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Cherkas E, Sivalingam MD, Klufas T, Klufas MA. Alternative Techniques To Remove Retained Silicone Oil Droplets On IOLs. Retina 2023; 43:2170-2172. [PMID: 36728882 DOI: 10.1097/iae.0000000000003722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND/PURPOSE To describe several modified approaches to remove retained silicone oil droplets on intraocular lens (IOLs). METHODS Four novel techniques for removing retained silicone oil droplets on IOLs were described. RESULTS All four techniques led to an improved IOL with a good view to the posterior segment. No intraoperative or long-term postoperative complications have been seen in any of these eyes. These modified approaches are safe, efficient, low cost, and use existing vitreoretinal operating room supplies to add to the vitreoretinal surgeon's armamentarium to clear retained IOL silicone droplets. CONCLUSION It is advocated for having multiple techniques at the disposal of the vitreoretinal surgeon to address retained silicone oil on IOLs. Being able to use multiple techniques may not be superior than a single approach but is often necessary to accomplish the surgical goal of removing these adherent droplets.
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Affiliation(s)
- Elliot Cherkas
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Meera D Sivalingam
- Wills Eye Hospital, Mid Atlantic Retina, Thomas Jefferson University, Philadelphia, Pennsylvania
| | | | - Michael A Klufas
- Wills Eye Hospital, Mid Atlantic Retina, Thomas Jefferson University, Philadelphia, Pennsylvania
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Luo C, Wang H, Chen X, Xu J, Yin H, Yao K. Recent Advances of Intraocular Lens Materials and Surface Modification in Cataract Surgery. Front Bioeng Biotechnol 2022; 10:913383. [PMID: 35757812 PMCID: PMC9213654 DOI: 10.3389/fbioe.2022.913383] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 05/23/2022] [Indexed: 11/13/2022] Open
Abstract
Advances in cataract surgery have increased the demand for intraocular lens (IOL) materials. At present, the progress of IOL materials mainly contains further improving biocompatibility, providing better visual quality and adjustable ability, reducing surgical incision, as well as dealing with complications such as posterior capsular opacification (PCO) and ophthalmitis. The purpose of this review is to describe the research progress of relevant IOL materials classified according to different clinical purposes. The innovation of IOL materials is often based on the common IOL materials on the market, such as silicon and acrylate. Special properties and functions are obtained by adding extra polymers or surface modification. Most of these studies have not yet been commercialized, which requires a large number of clinical trials. But they provide valuable thoughts for the optimization of the IOL function.
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Affiliation(s)
- Chenqi Luo
- Eye Center of the Second Affiliated Hospital, Medical College of Zhejiang University, Hangzhou, China
| | - Hanle Wang
- Eye Center of the Second Affiliated Hospital, Medical College of Zhejiang University, Hangzhou, China
| | - Xinyi Chen
- Eye Center of the Second Affiliated Hospital, Medical College of Zhejiang University, Hangzhou, China
| | - Jingjie Xu
- Eye Center of the Second Affiliated Hospital, Medical College of Zhejiang University, Hangzhou, China
| | - Houfa Yin
- Eye Center of the Second Affiliated Hospital, Medical College of Zhejiang University, Hangzhou, China
| | - Ke Yao
- Eye Center of the Second Affiliated Hospital, Medical College of Zhejiang University, Hangzhou, China
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Silicone Oil Adhesion to Hydrophobic Acrylic Intraocular Lenses: A Comparative Laboratory Study of a New versus an Established Hydrophobic Acrylic Intraocular Lens Material. J Ophthalmol 2021; 2021:1387987. [PMID: 34804605 PMCID: PMC8598322 DOI: 10.1155/2021/1387987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 10/23/2021] [Indexed: 11/24/2022] Open
Abstract
Background In vitro assessment of silicone oil adhesion to a new hydrophobic acrylic intraocular lens (IOL) material, the Clareon model CNA0T0, compared with the established AcrySof model SN60WF was carried out. Methods Silicone oil adhesion was assessed for two types of IOLs, Clareon CNA0T0 (n = 10) and AcrySof SN60WF (n = 10). Lenses were immersed in an aqueous sodium chloride solution for 12 hours and then incubated at room temperature in silicone oil for 12 hours. The lenses were washed with distilled water and photographed at 25x magnification using a microscope. The percent coverage was calculated by dividing the area of oil coverage by the total surface area of the lens. Results Silicone oil adhesion to the surface of the CNA0T0 lens ranged from 4% to 22%, with a mean ± SD coverage of 8% ± 4%. Silicone oil adhesion to the surface of the SN60WF lens ranged from 1% to 17%, with a mean coverage of 9% ± 4%. The silicone oil adhesion of CNA0T0 was equivalent to that of SN60WF (P > 0.05). Conclusions The new Clareon model CNA0T0 IOL has silicone oil adhesion and interaction that are equivalent to the established AcrySof IOL.
