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Batsos G, Bouratzis N, Kontomichos L, Casas DR, Atzamoglou S, Peponis V, Karagiannis D, Paroikakis E. A Novel Modified Surgical Approach for FIL SSF Lens. Cureus 2023; 15:e49857. [PMID: 38169895 PMCID: PMC10758903 DOI: 10.7759/cureus.49857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/30/2023] [Indexed: 01/05/2024] Open
Abstract
This study aimed to describe a novel modified surgical technique for FIL SSF lens (Rome, Italy: Soleko) implantation. A retrospective study of FIL SSF lens implantation on six eyes of six patients with subluxated or dislocated intraocular lens (IOL). Standard pars plana vitrectomy (PPV) was performed in all patients. The subluxated or dislocated IOL was removed from a 2.4 corneal incision. From the same incision, the folded FIL SSF lens was inserted. Then lens plugs were extremized through a 23G scleral incision inside two 4 mm pockets that were created at the beginning of the operation. In two cases one pocket had to be converted into a triagonal-shaped scleral flap. All scleral pockets were sutured with 7.0 Vicryl suture and the conjunctiva with 7.0 Vicryl. In the follow-up period of six months, the lens is centered and not tilted. The refractive outcome is within the expectations. Visual acuity is improved in all patients. No haptic exposure and no other complications were noted in all cases. FIL SSF lens is a good option for treating aphakia. This modified implantation technique is safe, fast, and easy. It is also versatile, combining the advantages of both previously described techniques, as it gives the option of flap conversion if needed. Larger studies and prospective comparative studies can highlight the best and more appropriate technique.
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Affiliation(s)
- Georgios Batsos
- First Department of Ophthalmology, Specialized Eye Hospital, Ophthalmiatreio Athinon, Athens, GRC
| | - Nikolaos Bouratzis
- First Department of Ophthalmology, Specialized Eye Hospital, Ophthalmiatreio Athinon, Athens, GRC
| | - Loukas Kontomichos
- First Department of Ophthalmology, Specialized Eye Hospital, Ophthalmiatreio Athinon, Athens, GRC
| | - Diego Ruiz Casas
- Department of Ophthalmology, Ramon y Cajal Hospital, Madrid, ESP
| | - Spyros Atzamoglou
- First Department of Ophthalmology, Specialized Eye Hospital, Ophthalmiatreio Athinon, Athens, GRC
| | - Vasileios Peponis
- First Department of Ophthalmology, Specialized Eye Hospital, Ophthalmiatreio Athinon, Athens, GRC
| | - Dimitris Karagiannis
- Second Department of Ophthalmology, Specialized Eye Hospital, Ophthalmiatreio Athinon, Athens, GRC
| | - Efstratios Paroikakis
- Second Department of Ophthalmology, Specialized Eye Hospital, Ophthalmiatreio Athinon, Athens, GRC
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[Secondary implantation of retropupillary fixated iris-claw intraocular lenses]. DIE OPHTHALMOLOGIE 2023; 120:184-190. [PMID: 36028580 DOI: 10.1007/s00347-022-01714-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 07/29/2022] [Accepted: 07/31/2022] [Indexed: 02/07/2023]
Abstract
BACKGROUND There is no standard for the treatment of functional aphakia in cases with a compromised capsular system. Retropupillary fixation of an Artisan iris-claw IOL ("Intraokularlinse") is one of the established procedures. OBJECTIVE Aim of this study was the evaluation of indications, visual and refractive long-term results and complication rates after retropupillary implantation of an iris-claw lens. MATERIAL AND METHODS This retrospective study comprised 366 eyes that received a retropupillary Artisan intraocular lens (IOL) in a single center between January 2009 and December 2019. The mean follow-up period was 249 days (8 months) ±516 days. RESULTS IOL dislocation (68%) was the most common reason for a retropupillary iris-claw implantation. Previous vitrectomy was a significant preoperative risk factor for IOL dislocation (p = 0.0001). Best corrected visual acuity improved from 0.65 ± 0.64 (logMAR) preoperatively to 0.57 ± 0.51 (logMAR) 4-6 weeks after the surgery. The mean deviation from the planned refraction was +0.40 ± 1.37 dpt and 73% of the patients had a deviation within ±1 dpt of the planned refraction. Relevant postoperative complications during the first 4 weeks were pupillary distortion (42%), ocular hypotony (15%) and transient hyphema (14%). Late complications (≥4 weeks after the surgery) included persistent pupillary distortion (20%), cystoid macular edema (13%) and iris-claw disenclavation (6%). CONCLUSION The retropupillary Artisan implantation is an efficient method for treating aphakia without capsular support and provides good visual and refractive results with an acceptable surgical risk profile.
