Study of peculiarities of intra- and postoperative state of the interface «intraocular lens - posterior capsule» in phacoemulsification of senile cataract

2021 ◽  
pp. 13-16
Author(s):  
L. Bai ◽  
◽  
A.V. Vasiliev ◽  
A.V. Egorova ◽  
◽  
...  
Keyword(s):  
Intraocular Lens ◽  
Anterior Segment ◽  
Early Period ◽  
Central Zone ◽  
Senile Cataract ◽  
Posterior Capsule ◽  
Dynamic Observation ◽  
Full Contact ◽  
Postoperative State ◽  
Capsular Bag

Presence of full contact of interface «intraocular lens (IOL) – posterior capsule (PC)» ensures the transparency of the latter in the early period after phacoemulsification (PE) of senile cataract (SC). The main reasons for absence of full contact of IOL with PC are: the presence of residuals of viscoelastic (VE) in the capsular bag, uneven tension of the capsule by the haptic elements of the IOL, and the incommensurability of the size of the IOL with the capsule. Purpose. To study the features of the intra- and postoperative state of interface «IOL – PC» during PE SC. Material and methods. Dynamic observation of 42 patients (42 eyes), who operated on immature senile cataracts, was carried out. All operations were performed using OPMI LUMERA 700 surgical microscope (Carl Zeiss Meditec AG, Jena, Germany) with integrated intra-operative OCT, state of interface «IOL – PC» was examined. 2 hours after and on the 1st day after the operation state of interface «IOL – PC» was studied in all eyes by OCT on Optovue RTVue-100 (Optovue, Inc., US) with module for anterior segment examining to protocols «Cornea Line» and «Cornea Cross Line». Results. During the operation, the presence of contact between IOL and PC was observed only in 9 eyes (21.4%). 2 hours after surgery, 40 eyes (95.2%) had absence of contact between lens and capsule. On the 1st day after surgery, the optimal interface between IOL and PC was observed in 32 eyes (76.2%). Conclusion. Studies have shown that state of interface «IOL – PC» on the 1st day does not depend on its characteristics revealed intraoperative and 2 hours after the operation. The main reason for absence of contact between IOL and PC is residues of VE, and the using «impulse-irrigation» technique allows completely removing VE from the central zone of the capsule in all cases. Key words: cataract, phacoemulsification, intraocular lens, lens capsule, viscoelastic, interface «IOL – PC».

scholarly journals Study of State of Interface “Intraocular Lens — Posterior Capsule” Depending on Size of Capsulorhexis in Senile Cataract Phacoemulsification

2021 ◽  
Vol 18 (3) ◽  
pp. 427-432
Author(s):  
Lina Bai ◽  
O. V. Kolenko ◽  
A. V. Egorova ◽  
A. V. Vasiliev
Keyword(s):  
Optical Coherence Tomography ◽  
Femtosecond Laser ◽  
Intraocular Lens ◽  
Senile Cataract ◽  
Posterior Capsule ◽  
Average Depth ◽  
Maximum Value ◽  
Full Contact ◽  
Corneal Opacities ◽  
Capsular Bag

Purpose. To study the state of interface “intraocular lens (IOL) — posterior capsule (PC)” depending on diameter of capsulorhexis in phacoemulsification of senile cataract.Patients and methods. 227 patients (227 eyes) were examined after phacoemulsification of senile cataract at LenSx femtosecond laser (Alcon, USA). The study did not include patients with corneal opacities, signs of axial displacement of lens, with irido- and phacodonesis, glaucoma, axial length less than 22 mm and more than 26 mm. Depending on diameter of performed capsulorhexis, we formed 3 groups: 1st group — 76 eyes with diameter capsulorexis 5.5 mm; 2nd group — 73 eyes with 5.0 mm; 3rd group — 78 eyes with 4.5 mm. We studied type of interface “IOL — PC”, the maximum value of PC diastasis and the maximum depth of its folds using an RTVue-100 Optical Coherence Tomography (Optovue, USA) on the first day after the operation.Results. The maximum number of eyes with absence of contact between IOL and PC was noted in the 3rd group (62.8 %), the largest number of eyes with full contact between IOL and PC (63.2 %) was in the 1st group. The minimum average depth of the PC folds (111.1 ± 32.7 μm) was noted in the 1st group, and the maximum (165 ± 75.4 μm) — in the 2nd group.Conclusion. The analysis showed that type of interface “IOL — PC” in the first day after phacoemulsification of senile cataract depends on diameter of capsulorhexis. The largest number of eyes (64.6 %) with full contact between IOL and PC was observed in the group of patients with capsulorhexis 5.5 mm, and the smallest (6.4 %) — in eyes with diameter capsulorexis 4.5 mm. Presumably, the main reason for the absence or incomplete contact between IOL and PC is the presence of viscous dispersive between them. The deformation of PC in the form of folds does not directly depend on diameter of capsulorhexis and, obviously, is due to the uneven tension of the capsular bag by the IOL haptics.

