Intraocular Lens Implantation In Eyes Research Articles

Pars-plana vitreous aspiration during combined trabeculectomy, phacoemulsification, and intraocular lens implantation in eyes with very shallow anterior chamber

Aim The aim of this study was to evaluate the outcome of pars-plana vitreous aspiration during combined trabeculectomy, phacoemulsification, and intraocular lens (IOL) implantation in eyes with shallow anterior chamber (AC) to prevent its associated complications. Patients and methods Fifty-four eyes of 46 patients were included in this study. All eyes were indicated for combined trabeculectomy, phacoemulsification and IOL implantation. All eyes had very shallow AC and injection of a viscoelastic substance through AC paracentesis failed to deepen the AC. Vitreous aspiration was performed with a 27 G needle on a 3 ml syringe over the pars plana 3.5 mm posterior to the limbus in the superotemporal quadrant. The cases were followed up for 12 months. The main outcome measures were the volume of aspirated vitreous, and intraoperative and postoperative complications. Results Intraoperative deepening of the AC occurred in all cases after vitreous aspiration. Aspirated vitreous volume varied from 0.3 to 0.7 ml (average 0.47 ml). There was no evidence of positive vitreous pressure during surgery in any case. No intraoperative complications occurred in all cases. Postoperative complications were detected in the form of shallow AC with hypotony in 5.5% of the cases (3 out of 54 cases) and shallow AC with high intraocular pressure was reported in 3.7% of the cases (2 out of 54 cases). All cases were managed without the need for a second surgery. Complications related to vitreous aspiration like vitreous hemorrhage, retinal tear, or detachment were not observed in any case. Conclusion Pars-plana vitreous aspiration is a safe procedure to prevent intraoperative shallow AC and its associated complications during combined trabeculectomy, phacoemulsification, and IOL implantation.

Customized Toric Intraocular Lens Implantation in Eyes with Cataract and Corneal Astigmatism after Deep Anterior Lamellar Keratoplasty: A Prospective Study.

Purpose To investigate the effectiveness of toric intraocular lenses (IOLs) for treating corneal astigmatism in patients with cataract and previous deep anterior lamellar keratoplasty (DALK). Setting San Giovanni-Addolorata Hospital, Rome, Italy. Design Prospective interventional case series. Methods Patients undergoing cataract surgery after DALK for keratoconus were enrolled. Total corneal astigmatism (TCA) was assessed by a rotating Scheimpflug camera combined with Placido-disk corneal topography (Sirius; CSO, Firenze, Italy). A customized toric IOL (FIL 611 T, Soleko, Rome, Italy) was implanted in all eyes. One year postoperatively, refraction was measured, the IOL position was recorded, and vectorial and nonvectorial analyses were performed to evaluate the correction of astigmatism. Results Ten eyes of 10 patients were analyzed. The mean preoperative TCA magnitude was 4.92 ± 1.99 diopters (D), and the mean cylinder of the IOL was 6.18 ± 2.44. After surgery, the difference between the planned axis of orientation of the IOL and the observed axis was ≤10° in all eyes. The mean surgically induced corneal astigmatism was 0.35 D at 20°. The mean postoperative refractive astigmatism power was 1.13 ± 0.94 D; with respect to preoperative TCA, the reduction was statistically significant (p < 0.0001). The mean change in astigmatism power was 3.80 ± 1.60 D, corresponding to a correction of 77% of preoperative TCA power. Nine eyes out of 10 had a postoperative refractive astigmatism power ≤ 2D. Conclusions Toric IOLs can effectively correct corneal astigmatism in eyes with previous DALK. The predictability of cylinder correction is partially lowered by the variability of the surgically induced changes of TCA. This trial is registered with NCT03398109.

Safety and efficacy of black iris diaphragm intraocular lens implantation in eyes with large iris defects: Report 4

