Implantation of multifocal lens in cataract surgery in patients after vitreoretinal surgery

2021 ◽  
pp. 10-12
Author(s):  
U.R. Altynbaev ◽  
Keyword(s):  
Visual Acuity ◽  
Retinal Detachment ◽  
Cataract Surgery ◽  
Macular Hole ◽  
Epiretinal Membrane ◽  
Vitreoretinal Surgery ◽  
Long Distance ◽  
Uncorrected Visual Acuity ◽  
Lens Implantation ◽  
Multifocal Lens

Purpose. To study the results of cataract surgery with implantation of multifocal IOLs in patients with various retinal pathologies who underwent vitreoretinal surgery. Material and мethods. Fifteen patients who had previously undergone vitreoretinal interventions for macular hole (n=6), epiretinal membrane (n=4) and retinal detachment (n=5) were observed. The criterion for choosing in favor of multifocal lens implantation was high visual acuity (0.7 or more) after undergoing vitreoretinal surgery. All patients underwent cataract phacoemulsification with implantation of two types of multifocal lenses: I group – IOL with an extended near focus (EDOF) (n=8) and II group – with a multifocal three-focus lens (n=7 eyes), including, in 3 cases – with toric component. In 55% of cases, the operation was performed on both eyes. The age of the patients varied from 34 to 59 years (51.4 ± 6.1 years). Results. Long-distance uncorrected visual acuity varied from 0.7 to 1.0 (0.85±0.25), which did not depend on the type of intraocular lens and correlated with morphological changes in the macular region of the retina. The highest uncorrected visual acuity (0.8±0.14) at an intermediate and near distance (0.75±0.25) was achieved in I group of patients. Postoperative spherical equivalent after 1 month corresponded to the planned target refraction (Em±0.5 diopters) in 14 cases and remained stable during 12 months of observation. In general, subjective satisfaction with MIOL implantation was higher in patients in II group, which was explained by minimal changes in the macular region of the retina. Additional spectacle correction for near was required for a patient of I group with a history of macular rupture, who underwent bilateral multifocal IOL implantation with high uncorrected visual acuity in the distance (OD=1.0 \ OS=1.0) and near (OD=0.6 \ OS=0,5). Conclusion. Implantation of multifocal lenses in patients with a good anatomical and functional outcome of vitreoretinal surgery allows obtaining high and stable functional results. Bilateral implantation of a multifocal lens with an extended near focus in patients with operated macular pathology does not cause specific adaptive difficulties in binocular vision. The choice in favor of multifocal lens implantation in patients with vitreoretinal pathology requires an individual approach and careful selection. Key words: multifocal lens, cataract, macular hole, retinal detachment, epiretinal membrane.

scholarly journals Analysis of Changes in Corneal Topography after 27-Gauge Transconjunctival Microincision Vitrectomy Combined with Cataract Surgery

2019 ◽  
Vol 2019 ◽  
pp. 1-5
Author(s):  
Tomoyuki Watanabe ◽  
Tamaki Gekka ◽  
Akira Watanabe ◽  
Tadashi Nakano
Keyword(s):  
Intraocular Pressure ◽  
Retinal Detachment ◽  
Cataract Surgery ◽  
Macular Hole ◽  
Epiretinal Membrane ◽  
Rhegmatogenous Retinal Detachment ◽  
Corneal Topography ◽  
High Order ◽  
Before And After ◽  
Port System

Purpose. To investigate changes in the corneal shape before and after vitrectomy, over a period of time, using a 27-gauge system. Methods. Forty-five eyes underwent a combination of cataract surgery and vitrectomy. The surgeries were performed using a 27-gauge transconjunctival vitrectomy system, in which the corneal topography could be performed up to three months after the surgery. The surgeries were performed for an epiretinal membrane in 11 eyes, a macular hole in 14 eyes, and rhegmatogenous retinal detachment in 20 eyes. All of the surgeries were performed by the same surgeon, and in all cases, a 4-port 27-gauge vitrectomy device was used. Cataract surgery in all patients was performed with a 2.4 mm corneoscleral incision at 11 o’clock. The surgeries were performed without suturing the operative wound in all cases. Corneal topography was performed using a TMS-4 topographer (Tomey Corporation, Tokyo, Japan). The examinations were performed the day before and 1 day, 1 week, 1 month, and 3 months after the surgery. The results of corneal topography for the spherical, regular astigmatic, asymmetric, and high-order irregular astigmatic components were compared before and after surgery. Results. No significant differences were seen in any of the components in the epiretinal membrane group, but significant differences were seen in the asymmetric components and the high-order irregular astigmatic components between the macular hole and rhegmatogenous retinal detachment groups (p<0.05). There were no significant changes in intraocular pressure on any measurement time in the postoperative period compared to preoperative intraocular pressure. Conclusion. Irregular astigmatism was seen after surgery when 27-gauge vitrectomy with a 4-port system was performed together with cataract surgery with a 2.4 mm incision.