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Werner L. Intraocular Lenses: Overview of Designs, Materials, and Pathophysiologic Features. Ophthalmology 2020; 128:e74-e93. [PMID: 32619547 DOI: 10.1016/j.ophtha.2020.06.055] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 06/17/2020] [Accepted: 06/24/2020] [Indexed: 11/29/2022] Open
Abstract
This article provides an overview of intraocular lenses (IOLs) currently used in cataract surgery. Aspects presented include design features related to IOL construction and sites of fixation; optic, filter, and haptic materials; as well as pathophysiologic features of uveal biocompatibility, capsular biocompatibility, and postoperative IOL opacification. This overview also includes supplementary (add-on; piggyback) lenses implanted in eyes that are already pseudophakic and considerations on IOLs used in the pediatric population. Different IOLs are made available to surgeons each year, including lenses with increasingly complex design characteristics owing to advancements in manufacturing and surgical techniques.
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Affiliation(s)
- Liliana Werner
- Intermountain Ocular Research Center, John A. Moran Eye Center, University of Utah, Salt Lake City, Utah.
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Abdul-Rahman A, House P, Richards J. Intraocular lens dystrophic calcification after trans-scleral diode laser treatment for a cyclodialysis cleft. Am J Ophthalmol Case Rep 2018; 11:78-83. [PMID: 30014050 PMCID: PMC6019761 DOI: 10.1016/j.ajoc.2018.06.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Revised: 04/25/2018] [Accepted: 06/18/2018] [Indexed: 11/23/2022] Open
Abstract
Purpose To describe a case of intraocular lens (IOL) dystrophic calcification as a complication of trans-scleral diode laser successfully used to treat a post-trabeculectomy cyclodialysis cleft. Observations A 76-year-old male with primary open angle glaucoma and pseudophakia (+19.0D Akreos M160L, Bausch & Lomb) was evaluated for vision impairment 4 months post-trabeculectomy complicated by a cyclodialysis cleft of his right eye. The patient was successfully treated with trans-scleral diode laser. After this treatment IOL opacification developed. Slit lamp examination and color photography of the anterior segment was performed prior to exchange of the opacified IOL. The explanted IOL underwent star testing, macroscopic imaging, phase contrast and scanning electron microscopy in addition to energy dispersive x-ray spectroscopy. Confluent IOL deposits developed 4 months after trans-scleral diode laser treatment requiring IOL exchange. Star optical testing of the explanted IOL showed disruption of the diffraction image. An asymmetric pattern of deposition was congruent with the laser treatment quadrant. The subsurface location and discrete nature of the deposits were seen on phase contrast and electron microscopy. Energy dispersive x-ray spectroscopy demonstrated a predominance of calcium/phosphate in the deposits. We are unaware of previous reports in the literature of IOL dystrophic calcification occurring as a complication of trans-scleral diode laser treatment for a post-trabeculectomy cyclodialysis cleft. Conclusion and importance Delayed postoperative IOL dystrophic calcification in our case may have been from a combination of IOL biomaterial susceptibility to diode laser energy; damaged IOL material providing a nidus for calcific nucleation; and blood ocular barrier breakdown altering aqueous composition. We suggest that pseudophakia should influence the consideration of diode laser as treatment of a cyclodialysis cleft.
