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Indian Journal of Ophthalmology Sep 2022Iris-fixated intraocular lens (IOL) is considered a safe and effective option for the correction of aphakia in patients with insufficient capsular support. This... (Meta-Analysis)
Meta-Analysis Review
Iris-fixated intraocular lens (IOL) is considered a safe and effective option for the correction of aphakia in patients with insufficient capsular support. This systematic review aims to summarize the existing evidence about the Artisan/Verisyse IOLs and to assess the influence of the IOL position on the postoperative outcomes. Three different databases were used for this systematic review and metaanalysis (PubMED, Scopus, and Embase). We searched for case series or clinical trials comparing the prepupillary versus retropupillary Artisan/Verisyse implantation. The statistical analysis was performed with the programming language R (version 3.6.1 2019-07-05). The number of articles included in the meta-analysis was six, with 506 eyes included in total. We found no significant differences in postoperative corrected distance visual acuity (CDVA) (0.309 [0.089-0.528] vs. 0.32 [0.2-0.44]), spherical equivalent (SE) (0.0153 D [-0.362 to 0.393] vs. -0.329 D [-0.62 to - 0.038]), and central corneal cell density (CECD) (1669.85 cells [1605.949-2150.937] vs. 1635.99 cells [1413.64-1858.363]) between the prepupillary and the retropupillary implantation, respectively. There were no significant differences in the rates of cystoid macular edema (CME; 7.70% vs. 9.8%), pupil deformation (4.5% vs. 5.4% retropupillary), or IOL luxation (2.3% and 2.2%). We found little influence of the IOL position in the postoperative analyzed outcomes. Thus, the implant position should be based on the surgeon's technical experience. Double-blind randomized prospective studies would improve the available evidence on the best implant position for the Artisan/Verisyse IOL.
Topics: Aphakia; Aphakia, Postcataract; Humans; Iris; Lens Implantation, Intraocular; Lenses, Intraocular; Postoperative Complications; Prospective Studies; Randomized Controlled Trials as Topic; Refraction, Ocular; Retrospective Studies
PubMed: 36018090
DOI: 10.4103/ijo.IJO_880_22 -
Neurobiology of Disease Aug 2022Parkinson's disease (PD) is characterized by the selective death of substantia nigra pars compacta (SNpc) dopaminergic neurons and includes both motor and non-motor...
Parkinson's disease (PD) is characterized by the selective death of substantia nigra pars compacta (SNpc) dopaminergic neurons and includes both motor and non-motor symptoms. While numerous models exist for the study of typical PD motor deficits, fewer exist for non-motor symptoms. Previous studies have shown that a Pitx3 mouse model (aphakia or ak mouse) has specific developmental failure of the dopaminergic neuron population in the SNpc and that it can be used for the study of PD-related gross motor dysfunction as well as cognitive functional deficits. It remains unclear whether the aphakia mouse, both male and female, might also be used to model fine motor deficits and for additional studies of non-motor deficits associated with PD. Here, using an extensive battery of behavioral tests, we demonstrate that the aphakia mouse shows both gross and fine motor functional deficits compared with control mice. Furthermore, aphakia mice show deficits of olfactory function in buried pellet, odor discrimination and odor habituation/dishabituation tests. We also found that aphakia mice suffer from gastrointestinal dysfunction (e.g., longer whole gut transit time and colon motility deficits), suggesting that the mutation also affects function of the gut-brain axis in this animal model. Moreover, our data demonstrate that in the aphakia mouse, L-DOPA, the gold standard PD medication, can rescue both gross and fine motor function deficits but neither olfactory nor gastrointestinal symptoms, a pattern much like that seen in PD patients. Altogether, this suggests that the aphakia mouse is a suitable model for fine motor, olfactory and gastrointestinal behavioral studies of PD as well as for the development of novel disease-modifying therapeutics. SIGNIFICANCE STATEMENT: While several animal models are available to study the major motor symptoms of PD, there are fewer that replicate non-motor symptoms, which constitute a major source of morbidity for patients. Moreover, available models often require manipulations resulting in sudden massive cell loss and inflammation, both of which may interfere with understanding of the direct effects of dopaminergic neuronal loss in the SNpc. We describe a model of congenital SNpc cell deficiency in a Pitx3 mouse and characterize it with a battery of behavioral tests suggesting that it closely mimics non-motor as well as motor symptoms of PD, providing a useful insight into the effects of the nigrostriatal dopamine deficit. Taken together, these data suggest that the ak mouse represents a useful model to study dopaminergic system function for both motor and non-motor symptoms of PD.