scholarly journals Anatomical and Topographical Relations between the Posterior Lens Capsule and the Intraocular Lens in Pseudoexfoliation Syndrome

2018 ◽  
Vol 15 (2S) ◽  
pp. 134-139
Author(s):  
E. V. Egorova
Keyword(s):  
Optical Coherence Tomography ◽  
Quantitative Analysis ◽  
Intraocular Lens ◽  
Postoperative Period ◽  
Anterior Segment ◽  
Posterior Capsule ◽  
Pseudoexfoliation Syndrome ◽  
Full Contact ◽  
High Resolution Oct ◽  
Late Postoperative Period

Purpose— to study the relations between the posterior capsule (PC) and intraocular lens (IOL) after cataract surgery in pseudoexfoliation syndrome (PEX).Patients and methods. We examined 46 eyes of 37 patients with PEX who underwent a standard and uncomplicated phacoemulsification. The age of patients was 60–94 years. Postoperative period ranged from 1 day to 10 years. An optical coherence tomography (OCT) (RTVue XR Avanti, “Optovue”) was used to image the IOL-PC space in early and late postoperative period.Results. In the first days full contact PC-IOL was not observed in any case. The maximum of space PC-IOL was noted on the first day postoperatively. Posterior capsule had a wavy or folded profile on the scans. In the next two weeks we observed a decrease of the distances between posterior capsule and IOL. After 1 month we noted the formation of capsular bend around optic edge, the full adhesion of posterior capsule to IOL was not detected. In the late postoperative period the fibroplastic and proliferative capsular changes with secondary discontact PC-IOL was noted. Primary inadhesion of a posterior capsule to IOL was recorded in half of the cases.и. High resolution OCT was suitable for quantitative analysis of IOL-PC space. Involution changes in structures of anterior segment in the eyes with PEX had a role in closure of the IOL-PC space. Complete adhesion of posterior capsule to IOL was not observed in the majority of eyes with PEX. 

Intraocular lens explantation following cataract surgery: Indications, techniques, and video demonstrations

2021 ◽  
pp. 112067212110396
Author(s):  
Steven G Safran ◽  
Erica Darian-Smith ◽  
Minas T Coroneo
Keyword(s):  
Cataract Surgery ◽  
Intraocular Lens ◽  
Anterior Segment ◽  
Specific Area ◽  
Patient Expectations ◽  
Effective Strategy ◽  
Capsular Bag

As techniques for modern cataract surgery have expanded and premium intraocular lens (IOL) use is now widespread, patient expectations are high. The need for IOL explantation, whilst still low, remains an ongoing issue. Intraocular lens explantation can be challenging for a number of reasons and as such we have introduced an additional technique to add to the surgeon’s repertoire. Bimanual haptic stripping of fibrosis at the specific area where the haptic is adherent to the capsular bag is an effective strategy to aid in dissection of haptics without compromising the capsule or zonules. Given the challenges associated with IOL explantation, newly designed IOLs need to avoid these “sticking points” at which the IOLs interact with the fibrosed capsule. Techniques we have evolved and which are described below should assist anterior segment surgeons to facilitate IOL removal in an efficient and safe way.

scholarly journals The Predictability of Preoperative Pilocarpine-Induced Lens Shift on the Outcomes of Accommodating Intraocular Lenses Implanted in Senile Cataract Patients

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Jin Li ◽  
Qi Chen ◽  
Zhibo Lin ◽  
Lin Leng ◽  
Fang Huang ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Intraocular Lens ◽  
Anterior Segment ◽  
Senile Cataract ◽  
Intraocular Lenses ◽  
Iol Implantation ◽  
Accommodation Stimulus ◽  
The Mean ◽  
Preoperative Parameter ◽  
Cataract Patients

