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Safety and Efficacy of Artisan aphakia Iris-Claw Intraocular Lens in Tertiary Hospital in Indonesia

Open Journal of Ophthalmology 2021年第1期11卷 25-35页

作者： Emmy Dwi Sugiarti Azalia Latuasan Andrew M. H. Knoch Budiman Budiman Cataract and Refractive Surgery Unit National Eye Centre Cicendo Eye Hospital Bandung Indonesia Ophtalmology Department Faculty of Medicine Universitas Padjadjaran Bandung Indonesia

Introduction: Iris-claw Intraocular Lens (IOL) is one of the alternatives to correct aphakia without sufficient capsular support. This technique is preferred because it has a simple procedure. Iris-claw IOL was originally designed to be fixated on the anterior chamber. The use of retropupillary fixation is increasing because the location is more physiologic and it shows less risk to corneal endothelial damage. Purpose: To describe safety and efficacy of iris-claw Artisan IOL in correcting aphakia without sufficient capsular support. Methods: This is a descriptive retrospective study of patients with aphakic iris-claw Artisan IOL implantation in National Eye Center Cicendo Eye Hospital, Indonesia from July 2017-July 2019. Patients were divided into prepupillary and retropupillary group. The Uncorrected Visual Acuity (UCVA), Best-Corrected Visual Acuity (BCVA), Safety Index (SI), Efficacy Index (EI), and complications were recorded. The procedure is safe if SI value ≥ 1.0 and effective if EI value ≥ 1.0. Results: There were 54 eyes in the retropupilary group and 17 eyes in the prepupillary group. In the prepupillary group, there were 94.11% eyes with SI ≥ 1.0, the mean SI was 1.79 ± 1.02, 50% of eyes with EI ≥ 1.0, and the mean EI was 0.77 ± 0.20. In the retropupillary group, there were 96.29% eyes with SI ≥ 1.0, the mean SI was 2.49 ± 2.23, 74.07% of eyes with EI ≥ 1.0, and the mean EI was 1.75 ± 1.64. Postoperative UCVA and BCVA were improved significantly compared to preoperative visual acuity in both groups (p Conclusion: Prepupillary and retropupillary iris-claw IOL implantation are safe. Retropupillary fixation technique is more effective in improving visual acuity.

关键词： Iris-Claw aphakia Safety Index Efficacy Index

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Y-Shaped Intra-Scleral Fixated Lens versus Retro-Pupillary Iris Claw Lens in the Treatment of aphakia

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Open Journal of Ophthalmology 2019年第2期9卷 105-124页

作者： Ahmed Mohamed Morshed Mahmoud Nasr Aldeeb Adel Kamal Abdeen Salah Mohamed Almosalamy Ophthalmology Department Faculty of Medicine Zagazig University Zagazig Egypt

Background: Many reasons can lead to an aphakia without adequate capsular support for implantation of a posterior chamber intraocular lens (IOL), such as intraoperative unintentional rupture of posterior capsule during phacoemulsification, planned intracapsular cataract extraction, ocular trauma and lens dislocation due to congenital and acquired causes. Purpose: To compare Y-shaped intra-scleral fixation of a posterior chamber IOL with retro pupillary fixation of an iris-claw intraocular lens (IOL) for Aphakic eyes without sufficient capsular support as respects safety, visual recovery and complications of both methods. Patients and Methods: One hundred Aphakic eyes were arbitrarily distributed between two groups. Group A included 50 eyes treated with retropupillary fixation of iris claw lens and group B included 50 eyes treated with Y-shaped intra-scleral fixation technique. Preoperative, intraoperative and postoperative data were analysed including best corrected visual acuity (BCVA), intraocular pressure (IOP), surgical time, intraoperative problems, IOL malposition and postoperative complications. Following up on patients was carried out for at least six months. Results: The mean duration of surgery was 21 ± 5.3 min in group A and was 53.4 ± 6.9 min in group B (p-value 0.05). IOL tilt was found in 0 (0%) eyes in group A and in 5 (10%) eyes in group B (p 0.05). Conclusion: The results of our study indicated that both methods are satisfactory in correcting aphakia without sufficient capsular support as regards postoperative best corrected visual acuity (BCVA);however the surgical technique of retropupillary iris claw lens is easier, shorter, with low intra- and postoperative complications and safer than those used for intra-scleral fixation of IOL. But for eyes which lack both iris and capsular support, a scleral fixation of a posterior chamber IOL remains the only option.