Topics: Animals; Aphakia; Disease Models, Animal; Dopamine; Dopaminergic Neurons; Female; Homeodomain Proteins; Humans; Levodopa; Male; Mice; Mice, Inbred C57BL; Parkinson Disease; Substantia Nigra; Transcription Factors
PubMed: 35636646
DOI: 10.1016/j.nbd.2022.105777 -
Transactions of the American... 1981
Topics: Adult; Aged; Aphakia, Postcataract; Cell Count; Cornea; Corneal Transplantation; Endothelium; Female; Follow-Up Studies; Humans; Male; Middle Aged; Surgical Procedures, Operative; Visual Acuity
PubMed: 7043866
DOI: No ID Found -
Arquivos Brasileiros de Oftalmologia Jun 2019To evaluate the efficacy and safety of the modified Yamane technique with sutureless transconjunctival intrascleral intraocular lens fixation.
PURPOSE
To evaluate the efficacy and safety of the modified Yamane technique with sutureless transconjunctival intrascleral intraocular lens fixation.
METHODS
Sutureless transconjunctival intrascleral haptic fixated intraocular lens implantation was performed in patients with aphakia and dislocated intraocular lenses. A clear corneal incision (2.8 mm) was made into the temporal quadrant and a three-piece intraocular lens was implanted into the anterior chamber. The haptics of the intraocular lens were externalized with a 27 G needle via transconjunctival scleral tunnels at the 6 and 12 o'clock positions. The transconjunctival scleral tunnels were prepared to conform to the haptic position and curvature. The site of the scleral tunnels was 2mm from the limbus with a length of 2 mm in the sclera and was aimed at the end of the posterior chamber. The tips of the haptics were cauterized to create a terminal knob. The haptics were pushed back and the knobs were implanted into the scleral tunnels.
RESULTS
The study cohort included 21 patients with unilateral aphakia and dislocated intraocular lenses. All patients were examined postoperatively and at postoperative day 1, day 7, month 1, and month 3. All examinations revealed formation of the anterior chamber and well-centralized intraocular lenses. No haptic-related complications of exposure, foreign body sensation, or discomfort were observed.
CONCLUSION
Sutureless transconjunctival intrascleral haptic fixated intraocular lensimplantation is an effective, safe, and practical surgical alternative. This technique was superior to the Yamane method with regard to comfort and surgical duration. Further studies with longer follow-up evaluations are warranted to verify long-term complications.
Topics: Aged; Aged, 80 and over; Anterior Chamber; Aphakia, Postcataract; Female; Humans; Lens Implantation, Intraocular; Lenses, Intraocular; Male; Middle Aged; Sclera; Suture Techniques; Sutureless Surgical Procedures; Visual Acuity
PubMed: 31166423
DOI: 10.5935/0004-2749.20190072 -
Eye & Contact Lens May 2021To describe visual outcomes with various contact lens modalities in patients with a history of ocular trauma who underwent surgical open globe repair.
OBJECTIVES
To describe visual outcomes with various contact lens modalities in patients with a history of ocular trauma who underwent surgical open globe repair.
METHODS
Records of all patients with a history of open globe injury and repair at a tertiary care hospital between January 1, 2010, and December 31, 2016, were reviewed. Demographics, type of injury, and visual acuity were assessed before and after contact lens evaluation.
RESULTS
Of 214 patients who underwent open globe repair, 29 (13.6%) were evaluated with a contact lens. Visual acuity improved in 97% (28 of 29) of patients from 1.47±0.75 to 0.67±0.71 logarithm of the minimal angle of resolution (logMAR) with manifest refraction to 0.28±0.45 logMAR with contact lenses (n=29; P<0.0001). Corneal opacity was the most common clinical indication (20 of 29) for fitting followed by aphakia (13 of 29). A range of contact lens modalities, including corneal rigid gas-permeable (12 of 28), soft (9 of 28), hybrid (3 of 28), scleral gas-permeable (2 of 28), and piggyback (2 of 28) lenses were prescribed.
