scholarly journals Sutureless 25-Gauge Pars Plana Vitrectomy Combined with Retropupillary Fixation of an Iris-Claw Intraocular Lens

2016 ◽  
Vol 7 (3) ◽  
pp. 433-439
Author(s):  
Spyridon E. Chalkiadakis ◽  
Efstratios A. Parikakis ◽  
Simon R.J. Taylor
Keyword(s):  
Intraocular Lens ◽  
Pars Plana Vitrectomy ◽  
Case Series ◽  
Visual Rehabilitation ◽  
Aesthetic Result ◽  
Viable Solution ◽  
Pars Plana ◽  
Real Challenge ◽  
Operating Surgeon ◽  
Iris Claw

Background: The surgical case of a dropped intraocular lens inside the vitreous cavity constitutes a real challenge for the operating surgeon. Herein, we describe a case series where an alternative optical rehabilitation technique for late intraocular lens-bag complex dislocation has been used. Methods: A modern vitrectomy device was used to remove the capsule with the dropped intraocular lens using sutureless 25-gauge pars plana vitrectomy. To ensure a better aesthetic result, with faster patient recovery and a reduced number of operations, the whole procedure was performed during the same operating session; an iris-claw intraocular lens for aphakia was selected for implantation. The implant was passed behind the constricted iris with the concave surface facing it. The lens was grasped with the manufacturer’s holding forceps and fixed onto the posterior surface of the iris using the special enclavation needles. Results: We have operated 12 eyes in two different clinical centres successfully, with minimal intra- and/or postoperative complications. Conclusion: We believe that this is a viable solution for the visual rehabilitation of patients, who would otherwise need more than one operation for a lens exchange.

scholarly journals Long-term surgical outcomes of primary retropupillary iris claw intraocular lens implantation for the treatment of intraocular lens dislocation

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Eun Young Choi ◽  
Chul Hee Lee ◽  
Hyun Goo Kang ◽  
Jae Yong Han ◽  
Suk Ho Byeon ◽  
...  
Keyword(s):  
Intraocular Lens ◽  
Pars Plana Vitrectomy ◽  
Case Series ◽  
Retrospective Case ◽  
Iol Implantation ◽  
Intraocular Lens Dislocation ◽  
Post Surgery ◽  
Pars Plana ◽  
Iol Dislocation ◽  
Iris Claw

AbstractWe aimed to investigate the efficacy and safety of primary retropupillary iris claw intraocular lens (R-IOL) implantation in patients with complete intraocular lens (IOL) dislocation. In this single-center retrospective case series, we reviewed the medical records of patients who underwent R-IOL implantation surgery with pars plana vitrectomy for the treatment of IOL dislocation between September 2014 and July 2019. The primary outcome was change in visual acuity (VA) up to 24 months postoperatively. The secondary outcomes included changes in intraocular pressure (IOP), refractive errors, and endothelial cell count (ECC) over the same period. Data of 103 eyes (98 patients) were analyzed. The mean uncorrected VA was significantly improved at one month postoperatively (− 0.69 logMAR, P < 0.001), compared to the preoperative value. IOP (− 2.3 mmHg, P = 0.008) and ECC (− 333.4 cells/mm2, P = 0.027) significantly decreased one month post-surgery and remained stable thereafter. Postoperative mean spherical equivalents were similar to the prediction error throughout the follow-up period. IOP elevation (n = 8, 7.8%), cystoid macular edema (n = 4, 3.9%), and dislocation of the R-IOL (n = 10, 9.7%) were managed successfully. Overall, primary R-IOL implantation with pars plana vitrectomy is effective and safe for correcting IOL dislocation due to various causes.

scholarly journals Pars plana vitrectomy combined with penetrating keratoplasty  and transscleral-sutured intraocular lens implantation in complex eyes: a case series

