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Passo RM, Thanos A. MEMBRANOUS ENCAPSULATION OF AN AKREOS INTRAOCULAR LENS FOLLOWING SCLERAL FIXATION MASQUERADING AS OPACIFICATION. Retin Cases Brief Rep 2024; 18:259-262. [PMID: 36730821 DOI: 10.1097/icb.0000000000001364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2022] [Accepted: 10/25/2022] [Indexed: 02/04/2023]
Abstract
BACKGROUND To report a case of membranous encapsulation of a scleral-fixated Akreos intraocular lens (IOL) that was successfully treated with vitrectomy and membranectomy without IOL exchange or removal. METHODS Case report. RESULTS A 58-year-old woman with a history of bilateral chronic anterior and intermediate uveitis underwent scleral fixation of Akreos IOL for dislocated 3-piece IOL in the vitreous cavity. She presented one year later with progressively worsening vision (decreased to 20/200) and was found to have a complete encapsulation of the IOL. The patient underwent successful vitrectomy and membranectomy with return of vision to 20/25 within three months of surgery. CONCLUSION There are numerous case reports of opacification after scleral fixation of Akreos IOL. To our knowledge, this is the first report of complete encapsulation of the IOL with a membrane of this type and character. The etiology for this patient's presentation is unclear, but was presumed to be related to her history of chronic intraocular inflammation.
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Affiliation(s)
- Ross M Passo
- Department of Ophthalmology, Casey Eye Institute, Oregon Health & Science University, Portland, Oregon; and
| | - Aristomenis Thanos
- Department of Vitreo-Retina and Ocular Oncology, Devers Eye Institute, Portland, Oregon
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Joshi R. Delayed complete opacification of intraocular lens. JOURNAL OF CLINICAL OPHTHALMOLOGY AND RESEARCH 2022. [DOI: 10.4103/jcor.jcor_64_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
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Intraoperative and Postoperative Intraocular Lens Opacifications: Analysis of 42545 Cases. J Ophthalmol 2021; 2021:1285947. [PMID: 34912573 PMCID: PMC8668301 DOI: 10.1155/2021/1285947] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 09/26/2021] [Accepted: 11/18/2021] [Indexed: 11/18/2022] Open
Abstract
Purpose To assess the types and causes of intraocular lens (IOL) turbidity in a tertiary eye center. Setting. Qingdao Eye Hospital of Shandong First Medical University, Qingdao, China. Design Retrospective case series. Methods Patients who underwent uncomplicated phacoemulsification and IOL implantation for cataract between January 2015 and December 2019 were included. Medical records were reviewed of participants with intraoperative or postoperative IOL opacification for clinical data, artificial crystal materials, and causes of the opacification. Results A total of 42545 IOLs were implanted in the five years, comprising 25471 (66.0%) hydrophilic IOLs, 11881 (27.9%) hydrophobic IOLs, and 2601 (6.1%) hydrophilic-hydrophobic acrylic IOLs. Among the operated eyes, 14 eyes (13 patients) experienced IOL opacification, which was permanent for 10 IOLs, including 7 (0.6%) hydrophilic IOLs (860UV) and 3 (0.2%) hydrophilic-hydrophobic acrylic IOLs (L-312). The mean interval between surgery and diagnosis of permanent opacification was 34.4 ± 18.4 (SD) months (range, 12 to 59 months). Permanent IOL clouding led to a statistically significant reduction in best corrected visual acuity (mean, 0.64 ± 0.4 logMAR; P < 0.004). Acute IOL clouding occurred in four eyes during the implantation of a hydrophilic-hydrophobic acrylic IOL of L-312, 809M, or 839M and returned to transparency several hours later. All four procedures were performed in winter, with the mean outside temperature being −5.75°C. Conclusions The rate of IOL opacification was 0.03%. Both delayed postoperative and acute intraoperative opacifications occurred with various characteristics in IOLs made of different materials and designs. Clinicians should be aware of this risk for cataract surgery.
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Lavine JA, Sharma S. OPACIFICATION OF A SCLERAL-SUTURED AKREOS AO60 INTRAOCULAR LENS: SURGICAL TECHNIQUE FOR REMOVAL. Retin Cases Brief Rep 2021; 15:738-740. [PMID: 31923039 DOI: 10.1097/icb.0000000000000906] [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: 06/10/2023]
Abstract
PURPOSE To report a case of an opacified scleral-sutured Akreos intraocular lens (IOL) and discuss the technique for surgical removal. METHODS A 27-year-old man presented with blurry vision in the right eye 1 year after trauma, pars plana vitrectomy, glaucoma tube shunt surgery, and a scleral-sutured Akreos AO60 IOL. Examination demonstrated a visual acuity of 20/300, a persistently dilated pupil, 360° of peripheral anterior synechiae, and an opacified IOL. The patient underwent IOL explantation. RESULTS Owing to the expected granulation of the Gore-Tex suture, an external approach for suture ligation was not attempted. The suture was identified and ligated nasally with forceps and IOL cutting scissors. The Gore-Tex suture was granulated into the ciliary body temporally and was unable to be identified. The eyelets of the Akreos IOL were ligated to remove the IOL. CONCLUSION Granulation of the Gore-Tex suture into the ciliary body and sclera requires an internal approach for ligation of the suture or eyelets to remove an opacified scleral-sutured Akreos IOL.
