scholarly journals Off-Label Use of Phakic Intraocular Lens with a “Piggyback” Technique

2018 ◽  
Vol 9 (3) ◽  
pp. 465-472 ◽  
Author(s):  
Tadgh Schempf ◽  
Hoon C. Jung
Keyword(s):  
Visual Acuity ◽  
Intraocular Lens ◽  
Posterior Chamber ◽  
Off Label Use ◽  
Phakic Intraocular Lens ◽  
Fellow Eye ◽  
Off Label ◽  
Label Placement ◽  
The Right ◽  
Label Use

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.

scholarly journals Postsurgical Cystoid Macular Edema following Posterior Chamber Toric Phakic Intraocular Lens Implantation Surgery: A Case Report

2015 ◽  
Vol 6 (2) ◽  
pp. 223-227 ◽  
Author(s):  
Julide Canan Umurhan Akkan ◽  
Kemal Tuncer ◽  
Ahmet Elbay
Keyword(s):  
Visual Acuity ◽  
Case Report ◽  
Macular Edema ◽  
Intraocular Lens ◽  
Cystoid Macular Edema ◽  
Posterior Chamber ◽  
Phakic Intraocular Lens ◽  
Distance Visual Acuity ◽  
Initial Surgery ◽  
The Right

Purpose: To describe a case of cystoid macular edema (CME) developing after posterior chamber toric phakic intraocular lens (PIOL) implantation. Methods: Case report. Results: A 33-year-old male underwent implantation of toric implantable collamer lenses (ICL), a new generation of PIOLs, for both eyes. Preoperative best spectacle-corrected distance visual acuity (BCVA) was 20/25 in the right eye and 20/32 in the left eye, with a manifest refraction of -9.25 -4.0 × 4° and -9.75 -4.25 × 171°, respectively. On day 1 postoperatively, the left eye had an uncorrected distance visual acuity (UDVA) of 20/60 with a refraction of +2.0 -3.5 × 11°. Despite the rotation of the PIOL, the cylindrical refractive component persisted in the left eye with a refraction of +2.0 -3.5 × 11°. Two weeks after the initial surgery, he presented with a decrease in his visual acuity in the left eye. The UDVA and BCVA were both 20/100 in the left eye with a refraction of +2.0 -4.25 × 3°. Dilated fundus examination and macular optical coherence tomography revealed a CME in the left eye. Following topical nepafenac therapy and explantation of the ICL, we observed a complete resolution of the CME at 3 months with an improvement in BCVA to 20/32 in the left eye. Conclusions: To our knowledge, this is the first reported case of postsurgical CME following toric ICL implantation. In cases of phakic eyes with an intact posterior capsule, postsurgical CME can develop, thus highlighting the purpose of this report.

scholarly journals Early Results with a New Posterior Chamber Phakic Intraocular Lens in Patients with High Myopia

2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Dilek Yaşa ◽  
Ufuk Ürdem ◽  
Alper Ağca ◽  
Yusuf Yildirim ◽  
Burçin Kepez Yildiz ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Endothelial Cell ◽  
Intraocular Lens ◽  
High Myopia ◽  
Posterior Chamber ◽  
Phakic Intraocular Lens ◽  
Phakic Iol ◽  
Distance Visual Acuity ◽  
Early Results ◽  
Manifest Refraction

