Porous polyethylene implant motility without muscle attachment

The clinical objective of this study was to evaluate a simple technique for porous polyethylene spherical implants after enucleation and to review literature to compare this technique with the classic technique. This study included 32 eyes but 7 cases could not be followed postoperatively, so only 25 cases were reported. The patients were not age or gender matched. Patients included in this study were patients coming for enucleation of their blind disfiguring, blind painful eye or blind disfiguring painful eye. No case of intraocular tumors was present in this study. Exclusion criteria were marked ocular motility defect, shallow contracted fornices, ocular infection, severe orbital vascular disorder or severe conjunctival fibrosis and dryness. Patients with lax lower lids underwent lid tightening surgery. All patients were operated under general anesthesia after a written consent was made. Patients were given systemic antibiotics for five days and local antibiotic drops for at least four weeks. Fitting of the prosthesis starts after four weeks. Outcome is assessed subjectively from patient satisfaction and reporting pain, if present. Objectively motility was assessed by reporting implant movement in the four cardinal position of gaze. Motility was described as good [15 degrees or more], fair [less than 15 degrees] or no motility. Follow up ranged from 6 months to 25 months. The average follow up period was 14.8 months. Good motility was achieved in 22 cases and fair motility in 3 cases. No pain was reported in 14 cases, tolerable pain in 9 cases and severe pain in 2 cases. Patients were satisfied in 18 cases, partially satisfied in 6 cases and unsatisfied in one case

Phakic anterior chamber lenses for the correction of high myopia

This study aimed to evaluate the clinical and refractive outcome of angle supported phakic intraocular lenses [PIOLs] in the correction of high myopia. Thirty-one eyes of 17 highly myopic patients with a mean age of 27.9 [ +/- 5.1 SD] years were implanted with PIOLs [phakic 6 IOL, OII]. Mean preoperative spherical equivalent [SE] was -16.9 diopters [ +/- 3.84 SD]. Preoperative evaluation included subjective refraction, slit lamp biomicroscopy, tonometry and dilated fundus examination for all patients. PIOL power calculation was based on subjective refraction, AC depth and keratometry using the nomogram supplied by the PIOL manufacturer. Mean follow up period was 11.8 months [range 6-18 months]. The results revealed that mean preoperative best-corrected visual acuity [BCVA] was 0.8 [ +/- 13 SD]. Mean postoperative SE was -0.86 [ +/- 0.75 SD]. Mean postoperative uncorrected visual acuity [UCVA] was 0.67 [ +/- 0.27]. Mean postoperative BCVA was 0.97 [ +/- 0.04 SD]. Specular microscopy was performed on 15 patients preoperatively and at 12 months postoperative. It showed a mean reduction of endothelial cell density of 5.6% one year after surgery. Postoperative anterior uveitis occurred in 2 patients [6.4%]. Pupil ovalization occurred in 2 patients [6.4%] at 12 months postoperative. Steroid induced ocular hypertension occurred in 3 patients [9.6%] at one week postoperative and resolved on adding a topical beta blocker until topical steroids were tapered then discontinued. The study concluded that PIOL implantation is a relatively simple, potentially reversible and a precise procedure for correction of high myopia. It has a predictable and stable refractive outcome. Longer follow up, however, is necessary to evaluate long-term complications such as endothelial cell loss, cataract formation, iris retraction and retinal changes