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Affiliation(s)
- Jeremy A Lavine
- Department of Ophthalmology, Northwestern University, Chicago, Illinois; and
| | - Sumit Sharma
- Cleveland Clinic Foundation, Cole Eye Institute, Cleveland, Ohio
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Mahapatra SK, Mannem N. Anterior chamber intraocular lens - An effective alternative in traumatic and surgical aphakia in the era of scleral-fixated intraocular lens. Indian J Ophthalmol 2021; 69:1404-1408. [PMID: 34011709 PMCID: PMC8302310 DOI: 10.4103/ijo.ijo_2192_20] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Purpose: To evaluate outcomes of anterior chamber intraocular lens (ACIOL) implantation with vitrectomy in eyes with surgical or traumatic aphakia, and subluxated or dislocated lens. Methods: In this retrospective study, we evaluated patients who underwent pars plans vitrectomy with ACIOL implantation from April 2016 to March 2019. Patients with minimum follow-up period of 1 year and operated by single surgeon were included. Ophthalmic history, indication for surgery, BCVA, IOP, slit-lamp examination, and fundus assessment findings were noted. Postoperatively best-corrected visual acuity (BCVA), intraocular pressure (IOP) and complications if any were noted. Results: Ninety eyes of 88 patients were included in the study. The mean age of the patients was 60.2 ± 10.2 yrs. Majority (75.6%) were males and 24.4% were females. Indications for pars-plana vitrectomy (PPV) with ACIOL implantation were nucleus drop in 16.6%, IOL drop in 25.5%, large posterior capsular rupture (PCR) with vitreous disturbance or zonular dehiscence (ZD) during cataract surgery in 33.3%, more than 180° subluxation of lens in 10% and traumatic lens or intraocular lens (IOL) drop in 14.4% cases. Preoperative and postoperative mean Log MAR visual acuity was 1.59 ± 0.44 and 0.36 ± 0.33 respectively, with few complications like cystoid macular edema (CME) in 8.8%, persistently raised IOP in 4.4%, persistent uveitis in 2.2%, retinal detachment (RD) in 2.2%, and tilted IOL in 1.1% cases. Conclusion: Out of different options available for secondary IOL implantation in patients with poor capsular support ACIOL has the advantages of cost-effectiveness, small learning curve, faster surgical time with a lesser rate of complications like IOL tilt, vitreous hemorrhage, and suture erosion as compared to scleral-fixated IOL (SF-IOL). Comparable visual outcome can be obtained by proper patient selection in these cases.
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Affiliation(s)
- Santosh K Mahapatra
- Chief Medical Officer and Vitreoretinal Surgeon, Department of Vitreoretina, JPM Rotary Club of Cuttack Eye Hospital and Research Institute, Cuttack, Odisha, India
| | - Navya Mannem
- Opthalmology Resident, Department of Vitreoretina, JPM Rotary Club of Cuttack Eye Hospital and Research Institute, Cuttack, Odisha, India
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Belin PJ, Kim JH, Sheikh A, Winokur J, Rhee D, Deramo V. Incidence and Risk of Scleral-Fixated Akreos (AO60) Lens Opacification: A Case Series. JOURNAL OF VITREORETINAL DISEASES 2021; 5:157-162. [PMID: 37009087 PMCID: PMC9979051 DOI: 10.1177/2474126420946605] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Purpose: Postoperative hydrophilic intraocular lens opacification can lead to decreased vision and may require intraocular lens exchange. This study aims to identify the incidence of scleral-fixated Akreos AO60’s (Bausch + Lomb) lens opacification and risk factors for this phenomenon. Methods: This is a retrospective case series of all patients who underwent scleral-fixated Akreos AO60 lens at our institution between January 1, 2015 and December 31, 2019. The following data were recorded: age, sex, medical history, indication for Akreos AO60 implantation, laterality, ocular history, previous ocular surgical procedures, subsequent intraocular surgical procedures after the Akreos implantation, lens opacification, visual significance of opacification, and Akreos explantation. Intraoperative and postoperative complications were recorded. Main outcome measures were the overall incidence of Akreos lens opacification as well as the incidence of these eyes undergoing subsequent intraocular surgery. Results: A total of 262 eyes of 257 patients underwent Akreos lens implantation. Overall, 2% (5 of 262) developed lens opacification. Two patients had Descemet stripping automated endothelial keratoplasty (DSAEK) concurrently with Akreos implantation. One patient underwent subsequent Baerveldt glaucoma implantation and DSAEK. The fourth patient had vitrectomy with sulfur hexafluoride gas followed by DSAEK. This represents a 25% (4 of 16) opacification rate among all patients who underwent DSAEK ( P ≤ .01, Fisher exact test). One patient developed opacification after undergoing 2 vitrectomies for retinal detachment in the absence of DSAEK. Conclusions: Akreos lens opacification can be visually significant and may occur after a retinal or corneal procedure that involves the use of intraocular gas or air.