To assess the safety and efficacy of Morcher 67B black iris diaphragm intraocular lens (IOL) implantation for managing large iris defects and aphakia. Stein Eye Institute, UCLA, Los Angeles, California, USA. Prospective case series. The demographic, preoperative, and postoperative data on patients implanted with a black iris diaphragm IOL and followed to 1year were reviewed. Safety measures included loss of corrected distance visual acuity (CDVA), perioperative complications, adverse events, and secondary surgical interventions. Efficacy measures included CDVA with glare, daytime and nighttime glare symptom scores, and subjective cosmesis scores. Thirty-one eyes of 31 patients were implanted. There was a 7-line improvement in median Snellen CDVA (P<.001). Four eyes worsened more than 1 line. There was 1 minor intraoperative complication. Twenty-one eyes experienced postoperative complications, most of which were related to preexisting ocular comorbidities. Three adverse events included cystoid macular edema, corneal graft dehiscence, and uveitis with ocular hypertension. There were 12 secondary surgical interventions. The CDVA with glare improved 6 Snellen lines (P<.0001). The mean subjective glare symptoms improved 4.94 points on a 0 to 10 scale during the day (P<.0001) and 3.61 points at night (P<.0001). The mean cosmesis score improved 2.23 points (P<.0001) on the same scale. Black iris diaphragm IOL implantation in aphakic eyes with large iris defects and significant ocular comorbidity was found to be relatively safe and very effective at improving CDVA and reducing light and glare sensitivity.

Outcome of phacoemulsification and intraocular lens implantion in eyes with pseudoexfoliation and weak zonules.

To evaluate the results of phacoemulsification and intraocular lens (IOL) implantation in eyes with pseudoexfoliation (PEX) and zonular weakness. Two hundred and ninety-five patients (295 eyes) were recruited. This study is a retrospective case review of 143 PEX eyes with preoperative (Group 1) and intraoperative (Group 2) signs of zonular weakness, 76 PEX eyes (Group 3) and 76 non-PEX eyes without zonular weakness (Group 4) undergoing phacoemulsification and IOL implantation performed by single surgeon from year 1988 to 2010. Outcome measures included frequency of postoperative pseudophakodonesis, anterior capsule contraction and IOL decentration/dislocation. Postoperative vision, intraocular pressure (IOP) and glaucoma medication requirements were also assessed. A subanalysis on identical postoperative outcomes of capsular tension ring (CTR) implantation was performed. Comparisons were made for 52 PEX eyes with zonular weakness receiving nonsutured CTR implantation (Group A), 91 PEX eyes with zonular weakness not receiving CTR implantation (Group B) and 142 PEX eyes without zonular weakness (Group C). Mean follow-up was 4.08±0.48years and maximum was 8.3years. Both Groups 1 and 2 showed higher incidence of complications than Groups 3 and 4 (p < 0.01). Vision, IOP and glaucoma medication requirements were similar postoperatively for all four groups. Groups A and B had a significantly higher proportion of postoperative complications than Group C (p<0.01). There was no significant difference in risk of developing these complications between Groups A and B (p=0.64). Postoperative complication rates are higher in PEX eyes with preoperative and/or intraoperative signs of zonular weakness undergoing phacoemulsification. Nonsutured CTR implantation does not prevent IOL and capsular complications postoperatively.

Angle evaluation after cataract operation using Swept‐Source OCT in elder Asian

PurposeTo investigate the change of anterior angle morphology after phacoemulsification with intraocular lens implantation in eyes with cataract using Swept‐Source optical tomography (SS‐OCT) in elder Asian peopleMethodsOne eye of 31 patients with cataract was performed phacoemulsification with intraocular lens implantation. Before and after the operation, the postop 1 day and 1 month, the anterior chamber angles were evaluated by SS‐OCT(CASIA®, Tomey) under dark conditions using three‐dimensional angle analysis scan protocol. In order not to indent eyes, in naturally eye opening status, we obtained SS‐OCT scans and analyzed with nasal and temporal quadrant of eyes. AOD, TISA, TIA were calculated automatically by SS‐OCT after an observer marked the scleral spurs (AOD: Angle Open Distance, TISA: Trabecular‐Iris Space Area, TIA: Trabecular‐Iris Angle).ResultsEnrolled 31 patients were 18 men and 13 women. The mean age was 68.71 ± 9.82 years. Preoperative means of AOD, TISA, TIA were 0.51 ± 0.27 (mm), 0.21 ± 0.11 (mm), 28.83 ± 11.51 (°). Postop 1day and 1month, the means of AOD, TISA, TIA were 0.63 ± 0.19 (mm), 0.24 ± 0.08 (mm), 32.05 ± 7.54 (°), and 0.67 ± 0.24 (mm), 0.26 ± 0.1 (mm), 36.78 ± 8.4 (°). Longitudinal data analysis was conducted based on multilevel model framework. The changes of AOD, TISA, TIA were significantly increased linearly or quadradically after adjusting age and gender (p = 0.004, p = 0.002, p = 0.000).ConclusionsThe eyes that were performed cataract operation have greater improved anterior chamber angle parameters. It means that cataract surgery can improve aqueous humor dynamic in angle closure suspect or glaucoma patients.

