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Results for “Aphakia, Postcataract”

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At least 181 records · Page 10Linked to original sources
PubMed2004

Single-piece AcrySof in the newborn rabbit eye.

PURPOSE: To evaluate the behavior of the single-piece AcrySof SA30AT intraocular lens (IOL) (Alcon) in the eyes of newborn rabbits and to compare the postoperative complications in aphakic and pseudophakic eyes. SETTING: St. Erik's Eye Hospital, Stockholm, Sweden. METHODS: Clear lens extraction was performed in both eyes of 20 3-week-old rabbits. In 1 randomly selected eye in each rabbit, a single-piece acrylic IOL was implanted. Preoperatively and 1 and 2 months postoperatively, axial length and corneal diameter were measured. Corneal thickness was measured at the endpoint. The rabbits were also examined clinically; the position of the IOL and signs of secondary glaucoma were noted. At 2 months, the 19 surviving animals were killed. In 10 rabbits, the wet mass of the after-cataract was measured, and the eyes of 9 rabbits were fixed in formalin for histologic evaluation. RESULTS: One animal died soon after surgery. Three rabbits developed secondary glaucoma in the aphakic eye. No rabbit developed glaucoma in the pseudophakic eye. In the 16 animals without secondary glaucoma, there were no significant differences in corneal diameter at 1 and 2 months or in corneal thickness at the endpoint; the axial length was significantly longer in aphakic eyes at 1 month, but not at 2 months. The aphakic eyes developed more posterior synechias and the pupil size at 1 and 2 months was significantly smaller in aphakic eyes than in pseudophakic eyes. Significantly more after-cataract developed in aphakic eyes than pseudophakic eyes (eyes with secondary glaucoma included). No difference in inflammation was seen between eyes in the histologic evaluation. In 11 of 19 pseudophakic eyes, the anterior capsulorhexis was not completely on the optic. In these eyes, the optic moved partly forward into the anterior chamber. CONCLUSION: The single-piece AcrySof SA30AT IOL seems to induce less inflammation and probably inhibits secondary glaucoma. It does not retard eye growth as much as previously tested IOLs. However, it is important to keep the entire capsulorhexis margin on the optic, especially in these small eyes.

Animals↗
PubMed2004

Postoperative aphakia in modern cataract surgery: part 1: analysis of incidence and risks based on 5-year data from the Swedish National Cataract Register.

PURPOSE: To study the incidence of aphakia after cataract extraction and evaluate the relative risk for this outcome in subgroups of patients based on preoperative conditions. SETTING: Sixty-two community-run or private clinics participating in the Swedish National Cataract Register. METHODS: Data on cataract extractions were collected prospectively from 1997 through 2001. The set of data also covered type of surgery and type of intraocular lens (IOL), including a "no lens implanted" option. All data were stored in a database. Database calculations were made of frequencies and risk ratios of postoperative aphakia in the subgroups of patients based on preoperative conditions. RESULTS: For the entire study period, postoperative aphakia was reported in 1410 of 287,951 surgeries for which complete IOL data were available, corresponding to an overall frequency of 0.49%. The occurrence of ocular comorbidity and poor preoperative visual acuity (< or = 0.1) in the eye to be operated on was significantly related to postoperative aphakia for each year of the study (P<.001). Glaucoma and poor visual acuity (< or =0.1) in the surgical eye meant a 12.8 higher risk for aphakia after surgery than a better visual acuity (>0.1) and no ocular comorbidity. CONCLUSIONS: This national 5-year survey showed that in routine cataract surgery performed during the study, 1 of every 200 operations ended in postoperative aphakia. Poor visual acuity (< or =0.1) in the eye to be operated on combined with ocular comorbidity was the highest risk factor for postoperative aphakia.

Aged↗
PubMed2004

Postoperative aphakia in modern cataract surgery: part 2: detailed analysis of the cause of aphakia and the visual outcome.