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Affiliation(s)
- Peter J. Belin
- Department of Ophthalmology, Northwell Health, Great Neck, NY, USA
| | - Jang H. Kim
- Department of Ophthalmology, Northwell Health, Great Neck, NY, USA
| | - Ahmed Sheikh
- Department of Ophthalmology, Northwell Health, Great Neck, NY, USA
| | - Jules Winokur
- Department of Ophthalmology, Northwell Health, Great Neck, NY, USA
| | - David Rhee
- Department of Ophthalmology, Northwell Health, Great Neck, NY, USA
| | - Vincent Deramo
- Department of Ophthalmology, Northwell Health, Great Neck, NY, USA
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Finn AP, Feng HL, Kim T, Mahmoud TH. Outcomes of Anterior Chamber Intraocular Lens Implantation in Patients Undergoing Pars Plana Vitrectomy. ACTA ACUST UNITED AC 2018; 2:895-899. [DOI: 10.1016/j.oret.2018.02.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2017] [Revised: 02/10/2018] [Accepted: 02/12/2018] [Indexed: 10/17/2022]
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Park HS, Kim YM, Yang JY. Two Cases of Intraoperative Acute Opacification of Hydrophilic Intraocular Lens. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2018. [DOI: 10.3341/jkos.2018.59.10.974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Hyo Song Park
- Siloam Eye Hospital, Seoul, Korea
- The Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, Seoul, Korea
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Liu Q, Zhang S, Wang X, Cao W, Jia Y. Acute clouding of trifocal lens during implantation: a case report. BMC Ophthalmol 2017; 17:242. [PMID: 29216854 PMCID: PMC5721382 DOI: 10.1186/s12886-017-0636-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Accepted: 11/28/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Intraoperative IOLs clouding of several kinds of hydrophilic acrylic intraocular lenses (IOLs) have been reported due to temperature changes. This phenomenon reported previously occurred in cold countries and during the winter months. However, no clinical case was reported about trifocal IOL opacification during operation. We report a case in which acute opacification of the optical region occurred simultaneously when AT LISA tri 839mp(Carl Zeiss) was implanted into the eye. CASE PRESENTATION A 79-year-old woman with a cortex and nucleus cataract was scheduled to undergo right eye phacoemulsification assisted by femtosecond technique. The trifocal lens (AT LISA tri 839mp), which is made of hydrophilic acrylic (25%) with hydrophobic surface properties, was chosen for implantation. As the IOL was implanted into the eye, it became cloudy immediately. Then it was replaced by another AT LISA tri 839mp, which was transferred from lens company outside, the same phenomenon was observed. These two lenses underwent the same temperature fluctuation from cold outside to operating room. Finally, a ZCB00 (Allergan) was implanted. CONCLUSIONS The acute intraoperative clouding of trifocal lens(AT LISA tri 839mp) results from fluctuation of temperature should be noticed.
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Affiliation(s)
- Qian Liu
- Shanxi Eye Hospital, No. 100 Fudong Street, Taiyuan, Shanxi, 030002, People's Republic of China
| | - Suhua Zhang
- Shanxi Eye Hospital, No. 100 Fudong Street, Taiyuan, Shanxi, 030002, People's Republic of China.