scholarly journals Effect of internal limiting membrane peeling on postoperative visual acuity in macula-off rhegmatogenous retinal detachment

PLoS ONE ◽  
2021 ◽  
Vol 16 (8) ◽  
pp. e0255827
Author(s):  
Shumpei Obata ◽  
Masashi Kakinoki ◽  
Osamu Sawada ◽  
Yoshitsugu Saishin ◽  
Yusuke Ichiyama ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Retinal Detachment ◽  
Cataract Surgery ◽  
Epiretinal Membrane ◽  
Rhegmatogenous Retinal Detachment ◽  
Internal Limiting Membrane ◽  
Ilm Peeling ◽  
Membrane Formation ◽  
Explanatory Variables ◽  
Long Duration

Purpose To investigate the effects of internal limiting membrane (ILM) peeling on visual acuity (VA) after rhegmatogenous retinal detachment (RRD) surgery. Methods This retrospective analysis examined the medical records of patients with RRD who underwent vitrectomy at 26 institutions. To detect prognostic factors of VA at 6 months postoperatively (post-VA), multivariate linear regression was performed with post-VA as the objective variable; ILM peeling, sex, age, preoperative VA (pre-VA), intraocular pressure, axial length, duration of RRD, and cataract surgery served as explanatory variables. Recurrence of RRD and epiretinal membrane formation within 6 months postoperatively were compared between groups of patients with and without ILM peeling, among patients with macula-on and macula-off RRD. Results The inclusion criteria were met by 523 eyes with a macula-on RRD and 364 eyes with a macula-off RRD. ILM peeling was performed in 85 eyes with a macula-on RRD and 57 eyes with a macula-off RRD. In eyes with a macula-on RRD, ILM peeling did not affect post-VA (p = 0.72). Vitrectomy without cataract surgery and poor pre-VA were significantly associated with poor post-VA (p = 0.01 and p < 0.001, respectively). In eyes with a macula-off RRD, ILM peeling, long duration of RRD, and poor pre-VA were significantly associated with poor post-VA (p = 0.037, p = 0.007, and p < 0.001, respectively). Recurrence of RRD and epiretinal membrane formation were similar between groups of patients with and without ILM peeling, among patients with macula-on and macula-off RRD. Retina sensitivity was not evaluated by microperimetry. Conclusion ILM peeling did not affect post-VA in eyes with a macula-on RRD, whereas post-VA was worse in eyes with ILM peeling than in eyes without peeling, among eyes with a macula-off RRD.

scholarly journals Toric Intraocular Lens Implants for Astigmatism

2012 ◽  
Vol 06 (03) ◽  
pp. 164
Author(s):  
Irene C Kuo ◽  
Victor E Reviglio ◽  
◽  
Keyword(s):  
Visual Acuity ◽  
Cataract Surgery ◽  
Intraocular Lenses ◽  
Toric Intraocular Lens ◽  
Refractive Lens Exchange ◽  
Astigmatism Correction ◽  
Uncorrected Visual Acuity ◽  
Refractive Lens ◽  
Multifocal Lens ◽  
High Level

Toric intraocular lenses are available in our surgical armamentarium for use in cataract surgery, refractive lens exchange, phakic lens procedures and multifocal lens procedures. These lens implants enjoy a high level of success in terms of post-operative uncorrected visual acuity, astigmatism correction and safety. With time, toric phakic lens implants, not available worldwide, may gain popularity as more surgeons gain comfort and confidence in offering and performing an elective intraocular procedure.

scholarly journals Early Vascular and Functional Changes after Vitreoretinal Surgery: A Comparison between the Macular Hole and Epiretinal Membrane

