Intraocular lens-sling technique: A safe approach for lens implantation in complicated cataract surgery and secondary intraocular lens implantation

Among 20 million cataract surgeries being performed worldwide every year, approximately 5% are being complicated by posterior capsule rent or zonular dialysis. Intraocular lens (IOL) implantation in such cases with intraoperative complications is quite challenging. Our next course of action is to place the IOL in the ciliary sulcus, however, there is a risk of IOL drop into the vitreous in cases of inadequate support. We have described a novel idea of using a suture material through the dialling hole of a three-piece rigid IOL which can be used as a leash to reduce the risk of IOL drop during implantation in such cases. This technique could also be used during sutureless scleral fixated IOL and retro-pupillary iris claw lens implantation. We found that in 90 consecutive patients where this technique was used, there was no incidence of IOL drop or retinal detachment.

Pars plana vitrectomy with posterior iris claw implantation for posteriorly dislocated nucleus and intraocular lens.

We evaluated the safety and efficacy of pars plana vitrectomy (PPV) with primary posterior iris claw intraocular lens (IOL) implantation in cases of posterior dislocation of nucleus and IOL without capsular support. This was a retrospective interventional case series. Fifteen eyes underwent PPV with primary posterior iris claw IOL implantation performed by a single vitreoretinal surgeon. The main outcome measures were changes in best corrected visual acuity and anterior and posterior segment complications. A total of 15 eyes were included in this study. Eight had nucleus drop, three had IOL drop during cataract surgery and four had traumatic posterior dislocation of lens. The final postoperative best corrected visual acuity was 20/60 or better in 11 patients. This procedure is a viable option in achieving good functional visual acuity in eyes without capsular support.

Clinical Outcomes of Implantable Contact Lens and Iris-Fixed Intraocular Lens for Correction of Myopia

PURPOSE: We compared the results of implanting an implantable contact lens (ICL) and an iris claw lens (Artisan(R) lens) in patients' wtih myopia and sought to determine a basis for choosing between the two lenses. METHODS: ICLs were implanted in 32 eyes of 18 patients, and Artisan(R) lenses were implanted in 40 eyes of 23 patients. Uncorrected visual acuity, refraction, endothelial cell density, intraocular pressure, and slit lamp measurements were taken for 12 months. RESULTS: All the patients had improved UCVA from the day after the operation until the 12th month. The mean spherical equivalent refraction at postoperative month 12 was -0.78+/-0.54D in the ICL group and -0.78+/-0.59D in the Artisan(R) lens group. In the same period, endothelial cell density loss was 5.34% in the ICL group but was not significant in the Artisan(R) lens group. There were no significant complications in either group. CONCLUSIONS: Both ICL and Artisan(R) lens implantation resulted in immediate visual improvement and stability of vision during the follow-up period. There was no significant difference in post-operative results. Further study will be needed to decide which lens is the better choice for delicate conditions in myopic patients.

Effect of Implantation of Verisyse Iris-claw Intraocular Lens for the Correction of High Myopia / 中国康复理论与实践

@#Objective To investigate the effect of Verisyse iris-claw intraocular lens implantation on correction of high myopia.Methods9 patients with highly myopic (18 eyes and diopter between-6.75 DS to-28.00 DS) were treated with Verisyse intraocular lens implantation. All the treated eyes were observed for uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), intraocular pressure, anterior segment changes and corneal endothelium preoperatively and postoperatively.ResultsThe implantation was successfully performed in all of 18 eyes. After 3 months, 11 eyes (61.1%) had the uncorrected visual acuity (UCVA) ≥0.5; 9 eyes (50.0%) had the best corrected visual acuity (BCVA) ≥0.8. UCVA and BCVA of every eye were significant improved ( P<0.01); the mean corneal astigmatism and mean intraocular pressure were not different from preoperation ( P>0.05). In all patients, one eye was oval and 2 other eyes showed decentered phakic IOL; 2 patients (2 eyes) complained of halo and glare; no severe complications occurred.ConclusionThe implantation of Verisyse iris-claw intraocular lens for the correction of high myopia has a significantly effect.

Clinical Result of Iris Claw Lens and Trans-scleral Fixation Technique of Posterior Chamber Lens

Recently, with the development of ophthalmic surgical technique, many of aphakic patients want secondary implantation of intraocular lens. In aphakic eye without posterior capsule, implantation of posterior chamber lens can be performed by sulcus fixation of lens with prolene suture. But sulcus fixation technique has some complications as iP~rmanent fistula, rotation or tilting of the optics, hyphema, endophthalmitis and so on. In this study, 24 aphakic eyes, 22 patients implanted withl itis claw lens were compared with 13 aphakic eyes, 13 patients implanted with sulcus fixated posterior chamber IOLs. In 24 eyes implanted with iris claw lens, 18 eyes (75%) had a postoperative visual acuity of 20/40 or better and cystoid macular edema, intraocular lens dislocation were observed on each 2 eyes (8.3%) and iridodialysis on 1 eye (4.1 %). In 13 eyes implanted with sulcus fixed PCLs, 12 eyes (92%) had a postoperative visual acuity of 20/40 or better, and cystoid macular edema, vitreous hemorrhage, acute iridocyclitis and glaucoma were observed in each 1 case (7.7%). In aphakic eyes without posterior capsular support, iris claw lens will be a alternative method of intraocular lens implantation.