PURPOSE: To study the incidence of aphakia after cataract surgery, the surgical complications that can lead to it, and the visual outcome. SETTING: Six community-run eye clinics participating in the Swedish National Cataract Register. METHODS: Data on cataract extractions were collected prospectively from 1997 through 2001. The data also covered the type of surgery and type of intraocular lens, including a "no lens implanted" option. All data were stored in a database. These data were supplemented with data on the intended type of surgery, type of complications, possible second surgery, and visual outcome. RESULTS: The overall incidence of postoperative aphakia was 0.65%. In 87.1% of cases, the aphakia was not planned, corresponding to an incidence of 0.48%. Unplanned aphakia was significantly related to poor preoperative vision, old age, and the presence of ocular comorbidity. The most frequent reasons for unplanned aphakia were intraoperative capsule problems and vitreous loss. In two thirds of cases, a second operation was performed. In 41% of all cases, the final visual acuity was 0.5 or better and in 27.7%, worse than 0.1. CONCLUSIONS: During the study period, 1 of every 200 routine cataract surgeries ended in unplanned aphakia. The incidence of surgical complications leading to unplanned aphakia and a final visual acuity worse than 0.1 (20/200) was 7.8 per 10,000 operations in cases with no ocular comorbidity and 27.6 per 10,000 operations in cases with ocular comorbidity.

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PubMed2004

Artisan lens implantation to correct aphakia after vitrectomy for retained nuclear lens fragments.

PURPOSE: To report the results of pars plana vitrectomy (PPV) for retained lens fragments with implantation of an Artisan intraocular lens (IOL) (Ophtec) to correct aphakia. SETTING: University-based referral center. METHODS: In this retrospective case-controlled study, patients who had had a PPV to remove dislocated lens fragments and implantation of an Artisan IOL for pseudophakic correction during initial cataract surgery or PPV were reviewed. RESULTS: Thirteen patients were identified. The preoperative visual acuity was better than 20/200 in 5 patients and the intraocular pressure (IOP) was higher than 21 mm Hg in 8 patients; 3 patients had normal corneas. In 4 patients, an Artisan IOL was implanted during cataract surgery. Postoperative complications included recurrent erosion (1 eye), premacular fibrosis (2 eyes), and a retinal tear (1 eye). Elevation of the IOP occurred in 2 patients and was controllable with medication. Pupillary block developed in 1 patient and persistent cystoid macular edema in another. All but 2 patients gained more than 2 lines of visual acuity postoperatively, and all corneas remained clear during the follow-up (mean 28.9 months; range 2.5 to 69.0 months). CONCLUSIONS: After the removal of dislocated lens fragments with a PPV, Artisan IOL implantation in aphakic patients without capsule support led to few complications and good visual acuity. Placement of an Artisan IOL requires fewer manipulations than transscleral suture fixation of a posterior chamber IOL.

Aged↗
PubMed2004

Phototoxic maculopathy after secondary intraocular lens implantation.

We report phototoxic maculopathy in 2 aphakic patients after secondary, scleral-sutured intraocular lens implantation. This rare complication may have been triggered by drugs that increased the photosensitivity of the tissue. Careful preoperative assessment is necessary to question the receipts of photosensitizing drugs and identify diseases that predispose patients to phototoxic injuries.

Aged↗
PubMed2005

Congenital cataract extraction with primary aphakia and secondary intraocular lens implantation in the ciliary sulcus.

PURPOSE: To evaluate the results of cataract extraction without primary intraocular lens (IOL) implantation in children. SETTING: Ophthalmology Unit, University Hospital, Strasbourg, France. METHODS: This retrospective study comprised 157 congenital cataract cases (55 bilateral and 47 unilateral) treated between 1985 and 2001. Evaluated were the functional results (visual acuity, binocular vision) and factors influencing the prognosis (age at surgery, stage of cataract development, associated pathology, postoperative complications). In all patients, cataract extraction was via the pars plana and anterior vitrectomy was performed, leaving a peripheral capsular collarette in place. Postoperatively, all the patients were fitted with glasses or contact lenses, after which they had secondary implantation of an IOL in the ciliary sulcus. RESULTS: The functional results were similar to those in the literature for eyes with or without an IOL. Nevertheless, the literature reports a 25% risk for reoperation in the first 2 years after implantation and secondary vitrectomy for reopacification of the visual axis in 20% of bilateral cases and 38% of unilateral cases. CONCLUSIONS: Our functional results indicate that in cases of bilateral congenital cataracts, initial rehabilitation with aphakic correction and secondary IOL implantation leads to a predictable postoperative refraction and fewer complications. Visual rehabilitation in unilateral aphakia was more difficult because of poor compliance with contact lenses, generally leading to a preference for early IOL implantation.

Aphakia, Postcataract↗
PubMed2005

Preoperative assessment of secondary intraocular lens implantation for aphakia: a comparison of 2 techniques.

