Outcomes of the sutureless-intrascleral fixation of posterior chamber intraocular lens implantation using modified Yamane's technique / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM:To observe the post-operative outcomes, safety and complications of the sutureless-intrascleral fixation of posterior chamber intraocular lens(SF-PCIOL)by using the modified Yamane's technique.<p>METHODS:This study involved 5 patients who underwent SF-PCIOL with the modified Yamane's technique, from December 2017 to September 2018. The longest follow-up time was 12mo, and the primary outcomes included uncorrected visual acuity(UCVA, LogAMR)and bestcorrected visual acuity(BCVA, LogMAR), intraocular pressure and the location and stability of IOLs.<p>RESULTS: The BCVA of 3 patients were ranged from 0.0 to 0.1 by the time of following up 12mo postoperatively. The difference between the spherical equivalent refraction and the predicted spherical equivalent refraction was in a range of 0.11-0.62 diopters. In the other two cases, at 3mo after the surgery, the UCVA was 0.2 for one case, and the BCVA was the same as preoperative corrected visual acuity for another case, where the patient manifested corneal leucoma and macular edema prior to surgery. During the follow-up period, the flanges and the IOL haptics of all the recruited patients were maintained in an ideal position, the optics were located in center of the pupils, and no visible IOL decentration or tilt was observed. Neither hypotony nor other complications were discovered in all the cases.<p>CONCLUSION: For SF-PCIOL by using modified Yamane's technique, smaller incisions and shorter operation time are feasible, and the need for scleral flaps, sutures and fibrin glue is eliminated. The IOLs are well centered and fixed securely. A learning curve is necessary to master this surgery technique. As revealed by our initial observation, the surgery is capable of producing satisfactory and consistent postoperative outcomes for patients with fewer postoperative complications as long as the crucial points are fully understood.

Vertical fixation with fibrin glue-assisted secondary posterior chamber intraocular lens implantation in a case of surgical aphakia.

We report the first case of vertical fixation by fibrin glue-assisted secondary posterior chamber intraocular lens implantation in a case of surgical aphakia. Advantages of vertical fixation are discussed.

Clinical Outcomes of Secondary Intraocular Lens Implantation in Vitrectomized Aphakic Eyes Due to Ocular Trauma

PURPOSE: To evaluate the clinical outcomes of secondary intraocular lens (IOL) implantation in eyes that underwent pars plana vitrectomy and lens removal due to ocular trauma. METHODS: We retrospectively investigated 40 vitrectomized aphakic eyes that had received secondary IOL from March 2005 to January 2012. Various parameters including pre- and postoperative best corrected visual acuity (BCVA) were reviewed. RESULTS: Incidence was higher in males (n = 35, 89.7%) and highest in the 6th decade of life (n = 13, 33.3%). Mean preoperative refractive error was +9.99 +/- 2.80 D in spherical equivalent, and astigmatism was 1.80 +/- 1.73 D. Mean BCVA (log MAR) was 0.53 +/- 0.51 preoperatively and 0.54 +/- 0.46 at 6 months postoperatively. Postoperative refractive error was -1.28 +/- 1.40 D and the astigmatism was 2.54 +/- 1.52 D. The difference between the target and postoperative refractive error was a myopic shift of -0.63 +/- 1.44 D. Postoperative BCVA had no significant correlation with preoperative factors other than preoperative BCVA (p < 0.001). The most common complication was temporarily increased IOP in 4 eyes. Choroidal detachment, recurrence of retinal detachment, bullous keratopathy, and cystoid macular edema were each found in 1 eye. IOL dislocation was corrected with reoperation in 2 eyes. CONCLUSIONS: Secondary IOL implantation can be performed safely in vitrectomized aphakic eyes due to ocular trauma and can be recommended in patients with good preoperative BCVA. Myopic shift of the postoperative refractive error should be considered when calculating IOL power.

Surgical Results of Transscleral Fixation of Foldable Acrylic Intraocular lens with Unique Shape of Haptics

PURPOSE: To report the surgical results of transscleral fixation of foldable acrylic intraocular lens with a unique haptic shape (CORNEAL(R), ACR6D, France). METHODS: We analyzed the medical records of 18 patients (19 eyes) who had transscleral fixation of posterior chamber intraocular lens implantation from July 2004 to July 2006. RESULTS: According to the cause of operation, there were five eyes with complicated cataract, eight with trauma, and six with aphakia associated with a previous operation. The mean age of the patients was 55.9+/-21.2 years. The mean preoperative best-corrected visual acuity was 0.31+/-0.35, and the postoperative value was 0.63+/-0.29 (p<0.05). The mean preoperative spherical refractive equivalent was 6.58+/-5.33 diopter, and the postoperative value was -1.77+/-1.59 diopter. The mean refractive error was -1.13+/-1.57 diopter. This showed a myopic shift (p<0.05). The mean astigmatism decreased with time, and it stabilized two months after the operation. The trend was toward mild against-the-rule astigmatism. The mean follow-up duration was 11.0+/-7.6 months. CONCLUSIONS: In eyes with inadequate capsular support, transscleral fixation of posterior chamber intraocular lens implantation with CORNEAL(R) lenses is a safe and effective procedure for visual correction.

The Refractive Change after Secondary Intraocular Lens Implantation

The authors analyzed one hundred and forty-six consecutive patients(146 eyes) receiving secondary intraocular lens implantation from May 1983 to September 1990 in respect to refractive change. The results were as follows: 1. The secondary implantation is gradually increased year by year and age range of that becomes younger than before. 2. ACL is replaced with PCL according to the introduction of transs-cleral fixation techmque. 3. The postoperative corrected visual acuity shows no difference between ACL group and PCL group. 4. The change of keratometric reading between before and after secondary IOL implantation shows 66.1% within 1 diopter. 5. The final refractive error shows no difference between ACL group and PCL group. 6. The final change of refractive error in relationsphip between with IOL power calculation and without that shows no different change. 7. The postoperative complication shows that after-cataract is the most common in PCL group and glaucoma in ACL group. The incidence of complication is not different between the two groups.

Clinical Results of Secondary Intraocular Lens Implantation

We conducted a retrospective study of sixty four consecutive patients(68 eyes) receiving secondary intraocular lens implants from May 1983 to August 1988. Most common reason why did not implant IOL at primary cataract operation was poor understanding on cataract operation, and most common motivation for secondary IOL implantation was ocular discomfort with spectacles or contact lenses. Final postoperative visual acuity of 0.5 or better was acquired 55 eyes(80.9%). Patients requiring anterior vitrectomy had the least favorable outcome, with a 7.5% incidence of retinal complications. There were 40 eyes(83.3%) in which endothelial cell loss under 30% developed, compared with contralateral phakic eyes. Complications included cystoid macular edema(5.9%), fibrinous membrane on IOL surface(2.9%), retinal detachment with bullous keratopathy(2.9%), neovascular glaucoma(1.5%), dislocation of posterior chamber lens(1.5%) and after cataract(1.5%). These data show secondary IOL implantations to be safe and effective, but greater caution is recommended for patients who will require anterior vitrectomy beca use of the higher rate of retinal complications.