Diagnostics ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. 1031
Author(s):  
Rossella D’Aloisio ◽  
Paolo Carpineto ◽  
Agbéanda Aharrh-Gnama ◽  
Carla Iafigliola ◽  
Luca Cerino ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Macular Hole ◽  
Epiretinal Membrane ◽  
Vitreoretinal Surgery ◽  
Macular Area ◽  
Functional Changes ◽  
Corrected Visual Acuity ◽  
Capillary Plexus ◽  
Best Corrected Visual Acuity ◽  
25 Gauge Vitrectomy

(1) Background: The aim of this observational comparative study was to investigate early retinal vascular and functional changes in patients undergoing vitreoretinal surgery for idiopathic epiretinal membrane (iERM) or macular hole (MH) using a widefield swept-source optical coherence tomography angiography (WSS-OCTA). (2) Methods: Forty one diseased eyes were enrolled in the study. Twenty three eyes with iERM diagnosis (ERM group) underwent 25-gauge vitrectomy with inner limiting membrane (ILM) and MER peeling, while eighteen eyes with MH (MH group) underwent 25-gauge vitrectomy with inverted flap technique. Functional and anatomical/perfusion parameters were evaluated pre- and postoperatively in all eyes by means of WSS-OCTA system, microperimetry (MP3), best corrected visual acuity assessment, central macular thickness (CMT) and MH diameter calculation. For each eye, 12 × 12 mm OCTA volume scans were acquired by a retinal specialist and a semi-automated algorithm was used for a quantitative vessel analysis of the superficial capillary plexus (SCP), deep capillary plexus (DCP) and choriocapillaris (CC). In detail, perfusion density (PD) of the SCP, DCP and CC was evaluated in four circles (one central in the macular area of 5 mm diameter; three midperiphery circles (temporal, superior and inferior) of 3 mm). In addition, the vessel length density (VLD) of the SCP and DCP for the same circles was quantified. (3) Results: In the MH group, PD of the SCP significantly increased in the macular area (p = 0.018) and in the superior ring (p = 0.016); PD of the DCP significantly increased in the macular area (p = 0.015) and in the superior and inferior ring (p = 0.016) 3 months after surgery. In the ERM group, PD of the SCP and DCP significantly increased in the macular area and superior ring, respectively (p = 0.001; p = 0.032), 3 months after surgery. During follow-up there was a significant improvement in terms of functional (Best corrected visual acuity, p = 0.007 and p = 0.029; microperimetry ((MP3) 10°, p = 0.003 and p = 0.004; MP3 2°, p = 0.028 and p = 0.003 in MH group and ERM group respectively) and anatomical parameters (CMT, p = 0.049 in ERM group; hole complete closure in MH group). (4) Conclusions: After vitreoretinal surgery, early retinal vascular and functional changes can be promptly observed and quantified to monitor and potentially predict surgery outcomes. Widefield OCTA devices allow for a detailed microvasculature analysis of retina and choriocapillaris in the macular area and in the periphery, showing a different behaviour of retinal sectors in two distinct vitreoretinal disorders.

scholarly journals A New Sutureless Illuminated Macular Buckle Designed for Myopic Macular Hole Retinal Detachment

2017 ◽  
Vol 2017 ◽  
pp. 1-7 ◽  
Author(s):  
Ahmed M. Bedda ◽  
Ahmed M. Abdel Hadi ◽  
Mohamed Lolah ◽  
Muhammad S. Abd Al Shafy
Keyword(s):  
Visual Acuity ◽  
Retinal Detachment ◽  
Macular Hole ◽  
High Myopia ◽  
Terminal Part ◽  
Macular Hole Retinal Detachment ◽  
Myopic Macular Hole ◽  
The Mean ◽  
Visual Results

Purpose. To report the anatomic and visual results of a new sutureless illuminated macular buckle designed for patients with macular hole retinal detachment related to high myopia (MMHRD). Design. Prospective nonrandomized comparative interventional trial. Methods. Twenty myopic eyes of 20 patients (mean age, 51.4 years; range, 35–65 years) presenting with MMHRD with a posterior staphyloma, in whom the new buckle was used, were evaluated. The buckle used was assembled from a 5 mm wide sponge and a 7 mm wide silicone tire; it was fixed utilizing the sterile topical adhesive Histoacryl Blue (B Braun, TS1050044FP) which polymerizes in seconds upon being exposed to water-containing substances. The primary outcomes measured included aided visual acuity (BCVA) and optical coherence tomography (OCT) findings. The mean follow-up period was 6 months. Results. Postoperatively, the MH closure was identified by OCT in 8 (40%) eyes. The mean BCVA increased from 0.11 to 0.21 (p<0.005). The axial length of the eyes included decreased from 30.5 mm preoperatively to 29.8 mm (p=0.002) postoperatively. Conclusion. Preparation of the new sutureless macular buckle is simple and easy. Illumination of the terminal part of the buckle ensures proper placement. Histoacryl Blue is effective in fixing the buckle in its place for at least 6 months with no reported intra- or postoperative complications.

