 3 months after surgery to be significantly different between the two groups (p=0.049). Differences in ACD between the preoperative and postoperative periods tended to be greater in group 1 than in group 2. At 3 months postoperatively, internal MTF values at 20, 25, and 30 cycles per degree were significantly better in group 1 than in group 2 (p=0.034, 0.017, and 0.017, respectively). Contrast sensitivity showed comparable results at almost all spatial frequencies between the groups.ConclusionRegarding visual acuity and quality, both groups showed comparable results. Co-implantation of a CTR and aberration-free monofocal IOL was associated with hyperopic refractive outcomes. Surgeons should consider the position of the IOL when planning co-implantation of a CTR and IOL.
| S-EPMC4960392 | biostudies-literature
Project description:Preoperatively, the surgeon instills two drops of 0.5% proparacaine and then marks the 0° and 180° points at the limbus using a Gentian violet marker and 26G needle edge. Intraoperatively, after phacoemulsification and irrigation and aspiration of the cortex are complete, the surgeon inspects the previously marked 0°–180° points on the limbus. In case the steeper astigmatic meridian needs to be marked, a Mendez Ring is used and the meridian is marked using a Gentian violet marker and 26G needle edge. The desired markings (2 mm in length only) on the anterior lens capsule can be made using 26G needle bent at the bevel or using micro-vitreoretinal scissors. The toric intraocular lens (IOL) is then rotated in the bag in the desired meridian (customized-toric IOL in 0°–180° meridian and noncustomized toric IOL in steeper marked meridian), viscoelastic substance is aspirated and corneal wounds are hydrated.
| S-EPMC7787088 | biostudies-literature
Project description:Pediatric ophthalmologists increasingly recognize that the ideal site for intraocular lens (IOL) implantation is in the bag for aphakic eyes, but it is always very difficult via conventional technique. We conducted a prospective case series study to investigate the success rate and clinical outcomes of capsular bag reestablishment and in-the-bag IOL implantation via secondary capsulorhexis with radiofrequency diathermy (RFD) in pediatric aphakic eyes, in which twenty-two consecutive aphakic pediatric patients (43 aphakic eyes) enrolled in the Childhood Cataract Program of the Chinese Ministry of Health were included. The included children underwent either our novel technique for secondary IOL implantation (with RFD) or the conventional technique (with a bent needle or forceps), depending on the type of preoperative proliferative capsular bag present. In total, secondary capsulorhexis with RFD was successfully applied in 32 eyes (32/43, 74.4%, age 5.6±2.3 years), of which capsular bag reestablishment and in-the-bag IOL implantation were both achieved in 30 eyes (30/43, 70.0%), but in the remaining 2 eyes (2/32, 6.2%) the IOLs were implanted in the sulcus with a capsular bag that was too small. Secondary capsulorhexis with conventional technique was applied in the other 11 eyes (11/43, 25.6%, age 6.9±2.3 years), of which capsular bag reestablishment and in-the-bag IOL implantation were both achieved only in 3 eyes(3/43, 7.0%), and the IOLs were implanted in the sulcus in the remaining 8 eyes. A doughnut-like proliferative capsular bag with an extensive Soemmering ring (32/43, 74.4%) was the main success factor for secondary capsulorhexis with RFD, and a sufficient capsular bag size (33/43, 76.7%) was an additional factor in successful in-the-bag IOL implantation. In conclusion, RFD secondary capsulorhexis technique has 70% success rate in the capsular bag reestablishment and in-the-bag IOL implantation in pediatric aphakic eyes, particularly effective in cases with a doughnut-like, extensively proliferative Soemmering ring.
| S-EPMC3634760 | biostudies-literature
Project description:To compare visual outcomes and performance between bilateral implantation of a diffractive trifocal intraocular lens (IOL) Acrysof®PanOptix® TFNT00 and blended implantation of two different near add power bifocal IOLs: Acrysof® Restor® SV25T0 in dominant eye and Acrysof® Restor® SN6AD1 in the nondominant eye.This prospective, nonrandomized, consecutive and comparative study assessed 20 patients (40 eyes) who had bilateral cataract surgery performed using the IOLs described. Patients were divided into groups, bilateral trifocal implant and blended implant. Evaluation included measurement of binocular uncorrected and corrected distance visual acuity at 4 m (UDVA, CDVA) and uncorrected intermediate (60 cm) and near (at 40 cm) visual acuity; contrast sensitivity (CS) and visual defocus curve.Postoperative CDVA comparison showed no statistical significance between groups. UDVA was significantly better in the trifocal groups. Under photopic conditions, the trifocal group had better CS in higher frequencies with and without glare. The binocular defocus curve demonstrated a trifocal behavior in both groups, with the bilateral trifocal group exhibiting better performance for intermediate vision.Both lens combinations were able to provide good near, intermediate and distance vision, with the trifocal group showing significantly better performance at intermediate distances and better CS under photopic conditions.
| S-EPMC5546829 | biostudies-other
Project description:Aim of studyWith an ab-interno technique of transscleral suturing of current one-piece posterior chamber intraocular lenses (PC IOLs) by injector implantation in the absence of capsular support, we aimed to demonstrate the possibility of the implantation of one-piece acrylic PC IOLs that might be produced in the future for only scleral fixation through small clear corneal incision.Materials and methodsCase report and literature review.ResultsThis procedure has been performed in eight aphakic eyes with four different types of IOLs. Good centration was achieved with minimal technical effort. All patients had well-centered and stable lenses postoperatively during 9-18 months follow-up.ConclusionWe managed to decrease the risks of surgical trauma and intricate surgical maneuvers requirement. With this technique, excessive fluid leakage and consecutive hypotony can be minimized.
| S-EPMC4185163 | biostudies-literature
Project description:The present study describes a surgical technique for the management of complex dislocation and subluxation of the intraocular lens (IOL)-capsular bag (CB)-capsular tension ring (CTR) complex. During the procedure, one double-curved suture was inserted through the sclera into the posterior chamber, passing through the anterior capsules and then into the anterior chamber. The suture lines were pulled out from above and below the IOL-CB-CTR complex and a knot was tied 1 mm away from the corneoscleral incision. The IOL-CB-CTR complex was repositioned by adjusting the suture length. This novel method does not require explanting of the original IOL, allowing the IOL-CB-CTR complex to be immobilized in a simple and effective way.
| S-EPMC6434259 | biostudies-literature