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Short-Term Efficacy and Safety of Cataract Surgery Combined with Iris-Fixated Phakic Intraocular Lens Explantation: A Multicentre Study.

ABSTRACT: The purpose of this study was to evaluate the short-term efficacy and safety of cataract surgery for patients with iris-fixated phakic intraocular lenses (pIOLs). This study included 96 eyes of 91 patients. The changes in the logMAR uncorrected visual acuity (UCVA), best-corrected visual acuity (BCVA), subjective spherical equivalent (SE), astigmatism, and endothelial cell density (ECD) were collected retrospectively. The intraoperative and postoperative complications also were investigated to assess the surgical safety. The preoperative UCVA and BCVA improved significantly at month 1 postoperatively, respectively (p < 0.001 for both comparisons). The efficacy and safety index at month 1 postoperatively were 1.02 ± 0.56 and 1.31 ± 0.64, respectively. The SE at month 1 postoperatively was significantly (p < 0.001) higher compared to preoperatively, whereas the subjective astigmatism did not differ significantly (p = 0.078). The ECD significantly decreased at month 1 (p < 0.001). The most common postoperative complication was intraocular pressure elevation exceeding 25 mmHg in 10.4% of eyes, which was controlled with medications in all cases until month 1 postoperatively. No intraoperative complications developed. Cataract surgeries for patients with iris-fixated pIOLs were performed safely with good visual outcomes.

SUBMITTER: Omoto MK

PROVIDER: S-EPMC8397074 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Two-year results after combined phacoemulsification and iris-fixated phakic intraocular lens removal.

Project description:PurposeTo describe and present results after a technique for cataract surgery combined with explantation of an iris-fixated phakic intraocular lens (IF-pIOL).MethodsThe medical records of all patients, who had undergone cataract surgery combined with IF-pIOL explantation and subsequent implantation of a posterior chamber IOL by the Single Incision Technique (SIT), were reviewed. Data collection included preoperative and postoperative corrected distance visual acuity (CDVA), manifest refraction, and endothelial cell density (ECD) up to a follow-up time of 24 months.ResultsFifty myopic eyes (34 patients) and 9 hyperopic eyes (6 patients) had undergone a SIT procedure mainly because of cataract (67%). Postoperative CDVA improved in both the myopic eyes to 0.16 ± 0.37 logMAR, as in the hyperopic eyes to - 0.10 ± 0.55 logMAR with no eyes having loss of Snellen lines. Mean postoperative spherical equivalent was - 0.34 ± 0.72 D and - 0.10 ± 0.55 D, respectively. ECD loss 6 months after surgery was 5% and remained stable thereafter.ConclusionSIT for combined phacoemulsification and IF-pIOL removal yields good visual and refractive results and is a safe procedure in regard to ECD loss. The technique has advantages over the conventional procedure and is easy to perform.

| S-EPMC8913490 | biostudies-literature

Phacoemulsification in phakic iris-claw lens with cataract.

Project description:In this new technique of cataract surgery in patients with iris-fixated phakic intraocular lens with cataract, phakic IOL is explanted at the end of surgery. Phakic IOL remains stable and securely enclaved to the iris during phacoemulsification which is performed through a small 2.2 mm incision. Endothelial protection is provided by viscodispersive OVD above the phakic IOL and space for surgery is created by high molecular weight viscocohesive OVD beneath the phakic IOL. This technique provides significant advantages from the previously described techniques in terms of chamber stability, endothelial protection, iris trauma and surgical ease.

| S-EPMC6213707 | biostudies-literature

Vertically Fixated Posterior Chamber Phakic Intraocular Lens Implantation Through a Superior Corneal Incision.

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| S-EPMC8927518 | biostudies-literature

A meta-analysis of sutureless scleral-fixated intraocular lens versus retropupillary iris claw intraocular lens for the management of aphakia.

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| S-EPMC10808084 | biostudies-literature

Implantable collamer lens versus iris-fixed phakic intraocular lens implantation to correct myopia: a meta-analysis.

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| S-EPMC4130551 | biostudies-literature

Modified sewing machine technique for iridodialysis repair, intraocular lens relocation, iris coloboma repair, Cionni ring fixation, and scleral-fixated intraocular lens.