2020 ◽  
Author(s):  
Takahiko Hayashi ◽  
Yasutsugu Ida ◽  
Toshiki Shimizu ◽  
Tsubasa Kuroki ◽  
Yuji Kobashigawa ◽  
...  
Keyword(s):  
Graft Survival ◽  
Intraocular Lens ◽  
Pars Plana Vitrectomy ◽  
Penetrating Keratoplasty ◽  
Case Series ◽  
Glaucoma Surgery ◽  
Bullous Keratopathy ◽  
Spherical Equivalent ◽  
Iol Implantation ◽  
Pars Plana

Abstract Background The aim of this study was to evaluate the clinical outcomes of pars plana vitrectomy (PPV) combined with penetrating keratoplasty (PKP) and transscleral-sutured intraocular lens (IOL) implantation (IOL-suture) in complex eyes.Methods In this prospective, consecutive interventional case series, patients who underwent PKP combined with PPV and IOL implantation from July 2014 to March 2018 at Yokohama Minami Kyosai Hospital were enrolled. The postoperative best corrected visual acuity (BCVA) (converted to logarithm of the minimal angle of resolution [logMAR] units), intraocular pressure (IOP, mmHg), endothelial cell density (ECD, cells/mm2), graft survival, complications, astigmatism, and spherical equivalent (dioptres [D]) were evaluated. Results This study included 11 eyes of 11 patients (three females and eight males; mean age, 61.8 ± 13.9 years) with an injury (n = 6) or bullous keratopathy (n = 5). The BCVA significantly improved from 1.50 ± 0.66 logMAR preoperatively to 0.78 ± 0.59 logMAR (p < 0.001) postoperatively. The baseline ECD significantly decreased from 2396 ± 238 cells/mm2 preoperatively to 1132 ± 323 cells/mm2 (p < 0.001) postoperatively. Despite two rejection episodes, graft survival rates were 100%. The mean follow-up period was 38.0 ± 20.5 months. Two patients required combined glaucoma surgery, and three patients underwent subsequent glaucoma surgery. Postoperative astigmatism and spherical equivalent were 3.9 ± 3.2 D and 0.29 ± 2.18 D, respectively.Conclusion The combination of PKP, PPV, and IOL-suture implantation could be a safe and effective approach for eyes requiring anterior segment surgery; however, these eyes are associated with a higher incidence of glaucoma surgery.

Retropupillary iris-claw intraocular lens and pars plana vitrectomy in aphakia management

Retina ◽  
2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Carolina Bernal-Morales ◽  
Adrián Hernández-Martínez ◽  
Manuel J. Navarro-Angulo ◽  
Miguel Ruiz-Miguel ◽  
Mariano Rodriguez-Maqueda ◽  
...  
Keyword(s):  
Intraocular Lens ◽  
Pars Plana Vitrectomy ◽  
Pars Plana ◽  
Iris Claw

SECONDARY IRIS CLAW INTRAOCULAR LENS IMPLANTATION FOR THE CORRECTION OF APHAKIA AFTER PARS PLANA VITRECTOMY

Retina ◽  
2010 ◽  
Vol 30 (1) ◽  
pp. 131-139 ◽  
Author(s):  
NUR ACAR ◽  
ZIYA KAPRAN ◽  
TUGRUL ALTAN ◽  
YASAR KUCUKSUMER ◽  
YAPRAK BANU UNVER ◽  
...  
Keyword(s):  
Intraocular Lens ◽  
Pars Plana Vitrectomy ◽  
Intraocular Lens Implantation ◽  
Lens Implantation ◽  
Pars Plana ◽  
Iris Claw

scholarly journals Pars plana vitrectomy combined with penetrating keratoplasty and transscleral-sutured intraocular lens implantation in complex eyes: a case series

