-
Asia-Pacific Journal of Ophthalmology... 2020Extended depth-of-focus (EDOF) is a new intraocular lens (IOL) technology in the treatment of presbyopia. In contrast to multifocal (MF) IOLs, EDOF lenses create a... (Review)
Review
Extended depth-of-focus (EDOF) is a new intraocular lens (IOL) technology in the treatment of presbyopia. In contrast to multifocal (MF) IOLs, EDOF lenses create a single elongated focal point, rather than several foci, to enhance depth of focus. In this way, EDOF IOLs aim to reduce photic phenomena, glare, and halos, which have been reported in MF IOLs. A potential disadvantage is a decrease of retinal image quality if the amount of the aberrations is excessively increased. Frequently, EDOF IOLs are combined with MF optical designs; for this reason, EDOF IOLs are commonly a subject of confusion with optical multifocality concepts. The aim of this article is to clarify what an EDOF IOL is and to discuss the recently reported outcomes with these IOLs. We propose naming lenses that have combined optical designs as "hybrid IOLs."
Topics: Aphakia, Postcataract; Depth Perception; Humans; Lenses, Intraocular; Prosthesis Design; Refraction, Ocular; Visual Acuity
PubMed: 32511121
DOI: 10.1097/APO.0000000000000296 -
JAMA Ophthalmology Apr 2020Although intraocular lenses (IOLs) are often implanted in children, little is known whether primary IOL implantation or aphakia and contact lens correction results in... (Randomized Controlled Trial)
Randomized Controlled Trial
IMPORTANCE
Although intraocular lenses (IOLs) are often implanted in children, little is known whether primary IOL implantation or aphakia and contact lens correction results in better long-term visual outcomes after unilateral cataract surgery during infancy.
OBJECTIVE
To compare long-term visual outcomes with contact lens vs IOL correction following unilateral cataract surgery during infancy.
DESIGN, SETTING, AND PARTICIPANTS
This multicenter randomized clinical trial enrolled 114 infants with a unilateral congenital cataract who underwent cataract surgery with or without primary IOL implantation between 1 and 6 months of age. Data on long-term visual outcomes were collected when the children were age 10.5 years (July 14, 2015, to July 12, 2019) and analyzed from March 30 through August 6, 2019.
INTERVENTIONS
Intraocular lens implantation at the time of cataract surgery.
MAIN OUTCOMES AND MEASURES
Best-corrected visual acuity using the electronic Early Treatment Diabetic Retinopathy Study (E-ETDRS) testing protocol. Analysis was performed on an intention-to-treat basis.
RESULTS
Best-corrected visual acuity was measured at age 10.5 years for 110 of the 114 patients (96%) enrolled as infants. The participants included 58 girls (53%) and 52 boys (47%). Overall, 27 of the children (25%) had good (logMAR 0.30 [Snellen equivalent, 20/40] or better) visual acuity in the treated eye (12 [22%] in the IOL group and 15 [27%] in the aphakia group), but 50 children (44%) had a visual acuity of logMAR 1.00 (Snellen equivalent, 20/200) or worse (25 [44%] in the IOL group and 25 [44%] in the aphakia group). The median logMAR acuity in the treated eye was similar in children randomized to receive an IOL at the time of cataract extraction (0.89; interquartile range [IQR], 0.33-1.43 [Snellen equivalent, 20/159]) and those who remained aphakic (0.86; IQR, 0.30-1.46 [Snellen equivalent, 20/145]) (IQR, 0.30-1.46; P = .82). Although the overall difference in median visual acuity between the 2 groups was small, the estimate was imprecise (99% CI for the difference in medians was -0.54 to 0.47).
CONCLUSIONS AND RELEVANCE
As in previous phases of the study, visual acuity outcomes were highly variable with only 27 children (25%) achieving excellent visual acuity in their treated eye and 50 children (44%) having poor vision in the treated eye. Implanting an IOL at the time of cataract extraction was neither beneficial nor detrimental to the visual outcome.
TRIAL REGISTRATION
ClinicalTrials.gov Identifier: NCT00212134.
Topics: Aphakia, Postcataract; Cataract; Cataract Extraction; Child; Contact Lenses, Hydrophilic; Female; Follow-Up Studies; Humans; Infant; Lens Implantation, Intraocular; Lenses, Intraocular; Male; Pseudophakia; Vision, Binocular; Visual Acuity
PubMed: 32077909
DOI: 10.1001/jamaophthalmol.2020.0006 -
Ophthalmology Oct 2018
Topics: Aphakia; Humans; Infant; Lens Implantation, Intraocular
PubMed: 30243340
DOI: 10.1016/j.ophtha.2018.03.058 -
Asia-Pacific Journal of Ophthalmology... 2017Intrascleral sutureless intraocular lens (IOL) fixation utilizes direct haptic fixation within the sclera in eyes with deficient capsular support. This has advantages of... (Review)
Review
Intrascleral sutureless intraocular lens (IOL) fixation utilizes direct haptic fixation within the sclera in eyes with deficient capsular support. This has advantages of long-term stability, good control of tilt and decentration, and lesser pseudophakodonesis. This review summarizes various techniques for intrascleral haptic fixation, results, complications, adaptations in special situations, modifications of the technique, combination surgeries, and intrascleral capsular bag fixation techniques (glued capsular hook).