PURPOSE: To compare the preoperative evaluation of secondary intraocular lens (IOL) implantation in aphakic adults following cataract extraction in childhood using slitlamp examination and high-frequency ultrasound (HFU). METHODS: In a prospective case series, patients who had had lensectomies for congenital cataracts without primary implantation IOL were evaluated for secondary IOL insertion. Slitlamp examination and HFU were performed to study the degree of ciliary sulcus support and iridocapsular adhesions. The choice of IOL (posterior sulcus supported or anterior chamber) was compared using the 2 techniques. RESULTS: Nine eyes of 5 patients (3 men and 2 women aged 15 to 40 years) were assessed for secondary IOL insertion. Clinical slitlamp examination suggested that 3 of 9 eyes had inadequate sulcociliary support, but HFU of these eyes revealed more than adequate capsular remnants. In all 9 eyes, sulcus-supported posterior chamber IOLs were implanted. No postoperative complications were observed, and no patients required surgery for dislocated IOL. CONCLUSIONS: High-frequency ultrasound is a useful adjunct for the preoperative assessment of secondary ciliary sulcus-supported IOL implantation in aphakic patients who had congenital cataract extraction without IOL implantation. In patients in whom inadequate dilation precludes the detection of capsular support, posterior ciliary sulcus-supported secondary IOL implantation should be considered preoperatively. Although the technique enhances surgical planning and informed patient consent, the final decision occurs at the time of surgery with direct visualization of the ciliary sulcus support.

Adolescent↗
PubMed2005

Cataracts in children.

Bilateral congenital cataract is the most common cause of treatable childhood blindness. Nuclear cataract is usually present at birth and is nonprogressive, whereas lamellar cataract usually develops later and is progressive. Surgery must be performed promptly in cases with dense congenital cataract; if nystagmus has developed, the amblyopia is irreversible. A treatment regimen based on surgery within 2 months of birth combined with prompt optical correction of the aphakia and aggressive occlusion therapy with frequent follow-up has been successful in unilateral and bilateral cases. Both anterior and posterior capsulorhexes are performed in most children. Intraocular lens implantation can be performed safely in children older than 1 year. Anterior dry vitrectomy is recommended in preschool children to avoid after-cataract. Opacification of the visual axis is the most common complication of cataract surgery in children. Secondary glaucoma is the most sight-threatening complication and is common if surgery is performed early. Life-long follow-up is essential in these cases.

Amblyopia↗
PubMed2005

Artificial iris-lens diaphragm in reconstructive surgery for aniridia and aphakia.

PURPOSE: To determine the efficacy and safety of surgical implantation of artificial iris-lens diaphragm in patients with anatomic or functional iris deficiencies, aphakia or cataract. SETTING: Svyatoslav Fyodorov MNTK Eye Microsurgery, Cheboksary, Russia. METHODS: Twenty eyes of 19 consecutive patients with combined iris and lens pathology of traumatic or congenital etiology were identified for an interventional noncomparative case series. The newly proposed model of an elastic iris-lens diaphragm with a colored haptic and additional support elements was implanted using various fixation approaches. RESULTS: Fifteen eyes (75%) experienced improvement in corrected visual acuities. The best spectacle-corrected visual acuity (BSCVA) in 2 eyes did not change, while the uncorrected visual acuity (UCVA) in these eyes increased. There were 3 eyes in which BSCVA deteriorated with no change or even slight improvement in UCVA. All patients were satisfied with the cosmetic results of the surgery and reported a decrease in glare and photophobia. There was 1 intraoperative complication of vitreous hemorrhage. Postoperatively, 2 cases of hyphema, 1 case of ciliochoroidal detachment, 4 eyes with exaggerated immediate postoperative reaction, and 1 eye with persistent low-grade cyclitis were observed. In 1 eye, there was persistent intraocular pressure rise. One eye showed signs of cystoid macular edema. No iris-lens diaphragm decentrations and no new or extensions of old retinal detachments were seen during the follow-up period. CONCLUSIONS: Artificial iris-lens diaphragm implantation effectively improved postoperative outcomes by correcting aphakia, reducing glare disability, and addressing cosmetic issues faced by iris-deficient, and aphakic or cataract patients. Although the iris-lens diaphragm appears to be safe, long-term results must be clarified in studies with longer follow-up and a larger patient population.

