1/33. Foldable posterior chamber intraocular lens implantation in the absence of capsular and zonular support.PURPOSE: To implant foldable posterior chamber intraocular lenses in the absence of capsular and zonular support. methods: case reports. In two patients, two eyes with aphakia, lack of capsular or zonular support, and contact lens intolerance underwent the implantation of a silicone and an acrylic foldable posterior chamber intraocular lens, respectively. RESULTS: In the two eyes, final visual acuity was 20/25 and 20/50, respectively. No intraoperative vitreal, retinal, or choroidal complications were noted. The postoperative recovery was rapid, and there was minimal induced astigmatism. CONCLUSIONS: The implantation of foldable posterior chamber intraocular lenses in aphakic eyes without capsular and zonular support may result in fewer intraoperative complications. It also allows for faster postoperative recovery and less postoperative astigmatism.- - - - - - - - - - ranking = 1keywords = aphakia (Clic here for more details about this article) |
2/33. Black iris-diaphragm intraocular lens for aniridia and aphakia.We present the first reported use in the united states of a black iris-diaphragm intraocular lens (IOL) for the treatment of traumatic aniridia and aphakic bullous keratopathy. The patient presented to a university-based practice with contact-lens-intolerant aniridia and aphakia with painful bullous keratopathy from a failed corneal graft. He was treated with combined penetrating keratoplasty and transscleral fixation of an aniridia IOL. The patient's preoperative symptoms of debilitating glare and photophobia resolved substantially after surgery, despite mild postoperative inflammation that resolved. The symptoms associated with aniridia can be successfully treated with a black iris-diaphragm IOL; however, chronic low-grade inflammation has been reported with its use in some cases.- - - - - - - - - - ranking = 5keywords = aphakia (Clic here for more details about this article) |
3/33. In-the-bag secondary intraocular lens implantation in children.BACKGROUND: Surgery for congenital cataracts in early infancy usually includes a primary posterior capsulectomy and an anterior vitrectomy. Initially, most of these infants have aphakia after surgery. Over time, remaining equatorial lens epithelial cells produce new cortical fibers, resulting in a ring of cortex trapped between the lens equator and the fused anterior and posterior capsulectomy edges. A potential space is maintained between the anterior and posterior capsular leaflets. We describe a technique for placing a secondary intraocular lens (IOL) within the capsular bag. patients AND methods: Eight children, ranging in age from 11 months to 14 years, who originally had aphakia after cataract extraction were operated on with the intent to reopen the capsular bag and place an IOL in the bag. RESULTS: Secondary in-the-bag IOL implantation was successfully completed in 7 of 8 children. This was accomplished by reopening the capsular bag 360 degrees at the edge of the fused anterior and posterior capsulectomy remnants, using the previously published vitrectorhexis technique. Residual cortical material was aspirated, and an IOL was placed within the capsular bag. In 1 child, aged 14 years, the capsular bag was reopened, but the lens was placed in the ciliary sulcus because the new anterior capsule edge could not be visualized for 360 degrees . CONCLUSION: Placement of secondary IOLs within the capsular bag can be accomplished successfully for selected patients in the pediatric population. Surgeons operating on infantile cataracts without primary IOL placement can facilitate capsular IOL sequestration later by limiting the anterior and posterior capsulectomy to 4 to 5 mm and performing a generous anterior vitrectomy to help prevent secondary closure of the smaller capsulectomy.- - - - - - - - - - ranking = 2keywords = aphakia (Clic here for more details about this article) |
4/33. Pars plana vitrectomy for persistent, visually significant vitreous opacities.PURPOSE: To evaluate the role of vitrectomy in patients with persistent, visually disabling vitreous opacities. methods: Six consecutive eyes of five men (age 58-66 years) with pseudophakia or aphakia and vitreous opacities resulting in visual symptoms for more than 1 year that underwent vitrectomy were retrospectively reviewed. Postoperative questionnaires regarding functional performance and quality-of-life issues were completed by the participants to assess subjective patient satisfaction. RESULTS: Postoperative Snellen visual acuity was improved or equal to preoperative acuity in all cases (8-44 month follow-up) and there were no surgical complications. All patients expressed high satisfaction with overall visual function. Analysis of the National eye Institute Visual Function Questionnaire-39 indicated that general vision, near activities, distance activities, mental health, role difficulties, and peripheral vision were significantly improved (P < 0.05) following surgical intervention. CONCLUSIONS: vitrectomy may be indicated in a select group of patients with visually disabling vitreous floaters, although objective assessment of visual dysfunction from vitreous floaters requires further evaluation.- - - - - - - - - - ranking = 1keywords = aphakia (Clic here for more details about this article) |
