Scleral fixation of dislocated posterior chamber intraocular lenses: Temporary haptic externalization through a clear corneal incision
Identifieur interne : 006B36 ( Main/Exploration ); précédent : 006B35; suivant : 006B37Scleral fixation of dislocated posterior chamber intraocular lenses: Temporary haptic externalization through a clear corneal incision
Auteurs : Gregg T. Kokame [États-Unis] ; Izumi Yamamoto [États-Unis] ; Huck Mandel [États-Unis]Source :
- Journal of cataract and refractive surgery [ 0886-3350 ] ; 2004.
Descripteurs français
- Pascal (Inist)
- Wicri :
- topic : Chirurgie.
English descriptors
- KwdEn :
- Aged, Aged, 80 and over, Cornea, Cornea (surgery), Female, Fixation, Foreign-Body Migration (surgery), Humans, Incision, Intraocular lens, Lens Implantation, Intraocular (methods), Lenses, Intraocular, Male, Middle Aged, Ophthalmology, Posterior chamber, Reoperation, Retrospective Studies, Sclera, Sclera (surgery), Surgery, Surgical Flaps, Suture Techniques, Treatment, Visual Acuity, Vitrectomy.
- MESH :
Abstract
Purpose: To report the results of managing dislocated posterior chamber intraocular lenses (PC lOLs) by externalizing the haptics through a clear corneal incision. Setting: The Retina Center at Pali Momi, Aiea, Hawaii, USA. Methods: This retrospective consecutive series comprised cases in which a dislocated PC IOL was managed with pars plana vitrectomy. With this method, the dislocated PC IOL is retrieved and stabilized in the anterior chamber. The haptic is externalized through a clear corneal incision for suture knot placement and then reinserted. A scleral fixation suture is placed 1.25 mm posterior to the limbus under a scleral flap. Results: The study included 14 eyes of 14 patients with a minimum follow-up of 6 months (median 15.4 months). There were 2 subluxated PC lOLs, 11 posteriorly dislocated PC lOLs, and 1 in-the-bag IOL dislocation. Postoperative vision and/or visual symptoms were stable or improved in 86% of eyes. Two eyes had worse vision caused by conditions not related to surgery including chronic cystoid macular edema from latanoprost use and optic atrophy. All lOLs were well fixated and stable, although 1 eye with asymmetric haptics had a slightly tilted IOL. Conclusions: Dislocated PC IOL management by externalizing the haptic through a clear corneal incision stabilized the IOL in the anterior chamber, minimized intraocular operative manipulations, and allowed easier placement of the opposite haptic over residual capsule, if available. Stable fixation was achieved without dislocation or IOL-related complications recurring.
Affiliations:
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Le document en format XML
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<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a">Scleral fixation of dislocated posterior chamber intraocular lenses: Temporary haptic externalization through a clear corneal incision</title>
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<author><name sortKey="Yamamoto, Izumi" sort="Yamamoto, Izumi" uniqKey="Yamamoto I" first="Izumi" last="Yamamoto">Izumi Yamamoto</name>
<affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Division of Ophthalmology, Department of Surgery, University of Hawaii School of Medicine</s1>
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<author><name sortKey="Mandel, Huck" sort="Mandel, Huck" uniqKey="Mandel H" first="Huck" last="Mandel">Huck Mandel</name>
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<series><title level="j" type="main">Journal of cataract and refractive surgery</title>
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<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Aged</term>
<term>Aged, 80 and over</term>
<term>Cornea</term>
<term>Cornea (surgery)</term>
<term>Female</term>
<term>Fixation</term>
<term>Foreign-Body Migration (surgery)</term>
<term>Humans</term>
<term>Incision</term>
<term>Intraocular lens</term>
<term>Lens Implantation, Intraocular (methods)</term>
<term>Lenses, Intraocular</term>
<term>Male</term>
<term>Middle Aged</term>
<term>Ophthalmology</term>
<term>Posterior chamber</term>
<term>Reoperation</term>
<term>Retrospective Studies</term>
<term>Sclera</term>
<term>Sclera (surgery)</term>
<term>Surgery</term>
<term>Surgical Flaps</term>
<term>Suture Techniques</term>
<term>Treatment</term>
<term>Visual Acuity</term>
<term>Vitrectomy</term>
</keywords>
<keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Lens Implantation, Intraocular</term>
</keywords>
<keywords scheme="MESH" qualifier="surgery" xml:lang="en"><term>Cornea</term>
<term>Foreign-Body Migration</term>
<term>Sclera</term>
</keywords>
<keywords scheme="MESH" xml:lang="en"><term>Aged</term>
<term>Aged, 80 and over</term>
<term>Female</term>
<term>Humans</term>
<term>Lenses, Intraocular</term>
<term>Male</term>
<term>Middle Aged</term>
<term>Reoperation</term>
<term>Retrospective Studies</term>
<term>Surgical Flaps</term>
<term>Suture Techniques</term>
<term>Visual Acuity</term>
<term>Vitrectomy</term>
</keywords>
<keywords scheme="Pascal" xml:lang="fr"><term>Sclérotique</term>
<term>Fixation</term>
<term>Chambre postérieure</term>
<term>Lentille intraoculaire</term>
<term>Cornée</term>
<term>Incision</term>
<term>Chirurgie</term>
<term>Ophtalmologie</term>
<term>Traitement</term>
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<keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Chirurgie</term>
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<front><div type="abstract" xml:lang="en">Purpose: To report the results of managing dislocated posterior chamber intraocular lenses (PC lOLs) by externalizing the haptics through a clear corneal incision. Setting: The Retina Center at Pali Momi, Aiea, Hawaii, USA. Methods: This retrospective consecutive series comprised cases in which a dislocated PC IOL was managed with pars plana vitrectomy. With this method, the dislocated PC IOL is retrieved and stabilized in the anterior chamber. The haptic is externalized through a clear corneal incision for suture knot placement and then reinserted. A scleral fixation suture is placed 1.25 mm posterior to the limbus under a scleral flap. Results: The study included 14 eyes of 14 patients with a minimum follow-up of 6 months (median 15.4 months). There were 2 subluxated PC lOLs, 11 posteriorly dislocated PC lOLs, and 1 in-the-bag IOL dislocation. Postoperative vision and/or visual symptoms were stable or improved in 86% of eyes. Two eyes had worse vision caused by conditions not related to surgery including chronic cystoid macular edema from latanoprost use and optic atrophy. All lOLs were well fixated and stable, although 1 eye with asymmetric haptics had a slightly tilted IOL. Conclusions: Dislocated PC IOL management by externalizing the haptic through a clear corneal incision stabilized the IOL in the anterior chamber, minimized intraocular operative manipulations, and allowed easier placement of the opposite haptic over residual capsule, if available. Stable fixation was achieved without dislocation or IOL-related complications recurring.</div>
</front>
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<affiliations><list><country><li>États-Unis</li>
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<name sortKey="Yamamoto, Izumi" sort="Yamamoto, Izumi" uniqKey="Yamamoto I" first="Izumi" last="Yamamoto">Izumi Yamamoto</name>
<name sortKey="Yamamoto, Izumi" sort="Yamamoto, Izumi" uniqKey="Yamamoto I" first="Izumi" last="Yamamoto">Izumi Yamamoto</name>
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