scholarly journals Sutureless, Glueless, Scleral Fixation of Single-Piece and Toric Intraocular Lens: A Novel Technique

2015 ◽  
Vol 6 (2) ◽  
pp. 239-245 ◽  
Author(s):  
Aditya Kelkar ◽  
Rachana Shah ◽  
Jai Kelkar ◽  
Shreekant Kelkar ◽  
Ekta Arora
Keyword(s):  
Intraocular Pressure ◽  
Intraocular Lens ◽  
Pigment Dispersion ◽  
Toric Intraocular Lens ◽  
Scleral Fixation ◽  
Novel Technique ◽  
Single Piece ◽  
Intraocular Hemorrhage ◽  
Elevated Intraocular Pressure ◽  
Capsular Support

Sutureless, glueless, scleral fixation of an intraocular lens is a known technique of fixing a lens in the scleral pockets. However, this technique is applied to single-piece and toric lenses instead of 3-piece lenses, allowing the advantage of the use of premium lenses in patients with poor capsular support. Favourable results without complications of pigment dispersion, iris transillumination defects, dysphotopsia, elevated intraocular pressure, intraocular hemorrhage and cystoid macular edema with a well-centered, stable intraocular lens have been observed in the 3-month postoperative period in both cases.

scholarly journals Diode laser transscleral cyclophotocoagulation causes intraocular collamer lens displacement in pseudophakic eye: a case report

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Wei Wei ◽  
Xueqing Yu ◽  
Lu Yang ◽  
Chan Xiong ◽  
Xu Zhang
Keyword(s):  
Intraocular Pressure ◽  
Visual Field ◽  
Anterior Chamber ◽  
Intraocular Lens ◽  
Angle Closure ◽  
Pigment Dispersion ◽  
Intraocular Lens Implantation ◽  
Lens Implantation ◽  
Elevated Intraocular Pressure ◽  
Transscleral Cyclophotocoagulation

Abstract Background With the rapid development of intraocular collamer lens (ICL) operation, it is foreseeable that we will encounter a large number of glaucoma patients with ICL implantation history. However, our current understanding of the treatment of glaucoma patients with ICL is limited. Hence we report a rare case of refractory glaucoma after intraocular collamer lens and intraocular lens implantation in a patient who underwent unsuccessful transscleral cyclophotocoagulation, which led to intraocular collamer lens displacement, angle closure and uncontrolled intraocular pressure. Case presentation A 39-year-old woman presented with intractably elevated intraocular pressure in the right eye. Since her intraocular collamer lens implantation surgery in 2017, her intraocular pressure had remained over 40 mmHg while using 3 types of anti-glaucoma medications. The patient had a history of phacoemulsification and posterior chamber phakic intraocular lens implantation for complicated cataracts secondary to uveitis in 2006. On gonioscope examination, there were signs of pigment dispersion, and the anterior chamber angle was open. Ultrasound biomicroscopy examination showed contact and rubbing between the intraocular collamer lens and posterior surface of the iris. And typical advanced glaucomatous optic neuropathy and visual field defects were observed. Transscleral cyclophotocoagulation was performed to control the intraocular pressure and prevent further visual field loss. However, the intraocular collamer lens was displaced after transscleral cyclophotocoagulation, which resulted in formation of a shallow anterior chamber 1 week later, angle closure and loss of intraocular pressure control 1 month later, even though the maximum dose of anti-glaucoma medication was used. Finally, an Ahmed glaucoma valve was successfully implanted in her anterior chamber, and the glaucoma was controlled, as observed at the 10-month follow-up. Conclusions Pigment dispersion is a common phenomenon after intraocular collamer lens implantation and may accelerate the progression of glaucoma. Transscleral cyclophotocoagulation should be carefully considered in glaucoma patients with elevated intraocular pressure after intraocular collamer lens implantation, given that transscleral cyclophotocoagulation may cause intraocular collamer lens displacement.

scholarly journals Implantation of a trifocal toric intraocular lens to a patient with pigment dispersion syndrome

2019 ◽  
Vol 100 (3) ◽  
pp. 495-499
Author(s):  
R F Akhmetshin ◽  
M R Gilyazev ◽  
A T Galeeva ◽  
S N Bulgar
Keyword(s):  
Intraocular Pressure ◽  
Intraocular Lens ◽  
Anterior Segment ◽  
Ultrasound Biomicroscopy ◽  
Pigment Dispersion ◽  
Toric Intraocular Lens ◽  
Lens Extraction ◽  
Pigment Dispersion Syndrome ◽  
Myopic Astigmatism ◽  
Peripheral Iridotomy

Aim. To present a clinical case of treatment of pigment dispersion syndrome by clear lens extraction and implantation of a toric intraocular lens in a patient with myopic astigmatism. Methods. A 33-year-old patient with a diagnosis of moderate myopia, complex mild myopic astigmatism, pigment dispersion syndrome of both eyes. Results. The first stage was laser peripheral iridotomy of both eyes. On follow-up pathological irido-zonular contact and increases intraocular pressure by 2 mm persisted. The second stage included clear lens extraction and implantation of a toric multifocal intraocular lens to both eyes. In 2 months, distance and near visual acuity was 1.0, intraocular pressure was normal, no pathological irido-zonular contact was observed according to the ultrasound biomicroscopy. Conclusion. Implantation of an intraocular lens in patients with myopia and pigment dispersion syndrome is both a method of preventing pigment glaucoma and myopia correction; patients with pigment dispersion syndrome after peripheral iridotomy should monitor the state of the anterior segment of the eye and the effectiveness of the treatment by ultrasound biomicroscopy.

scholarly journals 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

2021 ◽  
pp. 538-542
Author(s):  
Yuko Mano ◽  
Kei Mizobuchi ◽  
Tomoyuki Watanabe ◽  
Akira Watanabe ◽  
Tadashi Nakano
Keyword(s):  
Intraocular Pressure ◽  
Intraocular Lens ◽  
Combined Therapy ◽  
Swept Source ◽  
Needle Technique ◽  
Elevated Intraocular Pressure ◽  
Anterior Segments ◽  
The Right ◽  
End Stage

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.