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Takahiko Hayashi ◽  
Ida Yasutsugu ◽  
Toshiki Shimizu ◽  
Tsubasa Kuroki ◽  
Yuji Kobashigawa ◽  
...  
Keyword(s):  
Graft Survival ◽  
Intraocular Lens ◽  
Pars Plana Vitrectomy ◽  
Penetrating Keratoplasty ◽  
Case Series ◽  
Glaucoma Surgery ◽  
Bullous Keratopathy ◽  
Spherical Equivalent ◽  
Iol Implantation ◽  
Pars Plana

Abstract Background The aim of this study was to evaluate the clinical outcomes of pars plana vitrectomy (PPV) combined with penetrating keratoplasty (PKP) and transscleral-sutured intraocular lens (IOL) implantation (IOL-suture) in complex eyes. Methods In this prospective, consecutive interventional case series, patients who underwent PKP combined with PPV and IOL implantation from July 2014 to March 2018 at Yokohama Minami Kyosai Hospital were enrolled. The postoperative best corrected visual acuity (BCVA) (converted to logarithm of the minimal angle of resolution [logMAR] units), intraocular pressure (IOP, mmHg), endothelial cell density (ECD, cells/mm2), graft survival, complications, astigmatism, and spherical equivalent (dioptres [D]) were evaluated. Results This study included 11 eyes of 11 patients (three females and eight males; mean age, 61.8 ± 13.9 years) with an injury (n = 6) or bullous keratopathy (n = 5). The BCVA significantly improved from 1.50 ± 0.66 logMAR preoperatively to 0.78 ± 0.59 logMAR (p < 0.001) postoperatively. The baseline ECD significantly decreased from 2396 ± 238 cells/mm2 preoperatively to 1132 ± 323 cells/mm2 (p < 0.001) postoperatively. Despite two rejection episodes, graft survival rates were 100%. The mean follow-up period was 38.0 ± 20.5 months. Two patients required combined glaucoma surgery, and three patients underwent subsequent glaucoma surgery. Postoperative astigmatism and spherical equivalent were 3.9 ± 3.2 D and 0.29 ± 2.18 D, respectively. Conclusion The combination of PKP, PPV, and IOL-suture implantation could be a safe and effective approach for eyes requiring anterior segment surgery; however, these eyes are associated with a higher incidence of glaucoma surgery.

scholarly journals Advantage of pars plana vitrectomy combined with penetrating keratoplasty  and transscleral-sutured intraocular lens implantation in complex eyes: a case series

2020 ◽  
Author(s):  
Takahiko Hayashi ◽  
Yasutsugu Ida ◽  
Toshiki Shimizu ◽  
Tsubasa Kuroki ◽  
Yuji Kobashigawa ◽  
...  
Keyword(s):  
Graft Survival ◽  
Intraocular Lens ◽  
Pars Plana Vitrectomy ◽  
Penetrating Keratoplasty ◽  
Case Series ◽  
Glaucoma Surgery ◽  
Bullous Keratopathy ◽  
Spherical Equivalent ◽  
Iol Implantation ◽  
Pars Plana

Abstract Background The aim of this study was to evaluate the clinical outcomes of pars plana vitrectomy (PPV) combined with penetrating keratoplasty (PKP) and transscleral-sutured intraocular lens (IOL) implantation (IOL-suture) in complex eyes. Methods In this prospective, consecutive interventional case series, patients who underwent PKP combined with PPV and IOL implantation from July 2014 to Mar 2017 at Yokohama Minami Kyosai Hospital were enrolled. The postoperative best corrected visual acuity (BCVA) (converted to logarithm of the minimal angle of resolution [logMAR] units), intraocular pressure (IOP, mmHg), endothelial cell density (ECD, cells/mm2), graft survival, complications, astigmatism, and spherical equivalent (dioptres [D]) were evaluated. Results This study included 11 eyes of 11 patients (three females and eight males; mean age, 61.8 ± 13.9 years) with an injury (n = 6) or bullous keratopathy (n = 5). The BCVA significantly improved from 1.50 ± 0.66 logMAR preoperatively to 0.78 ± 0.59 logMAR (p < 0.001) postoperatively. The baseline ECD significantly decreased from 2396 ± 238 cells/mm2 preoperatively to 1132 ± 323 cells/mm2 (p < 0.001) postoperatively. Despite two rejection episodes, graft survival rates were 100%. The mean follow-up period was 38.0 ± 20.5 months. Two patients required combined glaucoma surgery, and three patients underwent subsequent glaucoma surgery. Postoperative astigmatism and the spherical equivalent were 3.9 ± 3.2 D and 0.29 ± 2.18 D, respectively. Conclusion The combination of PKP, PPV, and IOL-suture implantation could be a safe and effective approach for eyes requiring anterior segment surgery; however, these eyes are associated with a higher incidence of glaucoma surgery.