| | - Xiaogang Wang
- Shanxi Eye Hospital, No. 100 Fudong Street, Taiyuan, Shanxi, 030002, People's Republic of China
| | - Weifang Cao
- Shanxi Eye Hospital, No. 100 Fudong Street, Taiyuan, Shanxi, 030002, People's Republic of China
| | - Yading Jia
- Shanxi Eye Hospital, No. 100 Fudong Street, Taiyuan, Shanxi, 030002, People's Republic of China
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Postoperative diffuse opacification of a hydrophilic acrylic intraocular lens: analysis of an explant. Int Ophthalmol 2017; 38:1733-1739. [DOI: 10.1007/s10792-017-0603-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2016] [Accepted: 06/06/2017] [Indexed: 10/19/2022]
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Influence of aqueous humor convection current on IOL opacification. Int Ophthalmol 2016; 37:1337-1339. [DOI: 10.1007/s10792-016-0400-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2016] [Accepted: 11/25/2016] [Indexed: 11/26/2022]
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Cao D, Zhang H, Yang C, Zhang L. Akreos Adapt AO Intraocular lens opacification after vitrectomy in a diabetic patient: a case report and review of the literature. BMC Ophthalmol 2016; 16:82. [PMID: 27277708 PMCID: PMC4898468 DOI: 10.1186/s12886-016-0268-3] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2016] [Accepted: 06/04/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Postoperative optic opacification of hydrophilic acrylic intraocular lenses (IOLs) is an uncommon complication leading to IOL explantation. In the past decade, several studies reported that the granular deposits responsible for the opacification were probably calcium and phosphate salts; however, the exact mechanism causing calcification of IOLs is unknown. The aim of this study is to describe clinical and laboratory findings of a case of late postoperative opacification of an aspheric hydrophilic acrylic IOL (Akreos Adapt AO) after vitrectomy. CASE PRESENTATION A 60-year-old woman diagnosed with cataract and severe nonproliferative diabetic retinopathy (NPDR) underwent uneventful phacoemulsification and hydrophilic acrylic IOL (Akreos Adapt AO, Bausch & Lomb) implantation in both eyes. Seven months later, the woman came back with a complaint of blurry vision in the left eye. Fundus examination revealed vitreous hemorrhage in the left eye veiling the retinal detail. A 23-gauge vitrectomy with endolaser treatment was performed in the left eye. Ten months after the vitrectomy, the patient complained of decreased visual acuity in the left eye again. On slit-lamp examination, we observed a well circumscribed centrally and paracentrally located opacification within the pupillary area localized to the anterior surface of the IOL. The IOL was explanted from the left eye together with the capsular bag, and an iris-claw lens (Artisan Aphakia OPHTEC) was implanted. The explanted IOL was examined under pathological evaluation (alizarin red method). CONCLUSIONS IOL opacification is a rare event. We described a case of postoperative opacification of the Akreos Adapt AO IOL after vitrectomy in a patient with proliferative diabetic retinopathy and found the deposits on the anterior surface of the IOL consisted of calcium aggregates. Given the higher frequency of postoperative opacification observed in diabetic patients, hydrophilic acrylic IOLs should be used with caution in patients with diabetes.
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Affiliation(s)
- Dan Cao
- Department of Ophthalmology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Hongyang Zhang
- Department of Ophthalmology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Cheng Yang
- Department of Ophthalmology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Liang Zhang
- Department of Ophthalmology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China.
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Opacificación capsular posterior en lentes intraoculares hidrofílicos en comparación con lentes intraoculares hidrofóbicos usando imágenes de Scheimpflug. REVISTA MEXICANA DE OFTALMOLOGÍA 2016. [DOI: 10.1016/j.mexoft.2015.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Forlini M, Orabona GD, Bratu AI, Rossini P, Cavallini GM, Forlini C. Akreos Adapt AO Intraocular Lens Opacification: A Case Report. Case Rep Ophthalmol 2013; 4:151-4. [PMID: 24163684 PMCID: PMC3806673 DOI: 10.1159/000355414] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
A 79-year-old hyperglycemic patient was referred to the 'Santa Maria delle Croci' Hospital, Ravenna, Italy. He presented with visual impairment in the right eye. Four years ago, he had had an uneventful cataract surgery in the right eye. We observed an opacification of the intraocular lens (IOL) causing significant visual disturbance. The IOL was exchanged. Unfortunately, pathologic analysis was not performed. Patient-related factors such as hyperglycemia and hypertension might have been responsible for the opacification. To our knowledge, there is only one previous report of opacification of the Akreos Adapt AO IOL.
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Affiliation(s)
- Matteo Forlini
- Institute of Ophthalmology, University of Modena, Modena, Ravenna, Italy
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Moon K, Kim KS, Kim YC. A Case of Hydrophilic Acrylic Intraocular Lens Opacification in a Patient with Proliferative Diabetic Retinopathy. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2012. [DOI: 10.3341/jkos.2012.53.8.1172] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Kun Moon
- Department of Ophthalmology, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea
| | - Kwang Soo Kim
- Department of Ophthalmology, Keimyung University Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea
| | - Yu Cheol Kim
- Department of Ophthalmology, Keimyung University Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea
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