Purpose: To describe our experience in the surgical management of cataracts in patients with complications of closed-globe injury using pars plana lensectomy (PPL), pars plana vitrectomy (PPV), and scleral fixation of posterior chamber intraocular lens (PCIOL).
Methods: We retrospectively reviewed charts of all patients with closed-globe injury who underwent PPL, PPV and scleral fixation of PCIOL at our institution between January 1991 and July 1997. We identified 28 eyes; because of less than 2 weeks follow-up, 4 eyes were excluded from the current study. All eyes had lens subluxation/dislocation and visually significant cataract. Additional indications for surgery included secondary glaucoma (10 eyes), vitreous hemorrhage (3 eyes) and retinal detachment (1 eye).
Results: The postoperative follow-up interval ranged from 6 to 61 months (mean 18.5 months). Preoperative visual acuity (VA) ranged from 20/60 to hand motion and was 20/100 or better in 6 eyes (25%). Postoperatively, 19 eyes (79%) improved to 20/100 or better. Five eyes had subsequent surgery for the following indications: retinal detachment (2 eyes), poorly controlled glaucoma (2 eyes), and epiretinal membrane formation (1 eye).
Conclusions: In patients undergoing PPL, PPV and scleral fixation of PCIOL for cataract after a closed-globe injury, a substantial visual improvement occurred in a majority of the involved eyes.
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Eur J Ophthalmol
January 2025
Dept of Vitreoretinal Diseases, Sankara Nethralaya, Chennai, India.
Purpose: To evaluate long-term anatomical and functional outcomes in eyes undergoing scleral fixation of aniridic black diaphragm intraocular lens (BDIOL).
Methods: Total 38 eyes that underwent scleral fixation of BDIOL for secondary aniridia following ocular trauma with aphakia with absent posterior capsule or primary congenital aniridia with subluxated lens were retrospectively analyzed. Final visual acuity, early and late complications were examined.
Sci Rep
December 2024
Vienna Institute for Research in Ocular Surgery (VIROS), A Karl Landsteiner Institute, Hanusch Hospital, Vienna, Austria.
To compare two different secondary IOL fixation techniques, either flanged or hooked, regarding the least required force to dislocate the haptic in human corneoscleral donor tissue (CST). Experimental laboratory investigation. The least required dislocation force (LRDF) of two different fixation techniques, namely the flanged haptics (FH, as described by Yamane) and the harpoon haptic technique (HH, as described by Carlevale) were investigated using 20 three-piece IOLs (KOWA PU6AS) and 20 single-piece IOLs (SOLEKO CARLEVALE) fixated to human scleral tissue.
View Article and Find Full Text PDFClin Ophthalmol
December 2024
Department of Ophthalmology, Visual and Anatomical Sciences, Kresge Eye Institute/Wayne State University School of Medicine, Detroit, MI, USA.
Purpose: To evaluate the outcomes of scleral-fixated intraocular lenses (IOLs) implanted using either Yamane technique or Gore-Tex suture fixation, in comparison to intracapsular lens fixation, and to assess the efficacy of various lens formulas in achieving predicted refractive targets.
Patients And Methods: This study included 45 eyes from 44 patients with scleral-fixated IOLs, comprising 37 Yamane eyes and 8 Gore-Tex eyes. Preoperative refractive predictions from various formulae were compared with final postoperative refraction.
Eye Vis (Lond)
December 2024
Department of Ophthalmology, The Second Hospital of Jilin University, Changchun, China.
Over the past two decades, both suture and sutureless techniques for scleral fixation of intraocular lenses have seen significant advancement, driven by improvements in methodologies and instrumentation. Despite numerous reports demonstrating the effectiveness, safety, and superiority of these techniques, each approach carries with it its own drawbacks, including an elevated risk of certain postoperative complications. This article delves into various surgical techniques for scleral fixation of posterior chamber intraocular lenses, discussing their procedural nuances, benefits, drawbacks, postoperative complications, and outcomes.
View Article and Find Full Text PDFIndian J Ophthalmol
December 2024
Cornea, Cataract and Refractive Surgery Services, Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.
Intrascleral haptic fixation of intraocular lens (IOL) is an extremely useful technique to provide visual rehabilitation in eyes with inadequate capsular support. It requires exteriorization of haptics along with tucking of haptics in the scleral groove preferably and conventionally in the horizontal meridian. In eyes with large corneal diameter, there is difficulty in tucking enough length of the haptics into the intrascleral groove, carrying the risk of slippage of haptics and decentration of IOL.
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