关键词： aphakia Iris-Claw Intraocular Lens (IOL) Y-Shaped Intra Scleral Fixation

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Effect of silicone oil removal on central corneal thickness

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International Journal of Ophthalmology(English edition) 2012年第3期5卷 374-376页

作者： Gul Arikan Zeynep Ozbek F Hakan Oner Ismet Durak A Osman Saatci Department of Ophthalmology Dokuz Eylul UniversityIzmirTurkey

AIM:To evaluate the effect of silicone oil removal(SOR) on central corneal thickness(CCT) in aphakic and pseudophakic eyes prospectively.· METHODS:Patients who underwent SOR surgery between June 2005-August 2007 were included in this *** oil was actively removed behind the posterior capsule through the pars plana sclerotomy site(posterior approach) in pseudophakic eyes and through the pupil and the corneal tunnel incision(anterior approach) in aphakic eyes with the 18-gauge *** was assessed with Orbscan II corneal topography system preoperatively and at one month and three months postoperatively.A total of 34 eyes of 34 patients(26 males,8 females) comprised the study *** age was(55.6±12.3) years(Range:25-80 years).Twenty-six eyes(76.5%) were pseudophakic and 8(23.5%) *** time between silicone oil injection and removal was(15.1±13.6) months(Range:5-54 months).At baseline,CCT was 576.4±46.0μm in pseudophakic eyes and 611.6±36.2μm in aphakic eyes.· RESULTS:At the first postoperative month CCT was(573.3±40.1)μm and(630.9±72.9)μm in pseudophakic and aphakic eyes *** the third postoperative month,CCT was(582.7±49.5)μm and(614.5±82.4)μm in pseudophakic and aphakic eyes *** was no statistically significant difference in CCT measurements one month and 3 months after SOR when compared to preoperative values in both aphakic and pseudophakic eyes(P> 0.05).· CONCLUSION:Active SOR either by anterior or posterior approach did not affect the CCT.·

关键词： aphakia central corneal thickness silicone oil pseudophakia

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Evaluation of suturless scleral fixation with posterior chamber foldable intraocular lens implantation

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International Journal of Ophthalmology(English edition) 2019年第8期12卷 1283-1289页

作者： Ahmed MBedda Hesham FElGoweini Ahmed MAbdelhadi Amr MElhady Department of Ophthalmology Alexandria UniversityAlexandria11511Egypt Department of Ophthalmology the General OphthalmologyHospitalAlexandria21515Egypt

AIM: To assess the sutureless scleral fixation technique for posterior chamber foldable intraocular lens(PCIOL) implantation in aphakic eyes with insufficient or no capsular support. METHODS: A technique for sutureless intrascleral fixation of the haptics of a standard 3-piece PCIOL was used which ensures sutureless fixation by permanent incarceration of the haptics in a scleral tunnel parallel to the limbus. All patients were evaluated for preoperative status [visual acuity, refractive error, K readings, intraocular pressure(IOP) measurement, slit lamp examination, fundus examination and optical biometry], postoperative status and complications. Ultrasound biomicroscopy(UBM) was done for 10 cases to evaluate optic tilt. RESULTS: The study evaluated 42 eyes of 42 patients. The follow-up period was 6 mo. Improvement of best corrected visual acuity(BCVA) one line occurred in 10 cases(23.8%) and loss of one line in 3 cases(7.1%). Intraoperative complications included: haptic kink in 4 cases(9.5%), haptic breakage in 1 case(2.4%), haptic dislocation in 1 case(2.4%), haptic slippage in 3 cases(7.1%), IOL dislocation in 1 case(2.4%) and sclerotomy related bleeding in 1 case(2.4%). Postoperative complications included: transient mild vitreous hemorrhage in 3 cases(7.1%), choroidal detachment in 1 case(2.4%), cystoid macular edema(CME) in 1 case(2.4%), optic capture in 1 case(2.4%), subconjunctival haptic in 2 cases(4.8%), ocular hypotony in 4 cases(9.5%) and ocular hypertension in 1 case(2.4%). There were no cases of retinal detachment or endophthalmitis. UBM showed optic tilt in 3 cases(30%). CONCLUSION: Fixation of three-piece foldable IOL haptics in scleral tunnel parallel to the limbus-providedaxial stability and proper centration of the IOL with minimal or no tilt in most cases and a low complication rate during the follow up period which lasted 6 mo.