Pigmentary Glaucoma After Cataract Surgery with Single-Piece Hydrophobic Intraocular Lens Implanted into the Ciliary Sulcus: Case Report

2021 ◽  
Vol 5 (1) ◽  
Keyword(s):  
Intraocular Pressure ◽  
Intraocular Lens ◽  
Corneal Endothelium ◽  
Surgical Intervention ◽  
Posterior Segment ◽  
The Other ◽  
Pigmentary Glaucoma ◽  
Single Piece ◽  
History Of ◽  
Capsular Bag

A 59 years old man presented with a history of phacoemulsification with an hydrophobic intraocular lens implant in his left eye 4 years ago. The biomicroscopy revealed pigments in the corneal endothelium (Krukenberg’s spindle), peripheral transillumination of the iris and intraocular pressure of 52 mmHg in the left eye. Gonioscopy revealed hyperpigmentation of the posterior trabeculate. Posterior segment examination and visual field revealed a cup/disc 0.9 with significant field damage in strategy 10-2. Biomicroscopic ultrasonography showed asymmetric implantation of the IOL loops in the left eye (one loop in the ciliary sulcus and the other in the capsular bag). He underwent antiglaucomatous treatment with adequate control of intraocular pressure, with no need for surgical intervention.

Scleral Fixation of Carlevale Intraocular Lens in Children: A Novel Tool in Correcting Aphakia With No Capsular Support

2021 ◽  
Vol 52 (2) ◽  
pp. 94-101
Author(s):  
Stratos Gotzaridis ◽  
Ilias Georgalas ◽  
Evangelia Papakonstantinou ◽  
Dimitrios Spyropoulos ◽  
Agathi Kouri ◽  
...  
Keyword(s):  
Intraocular Lens ◽  
Scleral Fixation ◽  
Capsular Support

scholarly journals Scleral fixation of a dexamethasone intravitreal implant in a case of subluxated bag–intraocular lens complex

2019 ◽  
Vol 11 ◽  
pp. 251584141985652
Author(s):  
Carlos M. Rangel ◽  
Nathalia J. Moreno ◽  
M. Margarita Parra
Keyword(s):  
Macular Edema ◽  
Anterior Chamber ◽  
Intraocular Lens ◽  
Corneal Edema ◽  
Conventional Technique ◽  
Endothelial Damage ◽  
Scleral Fixation ◽  
Surgical Tool ◽  
Number Of Patients ◽  
Capsular Support

Macular edema is a condition of retinal tissue treated with anti-inflammatory agents including placement of an intravitreal sustained-release dexamethasone device, designed to deliver a controlled amount of the medication for a prolonged time, representing an excellent therapy. Nonetheless, the implantation cannot be carried out without an anatomical barrier, such as the presence of posterior capsular support, lens, or intraocular lens. The absence of these barriers could lead to several complications, due to migration of the device from the vitreous cavity to the anterior chamber, causing corneal endothelial damage, corneal edema, glaucoma, and uveitis, among others. In consequence, a large number of patients cannot be treated with this useful surgical tool, resulting in chronicity of macular edema and severe visual acuity impairment. Therefore, we modified the conventional technique, through scleral fixation of the device providing a continuous delivering of dexamethasone, avoiding its migration to the anterior chamber in a patient without capsular support.

scholarly journals Novel Technique to Overcome the Nonavailability of a Long Needle 9-0 Polypropylene Suture for Sutured Scleral Fixation of the Posterior Chamber Intraocular Lens Using a Single Fisherman’s Knot

2017 ◽  
Vol 2017 ◽  
pp. 1-4
Author(s):  
Yong Un Shin ◽  
Mincheol Seong ◽  
Hee Yoon Cho ◽  
Min Ho Kang
Keyword(s):  
Intraocular Lens ◽  
Posterior Chamber ◽  
Intraoperative Complication ◽  
Scleral Fixation ◽  
Polypropylene Suture ◽  
Endothelial Cell Count ◽  
Intraocular Hemorrhage ◽  
Posterior Chamber Intraocular Lens ◽  
Iol Dislocation

Purpose. To describe a method to overcome the nonavailability of a long needle 9-0 polypropylene suture for sutured scleral fixation of the posterior chamber intraocular lens (PC-IOL) using a single fisherman’s knot (SFK). Methods. First, a 10-0 polypropylene suture was passed from the sclera to the ciliary sulcus using a long needle. A 9-0 suture was tied to the unpassed portion of the 10-0 suture with an SFK. We pulled the 10-0 suture to pass the SFK through the sclera, and then we cut the knot and removed the 10-0 suture. IOL fixation with 9-0 sutures used the conventional techniques used for sutured scleral-fixated IOL. Preoperative and postoperative visual acuity, corneal astigmatism, and endothelial cell count and intraoperative/postoperative complications were evaluated. Results. An SFK joining the two sutures was passed through the sclera without breakage or slippage. A total of 35 eyes from 35 patients who underwent sutured scleral fixation of the IOL. An intraoperative complication (minor intraocular hemorrhage) was recorded in four cases. Knot exposure, IOL dislocation, subluxation, and retinal detachment were not observed. Conclusions. The SFK offers the opportunity to use 9-0 sutures for the long-term safety and may not require the surgeon to learn any new technique.

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