Dear Editor,We report a relatively safe and effective triple procedure for traumatic aphakia,glaucoma,and mydriasis.Blunt eye trauma can lead to various anterior-and posterior-segment conditions[1],that often occur si...Dear Editor,We report a relatively safe and effective triple procedure for traumatic aphakia,glaucoma,and mydriasis.Blunt eye trauma can lead to various anterior-and posterior-segment conditions[1],that often occur simultaneously.Closed-globe injuries can damage one or more ocular structures.展开更多
AIM:To evaluate the accuracy of intraocular lens(IOL)power calculation formulas with/without preoperative aphakic anterior chamber depth(aph-ACD)in pediatric aphakia.METHODS:A total of 102 pediatric patients(150 eyes)...AIM:To evaluate the accuracy of intraocular lens(IOL)power calculation formulas with/without preoperative aphakic anterior chamber depth(aph-ACD)in pediatric aphakia.METHODS:A total of 102 pediatric patients(150 eyes)undergoing secondary IOL implantation were divided into two groups(in-the-bag or ciliary sulcus).Prediction error was calculated for 9 IOL power calculation formulas,including:1)not requiring ACD:Hoffer Q,Holladay 1,SRK/T;2)usable without or with entering ACD:Barrett Universal II(BUII),Emmetropia Verifying Optical(EVO)2.0,and Ladas Artificial Intelligence Super(Ladas AI);3)requiring ACD:Haigis,Kane,and Pearl-DGS.Mean prediction error(ME),mean absolute error(MAE),median absolute error(MedAE)and the percentage of eyes within±0.25,±0.50,±0.75,and±1.00 D were calculated.RESULTS:For the BUII,EVO 2.0,and Ladas AI,with aph-ACD demonstrated a higher MedAE compared to without aph-ACD(BUII:1.27 vs 1.13 D,EVO 2.0:1.26 vs 1.06 D,Ladas AI:1.30 vs 1.10 D;all P<0.05).Formulas requiring ACD(Haigis,Kane,and Pearl-DGS)exhibited larger MedAE than those not requiring aph-ACD(Hoffer Q,Holladay 1,and SRK/T;P<0.05).In the capsular group,the percentage of eyes within±1.00 D ranged from 44.83%to 74.14%,and it was 19.57%to 32.61%in the sulcus group.CONCLUSION:The introduction of aph-ACD does not improve the accuracy of IOL calculation for pediatric aphakia,regardless of in-the-bag or sulcus IOL secondary implantation.The relationship between aph-ACD and effective lens position in pediatric aphakia warrants further study.展开更多
AIM： To evaluate the complications and outcomes of descemet stripping automated endothelial keratoplasty（DSAEK） combined with artisan aphakia intraocular lens（IOL） implantation in severely damaged eyes without ca...AIM： To evaluate the complications and outcomes of descemet stripping automated endothelial keratoplasty（DSAEK） combined with artisan aphakia intraocular lens（IOL） implantation in severely damaged eyes without capsular support.METHODS： DSAEK combined with artisan iris claw IOL implantation was performed on 29 eyes. All eyes were of abnormal structure due to complications from prior intraocular surgeries and ocular trauma. Ocular complications observed included graft dislocations, high intraocular pressure（IOP）, IOL dislocations, macular edema and hyphema. Best corrected visual acuity（BCVA）, IOP and mean central endothelial cell density（ECD） were recorded.RESULTS： Thirteen eyes had a history of ocular trauma, 10 eyes had an anterior chamber IOL, 16 eyes had prior vitrectomy. The iris was abnormal in 22 cases. Graft dislocation occurred in 5（17.2%） of 29 eyes. IOL dislocation occurred in 2 eyes（6.9%）. High IOP was found in 9 eyes and was controlled with treatment. The preoperative mean BCVA was 20/286. The 6 mo postoperative mean BCVA was 20/42. The average center ECD was 1965.3 cells/mm^2 at 6 mo, and the rate of the donor cell loss was 34.7%.CONCLUSION： DSAEK combined with artisan aphakia IOL implantation is an alternative option for resolving endothelial and lens disorders in aphakic eyes without capsular support. However, it should be performed cautiously for eyes with severe iris defects.展开更多
Background: Many reasons can lead to an aphakia without adequate capsular support for implantation of a posterior chamber intraocular lens (IOL), such as intraoperative unintentional rupture of posterior capsule durin...Background: Many reasons can lead to an aphakia without adequate capsular support for implantation of a posterior chamber intraocular lens (IOL), such as intraoperative unintentional rupture of posterior capsule during phacoemulsification, planned intracapsular cataract extraction, ocular trauma and lens dislocation due to congenital and acquired causes. Purpose: To compare Y-shaped intra-scleral fixation of a posterior chamber IOL with retro pupillary fixation of an iris-claw intraocular lens (IOL) for Aphakic eyes without sufficient capsular support as respects safety, visual recovery and complications of both methods. Patients and Methods: One hundred Aphakic eyes were arbitrarily distributed between two groups. Group A included 50 eyes treated with retropupillary fixation of iris claw lens and group B included 50 eyes treated with Y-shaped intra-scleral fixation technique. Preoperative, intraoperative and postoperative data were analysed including best corrected visual acuity (BCVA), intraocular pressure (IOP), surgical