关键词： aphakia correction sutureless scleral fixation foldable three-piece intraocular lens

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High speed small gauge anterior vitrectomy cutter for scleral fixated intraocular lens implantation

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International Journal of Ophthalmology(English edition) 2017年第1期10卷 77-80页

作者： Yuan Bo Liang Yoly Y.Y. FonG Lulu L. Cheng Alvin L. Young Clinical and Epidemiological Eye Research Center the Affiliated Eye Hospital School of Optometry and OphthalmologyWenzhou Medical University Wenzhou 325027 ZhejiangProvince China Department of Ophthalmology ＆ Visual Sciences the ChineseUniversity of Hong Kong Prince of Wales Hospital ShatinHong Kong China

AIM： To report the outcomes of anterior vitrectomy using high speed cutter for scleral fixated intraocular lens （SFIOL） implantation in patients with posterior capsular rupture .METHODS： Medical records of 51 patients with posterior capsular rupture who received high speed cutter anterior vitrectomy via limbal incision with SFIOL implantation from June 2011 to December 2013 were reviewed retrospectively for visual outcomes and ***： Totally 51 eyes of 51 patients were identified （23 males and 28 females）. Mean age at surgery was 67.2±15y （range 27-91y）, with mean follow-up of 23±8.2mo （range 12-40mo）. The 49 （96.1%） eyes had improvement or unchanged of final postoperative visual acuity. The most common complication was vitreous haemorrhage （5.9%） and transient rise in intraocular pressure （5.9%） which all spontaneously resolved CONCLUSION： High speed cutter anterior vitrectomy via limbal incision is a safe and effective method for those with posterior capsular rupture for SFIOL implantation.

关键词： cataract aphakia posterior capsular rupture intraocular lens scleral fixation

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New two-point scleral-fixation technique for foldable intraocular lenses with four hollow haptics

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International Journal of Ophthalmology(English edition) 2016年第3期9卷 469-471页

作者： He-Ting Liu Zheng-Xuan Jiang Li-Ming Tao Department of Ophthalmology the Second Hospital Affiliated to Anhui Medical University Hefei 230601 Anhui Province China

The study was to report a new two-point scleralfixation technique for foldable intraocular lenses with four *** were slid into the anterior chamber from a 2.8 mm corneal incision and fixed under two sclera flaps at two opposite *** postoperative best-corrected visual acuities（BCVAs） of all patients were significantly better than their preoperative *** results demonstrate that two-point,scleral fixations of foldable,intraocular lenses might be practicable and effective.

关键词： cataract intraocular lens aphakia scleral fixation

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Simple transscleral fixation of IOL technique without tying up haptics

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International Journal of Ophthalmology(English edition) 2020年第7期13卷 1152-1155页

作者： Junsung Lee Jae-Yong Jang Yong-Sok Ji Department of Ophthalmology Chonnam National University Medical School and HospitalGwangju 61469Republic of Korea Parangsae Eye Clinic Gwangju 61489Republic of Korea Bora Eye Hospital Gwangju 61964Republic of Korea

AIM: To introduce a novel technique for transscleral fixation of the posterior chamber intraocular lens(PC-IOL) that requires no sutures on the IOL ***: Instead of suturing polypropylene onto the IOL haptics, the method simply winds the thread on the haptics. Fifteen eyes of 15 patients underwent this technique and were followed up for more than 18 mo. Surgical outcomes and post-operative complications were evaluated and compared with those of the conventional transscleral fixation ***: Postoperative cylinder was significantly lower in the thread winding group than in the conventional transscleral fixation method group(-1.02±0.46 diopters vs-1.57±0.77 diopters;P=0.01). Further, no postoperative complications, such as optic capture, IOL dislocation, and hyphema, were detected in the thread winding ***: We believe that our thread winding technique is better than previously reported methods because it is simple, mechanically stable, and free from suture-related complications.

关键词： aphakia transscleral fixation pars plana vitrectomy intraocular lens implantation

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Safety and efficacy of trans-scleral glued intraocular lens implantation

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Annals of Eye Science 2017年第1期2卷 281-286页

作者： Rajkumar Maheshwari Thirumagal Vaishnavi Isiri Revanasiddappa Jerry Joseph Venkataramana Kalikivayi Sajeev Cherian Jacob Retina Services Ahalia Foundation Eye HospitalKozhipara PostPalakkadKeralaIndia Department of Ophthalmology Ahalia Foundation Eye HospitalKozhipara PostPalakkadKeralaIndia Fellow in Glaucoma&Phacoemulsification Ahalia Foundation Eye HospitalKozhipara PostPalakkadKeralaIndia Head of the Department Ahalia School of OptometryKozhipara PostPalakkadKeralaIndia Director Academics Ahalia Foundation Eye HospitalKozhipara PostPalakkadKeralaIndia