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| S-EPMC6080449 | biostudies-literature

Accuracy of intraocular lens calculation formulas based on swept-source OCT biometer in cataract patients with phakic intraocular lens.

Project description:PurposeTo research the accuracy of intraocular lens (IOL) calculation formulas and investigate the effect of anterior chamber depth (ACD) and lens thickness (LT) measured by swept-source optical coherence tomography biometer (IOLMaster 700) in patients with posterior chamber phakic IOL (PC-pIOL).MethodsRetrospective case series. The IOLMaster 700 biometer was used to measure axial length (AL) and anterior segment parameters. The traditional formulas (SRK/T, Holladay 1 and Haigis) with or without Wang-Koch (WK) AL adjustment, and new-generation formulas (Barret Universal II [BUII], Emmetropia Verifying Optical [EVO] v2.0, Kane, Pearl-DGS) were utilized in IOL power calculation.ResultsThis study enrolled 24 eyes of 24 patients undergoing combined PC-pIOL removal and cataract surgery at Xiamen Eye Center of Xiamen University, Xiamen, Fujian, China. The median absolute prediction error in ascending order was EVO 2.0 (0.33), Kane (0.35), SRK/T-WKmodified (0.42), Holladay 1-WKmodified (0.44), Haigis-WKC1 (0.46), Pearl-DGS (0.47), BUII (0.58), Haigis (0.75), SRK/T (0.79), and Holladay 1 (1.32). The root-mean-square absolute error in ascending order was Haigis-WKC1 (0.591), Holladay 1-WKmodified (0.622), SRK/T-WKmodified (0.623), EVO (0.673), Kane (0.678), Pearl-DGS (0.753), BUII (0.863), Haigis (1.061), SRK/T (1.188), and Holladay 1 (1.513). A detailed analysis of ACD and LT measurement error revealed negligible impact on refractive outcomes in BUII and EVO 2.0 when these parameters were incorporated or omitted in the formula calculation.ConclusionThe Kane, EVO 2.0, and traditional formulas with WK AL adjustment displayed high prediction accuracy. Furthermore, the ACD and LT measurement error does not exert a significant influence on the accuracy of IOL power calculation formulas in highly myopic eyes implanted with PC-pIOL.

| S-EPMC11299284 | biostudies-literature

Explantation of a sutureless scleral fixated Carlevale intraocular lens due to calcification: a clinical and laboratory report.

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| S-EPMC10433584 | biostudies-literature

Femtosecond laser-assisted cataract surgery in a patient with posterior chamber phakic intraocular lens.

Project description:We describe a case of modified femtosecond laser settings for cataract extraction in a patient with a posterior chamber phakic intraocular lens (PIOL), to avoid incomplete treatment patterns and treatment displacement. Modification of laser settings (increased depth for the capsulotomy, increased vertical spot spacing for the capsulotomy and increased anterior and posterior capsule safety margins for lens fragmentation) seems to make femtosecond laser-assisted cataract surgery feasible in patients with posterior chamber PIOLs, as complete treatment patterns are achieved.

| S-EPMC5757340 | biostudies-literature

Swivel haptics anterior capsule-fixated intraocular lens.

Project description:The purpose of the study is to report the feasibility of implantation of a new design of anterior capsule-fixated intraocular lens (IOL). The new IOL design is a foldable, hydrophilic, open-loop posterior chamber IOL with two extra polymethyl methacrylate swivel haptics created on the optic surface to capture the anterior capsulotomy after the IOL is implanted in the bag. In the pilot phase, the new IOL was implanted in 10 eyes of 10 patients of which 8 eyes underwent phacoemulsification and 2 eyes had laser cataract surgery. The mean spherical equivalent changed from *1.75 D to -0.75 D at 6 months. Postoperatively, from 1 week to 6 months, all eyes showed stable refraction and anterior chamber depth with no evidence of decentration. Subjective questionnaire revealed high patient satisfaction with no complaints of dysphotopsia. No intra- or postoperative complications such as swivel haptic breakage, iris chafing, pigment dispersion, postoperative uveitis, or endophthalmitis occurred in any of the eyes necessitating explantation of the IOL. The new IOL design was feasible to implant and provided satisfactory outcomes in terms of no dysphotopsias and stable effective lens position.

| S-EPMC6113843 | biostudies-literature

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