time, intraoperative problems, IOL malposition and postoperative complications. Following up on patients was carried out for at least six months. Results: The mean duration of surgery was 21 ± 5.3 min in group A and was 53.4 ± 6.9 min in group B (p-value 0.05). IOL tilt was found in 0 (0%) eyes in group A and in 5 (10%) eyes in group B (p 0.05). Conclusion: The results of our study indicated that both methods are satisfactory in correcting aphakia without sufficient capsular support as regards postoperative best corrected visual acuity (BCVA);however the surgical technique of retropupillary iris claw lens is easier, shorter, with low intra- and postoperative complications and safer than those used for intra-scleral fixation of IOL. But for eyes which lack both iris and capsular support, a scleral fixation of a posterior chamber IOL remains the only option.展开更多
<strong>Introduction:</strong> Iris-claw Intraocular Lens (IOL) is one of the alternatives to correct aphakia without sufficient capsular support. This technique is preferred because it has a simple proced...<strong>Introduction:</strong> Iris-claw Intraocular Lens (IOL) is one of the alternatives to correct aphakia without sufficient capsular support. This technique is preferred because it has a simple procedure. Iris-claw IOL was originally designed to be fixated on the anterior chamber. The use of retropupillary fixation is increasing because the location is more physiologic and it shows less risk to corneal endothelial damage. <strong>Purpose:</strong> To describe safety and efficacy of iris-claw Artisan IOL in correcting aphakia without sufficient capsular support. <strong>Methods:</strong> This is a descriptive retrospective study of patients with aphakic iris-claw Artisan IOL implantation in National Eye Center Cicendo Eye Hospital, Indonesia from July 2017-July 2019. Patients were divided into prepupillary and retropupillary group. The Uncorrected Visual Acuity (UCVA), Best-Corrected Visual Acuity (BCVA), Safety Index (SI), Efficacy Index (EI), and complications were recorded. The procedure is safe if SI value ≥ 1.0 and effective if EI value ≥ 1.0. <strong>Results:</strong> There were 54 eyes in the retropupilary group and 17 eyes in the prepupillary group. In the prepupillary group, there were 94.11% eyes with SI ≥ 1.0, the mean SI was 1.79 ± 1.02, 50% of eyes with EI ≥ 1.0, and the mean EI was 0.77 ± 0.20. In the retropupillary group, there were 96.29% eyes with SI ≥ 1.0, the mean SI was 2.49 ± 2.23, 74.07% of eyes with EI ≥ 1.0, and the mean EI was 1.75 ± 1.64. Postoperative UCVA and BCVA were improved significantly compared to preoperative visual acuity in both groups (p < 0.05) <strong>Conclusion:</strong> Prepupillary and retropupillary iris-claw IOL implantation are safe. Retropupillary fixation technique is more effective in improving visual acuity.展开更多
Purpose: To study the role of epikeratophakia in treating pediatric unilateral aphakia after traumatic cataract extraction.Methods: We performed epikeratophakia in 43 children to treat aphakia after traumatic cataract...Purpose: To study the role of epikeratophakia in treating pediatric unilateral aphakia after traumatic cataract extraction.Methods: We performed epikeratophakia in 43 children to treat aphakia after traumatic cataract extraction, using the corneal lenses made by ourselves. The rehabilitation of the the postoperative vision and the prevention of amblyopia were observed with a mean follow-up period of 20 months.Results: All the lenses remained transparent. Postoperatively, 31 cases (72. 1%) achieved uncorrected visual acuities (V. A) over 0. 2, 32 cases (74. 4%) achieved corrected V. A over 0. 4. Most of the cases achieved the best preoperative corrected V. A with spectacles of less than 3 diopters. No severe complication occurred. Conclusion: Epikeratophakia is predictable with quality lens and correct surgical technique. The result suggests that the epikeratophakia is one of the best treatment for the pediatric aphakia especially for those who are not optimal for IOL implantation. Eye Science 1997 ;展开更多
Dear Editor,We present the reported case of repetitive bilateral suprachoroidal expulsive hemorrhage(SEH)after anti-glaucoma surgeries.SEH is a rare but potentially devastating complication of intraocular surgery.Long...Dear Editor,We present the reported case of repetitive bilateral suprachoroidal expulsive hemorrhage(SEH)after anti-glaucoma surgeries.SEH is a rare but potentially devastating complication of intraocular surgery.Long-term ocular hypertension,high myopia,older age,arterial sclerosis,and aphakia have been reported as preoperative risk factors for developing SEH^([1]).The prognosis for the visual acuity is poor without proper management.A suggested time for surgical drainage is said to be 10-14d when the hemorrhagic clot begins to liquefy^([2]).展开更多
文摘Dear Editor,We report a relatively safe and effective triple procedure for traumatic aphakia,glaucoma,and mydriasis.Blunt eye trauma can lead to various anterior-and posterior-segment conditions[1],that often occur simultaneously.Closed-globe injuries can damage one or more ocular structures.