Outcomes of glued foldable intraocular lens implantation in eyes with preexisting complications and combined surgical procedures

To evaluate the visual outcomes and complications of glued foldable intraocular lens (IOL) implantation in patients with a wide range of ocular pathologies and/or having combined surgical procedures. New York Eye and Ear Infirmary of Mount Sinai, New York, New York, USA. Retrospective case series. A chart review was conducted of all glued foldable IOL procedures performed in eyes with absent or insufficient capsule support. Patients with a postoperative follow-up less than 3 months were excluded from analysis. Intraoperative and postoperative complications, the postoperative course, and visual and refractive outcomes were analyzed. Sixty-five eyes (64 patients) were evaluated over a mean follow-up of 9.1 months ± 6.2 (SD). Ocular comorbidities were present in 98.5% of eyes, and 95.4% had additional concurrent surgical procedures. There was a statistically significant improvement in corrected distance visual acuity (P = .046), with 89.2% of eyes achieving better or equal vision postoperatively. Intraoperative complications included ocular hemorrhage (10.8%), haptic deformation (10.8%), and haptic breakage (1.5%). Postoperative complications included elevated intraocular pressure (13.8%), optic capture (12.3%), persistent anterior chamber inflammation (6.2%), IOL tilt (4.6%), cystoid macular edema (3.1%), recurrent ocular hemorrhage (3.1%), and retinal detachment (1.5%). The glued foldable IOL technique resulted in favorable visual outcomes but with a moderate risk for IOL-related and other postoperative complications in eyes with complex ocular comorbidities having combined surgical procedures. No author has a financial or proprietary interest in any material or method mentioned.

Safety and Efficacy of Phacoemulsification and Intraocular Lens Implantation in Eyes with End-Stage Chronic Angle-Closure Glaucoma

Safety and Efficacy of Phacoemulsification and Intraocular Lens Implantation in Eyes with End-Stage Chronic Angle-Closure Glaucoma

Anterior chamber fixation of a posterior chamber intraocular lens: a novel technique.

We aimed to evaluate the implantation of a posterior chamber intraocular lens (IOL) in the anterior chamber (AC) with the haptics passing through two iridectomies to the posterior chamber. A total of 33 eyes of 33 patients with inadequate posterior capsular support due to either previous aphakia or posterior capsular rupture during cataract extraction were included in the study. A double iridectomy was performed on all patients using a vitrectomy probe on the midperiphery of the iris. IOLs were implanted in the AC, and the haptics were passed through the iridectomies to the posterior chamber. The mean follow-up time was 25.3 months. AC hemorrhage occurred in five patients during the iridectomy procedure. Corneal edema was detected in eight of 14 patients with primary IOL insertions. Haptic dislocation was detected in only one patient. This technique may be a good alternative to scleral-fixated IOL implantation in eyes with aphakia.

Effect of phacoemulsification with intraocular lens implantation in eyes with cataract and functioning filtering blebs

Aim: To evaluate the effect of phacoemulsification with intraocular lens implantation in eyes with pre-existing trabeculectomy.Methods: This prospective single-center clinical study evaluated intraocular pressure in 60 eyes of 60 patients who underwent phacoemulsification and implantation of a foldable intraocular lens after a previous successful trabeculectomy. Patients who had a trabeculectomy more than one year prior to the study were included. Intraocular pressure, number of antiglaucoma medications, bleb appearance, and visual acuity were recorded preoperatively, and at each follow-up examination and 12 months after phacoemulsification.Results: The mean intraocular pressure before phacoemulsification was 12.42 mmHg (SD, 4.60 mmHg), which increased to 14.98 mmHg (SD, 4.18 mmHg), 14.47 mmHg (SD, 3.58 mmHg), 15.44 mmHg (SD, 3.60 mmHg), and 15.71 mmHg (SD, 3.47 mmHg) after one, three, six, and 12 months, respectively. At each follow-up visit, the mean IOP was significantly higher than the preoperative value (p &lt; 0.001, p = 0.015, p ≤ 0.001, and p = 0.001 at month one, three, six, and 12, respectively). The mean preoperative best-corrected visual acuity was 0.98 logMAR (SD, 0.44 logMAR) and the mean postoperative best-corrected visual acuity at 12 months was 0.20 logMAR (SD, 0.21 logMAR) [p = 0.0001]. The mean preoperative number of antiglaucoma medications used was 0.57 (SD, 0.63), which increased to 0.65 (SD, 0.63 ), 0.70 (SD, 0.72 ) 0.68, (SD, 0.70), and 0.67 (SD, 0.77 ) at one, three, six, and 12 months, respectively, but there were no statistically significant differences. Bleb size decreased clinically after phacoemulsification. Nineteen of 60 eyes (32%) developed fibrosis of bleb with decreased bleb size.Conclusion: Phacoemulsification with intraocular lens implantation significantly increased intraocular pressure and increased the number of antiglaucoma medications in eyes with pre-existing functioning filtering blebs.