CONCLUSION
In this study, patients with a history of trauma and open globe repair with good neurosensory visual potential had improvements in visual acuity with contact lens greater than manifest refraction. Soft and gas-permeable lenses were used to improve visual acuity in patients with a history of open globe repair and corneal scarring, aphakia, iris abnormalities, or other ocular sequelae. Although corneal rigid gas-permeable lenses were prescribed most often, additional consideration should be given to other contact lens modalities, including soft, piggyback, hybrid, and scleral gas-permeable lenses.
Topics: Aphakia; Contact Lenses; Cornea; Humans; Prosthesis Fitting; Visual Acuity
PubMed: 33181528
DOI: 10.1097/ICL.0000000000000756 -
PloS One 2023To comprehensively investigate risk factors for proliferative vitreoretinopathy (PVR) after retinal detachment (RD) surgery. (Meta-Analysis)
Meta-Analysis
BACKGROUND
To comprehensively investigate risk factors for proliferative vitreoretinopathy (PVR) after retinal detachment (RD) surgery.
METHODS
PubMed, Embase, Cochrane Library, and Web of Science were systematically searched until May 22, 2023. Risk factors included demographic and disease-related risk factors. Odds ratios (ORs) and weighted mean differences (WMDs) were used as the effect sizes, and shown with 95% confidence intervals (CIs). Sensitivity analysis was conducted. The protocol was registered with PROSPERO (CRD42022378652).
RESULTS
Twenty-two studies of 13,875 subjects were included in this systematic review and meta-analysis. Increased age was associated with a higher risk of postoperative PVR (pooled WMD = 3.98, 95%CI: 0.21, 7.75, P = 0.038). Smokers had a higher risk of postoperative PVR than non-smokers (pooled OR = 5.07, 95%CI: 2.21-11.61, P<0.001). Presence of preoperative PVR was associated with a greater risk of postoperative PVR (pooled OR = 22.28, 95%CI: 2.54, 195.31, P = 0.005). Presence of vitreous hemorrhage was associated with a greater risk of postoperative PVR (pooled OR = 4.12, 95%CI: 1.62, 10.50, P = 0.003). Individuals with aphakia or pseudophakia had an increased risk of postoperative PVR in contrast to those without (pooled OR = 1.41, 95%CI: 1.02, 1.95, P = 0.040). The risk of postoperative PVR was higher among patients with macula off versus those with macula on (pooled OR = 1.85, 95%CI: 1.24, 2.74, P = 0.002). Extent of RD in patients with postoperative PVR was larger than that in patients without (pooled WMD = 0.31, 95%CI: 0.02, 0.59, P = 0.036). Patients with postoperative PVR had longer duration of RD symptoms than those without (pooled WMD = 10.36, 95%CI: 2.29, 18.43, P = 0.012).
CONCLUSION
Age, smoking, preoperative PVR, vitreous hemorrhage, aphakia or pseudophakia, macula off, extent of RD, and duration of RD symptoms were risk factors for postoperative PVR in patients undergoing RD surgery, which may help better identify high-risk patients, and provide timely interventions.
Topics: Humans; Retinal Detachment; Vitreoretinopathy, Proliferative; Vitreous Hemorrhage; Pseudophakia; Risk Factors; Aphakia
PubMed: 37903162
DOI: 10.1371/journal.pone.0292698 -
European Journal of Human Genetics :... Aug 2018
Topics: Aphakia; Forkhead Transcription Factors; Genetic Testing; Humans; Mutation; Phenotype
PubMed: 29769628
DOI: 10.1038/s41431-018-0171-x -
JAMA Ophthalmology Jan 2020Glaucoma can occur following cataract removal in children, and determining the risk for and factors associated with glaucoma and glaucoma suspect in a large cohort of...
IMPORTANCE
Glaucoma can occur following cataract removal in children, and determining the risk for and factors associated with glaucoma and glaucoma suspect in a large cohort of children after lensectomy can guide clinical practice.
OBJECTIVE
To estimate the incidence of glaucoma and glaucoma suspect and describe its management in the first year following lensectomy in children before 13 years of age.
DESIGN, SETTING, AND PARTICIPANTS
A multicenter clinical research registry containing data for 1361 eyes of 994 children who underwent unilateral or bilateral lensectomy between June 2012 and July 2015 at 1 of 61 sites in the United States (n = 57), Canada (n = 3), and the United Kingdom (n = 1). Patients were eligible for inclusion in the study if they were enrolled in the registry within 45 days after lensectomy and had at least 1 office visit between 6 and 18 months after lensectomy. Patient data were reviewed, and glaucoma and glaucoma suspect were diagnosed by investigators using standardized criteria. Statistical analysis was performed between June 2017 and August 2019.