Purpose. To report clinical results of a foldable, hydrophilic acrylic, single-piece, injectable, posterior chamber phakic intraocular lens (pIOL).Material and Methods. Medical records of patients who underwent posterior chamber phakic IOL (Eyecryl Phakic IOL, Biotech Vision Care, Ahmedabad, India) implantation for surgical correction of myopia were retrospectively reviewed. Only patients with at least a one-year follow-up were included. Manifest refraction, uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), endothelial cell density (ECD), and pIOL vault were analyzed at 1, 3, 6, and 12 months after surgery. Complications observed during and after surgery were also recorded.Results. The study included 58 eyes of 29 patients. Mean patient age was 32 ± 7 years. Spherical equivalent of manifest refraction was −13.41 ± 3.23 D preoperatively and −0.44 ± 0.55 D postoperatively. Preoperative CDVA was 0.29 ± 0.71 logMAR. Postoperative UDVA and CDVA were 0.21 ± 0.66 and 0.15 ± 0.69 logMAR, respectively, at the 12-month visit. At the 12-month visit, the efficacy index was 1.20 and the safety index was 1.39. Mean ECD was 2713 ± 339 cells/mm2at the preoperative visit and 2608 ± 362 cells/mm2at the 12-month visit (3.9% loss,p<0.001). ECD loss from 3 months to 12 months was not statistically significant. No significant cataract formation, significant endothelial cell loss, glaucoma, uveitis, or any other vision-threatening complication was observed.Conclusion. Based on postoperative experience, we have found that Eyecryl Phakic IOL is safe and effective for treating high myopia.

scholarly journals Ex-PRESS shunt implantation for intractable glaucoma with posterior chamber phakic intraocular lens: a case report

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Rongrong Hu ◽  
Wei Xu ◽  
Baishuang Huang ◽  
Xiaoyu Wang
Keyword(s):  
Anterior Chamber ◽  
Intraocular Lens ◽  
High Myopia ◽  
Posterior Chamber ◽  
Filtration Surgery ◽  
Phakic Intraocular Lens ◽  
Glaucoma Filtration Surgery ◽  
Shallow Anterior Chamber ◽  
The Right ◽  
Intractable Glaucoma

Abstract Background Implantation of the posterior chamber phakic intraocular lens has been widely performed to correct high and extreme myopia. Chronic intraocular pressure (IOP) elevation may occur in its late postoperative period. For medically uncontrolled cases, surgical treatment is necessary, and benefits should be weighed against risks when determining whether to remove the lens. Case presentation A 32-year-old man with extremely high myopia presented with progressive blurred vision and medically uncontrolled IOP in the right eye. His past ocular history was significant for bilateral implantable collamer lens (ICL) implantation ten years ago. On ophthalmic examination, the ICL was well placed with a vault height of 456 µm in the right eye. The anterior chamber angles were open but narrow, and mild to moderate trabecular pigmentation was noted. Ex-PRESS glaucoma filtration surgery without ICL removal was performed to control IOP. During surgery, an Ex-PRESS P50 shunt was inserted into the anterior chamber via the front edge of the blue-grey transition zone between the sclera and cornea. Transient hypotony and shallow anterior chamber occurred in the first week after surgery, along with an ICL tilt towards the cornea with reduced vault height. No other complications related to either the ICL or the Ex-PRESS shunt were noted. IOP remained stable at 12 ~ 14 mmHg at the first 3-month follow-up. Conclusions Ex-PRESS glaucoma filtration surgery might be a safe and effective alternative treatment for intractable glaucoma with high myopia and ICL implantation. Careful assessment of the ICL position and anterior chamber angle is necessary to plan the appropriate surgical procedure. A postoperative shallow anterior chamber may result in ICL dislocation.

scholarly journals Phacomorphic glaucoma in a high myope with phakic intraocular lens

2019 ◽  
Vol 12 (2) ◽  
pp. e227096
Author(s):  
Talvir Sidhu ◽  
Arjun Desai ◽  
Meghal Gagrani ◽  
Tanuj Dada
Keyword(s):  
Intraocular Lens ◽  
Pressure Control ◽  
Sudden Onset ◽  
Angle Closure ◽  
Posterior Chamber ◽  
Light Perception ◽  
Phakic Intraocular Lens ◽  
Cataractous Lens ◽  
Posterior Chamber Intraocular Lens ◽  
The Right

We report a case of a young, one-eyed woman with high myopia who presented to our emergency department with sudden onset painful diminution of vision in the right eye after undergoing laser treatment. Her right eye had a phakic intraocular lens (pIOL) implantation 4 years back and her left eye had absent light perception. She was diagnosed as right eye lens induced secondary angle closure glaucoma with pIOL touching the corneal endothelium and left eye atrophic bulbi. She was admitted under eye emergency for medical intraocular pressure control followed by pIOL explantation with lens aspiration of the cataractous lens and posterior chamber intraocular lens implantation.