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Affiliation(s)
- Anmar Abdul-Rahman
- Department of Ophthalmology, Counties Manukau DHB, Auckland, New Zealand
| | - Philip House
- Center for Ophthalmology and Visual Science, Lions Eye Institute, The University of Western Australia, Verdun St, Nedlands, 6009, Western Australia, Australia
| | - Josephine Richards
- Royal Perth Hospital, 197 Wellington St, Perth, 6000, Western Australia, Australia
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Abstract
Objective: This paper aimed to review the current literature on the surface modification of intraocular lenses (IOLs). Data Sources: All articles about surface modification of IOLs published up to 2015 were identified through a literature search on both PubMed and ScienceDirect. Study Selection: The articles on the surface modification of IOLs were included, but those on design modification and surface coating were excluded. Results: Technology of surface modification included plasma, ion beam, layer-by-layer self-assembly, ultraviolet radiation, and ozone. The main molecules introduced into IOLs surface were poly (ethylene glycol), polyhedral oligomeric silsesquioxane, 2-methacryloyloxyethyl phosphorylcholine, TiO2, heparin, F-heparin, titanium, titanium nitride, vinyl pyrrolidone, and inhibitors of cytokines. The surface modification either resulted in a more hydrophobic lens, a more hydrophilic lens, or a lens with a hydrophilic anterior and hydrophobic posterior surface. Advances in research regarding surface modification of IOLs had led to a better biocompatibility in both in vitro and animal experiments. Conclusion: The surface modification is an efficient, convenient, economic and promising method to improve the biocompatibility of IOLs.
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Affiliation(s)
| | | | | | - Gui-Qin Wang
- Department of Ophthalmology, Navy General Hospital of PLA, Beijing 100048; Department of Ophthalmilogy, Third Clinical Medical College of Southern Medical University, Guangzhou, Guangdong 510515, China
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Long-Term Observation of Triplex Surgery for Cataract after Phakic 6H Implantation for Super High Myopia. J Ophthalmol 2016; 2016:9569868. [PMID: 27190642 PMCID: PMC4848451 DOI: 10.1155/2016/9569868] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2015] [Revised: 02/09/2016] [Accepted: 02/24/2016] [Indexed: 12/31/2022] Open
Abstract
Purpose. To analyze the safety, effectiveness, and stability of triplex surgery for phakic 6H anterior chamber phakic intraocular lens explantation and phacoemulsification with in-the-bag IOL implantation for super high myopia in long-term observations. Methods. This retrospective case series evaluated 16 eyes of 10 patients who underwent triplex surgery. Best corrected visual acuity (BCVA), endothelial cell density (ECD), and associated adverse events were evaluated. Results. The mean follow-up time after the triplex surgery was 46 ± 14 months. The mean logMAR BCVA was significantly improved after triplex surgery (P = 0.047). One eye developed endophthalmitis five days postoperatively and underwent pars plana vitrectomy (PPV). Five eyes with preoperative severe endothelial cell loss developed corneal decompensation and underwent keratoplasty at a mean time of 9.4 ± 2.6 months after the triplex surgery. One eye had graft failure and underwent a second keratoplasty. The eye developed rhegmatogenous retinal detachment and underwent PPV with silicone oil 18 months later. ECD before the triplex surgery was not significantly different compared with that at last follow-up (P = 0.495) apart from these five eyes. Three eyes (18.8%) developed posterior capsule opacification. Conclusions. Triplex surgery was safe and effective for phakic 6H related complicated cataracts. Early extraction before severe ECD loss is recommended.
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Sayin N, Kara N, Pekel G. Ocular complications of diabetes mellitus. World J Diabetes 2015; 6:92-108. [PMID: 25685281 PMCID: PMC4317321 DOI: 10.4239/wjd.v6.i1.92] [Citation(s) in RCA: 163] [Impact Index Per Article: 18.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2014] [Revised: 10/06/2014] [Accepted: 12/10/2014] [Indexed: 02/05/2023] Open
Abstract
Diabetes mellitus (DM) is a important health problem that induces ernestful complications and it causes significant morbidity owing to specific microvascular complications such as, retinopathy, nephropathy and neuropathy, and macrovascular complications such as, ischaemic heart disease, and peripheral vasculopathy. It can affect children, young people and adults and is becoming more common. Ocular complications associated with DM are progressive and rapidly becoming the world’s most significant cause of morbidity and are preventable with early detection and timely treatment. This review provides an overview of five main ocular complications associated with DM, diabetic retinopathy and papillopathy, cataract, glaucoma, and ocular surface diseases.