Purpose. To evaluate the predictability of lens shift induced by pilocarpine (LSPilo) on the outcomes of accommodating intraocular lens (Acc-IOL) implantation.Methods. Twenty-four eyes of 24 senile cataract patients who underwent phacoemulsification and Acc-IOL implantation were enrolled.LSPilowas evaluated with anterior segment optical coherence tomography (AS-OCT). At 3 months postoperatively, the best corrected distance visual acuities (BCDVA), distance-corrected near visual acuities (DCNVA), and subjective and objective accommodations were measured. IOL shifts under accommodation stimulus (IOLSAcc) were evaluated with AS-OCT.Results. The meanLSPilowas 112.29 ± 30.72 µm.LSPilowas not associated with any preoperative parameters. The meanIOLSAccwas 130.46 ± 42.71 µm. The mean subjective and objective accommodation were 1.54 ± 0.39 D and 1.27 ± 0.41 D, respectively. The mean postoperative BCDVA and DCNVA (log MAR value) were 0.22 ± 0.11 and 0.24 ± 0.12, respectively.LSPilopositively correlated withIOLSAcc(r=0.541;P=0.006), subjective accommodation (r=0.412;P=0.022), and objective accommodation (r=0.466;P=0.045), respectively.Conclusion.LSPilois an independent preoperative parameter associated with the postoperative Acc-IOL mobility and pseudophakic accommodation. It may offer valuable information for ophthalmologists in determining the suitable candidates for Acc-IOL implantation.

Posterior capsule opacification and capsular bag performance of a microincision intraocular lens

2011 ◽  
Vol 37 (11) ◽  
pp. 1988-1992 ◽  
Author(s):  
Vinod Gangwani ◽  
Nino Hirnschall ◽  
John Koshy ◽  
Alja Crnej ◽  
Yutaro Nishi ◽  
...  
Keyword(s):  
Intraocular Lens ◽  
Posterior Capsule Opacification ◽  
Posterior Capsule ◽  
Microincision Intraocular Lens ◽  
Capsular Bag

scholarly journals Anterior segment OCT application in quantifying posterior capsule opacification severity with varied intraocular lens designs

2021 ◽  
Vol 14 (9) ◽  
pp. 1384-1391
Author(s):  
Sha-Sha Yu ◽  
◽  
Ya-Wen Guo ◽  
Yun Zhao ◽  
Xiao-Yong Yuan ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Intraocular Lens ◽  
Axial Length ◽  
Anterior Segment ◽  
Posterior Capsule Opacification ◽  
Posterior Capsule ◽  
Severity Assessment ◽  
Cross Sectional ◽  
Function Impairment ◽  
The Relationship

AIM: To evaluate the application of anterior segment-optical coherence tomography (AS-OCT) in posterior capsule opacification (PCO) severity assessment and analyse the relationship between PCO severity and intraocular lens (IOL) characters. METHODS: PCO patients were prospectively recruited. Cross-sectional images of the anterior segment at horizontal and vertical meridians were acquired with AS-OCT. The area of the IOL-PC (posterior capsular) space and PCO severity (area, thickness, and density at 3 mm and 5 mm IOL optic regions) were measured. The relationship between PCO severity and visual acuity, comparisons of PCO severity and IOL-PC space using varied IOL designs were analysed. RESULTS: One hundred PCO eyes were enrolled. IOL-PC space, PCO thickness and area were positively correlated with axial length. In addition, PCO area and thickness were positively correlated with visual acuity when it was ≤0.52 logMAR. The cut-off level of visual acuity should be 0.52 logMAR. With varied IOL designs, 3-piece C haptic IOL showed a smaller PCO area and thickness than the 1-piece 3 haptic IOL and 1-piece 4 haptic IOL. PCO area and thickness values for an IOL with a diameter ≤11.0 mm was greater than for an IOL with a diameter of 12.5 mm, and the differences were statistically significant. PCO area and thickness increased when IOL haptic angulation increased (from 0 to 12 degrees). CONCLUSION: In PCO eyes, cut-off level of visual acuity is 0.52 logMAR. With more severe PCO, visual acuity maybe not enough to describe the visual function impairment. PCO severity and IOL-PC space are significantly correlated with axial length and IOL design and material.

scholarly journals METHODS OF SURGICAL CORRECTION OF INTRAOCULAR LENS DISLOCATION AND APHACIA (review of literature)

2019 ◽  
Vol 26 (1) ◽  
pp. 20-28
Author(s):  
Vitaly V. Potemkin ◽  
Elena V. Goltsman
Keyword(s):  
Intraocular Lens ◽  
Intraoperative Complications ◽  
Anterior Segment ◽  
Review Of Literature ◽  
Safe Method ◽  
Lens Dislocation ◽  
Intraocular Lens Dislocation ◽  
Anterior Segment Surgery ◽  
Iol Fixation ◽  
Capsular Bag

Over the last several decades, there has been breakthrough in cataract surgery. The rate of intraoperative complications was minimized. One of the most common complications remained the intraocular lens (IOL) dislocations due to inadequate capsular bag support. Thus, the search for an effective and safe method of the IOL fixation in the absence of adequate support of the lens capsule continued to be one of the major problems in anterior segment surgery. This review was devoted to the main methods of correction of intraocular lens dislocation and aphacia.