scholarly journals Cataract Extraction and Toric Intraocular Lens Implantation for the Management of Pellucid Marginal Degeneration and Cataract

2012 ◽  
Vol 1 (1) ◽  
pp. 66-67
Author(s):  
Irit Bahar ◽  
Omer Bialer
Keyword(s):  
Visual Acuity ◽  
Cataract Surgery ◽  
Intraocular Lens ◽  
Cataract Extraction ◽  
Senile Cataract ◽  
Posterior Chamber ◽  
Intraocular Lens Implantation ◽  
Toric Intraocular Lens ◽  
Lens Implantation ◽  
The Right

ABSTRACT We report cataract surgery with toric intraocular lens implantation for the management of senile cataract combined with pellucid marginal degeneration. A 72-year-old man with bilateral senile cataract and significant against-the-rule astigmatism sought counseling for blurry vision and glare, mostly in the right eye. Based on ophthalmic examination and corneal topography, a diagnosis of pellucid marginal degeneration and cataract was made. Since visual acuity and refraction had been stable in the past 3 years, the patient underwent cataract extraction and implantation of a custom-designed toric posterior chamber intraocular lens. Postoperative follow-up of 1.5-year demons- trated marked improvement in visual acuity, stable refraction and patient satisfaction. This treatment for pellucid marginal degeneration offers the simplicity of regular cataract surgery, and avoids the known complications of keratoplasty and other corneal surgical manipulation for the management of pellucid marginal degeneration. How to cite this article Bahar I, Bialer O. Cataract Extraction and Toric Intraocular Lens Implantation for the Management of Pellucid Marginal Degeneration and Cataract. Int J Keratoco Ectatic Corneal Dis 2012;1(1):66-67.

scholarly journals Unilateral Multifocal Intraocular Lens Implantation in a Patient with Adie’s Pupil

2018 ◽  
Vol 9 (2) ◽  
pp. 369-374 ◽  
Author(s):  
Stephen A. LoBue ◽  
Fukutaro Mano ◽  
Erin Schaefer ◽  
Thomas D. LoBue
Keyword(s):  
Visual Acuity ◽  
Intraocular Lens ◽  
Cataract Extraction ◽  
Posterior Chamber ◽  
Bilateral Cataract ◽  
Multifocal Iol ◽  
Pupillary Constriction ◽  
Lens Implantation ◽  
The Right ◽  
Bilateral Cataract Extraction

Purpose: To report a case of a patient with unilateral Adie’s pupil who underwent bilateral cataract extraction with multifocal and monofocal posterior chamber intraocular lens (IOL) implantation. Methods: A 74-year-old woman presented to our institution complaining of worsening near vision. Gross examination revealed a 6-mm fixed pupil on the right eye (OD) and a 5-mm pupil reacting to 3 mm with light on the left eye (OS). Slit lamp examination revealed a tonic pupil with an exaggerated pupillary constriction to dilute pilocarpine OD. Dilated exam revealed 2–3+ nuclear and cortical lens changes bilaterally. The patient’s active lifestyle, personality, and biometry measurements made her a good candidate for multifocal IOL (MfIOL) implantation OS. Femtosecond laser-assisted cataract extraction with a ReSTOR +3 ADD (SN60D1) implantation was performed OS. Monofocal lens implantation (SN60WF) was performed OD 6 months later. Results: One year postoperatively, our patient had an uncorrected visual acuity (VAsc) of 20/15 for distance and J10 for near OD. Her VAsc was 20/25 +1 for distance and J1 for near OS. Visual acuity when using both eyes was 20/15 for distance and J1 for near. Conclusion: Optimizing success for MfIOL implantation is a multifactorial process. Large pupils preoperatively are of particular concern, as this may lead to increased dysphotopsia with pupil-dependent MfIOLs. Thus, patients with unilateral mydriasis, such as Aide’s pupil, may have a beneficial outcome combining multifocal-monofocal implantation after bilateral cataract extraction, especially if they are not a candidate for monovision but desire spectacle independence.