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Kleinmann G, Zaugg B, Apple DJ, Bleik J. Pediatric cataract surgery with hydrophilic acrylic intraocular lens. J AAPOS 2013; 17:367-70. [PMID: 23928003 DOI: 10.1016/j.jaapos.2013.04.007] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2012] [Revised: 03/23/2013] [Accepted: 04/02/2013] [Indexed: 10/26/2022]
Abstract
PURPOSE To assess the outcomes after hydrophilic acrylic intraocular lens (IOL) implantation during pediatric cataract surgery. METHODS This was a retrospective chart review of children who underwent cataract surgery or secondary IOL implantation at Beirut Eye Specialist Centre, Rizk Hospital, between March 2002 and August 2007. RESULTS A total of 57 eyes of 40 patients (20 boys) were included in this study. The average age at surgery was 48 ± 40 months (range, 5-172 months). Of these, 54 eyes had congenital or developmental cataracts and 3 eyes had traumatic cataracts. Primary cataract removal and IOL implantation accounted for 45 surgeries, and secondary IOL implantation accounted for 12 surgeries. Hydrophilic acrylic IOLs were implanted in all surgeries. Average follow-up time was 47 ± 21 months (range, 9-97 months). No intraoperative complications were recorded. Of the 57 eyes, 12 (21%) had postoperative complications, but only 7 (12%) required secondary intervention. Average best-corrected visual acuity improved from 2.0 ± 1.0 logMAR preoperatively to 0.8 ± 1.0 logMAR at last follow-up. Improved visual acuity was observed in 47 eyes (82.5%); 31 eyes (54.4%) had a visual acuity of ≥ 20/40 at the last follow-up. CONCLUSIONS Hydrophilic acrylic IOLs appear to be suitable for use in pediatric cataract surgery. Results from this study suggest that, compared with hydrophobic IOLs, these IOLs produce similar complication rates, secondary intervention rates, and visual acuity results.
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Affiliation(s)
- Guy Kleinmann
- John A. Moran Eye Center, Department of Ophthalmology and Visual Sciences, University of Utah, Salt Lake City, Utah.
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Huang XD, Li HY, Lin L, Yao K. Reduced Silicone Oil Adherence to Silicone Intraocular Lens by Surface Modification with 2-Methacryloyloxyethyl Phosphoryl-Choline. Curr Eye Res 2012; 38:91-6. [DOI: 10.3109/02713683.2012.704477] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Lee SJ, Choi JH, Sun HJ, Choi KS, Jung GY. Surface calcification of hydrophilic acrylic intraocular lens related to inflammatory membrane formation after combined vitrectomy and cataract surgery. J Cataract Refract Surg 2010; 36:676-81. [PMID: 20362864 DOI: 10.1016/j.jcrs.2009.08.045] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2009] [Revised: 08/28/2009] [Accepted: 08/28/2009] [Indexed: 10/19/2022]
Abstract
UNLABELLED Two patients complained of blurred vision approximately 6 months after having combined vitrectomy and phacoemulsification with implantation of a C-flex 570C hydrophilic acrylic intraocular lens (IOL). Multiple granules were noted on the anterior surface of the IOLs in both patients. Intraocular lens exchange was performed in both eyes, and the explanted IOLs were sent for histopathological analysis. Scanning electron microscopy confirmed the presence of cracks and granules on the IOL surfaces and energy-dispersive x-ray spectroscopy demonstrated calcium deposition. Based on the calcification pattern on the anterior surface of the IOLs, 2 additional cases of opacification were identified under slitlamp examination. FINANCIAL DISCLOSURE No author has a financial or proprietary interest in any material or method mentioned.
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Affiliation(s)
- Sung Jin Lee
- Department of Ophthalmology, College of Medicine, Soonchunhyang University, Seoul, Korea.
