scholarly journals Simultaneous phacoemulsification, lens implantation and endothelial keratoplasty: Triple procedure

2011 ◽  
Vol 68 (9) ◽  
pp. 800-803
Author(s):  
Ljubisa Nikolic ◽  
Vesna Jovanovic
Keyword(s):  
Visual Acuity ◽  
Intraocular Lens ◽  
Corneal Thickness ◽  
Good Choice ◽  
Endothelial Keratoplasty ◽  
Finger Counting ◽  
Triple Procedure ◽  
Lens Implantation ◽  
Lens Power ◽  
Fuchs Dystrophy

Introduction. Simultaneous Descemet stripping endothelial keratoplasty, phacoemulsification, and intraocular lens implantation are indicated in Fuchs? dystrophy with associated cataract. Compared to the standard method of the triple procedure which includes penetrating keratoplasty, this new method has the advantages of sutureless surgery, small limbal incision, faster recovery, less surface problems, less astigmatism, stronger tensile strength and more predictable calculation of the intraocular lens power. This is the first report of such a combination of procedures in our literature. Case report. A 76-year-old woman suffered from a gradual bilateral visual loss. The best corrected visual acuity was 20/60 (right eye) and finger counting at 1m (left eye). Corneal thickness was 590 ?m and 603 ?m, respectively. A marked cornea guttata and nuclear cataract were present in both eyes. Phacoemulsification, lens implantation, and Descemet stripping were done in the left eye. The posterior lamellar corneal graft, 8.0 mm in diameter and about 150 ?m thick, was bent and inserted through the limbal incision. The air was injected into the anterior chamber to attach the graft to the recipient stroma. The cornea remained clear, and the transplant was attached during a two-year follow-up. Visual acuity was 20/40 after two months, and 20/25 after one year. Conclusion. The new technique proved itself as a good choice for the treatment of a mild Fuchs? dystrophy associated with cataract.

scholarly journals Corneal Imaging and Densitometry Measurements in Patients with Fuchs' Dystrophy Undergoing Penetrating Keratoplasty and Descemet's Striping Automated Endothelial Keratoplasty

2021 ◽  
Author(s):  
Khaled Alzahrani ◽  
Arun Brahma ◽  
Fiona Carley ◽  
M. Chantal Hillarby
Keyword(s):  
Visual Acuity ◽  
Penetrating Keratoplasty ◽  
Corneal Thickness ◽  
Corneal Transplantation ◽  
Objective Evaluation ◽  
Endothelial Keratoplasty ◽  
Evaluation Tool ◽  
Corneal Densitometry ◽  
Post Surgery ◽  
Fuchs Dystrophy

Abstract Aims:In the present study, we used the densitometry software from the Oculus Pentacam to compare postoperative corneal clarity between penetrating keratoplasty (PK) and Descemet's stripping endothelial keratoplasty (DSAEK) in patients with Fuchs' dystrophy.Methods:A retrospective comparative study was carried out at Manchester Royal Eye Hospital. In 28 patients with Fuchs' dystrophy, corneal densitometry measurements were performed 12–18 months after corneal transplantation. The correlations of the densitometry measurements with the best corrected visual acuity (BCVA) and central corneal thickness (CCT) were analysed and compared between eyes that underwent PK and those that underwent DSAEKResults:Corneal densitometry measurements in the 33 eyes showed no significant differences between the PK and DSAEK post-surgery groups. There was no significant correlation between CCT and corneal densitometry measurements in either group (P > 0.05 in both cases). After DSAEK, corneal densitometry measurements were significantly correlated with BCVA in the central (P = 0.01), posterior (P = 0.007), and full-depth (P = 0.008) 0–2 mm zones of the cornea but not in PK group. The postoperative CCT was significantly different between the two groups (P˂0.01).Conclusion:The two types of corneal transplantation resulted in different outcomes in terms of corneal densitometry measurements. Improved visual acuity after DSAEK was found to positively correlate with improvements in corneal clarity. Oculus Pentacam provides an objective evaluation tool to monitor corneal status after surgery.

Factors influencing myopic shift in children after intraocular lens implantation

2019 ◽  
Vol 30 (5) ◽  
pp. 933-940 ◽  
Author(s):  
Sandra Valeina ◽  
Santa Heede ◽  
Renars Erts ◽  
Svetlana Sepetiene ◽  
Elina Skaistkalne ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Intraocular Lens ◽  
Intraocular Lenses ◽  
Intraocular Lens Implantation ◽  
Corrected Visual Acuity ◽  
Intraocular Lens Power ◽  
Lens Implantation ◽  
Myopic Shift ◽  
Lens Power ◽  
Best Corrected Visual Acuity