Complications and visual outcomes after glued foldable intraocular lens implantation in eyes with inadequate capsules

To evaluate the complications and visual outcomes of glued intrascleral-fixated foldable intraocular lens (IOL) in eyes with deficient capsules. Dr Agarwal's Eye Hospital and Eye Research Centre, Chennai, India. Case series. Data were evaluated from the records of patients with a primary glued foldable IOL for intraoperative capsular loss or subluxated lens or secondary glued foldable IOL for aphakia. Exclusion criteria included preoperative glaucoma, aniridia, macular scar, traumatic subluxation, combined surgeries, incomplete operative medical records, and postoperative follow-up less than 6 months. The intraoperative and postoperative complication rates, reoperation rate, and visual outcomes were analyzed. The study comprised 208 eyes (185 patients). The mean follow-up was 16.7 months ± 10.2 (SD). The intraoperative complications were hyphema (0.4%), haptic breakage (0.4%), and deformed haptics (0.9%). Early complications occurred in 29 eyes (13.9%) and included corneal edema (5.7%), epithelial defect (1.9%), and grade 2 anterior chamber reaction (2.4%). Late complications occurred in 39 eyes (18.7%) and included optic capture (4.3%), IOL decentration (3.3%), haptic extrusion (1.9%), subconjunctival haptic (1.4%), macular edema (1.9%), and pigment dispersion (1.9%). Reoperation was required in 16 eyes (7.7%). Haptic position was altered in eyes with IOL decentration. Corrected distance visual acuity (CDVA) improved or remained unchanged in 84.6% of eyes. The postoperative CDVA was 20/40 or better and 20/60 or better in 38.9% and 48.5% of eyes, respectively. The foldable glued-IOL procedure showed satisfactory visual outcomes without serious complications. Intraocular lens decentration was due to haptic-related problems.

Safety and efficacy of phacoemulsification and intraocular lens implantation in eyes with end‐stage chronic angle‐closure glaucoma

AbstractPurpose To evaluate surgical outcomes of phacoemulsification and intraocular lens implantation in eyes with end‐stage chronic angle‐closure glaucoma (CACG).Methods Patients with medically controlled end‐stage CACG (mean deviation, &lt; ‐19 dB) and clinically significant cataracts were enrolled in this prospective observational study. Standard phacoemulsification and intraocular lens implantation were performed. During at least 6 months of follow‐up, changes in visual acuity, intraocular pressure, visual field parameters, and number of antiglaucoma agents used were assessed. Intraoperative and postoperative complications were documented. Multiple regression analysis was performed to identify independent predictors of postoperative visual outcome.Results Twenty‐two eyes of 19 subjects were enrolled. The mean follow‐up period was 13.7 months (6–27 months). Corrected visual acuity improved from 0.63 ± 0.50 logarithm of the minimum angle of resolution (logMAR) preoperatively to 0.20 ± 0.31 logMAR postoperatively (p &lt; 0.001). Intraocular pressure decreased from 14.05 ± 3.11 mmHg to 10.55 ± 1.79 mmHg (p &lt; 0.001). No change was found in visual field parameters or number of antiglaucoma agents used. During surgery, 2 eyes had zonular dialysis and 1 eye had posterior capsule rupture. After surgery, 1 eye required additional trabeculectomy due to uncontrolled intraocular pressure after phacoemulsification. Preoperative visual acuity and mean sensitivities of 4 central points of the visual field were independent predictors of postoperative visual outcome.Conclusion Phacoemulsification and intraocular lens implantation was performed safely and effectively in end‐stage CACG eyes with cataracts.