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Becker KA, Martin M, Rabsilber TM, Entz BB, Reuland AJ, Auffarth GU. Prospective, non-randomised, long term clinical evaluation of a foldable hydrophilic single piece intraocular lens: results of the Centerflex FDA study. Br J Ophthalmol 2006; 90:971-4. [PMID: 16687454 PMCID: PMC1857197 DOI: 10.1136/bjo.2006.092437] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND Owing to the improvement of modern intraocular lenses (IOLs) in terms of design and material, posterior capsule opacification (PCO) usually takes 2-3 years to develop. Thus, long term clinical evaluation of new implants is important. METHODS As part of a prospective, non-randomised FDA trial, the Rayner Centerflex, a foldable hydrophilic acrylic, single piece IOL was implanted in one eye of 83 patients (mean age 73.5 (SD 7.0) years). Over 3 years postoperatively, a standardised FDA protocol concerning IOL safety and efficacy was followed including evaluation of spherical equivalent (SE), best corrected distance visual acuity (BCDVA), endothelial cell count (ECC), flare meter values, PCO development, and anterior capsule shrinkage. RESULTS Postoperatively, mean SE was stable ranging between -0.3D and 0.17D. After 1-2 months, all patients achieved a BCDVA of 20/40 or better. At 3-6 months postoperatively, mean ECC decreased from 2612 (SD 346) cells/mm2 to 2380 (316) cells/mm2. Mean PCO score for the entire optic increased from 0.20 (0.20) months (3-6 months postoperatively) to 0.87 (0.57) resulting in a Nd:YAG rate of 29.41% after 3 years. No anterior capsule shrinkage was found. CONCLUSION The Centerflex showed excellent functional results, low values for endothelial cell loss and inflammatory signs, and no anterior capsule shrinkage. PCO formation was higher compared to other IOLs, which could be explained by the incomplete sharp edge at the optic-haptic junctions representing an "Achilles' heel" for cell ingrowth.
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Affiliation(s)
- K A Becker
- Heidelberg IOL and Refractive Surgery Research Group, Department of Ophthalmology, Ruprecht-Karls-University of Heidelberg, Heidelberg, Germany
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Ohrstrom A, Svensson B, Tegenfeldt S, Celiker C, Lignell B. Silicone oil content in ophthalmic viscosurgical devices. J Cataract Refract Surg 2004; 30:1278-80. [PMID: 15177604 DOI: 10.1016/j.jcrs.2003.11.037] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/12/2003] [Indexed: 10/26/2022]
Abstract
PURPOSE To examine the silicone oil content in 5 brands of ophthalmic viscoelastic devices (OVDs). SETTING Department of Ophthalmology, Central Hospital of Vasteras, Vasteras, Sweden. METHODS Phacoemulsification with intraocular lens (IOL) implantation was performed in 250 patients. Five brands of OVD were used, each one in 50 procedures. From each brand, 5 separate batches, each consisting of 10 syringes, were used. The 250 samples from identical batches were sent for spectrophotometric analysis, and 250 samples were used during surgery. RESULTS The silicone oil content varied significantly between the OVD brands. CONCLUSIONS Silicone oil is a common contaminant in many OVDs. Ophthalmic viscosurgical devices with relatively low silicone oil content are available.
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Affiliation(s)
- Arne Ohrstrom
- Department of Ophthalmology, Central Hospital, Vasteras 72189, Sweden.
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Abstract
Pseudophakic retinal detachment is a rare, but potentially serious, complication of cataract surgery. The incidence of pseudophakic retinal detachment following current surgical techniques of cataract extraction, including extracapsular cataract extraction by nuclear expression and phacoemulsification, is lower than that found after intracapsular cataract extraction. The risk of pseudophakic retinal detachment appears to be increased in myopic patients, in those patients in whom vitreous loss had occurred at the time of cataract surgery, and in patients undergoing Nd:YAG posterior capsulotomy. Most cases present to the clinician when the macula is already detached and the central vision is affected. When evaluating patients with pseudophakic retinal detachment, the fundal view is often impaired by anterior or posterior capsular opacification, reflections related to the intraocular lens, or poor mydriasis. Scleral buckling, pneumatic retinopexy, and primary pars plana vitrectomy, with or without combined scleral buckling, are the surgical techniques used to treat pseudophakic retinal detachment. Anatomical success rates are high after vitreo-retinal surgery for pseudophakic retinal detachment, although a smaller proportion of patients recover good vision following surgery.