Introduction: Intraocular lenses have always been a controversial topic in pediatric cataract surgery. In the early 1990s in the post-Soviet states of Eastern Europe, intraocular lenses promised an easier full-time correction and amblyopia treatment. Since 1991, ophthalmologists in Latvia have been implanting intraocular lenses in infants. Amount of the postoperative myopic shift and its influencing factors, analyzed in this article, are important indicators of congenital cataract treatment. Materials and methods: A retrospective chart review off 85 children (137 eyes) who underwent foldable posterior chamber intraocular lens implantation at the Clinical University Hospital in Riga, Latvia, from 1 January 2006 until 31 December 2016, was performed. Depending on the age at surgery, patients were divided into six groups: 1–6, 7–12, 13–24, 25–48, 49–84, and 85–216 months. Results: The largest and more variable myopic shift was found in a group of diffuse/total and nuclear cataract with surgery before the age of 6 months. There was a statistically significant correlation between the acquired best-corrected visual acuity and the amount of myopic shift (rs = 0.33; p < 0.001). Comparing the amount of myopic shift in two groups of different intraocular lens implantation target refraction tactics, we did not find statistically significant differences. Comparing the amount of myopic shift and implanted intraocular lens power, a negative, statistically significant correlation was found. Conclusion: The earlier the cataract extraction surgery and intraocular lens implantation is performed, the larger the myopic shift. The morphological type of cataract, best-corrected visual acuity, secondary glaucoma, and intraocular lens power influence the amount of myopic shift.

scholarly journals Descemet Membrane Endothelial Keratoplasty in an Eye with Fuchs Endothelial Dystrophy and Keratoconus

2016 ◽  
Vol 1 (1) ◽  
pp. oapoc.0000002 ◽  
Author(s):  
Elizabeth Cooper ◽  
Jack S. Parker ◽  
John S. Parker ◽  
Gerrit R.J. Melles
Keyword(s):  
Intraocular Lens ◽  
Endothelial Keratoplasty ◽  
Intraocular Lens Implantation ◽  
Descemet Membrane Endothelial Keratoplasty ◽  
Descemet Membrane ◽  
Triple Procedure ◽  
Lens Implantation ◽  
Postoperative Time ◽  
Fuchs Endothelial Dystrophy ◽  
Significant Cataract

Purpose To report a case of Descemet membrane endothelial keratoplasty (DMEK) performed with phacoemulsification and intraocular lens implantation (triple procedure) for coexisting keratoconus (KC), Fuchs endothelial dystrophy (FED), and visually significant cataract. Case description One eye of one patient with moderate and stable KC, FED, and visually significant cataract was treated with combined DMEK and phacoemulsification with intraocular lens implantation (triple procedure). Visual acuity and corneal reflectivity/densitometry, thickness, and topographic measurements were recorded and compared to their preoperative values. At all postoperative time points, the endothelial graft was found to be completely attached. By 3 months postoperatively, the patient's best spectacle corrected vision had improved from 20/50 (0.4) to 20/25 (0.8) where it remained stable. No intra- or postoperative complications were experienced. Conclusions DMEK may be an effective alternative to penetrating keratoplasty in eyes with coexisting stable KC and FED.

scholarly journals Effect of phacoemulsification with intraocular lens implantation in eyes with cataract and functioning filtering blebs

2013 ◽  
Vol 13 (2) ◽  
pp. 33-41
Author(s):  
Devendra Maheshwari ◽  
Rengappa Ramakrishanan ◽  
Mohideen Abdul Kader ◽  
Neelam Pawar ◽  
Ankit Gupta
Keyword(s):  
Visual Acuity ◽  
Intraocular Pressure ◽  
Intraocular Lens ◽  
Intraocular Lens Implantation ◽  
Corrected Visual Acuity ◽  
Lens Implantation ◽  
The Mean ◽  
One Year ◽  
Best Corrected Visual Acuity

Aim: To evaluate the effect of phacoemulsification with intraocular lens implantation in eyes with pre-existing trabeculectomy.Methods: This prospective single-center clinical study evaluated intraocular pressure in 60 eyes of 60 patients who underwent phacoemulsification and implantation of a foldable intraocular lens after a previous successful trabeculectomy. Patients who had a trabeculectomy more than one year prior to the study were included. Intraocular pressure, number of antiglaucoma medications, bleb appearance, and visual acuity were recorded preoperatively, and at each follow-up examination and 12 months after phacoemulsification.Results: The mean intraocular pressure before phacoemulsification was 12.42 mmHg (SD, 4.60 mmHg), which increased to 14.98 mmHg (SD, 4.18 mmHg), 14.47 mmHg (SD, 3.58 mmHg), 15.44 mmHg (SD, 3.60 mmHg), and 15.71 mmHg (SD, 3.47 mmHg) after one, three, six, and 12 months, respectively. At each follow-up visit, the mean IOP was significantly higher than the preoperative value (p < 0.001, p = 0.015, p ≤ 0.001, and p = 0.001 at month one, three, six, and 12, respectively). The mean preoperative best-corrected visual acuity was 0.98 logMAR (SD, 0.44 logMAR) and the mean postoperative best-corrected visual acuity at 12 months was 0.20 logMAR (SD, 0.21 logMAR) [p = 0.0001]. The mean preoperative number of antiglaucoma medications used was 0.57 (SD, 0.63), which increased to 0.65 (SD, 0.63 ), 0.70 (SD, 0.72 ) 0.68, (SD, 0.70), and 0.67 (SD, 0.77 ) at one, three, six, and 12 months, respectively, but there were no statistically significant differences. Bleb size decreased clinically after phacoemulsification. Nineteen of 60 eyes (32%) developed fibrosis of bleb with decreased bleb size.Conclusion: Phacoemulsification with intraocular lens implantation significantly increased intraocular pressure and increased the number of antiglaucoma medications in eyes with pre-existing functioning filtering blebs.

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