EXPOSURES
Clinical care 6 to 18 months after lensectomy.
MAIN OUTCOMES AND MEASURES
Incidence risk using standardized definitions of glaucoma and glaucoma suspect after lensectomy.
RESULTS
Among 702 patients included in this cohort study, 353 (50.3%) were male and 427 (60.8%) were white; mean age at lensectomy was 3.4 years (range, 0.04-12.9 years). After lensectomy, glaucoma or glaucoma suspect was diagnosed in 66 of 970 eyes (adjusted overall incidence risk, 6.3%; 95% CI, 4.8%-8.3%). Glaucoma was diagnosed in 52 of the 66 eyes, and glaucoma suspect was diagnosed in the other 14 eyes. Mean age at lensectomy in these 66 eyes was 1.9 years (range, 0.07-11.2 years), and 40 of the 66 (60.6%) were eyes of female patients. Glaucoma surgery was performed in 23 of the 66 eyes (34.8%) at a median of 3.3 months (range, 0.9-14.8 months) after lensectomy. The incidence risk of glaucoma or glaucoma suspect was 15.7% (99% CI, 10.1%-24.5%) for 256 eyes of infants 3 months or younger at lensectomy vs 3.4% (99% CI, 1.9%-6.2%) for 714 eyes of infants older than 3 months (relative risk, 4.57; 99% CI, 2.19-9.57; P < .001) and 11.2% (99% CI, 7.6%-16.7%) for 438 aphakic eyes vs 2.6% (99% CI, 1.2%-5.6%) for 532 pseudophakic eyes (relative risk, 4.29; 99% CI, 1.84-10.01; P < .001). No association was observed between risk of developing glaucoma or glaucoma suspect and any of the following variables: sex, race/ethnicity, laterality of lensectomy, performance of anterior vitrectomy, prelensectomy presence of anterior segment abnormality, or intraoperative complications.
CONCLUSIONS AND RELEVANCE
This study found that glaucoma or glaucoma suspect developed in a small number of eyes in the first year after lensectomy and may be associated with aphakia and younger age at lensectomy. Frequent monitoring for signs of glaucoma following lensectomy is warranted, especially in infants 3 months or younger at lensectomy and in children with aphakia after lensectomy.
Topics: Adolescent; Antihypertensive Agents; Aphakia, Postcataract; Cataract; Cataract Extraction; Child; Child, Preschool; Cohort Studies; Female; Filtering Surgery; Glaucoma; Humans; Incidence; Infant; Intraocular Pressure; Male; Ocular Hypertension; Registries; Risk Factors
PubMed: 31750862
DOI: 10.1001/jamaophthalmol.2019.4571 -
Iranian Journal of Nursing and... 2023Contact lenses play a substantial role in the management of childhood aphakia. However, the use and care of the lenses can be challenging. Despite its prevalence, the...
BACKGROUND
Contact lenses play a substantial role in the management of childhood aphakia. However, the use and care of the lenses can be challenging. Despite its prevalence, the phenomenon of living with children with aphakia is not explained in Iran yet. The aim of this study was to illuminate the lived experience of the parents of children with aphakia.
MATERIALS AND METHODS
This hermeneutic phenomenological study was conducted on the parents who have been referred to Farabi Eye Hospital of Tehran, Iran in 2019, whose children were diagnosed with aphakia, and the condition was corrected with contact lenses. Qualitative semi-structured interviews were conducted with 20 parents of children with congenital cataract. Analysis was based on the framework of Diekelmann enabled data interpretation and elaboration of shared themes.
RESULTS
The 20 parents involved in the study consisted of 12 women and 8 men. The participant's experiences were classified in 4 categories: Self-Ignorance, Troubled mind, Self-Regulation, and Coping with the problem while hoping for the future.
CONCLUSIONS
"Self-Ignorance" and "Troubled Mind" indicates that because of the risk of burnout in the long-term process of treatment, the psychological support of parents is necessary. Psychological support will continue until the parents acquire the ability of self-regulation. Giving a realistic hope to families is a core element in psychological support.
PubMed: 37332380
DOI: 10.4103/ijnmr.ijnmr_320_21