基金Supported by the Joint Funding Project of Municipal Schools(Colleges)of Science and Technology Program of Guangzhou,China(No.2023A03J0188)the Construction Project of High-Level Hospitals in Guangdong Province(No.303020102)the Natural Science Fund of Guangdong Province(No.2023A1515011102).
文摘AIM:To evaluate the accuracy of intraocular lens(IOL)power calculation formulas with/without preoperative aphakic anterior chamber depth(aph-ACD)in pediatric aphakia.METHODS:A total of 102 pediatric patients(150 eyes)undergoing secondary IOL implantation were divided into two groups(in-the-bag or ciliary sulcus).Prediction error was calculated for 9 IOL power calculation formulas,including:1)not requiring ACD:Hoffer Q,Holladay 1,SRK/T;2)usable without or with entering ACD:Barrett Universal II(BUII),Emmetropia Verifying Optical(EVO)2.0,and Ladas Artificial Intelligence Super(Ladas AI);3)requiring ACD:Haigis,Kane,and Pearl-DGS.Mean prediction error(ME),mean absolute error(MAE),median absolute error(MedAE)and the percentage of eyes within±0.25,±0.50,±0.75,and±1.00 D were calculated.RESULTS:For the BUII,EVO 2.0,and Ladas AI,with aph-ACD demonstrated a higher MedAE compared to without aph-ACD(BUII:1.27 vs 1.13 D,EVO 2.0:1.26 vs 1.06 D,Ladas AI:1.30 vs 1.10 D;all P<0.05).Formulas requiring ACD(Haigis,Kane,and Pearl-DGS)exhibited larger MedAE than those not requiring aph-ACD(Hoffer Q,Holladay 1,and SRK/T;P<0.05).In the capsular group,the percentage of eyes within±1.00 D ranged from 44.83%to 74.14%,and it was 19.57%to 32.61%in the sulcus group.CONCLUSION:The introduction of aph-ACD does not improve the accuracy of IOL calculation for pediatric aphakia,regardless of in-the-bag or sulcus IOL secondary implantation.The relationship between aph-ACD and effective lens position in pediatric aphakia warrants further study.
基金Supported by the National Natural Science Foundation of China(No.30871315No.31140025No.31271045)
文摘AIM： To evaluate the complications and outcomes of descemet stripping automated endothelial keratoplasty（DSAEK） combined with artisan aphakia intraocular lens（IOL） implantation in severely damaged eyes without capsular support.METHODS： DSAEK combined with artisan iris claw IOL implantation was performed on 29 eyes. All eyes were of abnormal structure due to complications from prior intraocular surgeries and ocular trauma. Ocular complications observed included graft dislocations, high intraocular pressure（IOP）, IOL dislocations, macular edema and hyphema. Best corrected visual acuity（BCVA）, IOP and mean central endothelial cell density（ECD） were recorded.RESULTS： Thirteen eyes had a history of ocular trauma, 10 eyes had an anterior chamber IOL, 16 eyes had prior vitrectomy. The iris was abnormal in 22 cases. Graft dislocation occurred in 5（17.2%） of 29 eyes. IOL dislocation occurred in 2 eyes（6.9%）. High IOP was found in 9 eyes and was controlled with treatment. The preoperative mean BCVA was 20/286. The 6 mo postoperative mean BCVA was 20/42. The average center ECD was 1965.3 cells/mm^2 at 6 mo, and the rate of the donor cell loss was 34.7%.CONCLUSION： DSAEK combined with artisan aphakia IOL implantation is an alternative option for resolving endothelial and lens disorders in aphakic eyes without capsular support. However, it should be performed cautiously for eyes with severe iris defects.