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Affiliation(s)
- Noemi Lois
- Retina Service, Ophthalmology Department, Aberdeen Royal Infirmary, Foresterhill, Aberdeen, Scotland, UK
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15
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Oner FH, Saatci OA, Sarioğlu S, Durak I, Kaynak S, Cabuk M. Interaction of intraocular lenses with various concentrations of silicone oil: an experimental study. Ophthalmologica 2003; 217:124-8. [PMID: 12592051 DOI: 10.1159/000068561] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2002] [Indexed: 11/19/2022]
Abstract
The aim of this study was to evaluate the interaction between various widely used intraocular lenses (IOLs) and silicone oils of different viscosities. Four groups of IOLs, including monoblock foldable hydrophilic acrylic IOLs (Morcher, type 92s); monoblock hydrophobic acrylic IOLs (Acrysof-SA60AT, Alcon); single-piece rigid polymethylmethacrylate (PMMA) IOLs (Intraocular Optical International-IOI-65130) and a three-piece foldable silicone optic IOL (CeeOn Edge 911A, Pharmacia UpJohn) were analyzed in vitro to determine the percentage adherence 1,000-centistoke, 1,300-centistoke or 5,000-centistokes silicone oil on the IOL optic. For each IOL type, there was no statistically significant difference in the mean silicone oil coverage (MSC) of the IOL optics for the different viscosities of silicone oil. Silicone IOLs had the highest MSC percentage (79.9%) whereas hydrophilic acrylic IOLs were the least silicone-covered IOLs (7.8%) compared to the other IOL types tested in this study. It is not the concentration of silicone oil that affects silicone oil coverage. When performing small-incision cataract surgery in patients who may require silicone oil injection, foldable hydrophilic acrylic or hydrophobic acrylic lenses should be preferred over standard foldable silicone lenses.
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Affiliation(s)
- F Hakan Oner
- Department of Ophthalmology, Dokuz Eylül University School of Medicine, Izmir, Turkey.
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Trivedi RH, Werner L, Apple DJ, Pandey SK, Izak AM. Post cataract-intraocular lens (IOL) surgery opacification. Eye (Lond) 2002; 16:217-41. [PMID: 12032712 DOI: 10.1038/sj.eye.6700066] [Citation(s) in RCA: 60] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Intraocular lens (IOL) implantation has no doubt been one of the most satisfying advances of medicine. Millions of individuals with visual disability or frank blindness from cataracts had and continue to have benefit from this procedure. It has been reported by ophthalmologists that the modern cataract-intraocular lens (IOL) surgery is safe and complication-free most of the time. This makes the watchword for any cataract surgeon to be 'implantation,' 'implantation,' 'implantation.' In the mid-1980s, as IOLs were evolving rapidly, the watchword of the implant surgeon was 'fixation,' 'fixation,' 'fixation.' Most techniques, lenses and surgical adjuncts now allow us to achieve the basic requirement for successful IOL implantation, namely long-term stable IOL fixation in the capsular bag. However despite this advancement some items 'slipped through cracks.' In this article, we would like to alert the reader to a new watchword, namely 'opacification,' 'opacification,' 'opacification.' Here we will be talking about the good, the bad, and the ugly. Examples of the 'good' include the recent successes now being achieved in reducing the incidence of posterior capsule opacification. Examples of the 'bad' include various proliferations of anterior capsule cells, problems caused by silicone oil adherence to IOLs and problems with piggyback IOLs. The 'ugly' include the sometimes striking and often visually disabling opacifications occurring on and within IOL optics, both on some modern foldable IOLs as well as a poly(methyl methacrylate) (PMMA) optic degradation occurring with some models a decade or more after implantation.
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Affiliation(s)
- R H Trivedi
- Center for Research on Ocular Therapeutics and Biodevices, Storm Eye Institute, Medical University of South Carolina, Charleston, SC 29425-5536, USA
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