Efficacy and safety of the implantation of a single-piece angulated foldable IOL in the sulcus.

PURPOSE: To study the visual results and tolerance of a Zeiss CT Lucia 601P intraocular lens (IOL) implanted in the sulcus after complicated cataract surgery or during IOL exchange for clouded IOL. METHODS: In total, 64 patients who underwent sulcus implantation were recalled to the hospital to undergo subjective and objective refraction, best corrected visual acuity measurement, tonometry, optical coherence tomography, laser flare photometry, biometry, and wavefront aberrometry. RESULTS: In spite of a large variation in preoperative refraction, the target refraction was obtained within 1.5 diopters in approximately 97% of patients and within 0.5 diopter in 53% of patients. Average BCVA was high (Snellen 0.86) and related to concomitant (mostly retinal) pathologies in eyes with poorer visual performance. Wavefront aberrometry showed no evidence of IOL tilting or decentration after long-term implantation in the sulcus. Tonometry was not different from the fellow eye of the patient (p > 0.5). In 53 patients with bilateral pseudophakia, the laser flare photometry was not significantly different from the fellow eye (p < 0.05). CONCLUSION: This study demonstrates that this single-piece angulated foldable acrylic IOL can be considered for implantation in the sulcus. The visual results are favorable, and the IOL can be well-positioned and tolerated in the sulcus. Moreover, there were no safety issues found since there was no evidence of elevated IOP or chronic uveitis.

Sutureless scleral fixation Carlevale IOL: a review on the novel designed lens.

BACKGROUND:  Complicated cataract surgery is the main cause of secondary lens implantation surgery. Several approaches have been introduced to face those circumstances. As it concerns scleral-fixated IOLs for the posterior chamber, many types of IOL can be implanted. The aim of article is to review the single piece sutureless scleral fixation Carlevale lens; Methods: Narrative review; Results: Several works described as safe the IOL implantation utilizing the handshake approach, without tactile manipulation, which allows for self-centration and lens firm fixation in uncomplicated surgery. This allows to reduce high order aberration such as astigmatism and coma, with a very good postoperative BCVA Conclusions: Carlevale lens is one of the best option to manage insufficient capsular support.

Management of sulcus-fixated single-piece intraocular lens-induced pigmentary glaucoma with 3-piece IOL exchange.

PURPOSE: To describe our experience with exchanging sulcus-fixated single-piece intraocular lens (IOL) with 3-piece IOLs for management of pigmentary glaucoma. METHOD: In this retrospective study, records of patients who underwent sulcus-fixated single-piece IOL exchanged with 3-piece IOLs were retrieved, and demographic and baseline data of patients, type of IOL, pre- and post-IOL exchange BCVA, IOP, number of anti-glaucoma medications, and optic nerve head examination were documented. Baseline and final examinations were analyzed and compared. RESULTS: Mean age of the patients was 59 ± 10 years, and 5 (41.6%) were female. Mean interval between primary cataract extraction operation and IOL exchange was 17 ± 5 months. Nine patients received in sulcus implantation of Alcon SA60AT, and three patients had SN60WF model at the end of primary surgery. BCVA changed insignificantly from 0.06 ± 0.06 logMAR to 0.06 ± 0.06 after IOL exchange. (P = 0.22) IOP was controlled in 8 cases (66.6%), but four cases (33.3%) needed glaucoma surgery to further control glaucoma condition. IOP decreased significantly from preoperative 17 ± 3 to 14 ± 1 mmHg postoperatively. Patients with advanced age and higher baseline IOP were more likely to undergo glaucoma surgery after IOL exchange. (P = 0.07 and 0.00, respectively). CONCLUSION: single-piece IOL exchange with 3-piece IOL dramatically decreases pigment release and reduces IOP. Those with advanced age and higher IOP are less likely to respond to IOL exchange and may need glaucoma surgery to control high intraocular pressure.

Clinical Outcomes of Aspheric 1-Piece (Tecnis(R) ZCB00) and 3-Piece (Tecnis(R) ZA9003) Aspheric Intraocular Lens for 12 Months

PURPOSE: To evaluate the postoperative outcome of Tecnis(R) ZCB00 1-Piece acrylic intraocular lens (IOL), the new single piece, aspheric IOL until 12 months. METHODS: Sixty eyes undergone cataract surgery using two different IOLs; The Tecnis(R) ZCB00 1-Piece Acrylic IOL (30 eyes) and the Tecnis(R) ZA9003 3-Piece Acrylic IOL (30 eyes). Cataract surgery was performed in the same period. All complicated cases were excluded. Best corrected visual acuity (BCVA), refractive error, photopic and mesopic contrast sensitivity, total high order aberration, spherical aberration and anterior chamber depth were measured preoperatively and at 1, 6 and 12 months after surgery. RESULTS: There were no statistically significant differences between two groups in BCVA, refractive error, total high order aberration and spherical aberration all the time after surgery. Both groups have negative ocular spherical aberration until 12 months after surgery. 1-piece and 3-piece groups had different tendency in axial movement. But there were no statistically significant differences in anterior chamber depth measured at 1 week, 1, 6 and 12 months after surgery. There was no statistically significant difference in contrast sensitivity at 1, 6 and 12 months after surgery. CONCLUSIONS: The Tecnis(R) ZCB00 1-Piece acrylic intraocular lens (IOL) showed comparable clinical outcomes to the Tecnis(R) ZA9003 3-Piece acrylic intraocular lens (IOL) until 12 months after cataract surgery. 1-piece and 3-piece IOL group had different tendency in axial movement. However, refraction remained stable during 12 months after surgery. Mostly, both IOL groups had negative ocular spherical aberration during whole follow-up period.