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Bernal-Morales C, Navarro-Angulo MJ, Rodriguez-Maqueda M, Velazquez-Villoria D, Cubero-Parra JM, Marticorena J, Hernández-Martínez A, Ruiz-Miguel M, Adan A, Ruiz-Casas D, Zarranz-Ventura J. Predictive Factors and Management of Macular Edema after Retropupillary Iris-Claw Intraocular Lens Implantation in Aphakia: National Multicenter Audit-Report 2. J Clin Med 2023; 12:jcm12020436. [PMID: 36675364 PMCID: PMC9862359 DOI: 10.3390/jcm12020436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 12/16/2022] [Accepted: 12/31/2022] [Indexed: 01/06/2023] Open
Abstract
The aim of this multicenter, national clinical audit is to evaluate the predictive factors and management of postoperative macular edema (ME) after retropupillary iris-claw intraocular lens (RICI) implantation and pars plana vitrectomy (PPV). Preoperative, surgical and postoperative data were collected. Number and type of intravitreal injections (IT) administered (anti-VEGF or dexamethasone implant), visual acuity (VA), intraocular pressure (IOP) and central retinal thickness (CRT) assessed by OCT were collected at 1, 3, 6 and 12 months. From 325 eyes (325 patients), 11.7% (38/325) developed postoperative ME. Previous complicated cataract surgery with no capsular support was the only significant predictive factor for developing postoperative ME (OR 2.27, 95% CI 1.38-4.52, p = 0.02) after RICI implant. Mean time to ME development was 11.4 ± 10.7 weeks, and mean CRT peaked at 3 months follow-up. Different treatment options were non-steroidal anti-inflammatory (NSAIDs) drops (31.6%, 12/38), dexamethasone (DEX) implant (50%, 19/38), anti-VEGF (7.9%, 3/38) or combined IT (10.5%, 4/38). Cumulative probability of ME resolution was higher in the group treated with IT than in the group treated with topical NSAIDs (85.2% vs. 58.3%, p = 0.9). Performing RICI implantation after complicated cataract surgery is a risk factor for the development of postoperative ME. DEX implants may be an effective treatment for postoperative ME in these cases.
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Affiliation(s)
- Carolina Bernal-Morales
- Institut Clínic d’Oftalmologia (ICOF), Hospital Clínic, 08028 Barcelona, Spain
- August Pi i Sunyer Biomedical Research Institute (IDIBAPS), 08036 Barcelona, Spain
| | | | | | | | | | - Joaquín Marticorena
- Instituto Oftalmológico La Esperanza, HM La Esperanza, 15705 Santiago de Compostela, Spain
- Servicio de Oftalmología, Complejo Hospitalario Universitario, 15006 A Coruña, Spain
| | | | | | - Alfredo Adan
- Institut Clínic d’Oftalmologia (ICOF), Hospital Clínic, 08028 Barcelona, Spain
- August Pi i Sunyer Biomedical Research Institute (IDIBAPS), 08036 Barcelona, Spain
| | - Diego Ruiz-Casas
- Servicio de Oftalmología, Hospital Ramon y Cajal, 28029 Madrid, Spain
| | - Javier Zarranz-Ventura
- Institut Clínic d’Oftalmologia (ICOF), Hospital Clínic, 08028 Barcelona, Spain
- August Pi i Sunyer Biomedical Research Institute (IDIBAPS), 08036 Barcelona, Spain
- Correspondence:
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Zheng Q, Li S, Ren Y, Chen Y, Wang H, Zhao J, Chen J, Jhanji V, Chen W. Impact of cone base diameter on outcomes of deep anterior lamellar keratoplasty in keratoconus. Graefes Arch Clin Exp Ophthalmol 2022; 260:3303-3312. [PMID: 35522294 DOI: 10.1007/s00417-022-05658-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Revised: 03/18/2022] [Accepted: 03/31/2022] [Indexed: 11/24/2022] Open
Abstract
