Black Intraocular Lens Research Articles

Optic disc optical coherence tomography imaging through a black intraocular lens

Black intraocular lenses (IOLs) are implanted for intractable diplopia, leucocoria, visual confusion and a variety of neuro‐ophthalmic indications.2013 Two categories exist: black IOLs that transmi...

Ultra-widefield retinal imaging through a black intraocular lens

To evaluate the feasibility of ultra-widefield retinal imaging in patients with near infrared (IR)-transmitting black intraocular lenses (IOLs). Oxford Eye Hospital, Oxford, United Kingdom. Laboratory evaluation of a diagnostic technology with interventional case report. The field of retinal imaging through a Morcher poly(methyl methacrylate) (PMMA) black IOL was determined in a purpose-built adult schematic model eye with the HRA2 Spectralis confocal scanning laser ophthalmoscope using standard imaging, Staurenghi retina lens-assisted imaging, and ultra-widefield noncontact imaging. Retinal imaging using each modality was then performed on a patient implanted with another Morcher PMMA black IOL model. Ultra-widefield noncontact imaging and lens-assisted imaging captured up to 150 degrees of field (versus 40 degrees with a standard confocal scanning laser ophthalmoscope). Ultra-widefield retinal images were successfully acquired in a patient eye with a black IOL. This study has identified the first ultra-widefield retinal imaging modalities for patients with near IR-transmitting black IOLs. Should larger studies confirm this finding, noncontact ultra-widefield confocal scanning laser ophthalmoscopy might be considered the gold standard imaging technique for retinal surveillance in patients with near IR-transmitting black IOLs. No author has a financial or proprietary interest in any material or method mentioned.

Pinhole iris-fixated intraocular lens for dysphotopsia and photophobia

We present the pinhole iris-fixated diaphragm intraocular lens (IOL), which is a 1-piece black polycarbonate IOL with rigid iris-fixated haptics, an 8.5 mm overall length, a 6.0 mm diameter optic, and a central opening, the pinhole. The IOL was implanted in a 36-year-old man who had a history of debilitating dysphotopsia (star burst, halos, glare, and ghosting) and severe light sensitivity in his right eye following several interventions for keratoconus. The diameter of the central opening of the pinhole IOL, 2.0 mm, was based on the patient's corneal aberration profile. Postoperatively, the dysphotopic symptoms and photophobia markedly improved. We recommend the use of the pinhole iris-fixated IOL in patients with severe photophobia or dysphotopsia refractory to other treatment modalities. No author has a financial or proprietary interest in any material or method mentioned.

Economic constraints in managing complicated cataracts

Practicing in a low-resource environment presents unusual challenges with the management of even the simplest conditions when physicians must choose between investigating their patients and proceeding to intervention with patients' limited resources. Failure to perceive light, inaccurate light projection, or sonographic evidence of retinal detachment are all reasons to avoid cataract surgery, as there is no hope of visual recovery. However, when a patient already accepts a blind eye, but wants cataract surgery to remove the cosmetic blemish of leukocoria, they may question the necessity of preoperative ultrasonography because of the additional expense involved. Market forces can be defined as the economic factors affecting the price, demand, and availability of a commodity. In recent times, market forces have played increasingly significant role in the accessibility of standard healthcare in Nigeria; as Medical Services in Public Hospitals are no longer free, and the majority of Nigerians fund their healthcare through out-of-pocket expenditure, which places a burden on the economically challenged and uninsured. The main objective is to emphasize the importance of ultrasonography in a blind eye for the purpose of determining the position of a suspected retinal detachment, and to introduce the black occlusive intraocular lens (IOL). This is a report of cosmetic cataract surgery performed in a blind eye, with failure to achieve desired results, due to anteriorly displaced retinal detachment. This case describes the difficulties encountered with cosmetic cataract surgery in a low resource setting and discusses the use of occlusive IOL to improve cosmetic outcome. Cataract surgery is to be avoided in the presence of total retinal detachment. However, black occlusive IOL implantation may provide a cosmetically acceptable outcome.

Anterior segment optical coherence tomography in black‐on‐clear polypseudophakia

Anterior segment optical coherence tomography in black‐on‐clear polypseudophakia

Inability to perform posterior segment monitoring by scanning laser ophthalmoscopy or optical coherence tomography with some occlusive intraocular lenses in clinical use

To evaluate whether occlusive intraocular lenses (IOLs) produced by several manufacturers for clinical use equivalently transmit near-infrared (IR) light for scanning laser ophthalmoscopy (SLO) or optical coherence tomography (OCT) imaging. Nuffield Laboratory of Ophthalmology, Oxford University, United Kingdom. Evaluation of diagnostic test or technology. The study evaluated 6 black IOLs of 2 designs: 3 poly(methyl methacrylate) (PMMA) and 3 iris-claw anterior chamber IOLs. Each IOL was placed between a broad-spectrum white light source and a spectroradiometer to generate transmission spectra. Transmission in the near-IR range was examined using an 850 nm light-emitting diode. Scanning laser ophthalmoscopy or OCT imaging using Spectralis spectral-domain SLO or OCT was attempted through occlusive IOLs in a model eye. Artisan iris-claw and MS 612 PMMA occlusive IOLs totally occluded all wavelengths of light, including in the near IR range in which SLO and OCT imaging systems operate. It was not possible to capture SLO or OCT images through the iris-claw and PMMA occlusive IOLs in a model eye. Results suggest the property of near-IR transmission that permits SLO or OCT imaging through occlusive IOLs is restricted to the Morcher range of occlusive IOLs. Patients with non-near IR transmitting IOLs will not be able to receive detailed posterior segment monitoring with SLO or OCT. This finding may have a significant impact on preoperative occlusive IOL selection and the management of current patients with occlusive IOLs. No author has a financial or proprietary interest in any material or method mentioned.

Phakic implantation of a black intraocular lens in a blind eye with leukocoria

A 54-year-old woman with leukocoria from a white cataract requested evaluation for the undesired cosmetic appearance of her blind right eye. The eye was hypotonous from chronic total retinal detachment, and the lens appeared loose and partially resorbed. A solid, black poly(methyl methacrylate) intraocular prosthesis was placed in the phakic posterior chamber and sutured into the ciliary sulcus, leaving the lens undisturbed. The patient achieved excellent cosmesis and a significant improvement in self-image.