ABSTRACT
PURPOSE: To assess the long-term (6-12 years) results and complications of glued transscleral-fixated intraocular lens (IOL). SETTING: Dr. Agarwal's Eye Center, Chennai, India. DESIGN: Retrospective case series. METHODS: Eyes with glued IOL of more than 5-year follow-up were evaluated. Visual acuity (logarithm of the minimum angle of resolution [logMAR]), IOL tilt, corneal topography, corneal endothelial cell density, intraocular pressure, central corneal thickness, central foveal thickness, and ocular residual astigmatism (ORA) were evaluated. RESULTS: Overall, 91 eyes (63 patients) with mean postoperative 8.2 ± 2.3 years were analyzed. The duration was 10 to 12 years in 31 eyes (34%), 9 years in 14 eyes (15.3%), and 6 to 9 years in 46 eyes (50.5%). No subscleral haptic was visible in 50% eyes. Mild, moderate, and severe grade of haptic visibility was noted in 33.5%, 9.4%, and 7%, respectively. The corrected distance visual acuity (CDVA) was 0.50 ± 0.50 logMAR. Clinically, no tilt was seen in 87 eyes (95.6%), whereas detectable tilt was seen in 4 eyes (4.3%). The optical coherence tomography microtilt was 0.8 ± 1.7 and 0.4 ± 1.2 degrees in 90- and 180-degree axes, respectively. The mean iris vault was 0.45 mm, and the mean ORA was 1.10 ± 1.00 diopter. Complications were glaucoma (7.6%), IOL luxation (4.4%), retinal detachment (3.2%), macular edema (4.3%), corneal decompensation (3.2%), uveitis (2.1%), and uveitis-glaucoma-hyphema syndrome (1%). Haptic reposition (3.2%), retinal detachment surgery (3.2%) keratoplasty (1%), pupilloplasty (2.1%), and IOL explantation (1%) were the second surgeries performed. CONCLUSIONS: Glued IOL has shown good anatomical and functional stability with minimal incidence of vision-threatening complications on long-term.
Subject(s)
Lenses, Intraocular , Tissue Adhesives , Adhesives , Capsules , Fibrin Tissue Adhesive , Humans , India , Lens Implantation, Intraocular , Postoperative Complications , Retrospective StudiesSubject(s)
Adhesives/adverse effects , Device Removal/methods , Dexamethasone/adverse effects , Foreign-Body Migration/diagnosis , Lenses, Intraocular , Ophthalmologic Surgical Procedures/methods , Anterior Chamber/pathology , Dexamethasone/administration & dosage , Drug Implants/adverse effects , Foreign-Body Migration/surgery , Glucocorticoids/administration & dosage , Glucocorticoids/adverse effects , Humans , Intravitreal Injections , Male , Middle Aged , Reoperation , Slit Lamp Microscopy , Tomography, Optical CoherenceABSTRACT
PURPOSE: To report ophthalmic features in hyperornithinemia-hyperammonemia-homocitrullinuria syndrome, an uncommon presentation. METHODS: Case report. RESULTS: An 18-year-old Indian boy presented with progressive diminution of vision, night blindness, lenticular opacities, and midperipheral chorioretinal atrophy. Spectral domain optical coherence tomography revealed myopic foveoschisis, and Humphrey visual fields 30-2 showed peripheral field constriction. He had no neurocognitive disabilities. Serum biochemical analysis revealed hyperornithinemia, hyperglycinemia, and raised ornithine/citrulline ratio suggestive of hyperornithinemia-hyperammonemia-homocitrullinuria syndrome. CONCLUSION: Ocular findings of midperipheral chorioretinal degeneration with myopic foveoschisis can be the initial presenting manifesation of hyperornithinemia-hyperammonemia-homocitrullinuria syndrome.