Visual Quality after Acrysof IQ ReSTOR Intraocular Lens Implantation in Eyes with High Myopia

To evaluate the visual performance of patients with high myopia with diffractive multifocal intraocular lens (MIOL) as compared with aspheric monofocal intraocular lens (IOL). A prospective nonrandomized controlled study was conducted. Consecutively, 36 patients with senile cataract (72 eyes) received phacoemulsification and IOL implantation: 12 patients (24 eyes) were implanted with AcrySof IQ ReSTOR SN6AD3 IOL, 12 patients (24 eyes) were implanted with AcrySof IQ ReSTOR SN6AD1 IOL, and another 12 patients (24 eyes) were implanted with AcrySof IQ SN60WF as control group. All patients were assessed at 6 months postoperatively in these aspects: uncorrected and best-corrected visual acuities for distance (5 mo), intermediate (60 cm), and near (30 cm), modulation transfer function, and defocus curve. Patient satisfaction (spectacle independence, glare or halo disturbance, and overall satisfaction) was assessed by a questionnaire. At 6 months postoperatively, both uncorrected and distance-corrected intermediate and near visual acuity were significantly better in multifocal groups than the control monofocal group (p<0.01). Intermediate visual acuity in the SN6AD1 group was a little higher than that in the SN6AD3 group (p<0.05); conversely, the near visual acuity in the SN6AD3 group was better than in the SN6AD1 group (p<0.05). Modulation transfer function with a 5.0-mm aperture was similar in the 3 groups and there was no statistically significant difference. Patients in both multifocal groups reported excellent overall spectacle independence and satisfaction with the IOLs. Compared with aspheric monofocal IOL, AcrySof ReSTOR IQ multifocal IOLs could provide a functional vision range from near to distance, resulting in high level of spectacle independence and satisfaction among patients with high myopia.

Visual quality after diffractive intraocular lens implantation in eyes with previous hyperopic laser in situ keratomileusis

To evaluate distance, intermediate, and near visual quality in eyes with diffractive intraocular lens (IOL) implantation after previous hyperopic laser in situ keratomileusis (LASIK). Fernández-Vega Ophthalmological Institute, Oviedo, Spain. Cohort study. Corrected distance visual acuity (CDVA) at 12.5%, 25.0%, and 100% contrast levels under photopic and mesopic conditions; uncorrected (UNVA) and distance-corrected (DCNVA) near visual acuity, defocus curves, and corneal higher-order aberrations (HOAs) were measured in eyes that had AcrySof Restor SN60D3 spherical IOL implantation (study group) and in phakic eyes (control group) after hyperopic LASIK. Under photopic conditions at 100% contrast, there were no statistically significant differences between the 2 groups (P > .01) and the CDVA was 0.1 logMAR or better (approximately 20/25) in both groups. At 25.0% and 12.5% contrast, there were no statistically significant differences between the 2 groups (P > .01). Under mesopic conditions, the control group had better CDVA than the study group without glare at all contrasts (P < .01). In the study group, the mean UNVA was 0.017 logMAR ± 0.030 (SD) (approximately 20/20) and the mean DCNVA, 0.009 ± 0.030 logMAR. There was statistically significant worsening of visual acuity as a function of the distance to the test (P < .01). There were no statistically significant differences in HOAs between the 2 groups (P > .01). In eyes with previous hyperopic LASIK, the diffractive IOL provided good visual quality at distance, comparable to that obtained in phakic eyes under photopic conditions, although visual performance was slightly poorer under mesopic conditions. No author has a financial or proprietary interest in any material or method mentioned.

Glued intraocular lens implantation for eyes with defective capsules: A retrospective analysis of anatomical and functional outcome