Off-label use of percutaneous pulmonary valved stents in the right ventricular outflow tract: Time to rewrite the label?

2013 ◽  
Vol 81 (6) ◽  
pp. 987-995 ◽  
Author(s):  
Derize E. Boshoff ◽  
Bjorn L.M. Cools ◽  
Ruth Heying ◽  
Els Troost ◽  
Joelle Kefer ◽  
...  
Keyword(s):  
Right Ventricular ◽  
Right Ventricular Outflow Tract ◽  
Ventricular Outflow Tract ◽  
Outflow Tract ◽  
Off Label Use ◽  
Off Label ◽  
The Right ◽  
Label Use

scholarly journals Etiology and outcomes of current posterior chamber phakic intraocular lens extraction

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Hideki Hayakawa ◽  
Kazutaka Kamiya ◽  
Wakako Ando ◽  
Masahide Takahashi ◽  
Nobuyuki Shoji
Keyword(s):  
Visual Acuity ◽  
Patient Satisfaction ◽  
Intraocular Lens ◽  
Posterior Chamber ◽  
Phakic Intraocular Lens ◽  
Distance Visual Acuity ◽  
Lens Extraction ◽  
Refractive Outcomes ◽  
Uncorrected Distance Visual Acuity ◽  
Surgical Extraction

AbstractThis study was aimed to review the etiology and the outcomes of current posterior chamber phakic intraocular lens (Visian ICL, STAAR Surgical) extraction. This review comprised 770 eyes of 403 consecutive patients undergoing ICL extraction. We evaluated prevalence, etiology, uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), predictability, and patient satisfaction. ICL extraction was required in 8 of 770 (1.0%) eyes. The most common reason was the progression of the pre-existing cataract formation in 5 eyes (63%), followed by residual refractive errors in 3 eyes (38%). Of the 7 eyes targeted for emmetropia, 7 (100%) and 6 (86%) achieved UDVAs of 20/40 and 20/20 or better, respectively. Three eyes (38%) showed no change in CDVA, 3 eyes (38%) gained 1 line, 2 eyes (25%) gained 3 or more lines. 88% and 100% were within ± 0.5 and 1.0 diopter (D), respectively, of the targeted correction. Patient satisfaction improved significantly, from 3.0 ± 1.4 preoperatively, to 8.0 ± 2.4 postoperatively. No vision-threatening complications occurred. ICL extraction was required in approximately 1% of ICL-implanted eyes. Visual and refractive outcomes were good, and patient satisfaction was overall high, even in ICL-extracted eyes.

scholarly journals Development and treatment of cataract in myopic eye with phakic intraocular lens Fyodorov in the posterior chamber

2011 ◽  
Vol 58 (4) ◽  
pp. 97-101
Author(s):  
Milos Jovanovic ◽  
Anica Bobic-Radovanovic ◽  
Selimir Glisic ◽  
Zora Stankovic
Keyword(s):  
Visual Acuity ◽  
Intraocular Lens ◽  
High Myopia ◽  
Surgical Intervention ◽  
Posterior Chamber ◽  
Phakic Intraocular Lens ◽  
Corneal Incision ◽  
Clear Corneal Incision ◽  
Anterior Subcapsular Cataract ◽  
Capsular Bag

This is a case report of a female patient who, due to high myopia, had silicone phakic intraocular lens type Fyodorov with plate-haptics implanted in the posterior chamber (PC pIOLs). The anterior subcapsular cataract (ASC) resulted in significant reduction of visual acuity and, therefore, the patient, after 16 years of the first surgery, underwent another surgical intervention. She had the pIOLs explantation, phacoemulsification and implantation of the flexible intraocular lens (IL) in the capsular bag. Explantation of the pIOLs, cataract surgery by phacoemulsification and IOL implantation were carried out through the same clear corneal incision and the intraoperative course was uneventful. The visual acuity of the operated eye was equal to pre-cataract period.

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