Background:The commonly used intraocular lens(IOL)implantation modalities when there is a rent in a posterior capsule or lack of posterior capsular support includes iris fixated IOL,anterior chamber(AC)IOL,sutured and suture less trans-scleral fixated *** work was planned to evaluate the safety and efficacy of trans-scleral glued IOL ***:Retrospective study was undertaken with 28 patients of glued IOL fixation,performed by a single surgeon over a period of 4 *** pre-operative and post-operative data including visual acuity,intraocular pressures,associated ocular conditions and complications were collected and statistically ***:The mean age of males in our study group was 39.1±4.6 years and mean age of females were 37.9±7.5 *** IOL was implanted in 13 eyes with traumatic cataract with subluxation of 46.4%.The most common associated ocular condition was found to be a penetrating ocular trauma with corneal tear in three patients(10.6%).The mean pre-operative and post-operative Log MAR acuity was found to be 1.18 and 0.55 respectively,which was found to be statically significant with P value of *** five out of 28 patients(89%)of the study population had no postoperative ***:Glued IOL implantation technique has 89%of success rate and statistically significant improvement in visual acuity with no significant change in intraocular pressure.

关键词： Glued intraocular lens(glued IOL) traumatic cataract aphakia

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Toric markers-assisted implantation of the scleral-fixated intraocular lens

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International Journal of Ophthalmology(English edition) 2016年第9期9卷 1289-1293页

作者： Hu-Ping Song Bing-Yu Tian Jing Peng Department of Ophthalmology Xi'an No.4 Hospital

AIM：To evaluate the efficacy of toric intraocular lens markers-assisted implantation of the scleral-fixated intraocular lens（SFIOL）.METHODS：From October 2010 to December 2013,all patients who had undergone secondary SFIOL implantation were assigned to group 1 and 2,in group 1SFIOL was performed with the assist of radial keratotomy（RK）-marker,and in group 2 SFIOL was performed with the assisted of toric intraocular lens markers（T-and axis markers）.Patients＇ demographic data and information on baseline preoperative visual acuity,indication for surgery and latest postoperative visual acuity were collected and *** haptic and optic positions were determined by ultrasound *** optic tilt angle and decentration distance were ***：The study evaluated 43 eyes of 43 patients ranging in age from 3 to 66 *** 1 comprised 24 eyes（24 patients） and group 2,19 eyes（19 patients）.Uncorrected reoperative acuity was improved on all the eyes *** improved postoperative acuity was significantly more in group 2 than that in group 1（1.11 ±0.38 vs 0.82 ±0.45 logMAR;F=4.85,P=0.03）.Ultrasonic biomicrograph examination showed that the rate of haptic asymmetry was significantly higher in group 1（42%,10/24） than that in group 2（11%;2/19）（Chi square=3.68,P=0.04）.The mean tilted degree in group 1was significantly higher than that in group 2（P=0.04）.Mean decentration distance in group 1 was greater than that in group 2（P=0.03）.CONCLUSION：During SFIOL the toric markers help the surgeon identify the placement of fixation more precisely than that with the use of RK marker.

关键词： scleral fixation intraocular lens aphakia toric markers

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Supracapsular implantation with optic capture of posterior chamber intraocular lens in Chinese children with aphakic after traumatic cataract

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Annals of Eye Science 2017年第1期2卷 307-311页

作者： Fei You Hanwen Shen Shouling Li Department of Ophthalmology the First Affiliated Hospital of Anhui Medical UniversityHefei 230022China Department of Nosocomial Infection Control Affiliated Provincial Hospital of Anhui Medical UniversityHefei 230001China Department of Endocrinology the 105 Hospital of PLAHefei 230031China

Background:To assess the safety and efficacy of supracapsular implantation with optic capture of the posterior chamber intraocular lens in Chinese children with aphakic after traumatic ***:It was a retrospective case series *** cases(15 eyes)Chinese children received supracapsular implantation with optic capture of the posterior chamber intraocular ***-and post-operative visual acuities were ***-and post-operative complications were *** follow-up period ranged from 7 to 43(28.7±7.2)***:Implantation of optic capture of the posterior chamber intraocular lens was successfully performed in 15 *** best corrected visual acuity(BCVA)ranged from 0.3 to 1.0(0.61±0.19).No optic axis opaque was found in 15 eyes with optic *** major complications of optic capture were iris posterior synechia and intraocular lens(IOL)*** dislocation was found in one case three weeks after the ***:Supracapsular implantation with optic capture of the posterior chamber intraocular lens is safe and effective for the treatment of traumatic cataract in Chinese children.

关键词： Post-cataract aphakia lens implantation optic capture

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