Posterior Chamber Scleral Fixation of Intraocular Lenses in Post-Vitrectomised Aphakic Eyes
Introduction: The best method of aphakia correction is in the bag implantation of Posterior Chamber Intraocular Lens (PCIOL). When this ideal procedure is not possible due to lack of integrity of posterior capsule or zonules, the other alternatives are broadly categorized into two: extraocular a...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
JCDR Research and Publications Private Limited
2017-03-01
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| Series: | Journal of Clinical and Diagnostic Research |
| Subjects: | |
| Online Access: | https://jcdr.net/articles/PDF/9533/20989_CE(RA1)_F(T)_PF1(P_RK)_PFA(DK)_PF2(P_NESY).pdf |
| Summary: | Introduction: The best method of aphakia correction is in the
bag implantation of Posterior Chamber Intraocular Lens (PCIOL).
When this ideal procedure is not possible due to lack of integrity
of posterior capsule or zonules, the other alternatives are broadly
categorized into two: extraocular and intraocular. Whereas, the
former includes contact lenses and aphakic glasses, the latter
ones are further divided into anterior and posterior chamber
methods. Anterior Chamber Intraocular Lenses (ACIOL) can be
with or without iris claw. At the posterior chamber, fixation of the
lenses can be with glue or sutures.
When there is combined Pars Plana Vitrectomy (PPV) and
lensectomy or if the indication of PPV is dropped nucleus or
intraocular lens, a modality of aphakia correction should be
devised. Posterior Chamber Scleral Fixation of Intraocular
Lenses (PCSFIOL) with sutures is a preferred method because
of its low complication profile. However, data on correction of
aphakia after combined PPV and lensectomy is limited. To fill in
this gap in knowledge, we evaluated the secondary PCSFIOL in
aphakic eyes after previous PPV and lensectomy.
Aim: To assess the outcome and complication profile of a
large series of patients who underwent secondary PCSFIOL
implantation with sutures after combined PPV and lensectomy.
Materials and Methods: Records of all patients who had
undergone secondary PCSFIOL implantation with sutures
after combined PPV and lensectomy from 2010 to 2014 were
reviewed retrospectively for visual outcomes and complications.
Patients’ demographic data, indication for PPV, best corrected
preoperative and postoperative visual acuities, complications
of surgery, and indications of PCSFIOL and length of follow up
were collected and analyzed.
Results: A total of 148 eyes of 148 patients (127 males and
21 females) were identified. Mean age at surgery was 32.5+8
years (range 2.5-73 years) with a mean follow up 23+14 months
(range 3-114 months). A total of 95.27%, 2.70% and 2.02%
of patients had improvement, maintenance and worsening of
their final postoperative visual acuities respectively. A total of
32 (21.62%) of 148 eyes had postoperative complications from
PCSFIOL with Epiretinal Membrane (ERM) formation being the
most common. They all required one form of management or
the other. Suture breakage leading to PCSFIOL subluxation or
dislocation occurred in four eyes (2.70%).
Conclusion: PCSFIOL with sutures is a preferred method in
the management of post-vitrectomised aphakic eyes when
the capsular or zonular support is not adequate for in the bag
implantation of posterior chamber intraocular lenses. |
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| ISSN: | 2249-782X 0973-709X |