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...

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Main Authors: Francis Kwasi Obeng, Vipan Kumar Vig, Preetam Singh, Rajbir Singh, Bodhraj Dhawan, Nikhil Sahajpal
Format: Article
Language:English
Published: JCDR Research and Publications Private Limited 2017-03-01
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
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author Francis Kwasi Obeng
Vipan Kumar Vig
Preetam Singh
Rajbir Singh
Bodhraj Dhawan
Nikhil Sahajpal
author_facet Francis Kwasi Obeng
Vipan Kumar Vig
Preetam Singh
Rajbir Singh
Bodhraj Dhawan
Nikhil Sahajpal
author_sort Francis Kwasi Obeng
collection DOAJ
description 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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spelling doaj.art-56ddeeea735a4830a8cd2da91244ba432022-12-22T01:20:34ZengJCDR Research and Publications Private LimitedJournal of Clinical and Diagnostic Research2249-782X0973-709X2017-03-01113NC09NC1310.7860/JCDR/2017/20989.9533Posterior Chamber Scleral Fixation of Intraocular Lenses in Post-Vitrectomised Aphakic EyesFrancis Kwasi Obeng0Vipan Kumar Vig1Preetam Singh2Rajbir Singh3Bodhraj Dhawan4Nikhil Sahajpal5Long Term Vitreoretinal Fellow, Department of Vitreoretinal, Sardar Bahadur Dr. Sohan Singh Eye Hospital, Amritsar, Punjab, India.Consultant Vitreoretinal Surgeon, Department of Vitreoretinal, Member Vitreoretinal Society of India, Sardar Bahadur Dr. Sohan Singh Eye Hospital, Amritsar, Punjab, India.Consultant Vitreoretinal Surgeon, Department of Vitreoretinal, Member Vitreoretinal Society of India, Sardar Bahadur Dr. Sohan Singh Eye Hospital, Amritsar, Punjab, India.Consultant Vitreoretinal Surgeon, Department of Vitreoretinal, Member American Academy of Ophthalmology, Sardar Bahadur Dr. Sohan Singh Eye Hospital, Amritsar, Punjab, India.Consultant Vitreoretinal Surgeon, Department of Vitreoretinal, NKP Salve Institute of Medical Sciences, Hingna, Nagpur, Maharashtra, India.Medical Statistician, Department of Medical Statistics, Sardar Bahadur Dr. Sohan Singh Eye Hospital, Amritsar, Punjab, India.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.https://jcdr.net/articles/PDF/9533/20989_CE(RA1)_F(T)_PF1(P_RK)_PFA(DK)_PF2(P_NESY).pdfaphakia correctionlensscleral fixated intraocular lensvitrectomy
spellingShingle Francis Kwasi Obeng
Vipan Kumar Vig
Preetam Singh
Rajbir Singh
Bodhraj Dhawan
Nikhil Sahajpal
Posterior Chamber Scleral Fixation of Intraocular Lenses in Post-Vitrectomised Aphakic Eyes
Journal of Clinical and Diagnostic Research
aphakia correction
lens
scleral fixated intraocular lens
vitrectomy
title Posterior Chamber Scleral Fixation of Intraocular Lenses in Post-Vitrectomised Aphakic Eyes
title_full Posterior Chamber Scleral Fixation of Intraocular Lenses in Post-Vitrectomised Aphakic Eyes
title_fullStr Posterior Chamber Scleral Fixation of Intraocular Lenses in Post-Vitrectomised Aphakic Eyes
title_full_unstemmed Posterior Chamber Scleral Fixation of Intraocular Lenses in Post-Vitrectomised Aphakic Eyes
title_short Posterior Chamber Scleral Fixation of Intraocular Lenses in Post-Vitrectomised Aphakic Eyes
title_sort posterior chamber scleral fixation of intraocular lenses in post vitrectomised aphakic eyes
topic aphakia correction
lens
scleral fixated intraocular lens
vitrectomy
url https://jcdr.net/articles/PDF/9533/20989_CE(RA1)_F(T)_PF1(P_RK)_PFA(DK)_PF2(P_NESY).pdf
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