scholarly journals Scleral Fixation of Akreos AO60 Intraocular Lens Using Gore-Tex Suture: An Eye on Visual Outcomes and Postoperative Complications

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Mariana Leuzinger-Dias ◽  
Mário Lima-Fontes ◽  
Rita Rodrigues ◽  
Cláudia Oliveira-Ferreira ◽  
Carolina Madeira ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Postoperative Complications ◽  
Intraocular Lens ◽  
Pars Plana Vitrectomy ◽  
Case Series ◽  
Scleral Fixation ◽  
Open Globe ◽  
Pars Plana ◽  
The Mean ◽  
Clinical Records

Purpose. “In-the-bag” placement of an IOL is the Holy Grail for any cataract surgeon. However, in the absence of capsular integrity, alternative surgical options to place the IOL must be sought. We aim to report the clinical outcomes and safety profile of scleral-fixated Akreos AO60 intraocular lens implantation using Gore-Tex suture, combined with pars plana vitrectomy. Methods. This is a single-center, retrospective case series descriptive study. Electronic clinical records of all patients subjected to scleral fixation of a Bausch and Lomb Akreos AO60 IOL combined with pars plana vitrectomy, between April 1, 2017, and August 1, 2021, were reviewed. Data concerning age, sex, laterality, past ophthalmological history, pre- and postoperative best-available visual acuity, surgical indication, and intra- and postoperative complications were collected. Measured outcomes were the differences in best-available visual acuity and frequency of postoperative complications. Results. A total of 37 eyes (20 right eyes and 17 left eyes) from 36 patients (16 females and 20 males) were included in the statistical analysis. The mean age at time of surgery was 72.0 ± 12.4 years. The mean follow-up period was 548.9 days (range 39–1564 days). Globally, the mean best-available logMAR visual acuity improved from 1.61 preoperatively (0.025 decimal equivalent) to 0.57 postoperatively (0.3 decimal equivalent), this difference being statistically significant ( P < 0.001 ). Indications for surgery included aphakia due to complicated cataract surgery (24.3%; n = 9); subluxated IOL due to closed trauma (21.6%; n = 8); PEX-related subluxated IOL (16.2%; n = 6); non-traumatic, non-PEX-related subluxated IOL (18.9%; n = 7); subluxated crystalline lens due to closed trauma (8.1%; n = 3); aphakia due to open-globe injury (5.4%; n = 2); silicone-induced IOL opacification (2.7%; n = 1); and aphakia post-endophthalmitis (2.7%; n = 1). Postoperative complications included transient ocular hypertension (27.0%; n = 10), transient corneal edema (18.9%; n = 7), cystoid macular edema (18.9%, n = 7), self-limited hypotension (5.4%, n = 2), self-limited vitreous hemorrhage (2.7%, n = 1), central retinal vein occlusion (2.7%, n = 1), late retinal detachment (2.7%, n = 1), and Akreos IOL opacification (2.7%, n = 1). No suture-related complications were observed. Conclusion. There was a statistically significant improvement in visual acuity after scleral fixation of Akreos AO60 intraocular lens using Gore-Tex suture, with no suture-related problems recorded. This procedure seems to be a valuable alternative for posterior chamber IOL placement when secondary IOL implantation is required.

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