scholarly journals Optic shrinkage and retraction in opacified hydrophilic acrylic intraocular lens: an anterior segment optical CT-based observation

2019 ◽  
Vol 12 (9) ◽  
pp. e231545
Author(s):  
Rinky Agarwal ◽  
Mayank Bhardwaj ◽  
Chetan Chetan ◽  
Namrata Sharma
Keyword(s):  
Intraocular Lens ◽  
Anterior Segment ◽  
The Other ◽  
Posterior Capsule ◽  
Similar Material ◽  
Non Invasive ◽  
Rare Phenomenon ◽  
Optical Ct ◽  
Hydrophilic Acrylic Intraocular Lens ◽  
Iol Exchange

Intraocular lens (IOL) opacification is a rare phenomenon noted with hydrophilic acrylic IOLs. We report a case of advanced IOL opacification appreciated on anterior segment optical CT (ASOCT)as a shrunken biconcave optic retracted away from the posterior capsule (PC), unlike the other eye which had a clear biconvex IOL of similar material abutting the PC. After IOL exchange, the affected eye was noted to have more folds and Elschnig’s pearls on the PC when compared with the other eye. Our case points towards rare IOL changes seen in advanced cases of opacification, their association with posterior capsular changes and the aid of ASOCT as a non-invasive tool in diagnosing them correctly.

Comparing capsular bag performance of a hydrophilic and a hydrophobic intraocular lens: A randomised two-centre study

2018 ◽  
Vol 28 (6) ◽  
pp. 639-644 ◽  
Author(s):  
John Koshy ◽  
Nino Hirnschall ◽  
Ashok Kumar V Vyas ◽  
R Narendran ◽  
Alja Crnej ◽  
...  
Keyword(s):  
Cataract Surgery ◽  
Intraocular Lens ◽  
Posterior Capsule Opacification ◽  
Intraocular Lenses ◽  
Posterior Capsule ◽  
Fort Worth ◽  
Slit Lamp ◽  
Significant Difference ◽  
Capsular Bag

Purpose: To evaluate the capsular bag performance and posterior capsule opacification development of two intraocular lenses differing in material and design. Methods: This study included patients who were scheduled for cataract surgery and compared a hydrophilic intraocular lens (Super flex® intraocular lens; Rayner Surgical, Worthing, UK) with a hydrophobic intraocular lens (AcrySof® SA60AT; Alcon, Fort Worth, TX, USA). Follow-ups were performed 1 month and 2 years after cataract surgery, including a slit lamp examination and retroillumination images. Results: In total, 80 eyes of 80 patients were recruited. At the 1-month follow-up, 6 of 39 cases had a gap between the posterior lens capsule and intraocular lens (1 case in the hydrophilic intraocular lens group and 5 cases in the hydrophobic intraocular lens group; p = 0.348). Objective and subjective posterior capsule opacification scoring showed no statistically significant difference between both groups (p = 0.123). Conclusion: Both intraocular lens showed a good capsular bag performance and a relatively low posterior capsule opacification development within the first 2 years after surgery.

scholarly journals Diagnostic imaging versus surgical procedure: intra- and postoperative OCT evaluation of sutureless scleral-fixated intraocular lens implantation and possible related complications

2021 ◽  
Author(s):  
Raffaele Nuzzi ◽  
Alessandro Rossi
Keyword(s):  
Intraocular Lens ◽  
Refractive Surgery ◽  
Anterior Segment ◽  
Iol Implantation ◽  
Anterior Segment Oct ◽  
Preoperative Stage ◽  
Lens Implantation ◽  
Corneal Refractive Surgery ◽  
Capsular Bag ◽  
Scleral Fixated Intraocular Lens

AbstractBecause the popularity of corneal refractive surgery has been increasing throughout the last 25 years, many authors have thought to apply optical coherence tomography (OCT) to the anterior segment (AS-OCT); by revising the instrumentation needed and slightly improve the technique, it has become an element of vital importance in order to ensure a complete and exhaustive pre- and postsurgical evaluation. Many applications of OCT have been recently developed—mostly in cataract surgery due to the increasing numbers—such as chamber biometry, which is used in a preoperative stage to determine the details of IOL implantation, and lens evaluation. The aim of this review is to assess the applications of anterior segment OCT in dislocated IOL and/or capsular bag exchange surgery with scleral sutureless fixated intraocular lens and monitoring of possible postoperative complications.

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