Adolescent↗
PubMed2005

Secondary Artisan-Verysise aphakic lens implantation.

PURPOSE: To evaluate efficacy, predictability and safety of Artisan-Verysise intraocular lens (IOL) secondary implantation for aphakia correction. SETTING: Instituto de Microcirugía Ocular, and Autonoma University of Barcelona, Barcelona, Spain. METHODS: Uncorrected visual acuity, best spectacle-corrected visual acuity (BSCVA), manifest refraction, endothelial cell count, and clinical complications were evaluated. Sixteen consecutive eyes of 14 patients with aphakia were submitted to surgery. Postoperative examinations were done at 6 weeks, 6 months, 1 year, and every year for at least 3 years. An iris-supported Artisan-Verysise IOL was implanted for aphakia correction. RESULTS: Thirty-six months after Artisan-Verysise lens implantation, BSCVA was 20/40 or better in 6 eyes (37.5%). Preoperatively, 5 eyes had the same BSCVA (31.25%). Mean postoperative spherical equivalent (SE) was 0.46 diopter (D). Mean endothelial cell loss was 10.9% 36 months postoperatively. The cell loss occurred predominantly during the first year (7.78%). Cystoid macular edema was observed in 2 cases, 1 of them associated with chronic unresponsive low intraocular pressure. No other serious complications were observed. CONCLUSION: Artisan-Verysise IOL implantation seems a safe, predictable, and effective option for aphakic eyes without capsule support.

Adult↗
PubMed2006

Intraocular lens power calculation after laser in situ keratomileusis: Aphakic refraction technique.

PURPOSE: To evaluate the accuracy of a new method of intraocular lens (IOL) power calculation for eyes having cataract extraction after previous laser in situ keratomileusis (LASIK). SETTING: Clinical private practice and ambulatory surgical center, Astoria, New York, USA. METHODS: This retrospective study was of 12 eyes of 9 patients who presented for cataract extraction after previous LASIK. Cataract removal was performed under topical anesthesia without IOL implantation. Approximately 30 minutes later, a manifest aphakic refraction was performed. The calculation of the IOL power was obtained by using an algorithm derived from previous experience with secondary IOL implantation (Mackool algorithm). The patient then returned to the operating room for lens implantation (aphakic refraction technique). RESULTS: The refractive error 2 weeks postoperatively, defined as the difference between the intended and actual refractive outcome, ranged from 0.50 diopter (D) of unintended hyperopia to 0.75 (D) of unintended myopia. CONCLUSIONS: The aphakic refraction technique provided an extremely accurate postoperative refraction in eyes having cataract with IOL implantation surgery after previous LASIK. Although the pool sample was small (12 eyes) and the range of the aphakic refraction was limited (+8.50 to 12.375 D), the technique was found to be remarkably accurate.

Algorithms↗
PubMed2006

Bilateral Artisan lens for aphakia and megalocornea: Long-term follow-up.

We received approval from the U.S. implant Food and Drug Administration and the University's Institutional Review Board to the Artisan lens (Ophtec BV) in both eyes of a patient who was aphakic and had megalocornea. No other intraocular lens would easily solve this patient's need because of the large anterior segment. The patient was having increasing difficulty with aphakic contact lenses because of his work environment. We present almost 5 years of follow-up data of this patient.

Anterior Chamber↗
PubMed2006

Vertical placement of aphakic Artisan intraocular lens in a patient with traumatic localized aniridia.

We report a 50-year-old patient who had secondary implantation of an aphakic Artisan (Ophtec) intraocular lens (IOL) that was placed vertically in the anterior chamber. The patient had had a perforating injury to the cornea that required corneal wound repair, lensectomy, and anterior vitrectomy. Because of the localized traumatic aniridia, the Artisan IOL could not be placed horizontally. Three months after surgery, the best corrected visual acuity was 0.9 and there were no complications.

Anterior Chamber↗
PubMed2007

Injection of an intraocular lens in an eye without capsular support.

We describe a technique that can be used to facilitate posterior chamber intraocular lens (IOL) placement with iris fixation in cases with compromised capsular support. This procedure allows injection of an IOL through an unenlarged clear corneal incision. A safety net suture is temporarily fixed in the posterior chamber to act as a surrogate capsule. This suture supports the IOL while the surgeon injects it and secures it to the iris. The addition of this single step facilitates the remainder of the procedure and potentially makes it safer.

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