Cases Of Aphakia Research Articles

Application of modified Yamane technique in intrascleral intraocular lens fixation combined with or without iris reconstruction

AimsTo explore the application and long-term clinical effects of modified Yamane technique in intrascleral intraocular lens (IOL) fixation combined with or without iris reconstruction.Settings and designThe data of patients receiving IOL fixation with modified Yamane technique in an ophthalmology department between December 2021 and August 2023 were analyzed retrospectively. The longest follow-up duration was > 12 months.Methods and materialThe trailing haptic was fixed with the needle before the leading haptic. The silicone haptic stoppers were used to stabilize the IOL when iris reconstruction was combined. Preoperative and postoperative best-corrected visual acuity (BCVA), corneal endothelial cells (CECs), postoperative intraocular pressure (IOP), surgical indications and methods, and postoperative complications were recorded. Anterior segment optical coherence tomography (OCT) was used to evaluate IOL decentration and tilt. The paired sample t-test or Wilcoxon rank sum test were used to compare the results of the same index before and after the operation.ResultsTwelve patients (12 eyes) were included in this cohort. There were 1 case of IOL dislocation, eight cases of lens dislocation or subluxation, and three cases of aphakia. Traumatic lens dislocation was the main cause of aphakia. Primary lens extraction was performed in previous surgeries, and all three were combined with pars plana vitrectomy (PPV). Four of 12 patients underwent IOL fixation and iris reconstruction. The mean age of participants was 63 ± 10.61 years. The mean BCVA increased from 0.89 ± 0.72 logMAR to 0.39 ± 0.56 logMAR at the last visit (p < 0.05). The postoperative relative refractive error was − 0.13 ± 0.42 D (–0.60 D to + 0.57 D). The OCT showed that the IOLs were well centered, with a mean decentration of 0.20 ± 0.13 mm and a mean tilt of 2.31°±0.93°. Ten patients did not experience any complications.ConclusionsThe modified Yamane technique in IOL fixation surgery, especially combined with iris reconstruction, reduces operation difficulty, increases operational stability and safety, and improves postoperative visual acuity without serious intra- or postoperative complications. The long-term improvement effect was remarkable.

Long-Term Complications of Anterior Chamber Iris Claw Lens

Cases of aphakia with no capsular support can be managed with anterior chamber intraocular lens (ACIOL), iris fixated IOL or scleral fixated IOL(SFIOL). The procedure of choice depends on the status of the patient’s eye as well as the surgeon’s experience. Iris-claw lens implantation is an effective method for correction of aphakia with several advantages such as having fewer complications, with its easy placement and good visual outcomes. Herein, we report a case of a 42-year-old male patient who presented with pseudophakic bullous keratopathy with secondary glaucoma as a complication of anterior chamber iris-claw lens.

Corneal transplantation in cases of aphakia and ectopia of the lens; selection of cases; technic of operations outlined; report of new instruments.

THE PURPOSE of this article is to discuss the problem of corneal transplantation in cases of aphakia and displacement of the lens and to present a new technic and instruments for carrying out this type of operation in such cases. Corneal transplantation has long been recognized as a highly successful procedure in properly selected cases; but there have been definite contraindications to this operation, and until recently the condition of aphakia has been considered unfavorable for operation (Rycroft and Somerset, 1 McArevey, 2 Filatov, 3 Elschnig, 4 Castroviejo 5 ). APHAKIA It is now known that corneal grafts heal and remain transparent in aphakic eyes. Cases of aphakia are by no means the most favorable, but, owing to improved technics, a reasonably good chance of a successful corneal transplantation is offered in these cases. In cases in which both corneal leukoma and cataract are present and it has been determined beforehand