Accuracy of Predictive Refraction in Combined Vitrectomy-Cataract Surgery for Epiretinal Membrane and Macular Hole

2015 ◽  
Vol 56 (2) ◽  
pp. 219 ◽  
Author(s):  
Hyo Cheol Lim ◽  
Kyung Ho Kim ◽  
Min Kyu Shin ◽  
Sung Who Park ◽  
Ik Soo Byon ◽  
...  
Keyword(s):  
Cataract Surgery ◽  
Macular Hole ◽  
Epiretinal Membrane

scholarly journals Comparison of the Outcomes of Manual Small Incision Cataract Surgery (MSICS) and Phacoemulsification (PHACO) in Ghana

2021 ◽  
Vol 18 (3) ◽  
pp. 143-149
Author(s):  
Samuel Kyei ◽  
Ebenezer Zaabaar ◽  
Frank Assiamah ◽  
Michael Agyemang Kwarteng ◽  
Kofi Asiedu
Keyword(s):  
Visual Acuity ◽  
Postoperative Complications ◽  
Cataract Surgery ◽  
Medical Records ◽  
Cross Sectional Study ◽  
Small Incision Cataract Surgery ◽  
Cross Sectional ◽  
Small Incision ◽  
Uncorrected Visual Acuity

Background: The growing middle-class population of Ghana has seen more people being employed in visually demanding occupations  and hence there is an increased desire for quality post-cataract surgical visual outcomes. This study aimed at comparing the outcomes of manual small incision cataract surgery (MSICS) and phacoemulsification (PHACO) among Ghanaians. Methods: This was a retrospective cross-sectional study in which records of patients who underwent MSCIS or phacoemulsification by the same surgeon were reviewed. Results: Medical records of 248 eyes were reviewed, out of which 132 underwent PHACO and 116 had MSICS. A significant number of the  PHACO group had good (6/6–6/18) uncorrected visual acuity (UCVA) compared to the MSICS group at 1–2 weeks follow-up (p = 0.003) and 4–6 weeks follow-up (p = 0.002). MSICS resulted in a higher total astigmatic change compared to PHACO (p < 0.001). The PHACO grouphad a higher number of postoperative complications compared with the MSICS group (p <0.001). Postoperative borderline and poor  uncorrected visual acuity were associated with age, total astigmatic change, and postoperative complications. Conclusion: The postoperative UCVA outcomes at 4–6 weeks’ follow-up indicates that PHACO resulted in noticeably less spectacle dependency when compared to MSICS.

scholarly journals Surgical Management of Traumatic Retinal Detachment with Primary Vitrectomy in Adult Patients

2017 ◽  
Vol 2017 ◽  
pp. 1-4 ◽  
Author(s):  
Katarzyna Nowomiejska ◽  
Tomasz Choragiewicz ◽  
Dorota Borowicz ◽  
Agnieszka Brzozowska ◽  
Joanna Moneta-Wielgos ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Retinal Detachment ◽  
Silicone Oil ◽  
Vitreoretinal Surgery ◽  
Eye Injuries ◽  
Primary Vitrectomy ◽  
Eye Trauma ◽  
Open Globe ◽  
Pars Plana ◽  
23 Gauge

Purpose.To evaluate functional and anatomical results of pars plana vitrectomy (PPV) in the retinal detachment (RD) followed by severe eye trauma.Methods.Retrospective analysis of medical records of forty-one consecutive patients treated with 23-gauge PPV due to traumatic RD. Age, gender, timing of PPV, visual acuity, and presence of intraocular foreign body (IOFB) and proliferative vitreoretinopathy (PVR) were included in the analysis.Results.Mean age of patients was 47 years; the majority of patients were men (88%). Closed globe injury was present in 21 eyes and open globe injury in 20 eyes (IOFB in 13 eyes, penetration injury in 4 eyes, and eye rupture in 3 eyes). Mean follow-up period was 14 months; mean timing of PPV was 67 days. Twenty-seven (66%) eyes had a functional success; 32 eyes (78%) had anatomical success. As a tamponade silicone oil was used in 33 cases and SF6 gas in 8 cases.Conclusions.Severe eye injuries are potentially devastating for vision, but vitreoretinal surgery can improve anatomical and functional outcomes. Among analysed pre- and intra- and postoperative factors, absence of PVR, postoperative retinal attachment, and silicone oil as a tamponade were related to significantly improved visual acuity.