Topics: Aphakia; Humans; Lens Implantation, Intraocular; Lenses, Intraocular; Refraction, Ocular; Retrospective Studies; Sclera; Suture Techniques; Sutures
PubMed: 28726356
DOI: 10.22608/APO.2017158 -
Middle East African Journal of... 2014
Topics: Aphakia, Postcataract; Cataract Extraction; Female; Humans; Lens Implantation, Intraocular; Lens Subluxation; Lens, Crystalline; Lenses, Intraocular; Male; Sclera
PubMed: 25371650
DOI: No ID Found -
Medical Hypothesis, Discovery &... 2014Implantation of intraocular lens with Iris-fixation is a safe, efficient and predictable surgical procedure, which empowers the refractive surgeon with singular... (Review)
Review
Implantation of intraocular lens with Iris-fixation is a safe, efficient and predictable surgical procedure, which empowers the refractive surgeon with singular capabilities. Among their advantages are the reversibility, preservation of accommodation and a broad spectrum of ametropic correction. This lens also appears to be a valid option, with a favorable complication rate, for the treatment of aphakic eyes without capsular support. This article is a review of iris-fixated intraocular lenses and considers their principal indications, complications, and outcomes.
PubMed: 25756061
DOI: No ID Found -
Ophthalmologica. Journal International... 2011Phacoemulsification with an intraocular lens implant is a safe and effective means of correction of visual loss from cataract. The high frequency of this procedure world... (Review)
Review
Phacoemulsification with an intraocular lens implant is a safe and effective means of correction of visual loss from cataract. The high frequency of this procedure world wide means inevitable direct surgical complications will be numerous even though infrequent. The approach to correcting aphakia following complicated cataract surgery is dependent on multiple factors including the degree to which the capsular bag is intact and the type of intraocular lens that has been inserted. We discuss several approaches and strategies for managing dropped intraocular lenses, the correction of aphakia and the safety and long-term results of anterior chamber intraocular lens placement.
Topics: Anterior Chamber; Aphakia; Humans; Lens Implantation, Intraocular; Lenses, Intraocular; Prosthesis Failure; Suture Techniques; Vitrectomy
PubMed: 21778780
DOI: 10.1159/000328210 -
BMJ Case Reports Oct 2013An 80-year-old Chinese man with high myopia and a history of right eye cataract extraction and superior peripheral iridectomy developed peripheral corneal oedema after a...
An 80-year-old Chinese man with high myopia and a history of right eye cataract extraction and superior peripheral iridectomy developed peripheral corneal oedema after a period of aphakia. The peripheral corneal oedema was static over years and did not progress to involve central cornea hence his visual acuity remained stable. The condition was compatible with the relatively rare Brown-McLean syndrome. Specular microscopy showed normal endothelial cell density in the oedematous peripheral as well as central cornea. While anterior segment optical coherence tomography demonstrated the cross-sectional architecture of cornea, Scheimpflug imaging was used to measure the peripheral corneal thickening and to demonstrate increased corneal density as compared with the contralateral normal eye. These investigations not only help better characterise the rare disease, but also in precisely monitoring any disease progression by periodic measurements.
Topics: Aged, 80 and over; Aphakia, Postcataract; Cataract Extraction; Corneal Edema; Diagnosis, Differential; Endothelium, Corneal; Follow-Up Studies; Humans; Male; Syndrome; Time Factors; Tomography, Optical Coherence
PubMed: 24108775
DOI: 10.1136/bcr-2013-201280 -
Clinical Ophthalmology (Auckland, N.Z.) 2018We describe a modified scleral fixation method to facilitate the good centration and adequate tension of sutures at both ends with addition of an internal fixation knot... (Review)
Review
We describe a modified scleral fixation method to facilitate the good centration and adequate tension of sutures at both ends with addition of an internal fixation knot that reduces decentering of the IOL in a patient with postsurgical aphakia. Using an ab externo suture technique to fixate the haptics to the scleral wall, an additional loop knot is tied 1 mm next to the fixation knot at the haptic. In the technique, an internalized suture and an additional suture knot is tied while holding it close to the fixation knot at the haptic using a needle holder or McPherson forceps. The externalized sutures are secured by taking a bite of transclera and tying the suture to itself. This technique is simple and easy, and adds an internal check valve to prevent excessive pull and decentering of the intraocular lens at one side. The internal check valve also serves as a criterion for the point of fixation at each end.
PubMed: 30050280
DOI: 10.2147/OPTH.S157462 -
Journal of Ophthalmic Inflammation and... Mar 2012To report the behavior of intravitreal Ozurdex(®) implant in eyes with post-lensectomy-vitrectomy (PLV) aphakia.
PURPOSE
To report the behavior of intravitreal Ozurdex(®) implant in eyes with post-lensectomy-vitrectomy (PLV) aphakia.
METHODS
Retrospective chart review of three eyes with PLV aphakia (three patients with uveitis) who received intravitreal injection of Ozurdex(®) for cystoid macular edema (one eye), persistent inflammation (one eye), and ocular hypotony (one eye). Final outcome was assessed in terms of effectiveness, stability, and tolerance of the implant.
RESULTS
Following the implant, an initial improvement was seen in all the three eyes. However, the implant migrated into the anterior chamber (AC) at 1 week in two eyes and at 5 weeks in one eye, and wandered between the AC and vitreous cavity with changing postures of the patient. Two eyes developed corneal edema, of which one eye underwent implant removal from the AC.
CONCLUSION
Ozurdex(®) implant should be contraindicated in eyes with PLV aphakia to avoid its deleterious effect on the corneal endothelium.
PubMed: 21960148
DOI: 10.1007/s12348-011-0042-x