Purpose To analyze the anatomical and functional outcome of glued intra ocular lens (IOL) implantation technique and its modifications. Design Retrospective observational case series. Methods This is a retrospective analysis of the patients who underwent glued intra ocular lens implantation from December 2007 to August 2010. Post operative uncorrected vision, best corrected visual acuity (BCVA), intra ocular pressure, IOL position, endothelial cells and anterior chamber reaction at their last follow up are analyzed from their concerned case sheets documentation. Subjective changes are analyzed via individual questionnaire. Immediate and late postoperative complications are also evaluated. Surgical modifications and the difference in the operated eyes are analyzed. Results Total 210 glued IOL eyes have been reviewed. Out of this 210, there are 152 (PMMA glued IOL), 21 (three piece foldable IOL), 5 (multifocal foldable IOL), 12 (pediatric glued IOL), 5 (20G sutureless vitrectomy), 2 (glued iris prosthesis) and 3 (transposition of posterior chamber IOL into anterior chamber). In combined surgeries there are, 5 (optical penetrating keratoplasty), 2 (descemet’s stripping endothelial keratoplasty) and 3 (iridoplasty). The modifications in glued IOL are handshake technique, injectable or foldable glued IOL, Multifocal glued IOL and intraoperative 23/25G trocar cannula infusion. Decentration (1.97%), macular edema (1.97%) and optic capture (2.63%) are the post operative complications encountered in rigid glued IOL. Good patient satisfaction is seen in the eyes with IOL repositioning, IOL exchange and multifocal glued IOL. There is significant improvement in BCVA in PMMA IOL ( p = 1.35 × 10 −5) and foldable IOL ( p = 0.000). Conclusion Glued IOL seems to be a good alternative in IOL implantation in eyes with deficient capsules. The modifications in the existing technique decrease the learning time and risk for complications.

Phacoemulsification and customized toric intraocular lens implantation in eyes with cataract and high astigmatism after penetrating keratoplasty

Phacoemulsification and implantation of a hydrophilic acrylic toric intraocular lens (IOL) (T-flex 623T) with customized cylindrical power was performed in 1 eye in 3 consecutive patients with cataract and high postkeratoplasty astigmatism (range 6.75 to 8.75 diopters [D]). Twelve months postoperatively, the uncorrected distance visual acuity improved from 20/200 to 20/30 in Case 1, from 20/400 to 20/40 in Case 2, and from 20/200 to 20/25 in Case 3 and the corrected distance visual acuity was 20/25 or better in all 3 eyes. The spheroequivalent was within ± 0.50 D of the intended value and the refractive astigmatism was less than 1.00 D. The corneal grafts were transparent, and the endothelial cell loss range was 6% to 12%. Rotation of the toric IOL was less than 5 degrees. The toric IOL with customized cylindrical power provided good postoperative rotational stability and very satisfactory postoperative visual recovery. This type of toric IOL is appropriate to correct high postkeratoplasty astigmatism in eyes operated on for cataract. No author has a financial or proprietary interest in any material or method mentioned.

Results of Coaxial Phacoemulsification Through a 1.8-mm Microincision in Hard Cataracts

To assess the results of coaxial phacoemulsification through 1.8-mm coaxial microincision cataract surgery (C-MICS) phacoemulsification with foldable intraocular lens implantation in eyes with hard cataracts in comparison to eyes with soft cataracts. Group 1 consisted of 40 eyes of 40 patients with hard cataracts (grade ≥ 4, Lens Opacities Classification System III scale) and group 2 consisted of 45 eyes of 45 patients with non-mature cataracts (grade ≤ 2, Lens Opacities Classification System III scale). All surgeries were performed by two experienced surgeons under topical and intracameral anesthesia. Examinations were performed preoperatively and 1 month after the surgery. Examined parameters included distance-corrected visual acuity (DCVA), autorefractometry, keratometry, tonometry, endothelial cell counts, and biomicroscopy of the anterior and posterior segment. Surgically induced astigmatism was calculated with vector analysis. Mean DCVA was 0.16 ± 0.16 preoperatively and 0.92 ± 0.21 postoperatively in group 1 (P < .05) and 0.62 ± 0.18 preoperatively and 0.97 ± 0.08 postoperatively in group 2 (P < .05). Mean surgically induced astigmatism was 0.48 ± 0.44 in group 1 and 0.53 ± 0.38 in group 2 (P > .05). Mean endothelial cell loss was 11.37% ± 12.87% in group 1 and 2.87% ± 9.66% in group 2 (P < .05). Although density of cataract has an unfavorable influence on early postoperative corneal endothelial cell loss, it did not significantly influence final DCVA and surgically induced astigmatism. C-MICS is a safe and effective method of treatment of cataracts, including cataracts with hard nuclei, and usually leads to good functional outcomes.

Pseudoaccommodating bifocal intraocular lens implantation in eyes with previous corneal refractive surgery - refractive outcomes: case series of 8 eyes

OBJECTIVE: Accurate intraocular lens power calculation may be a challenging issue in eyes with previous corneal refractive surgery. METHODS: The authors present a series of 8 eyes (4 previously submitted to hyperopic laser in situ keratomileusis and 4 to radial keratectomy) submitted to phacoemulsification and implantation of pseudoaccommodating bifocal intraocular lens. Double-K SRK/T formula has been used. RESULTS: Acceptable refractive visual outcomes have been achieved. CONCLUSION: Pseudoaccommodating bifocal intraocular lenses can be safely implanted in patients with previous corneal refractive surgery.