Surgical management of a case of contractile peripapillary staphyloma with retinal detachment and macular hole

2020 ◽  
pp. 112067212092022
Author(s):  
Sofía H Vidal ◽  
Diego Bueso Ponce ◽  
Juan Esteban Unigarro ◽  
Sergio Arrascue Limo ◽  
Carlos Abdala Caballero
Keyword(s):  
Visual Acuity ◽  
Retinal Detachment ◽  
Macular Hole ◽  
Retinal Pigment ◽  
Silicon Oil ◽  
Corrected Visual Acuity ◽  
Intraocular Gas ◽  
Best Corrected Visual Acuity ◽  
Peripapillary Staphyloma

A healthy 4-year-old male presented a fundus examination with a unilateral contractile peripapillary staphyloma surrounded by redundant retina and retinal pigment epithelium atrophy. Five years later, best-corrected visual acuity decreased to hand motion due to a retinal detachment with macular hole. One month after first vitrectomy, scleral buckle and intraocular gas, retina re-detached. Second surgery was performed with silicon oil tamponade and lensectomy without intraocular lens (IOL). Subretinal silicon oil was detected at the third month of follow-up when vitrectomy, inferior retinectomy, and laser photocoagulation of temporal border of staphyloma with silicon oil tamponade were performed. The retina remained attached and best-corrected visual acuity was 20/600 with intraocular silicon oil. A fourth surgery was performed for emulsified silicon oil extraction replaced with intraocular gas. At 6 months of follow-up, the retina re-detached again. This is a challenging vitreoretinal surgery in which re-detachments were due to retinal folds around the contractile staphyloma that raised macular hole. This is the first report of the combined presentation of contractile peripapillary staphyloma, retinal detachment and macular hole with a long-time follow-up period of years.

Full-Thickness Macular Hole Formation After Repair of Rhegmatogenous and Tractional Retinal Detachment

2019 ◽  
Vol 3 (5) ◽  
pp. 341-345
Author(s):  
Matthew A. Cunningham ◽  
Samantha Fink ◽  
Jaya B. Kumar ◽  
Elias C. Mavrofrides ◽  
S.K. Steven Houston ◽  
...  
Keyword(s):  
Retinal Detachment ◽  
Macular Hole ◽  
Case Series ◽  
Vitreoretinal Surgery ◽  
Visual Outcome ◽  
Full Thickness ◽  
Tractional Retinal Detachment ◽  
Full Thickness Macular Hole ◽  
Pars Plana

Purpose: This article reports the clinical features, associations, and outcomes of patients with full-thickness macular hole (MH) formation after pars plana vitrectomy for retinal detachment (RD). Methods: A retrospective, interventional case series is presented of consecutive patients undergoing surgical repair of MH following prior tractional or rhegmatogenous retinal detachment repair from September 2014 to October 2018 at a single vitreoretinal surgery practice. The size of the MH, presence of epiretinal membrane (ERM), rate of MH closure, and visual outcome following repair were evaluated. Results: A total of 996 cases of rhegmatogenous and tractional retinal detachment repair were identified. The average time from the RD surgery to MH diagnosis was 72 days. The incidence of subsequent MH formation in patients who underwent surgery was 0.8% (8/996). The presence of ERM prior to MH repair was noted in 50% of these cases (4/8). In cases with at least 3 months of postoperative follow-up, MH closure was achieved in 100% of eyes after a single surgery. The mean preoperative visual acuity (VA) was 2.06 logMAR (logarithm of the minimum angle of resolution) units (Snellen equivalent, 20/2296) and significantly improved to 0.72 logMAR units (Snellen, 20/104; P = .017) at the last follow-up after MH repair. All patients had improvement in VA at the final postoperative visit, with a VA of 20/200 or better achieved in 87.5% of cases. Conclusions: Although MH formation after successful RD repair is uncommon, favorable visual and anatomic results can be obtained.

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