PURPOSE To evaluate the outcomes of deep anterior lamellar keratoplasty (DALK) in treating keratoconus in relation to cone base diameter (CBD). METHODS A retrospective study. Sixty-one eyes of 49 keratoconus patients who underwent DALK between 2009 and 2018 were enrolled. Preoperative and postoperative uncorrected visual acuity (UCVA), best-corrected visual acuity (BCVA), spherical equivalent, and astigmatism were measured. Scheimpflug tomography (Pentacam) was used to measure the cone base area (CBA) and CBD using MATLAB software. RESULTS The mean age of the patients was 20.8 ± 6.1 years old, and the mean follow-up time was 27.3 ± 15.2 months. Mean UCVA improved from 1.23 ± 0.48 to 0.57 ± 0.27 (LogMAR, 95% CI [0.52, 0.80]; P < 0.001), whereas mean BCVA improved from 0.98 ± 0.55 to 0.18 ± 0.13 (95% CI [0.66, 0.94]; P < 0.001). The mean spherical equivalent decreased by 4.53 ± 5.65 D (95% CI [- 6.25, - 2.82]; P < 0.001), with little change in astigmatism (95% CI [- 1.39, 0.64]; P = 0.457). The postoperative BCVA in the patients with CBD < 5.07 mm and corneal curvature ≥ 55D was significantly better than those whose CBD ≥ 5.07 mm (0.14 ± 0.09 vs 0.25 ± 0.15, P = 0.001). The follow-up time was negatively correlated with the BCVA (P = 0.004). CONCLUSIONS In this study, outcomes of DALK in keratoconus were related to CBD and corneal curvature. Patients with large CBD (≥ 5.07 mm) where the corneal curvature ≥ 55D are more likely to have poor visual outcomes after DALK.
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Affiliation(s)
- Qinxiang Zheng
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, 270 Xueyuan West Road, Wenzhou, 325027, Zhejiang, People's Republic of China.,National Clinical Research Center for Ocular Diseases, Wenzhou, Zhejiang, China
| | - Saiqing Li
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, 270 Xueyuan West Road, Wenzhou, 325027, Zhejiang, People's Republic of China.,National Clinical Research Center for Ocular Diseases, Wenzhou, Zhejiang, China
| | - Yueping Ren
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, 270 Xueyuan West Road, Wenzhou, 325027, Zhejiang, People's Republic of China.,National Clinical Research Center for Ocular Diseases, Wenzhou, Zhejiang, China
| | - Yunyun Chen
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, 270 Xueyuan West Road, Wenzhou, 325027, Zhejiang, People's Republic of China.,National Clinical Research Center for Ocular Diseases, Wenzhou, Zhejiang, China
| | - Haiou Wang
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, 270 Xueyuan West Road, Wenzhou, 325027, Zhejiang, People's Republic of China.,National Clinical Research Center for Ocular Diseases, Wenzhou, Zhejiang, China
| | - Jiawei Zhao
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, 270 Xueyuan West Road, Wenzhou, 325027, Zhejiang, People's Republic of China.,National Clinical Research Center for Ocular Diseases, Wenzhou, Zhejiang, China
| | - Jiaojie Chen
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, 270 Xueyuan West Road, Wenzhou, 325027, Zhejiang, People's Republic of China.,National Clinical Research Center for Ocular Diseases, Wenzhou, Zhejiang, China
| | - Vishal Jhanji
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.,Department of Ophthalmology, The Chinese University of Hong Kong, Hong Kong, China
| | - Wei Chen
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, 270 Xueyuan West Road, Wenzhou, 325027, Zhejiang, People's Republic of China. .,National Clinical Research Center for Ocular Diseases, Wenzhou, Zhejiang, China.
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