Clinical outcomes and patient satisfaction after Visian Implantable Collamer Lens removal and phacoemulsification with intraocular lens implantation in eyes with induced cataract

To assess the clinical outcomes and patient satisfaction after simultaneous Implantable Collamer Lens (ICL) removal and phacoemulsification with intraocular lens (IOL) implantation in ICL-implanted eyes with developing cataracts. We retrospectively reviewed the clinical charts of 10 eyes of eight patients who developed significant cataract after ICL implantation. Patient age was 47.2+/-5.9 (mean+/-SD) years (range, 37-57 years). We determined visual acuity (log MAR), manifest refraction, endothelial cell density, and subjective satisfaction with visual outcomes measured using a visual analogue scale, that ranged from 0 (very dissatisfied) to 10 (very satisfied), before and 3 months after cataract surgery. Log MAR best spectacle-corrected visual acuity was significantly improved from 0.19+/-0.30 preoperatively to -0.06+/-0.07 postoperatively (P=0.007, Wilcoxon signed-rank test). Eight (80%) and nine (90%) of the 10 eyes were within 0.5 D (diopter) and 1.0 D of the targeted correction, respectively. The endothelial cell density was 2584.9+/-266.2 cells/mm(2) preoperatively, and 2340.1+/-269.7 cells/mm(2) postoperatively. The overall satisfaction with visual outcomes was scored 1.8+/-1.1 (range: 0-3) preoperatively, and 7.9+/-1.4 (range: 6-10) postoperatively. No vision-threatening complications were seen throughout the follow-up period. Simultaneous ICL removal and phacoemulsification with IOL implantation was safe and effective with predictable refractive results, and thus yielded a high level of patient satisfaction with ICL-induced cataract treatment.

Visual quality after diffractive intraocular lens implantation in eyes with previous myopic laser in situ keratomileusis

To evaluate distance, intermediate, and near visual quality in eyes having diffractive intraocular lens (IOL) implantation after previous myopic laser in situ keratomileusis (LASIK). Fernández-Vega Ophthalmological Institute, Oviedo, Spain. Best corrected distance visual acuity at 12.5%, 25%, and 100% contrasts under photopic and mesopic conditions, best distance-corrected near visual acuity, defocus curve, and corneal higher-order aberrations (HOAs) were measured in eyes with a spherical AcrySof ReSTOR SNA60D3 IOL or aspherical Acri.LISA 366D IOL after myopic LASIK and in phakic eyes after myopic LASIK (control group). Under photopic conditions at 100% contrast, best corrected distance acuity was 0.1 logMAR or better in all groups. At 25% and 12.5%, there were no statistically significant differences between the Acri.LISA and AcrySof ReSTOR groups or the Acri.LISA and control groups (P >.01). The control group had better best corrected distance acuity than the AcrySof ReSTOR group (P = .0002 and P < .0001 at 25% and 12.5%, respectively). Under mesopic conditions, the Acri.LISA group had better best corrected distance acuity than the AcrySof ReSTOR group at all contrasts (P > .01). The best distance-corrected near acuity was comparable in the 2 IOL groups (P < .01). Intermediate visual acuity was statistically significantly better in the Acri.LISA group than in the AcrySof ReSTOR group (P < .01). There were no statistically significant differences in HOAs between the 3 groups (P > .01). Both multifocal IOLs provided good and comparable visual acuity at distance and near. However, the aspherical Acri.LISA IOL gave better intermediate visual acuity than the spherical AcrySof ReSTOR IOL.

Phacoemulsificatıon and Intraocular Lens Implantation in Eyes with Long Axial Length

We evaluated the results of phacoemulsification and intraocular lens implantation in 414 eyes with long axial length and classified them according to axial length (AL): Group A: AL: 25-28 mm, Group B: AL >28 mm. Intraoperative maneuvers, pre- and postoperative photocoagulation for predisposing retinal lesions and retinal detachment rates were significantly higher in Group B than Group A. Eyes with an axial length over 28 mm are prone to more problems when compared to those with an axial length between 25 and 28 mm.