文摘Background: Many reasons can lead to an aphakia without adequate capsular support for implantation of a posterior chamber intraocular lens (IOL), such as intraoperative unintentional rupture of posterior capsule during phacoemulsification, planned intracapsular cataract extraction, ocular trauma and lens dislocation due to congenital and acquired causes. Purpose: To compare Y-shaped intra-scleral fixation of a posterior chamber IOL with retro pupillary fixation of an iris-claw intraocular lens (IOL) for Aphakic eyes without sufficient capsular support as respects safety, visual recovery and complications of both methods. Patients and Methods: One hundred Aphakic eyes were arbitrarily distributed between two groups. Group A included 50 eyes treated with retropupillary fixation of iris claw lens and group B included 50 eyes treated with Y-shaped intra-scleral fixation technique. Preoperative, intraoperative and postoperative data were analysed including best corrected visual acuity (BCVA), intraocular pressure (IOP), surgical time, intraoperative problems, IOL malposition and postoperative complications. Following up on patients was carried out for at least six months. Results: The mean duration of surgery was 21 ± 5.3 min in group A and was 53.4 ± 6.9 min in group B (p-value 0.05). IOL tilt was found in 0 (0%) eyes in group A and in 5 (10%) eyes in group B (p 0.05). Conclusion: The results of our study indicated that both methods are satisfactory in correcting aphakia without sufficient capsular support as regards postoperative best corrected visual acuity (BCVA);however the surgical technique of retropupillary iris claw lens is easier, shorter, with low intra- and postoperative complications and safer than those used for intra-scleral fixation of IOL. But for eyes which lack both iris and capsular support, a scleral fixation of a posterior chamber IOL remains the only option.
文摘<strong>Introduction:</strong> Iris-claw Intraocular Lens (IOL) is one of the alternatives to correct aphakia without sufficient capsular support. This technique is preferred because it has a simple procedure. Iris-claw IOL was originally designed to be fixated on the anterior chamber. The use of retropupillary fixation is increasing because the location is more physiologic and it shows less risk to corneal endothelial damage. <strong>Purpose:</strong> To describe safety and efficacy of iris-claw Artisan IOL in correcting aphakia without sufficient capsular support. <strong>Methods:</strong> This is a descriptive retrospective study of patients with aphakic iris-claw Artisan IOL implantation in National Eye Center Cicendo Eye Hospital, Indonesia from July 2017-July 2019. Patients were divided into prepupillary and retropupillary group. The Uncorrected Visual Acuity (UCVA), Best-Corrected Visual Acuity (BCVA), Safety Index (SI), Efficacy Index (EI), and complications were recorded. The procedure is safe if SI value ≥ 1.0 and effective if EI value ≥ 1.0. <strong>Results:</strong> There were 54 eyes in the retropupilary group and 17 eyes in the prepupillary group. In the prepupillary group, there were 94.11% eyes with SI ≥ 1.0, the mean SI was 1.79 ± 1.02, 50% of eyes with EI ≥ 1.0, and the mean EI was 0.77 ± 0.20. In the retropupillary group, there were 96.29% eyes with SI ≥ 1.0, the mean SI was 2.49 ± 2.23, 74.07% of eyes with EI ≥ 1.0, and the mean EI was 1.75 ± 1.64. Postoperative UCVA and BCVA were improved significantly compared to preoperative visual acuity in both groups (p < 0.05) <strong>Conclusion:</strong> Prepupillary and retropupillary iris-claw IOL implantation are safe. Retropupillary fixation technique is more effective in improving visual acuity.
文摘Purpose: To study the role of epikeratophakia in treating pediatric unilateral aphakia after traumatic cataract extraction.Methods: We performed epikeratophakia in 43 children to treat aphakia after traumatic cataract extraction, using the corneal lenses made by ourselves. The rehabilitation of the the postoperative vision and the prevention of amblyopia were observed with a mean follow-up period of 20 months.Results: All the lenses remained transparent. Postoperatively, 31 cases (72. 1%) achieved uncorrected visual acuities (V. A) over 0. 2, 32 cases (74. 4%) achieved corrected V. A over 0. 4. Most of the cases achieved the best preoperative corrected V. A with spectacles of less than 3 diopters. No severe complication occurred. Conclusion: Epikeratophakia is predictable with quality lens and correct surgical technique. The result suggests that the epikeratophakia is one of the best treatment for the pediatric aphakia especially for those who are not optimal for IOL implantation. Eye Science 1997 ;
基金Supported by National Natural Science Foundation of China(No.82171087No.82201228)+1 种基金Natural Science Foundation of Hunan Province(No.2024JJ6570)the Scientific Research Launch Project for new employees of the Second Xiangya Hospital of Central South University.
文摘Dear Editor,We present the reported case of repetitive bilateral suprachoroidal expulsive hemorrhage(SEH)after anti-glaucoma surgeries.SEH is a rare but potentially devastating complication of intraocular surgery.Long-term ocular hypertension,high myopia,older age,arterial sclerosis,and aphakia have been reported as preoperative risk factors for developing SEH^([1]).The prognosis for the visual acuity is poor without proper management.A suggested time for surgical drainage is said to be 10-14d when the hemorrhagic clot begins to liquefy^([2]).