5/33. Diagnosing glaucoma in pediatric aphakia.BACKGROUND: Cataracts pose a serious threat to the visual system in infants and children, requiring prompt surgical intervention and rehabilitation to optimize visual development. glaucoma is a serious complication following cataract surgery in infants and can lead to loss of vision. early diagnosis of glaucoma, however, can be quite challenging in these patients. case reports: Three cases are presented in which comeal edema was the initial presenting sign that led to the diagnosis of glaucoma during routine contact lens follow-up examinations for pediatric aphakia. CONCLUSION: The contact lens practitioner, during the course of management of aphakic infants and children, should always be suspicious of glaucoma as a complication of cataract surgery, and the presenting sign may be corneal edema.- - - - - - - - - - ranking = 5keywords = aphakia (Clic here for more details about this article) |
6/33. Cystoid macular edema in aphakia and pseudophakia after use of prostaglandin analogs.Prostaglandin analogs are powerful ocular hypotensive agents that may also be associated with a breakdown of the blood-retinal barrier and cystoid macular edema. The association is evident in pseudophakic or aphakic patients. This paper presents a case of unilateral latanoprost-associated clinical cystoid macular edema in a bilaterally pseudophakic patient; the only difference between the two eyes was the presence of a capsulotomy in the affected eye. We review the literature concerning prostaglandin analog-associated cystoid macular edema, as well as the evidence for prostaglandin analog-associated breakdown of the blood-retinal barrier. Although some evidence is suggestive of a connection between prostaglandin analogs and cystoid macular edema, many questions concerning the complex physiology of prostanoids remain. Until our understanding of these issues is more advanced, judicious use of prostaglandin analogs in patients at risk for cystoid macular edema would be prudent.- - - - - - - - - - ranking = 4keywords = aphakia (Clic here for more details about this article) |
7/33. Management of traumatic aniridia and aphakia with an iris reconstruction implant.We describe the clinical features and management of a 36-year-old man with aniridia and aphakia following blunt ocular trauma. Examination showed partial aniridia and aphakia. We discuss the various options available in the management of this patient and describe the surgical technique involved in the implantation of an iris reconstruction implant.- - - - - - - - - - ranking = 6keywords = aphakia (Clic here for more details about this article) |
8/33. Bilateral Artisan lens for aphakia and megalocornea: Long-term follow-up.We received approval from the U.S. implant food and Drug Administration and the University's Institutional review Board to the Artisan lens (Ophtec BV) in both eyes of a patient who was aphakic and had megalocornea. No other intraocular lens would easily solve this patient's need because of the large anterior segment. The patient was having increasing difficulty with aphakic contact lenses because of his work environment. We present almost 5 years of follow-up data of this patient.- - - - - - - - - - ranking = 4keywords = aphakia (Clic here for more details about this article) |
9/33. Difficult vertical diplopia studied by video-oculography in aphakia after contact lens use. A case report.PURPOSE: To establish the utility of a video-oculography system (3D-VOG) in the diagnosis of a patient with difficult idiopathic vertical diplopia. CASE REPORT: We present a clinical case of an 87 year old female who was operated for glaucoma and cataract with the intracapsular technique in both eyes. She reported vertical diplopia with the use of contact lenses but not while using her aphakia spectacles. A complete ophthalmological study was carried out with special interest in the ocular motility study with 3D-VOG. RESULTS: Besides the hypertropia in lateroversion of the non-fixing eye, the video-oculography showed an incyclotorsion of the hypertropic eye, a fundamental factor for the differential diagnosis between bilateral superior oblique overaction and DVD or dissociated vertical divergence. Such a torsional strabismic deviation is very difficult to detail by other methods and is the important clue for diagnosis. The 3D-VOG made this diagnosis possible. CONCLUSIONS: The occurrence of a vertical diplopia with use of contact lenses, and not with spectacles, is explained by the limitation of ocular gaze movements with the aphakia spectacles which limitation is not found with the use of contact lenses, with diplopia appearing in the more extreme lateroversion possible with the contact lenses. The 3D-VOG system enabled us to analyze torsional movements in lateroversion that allowed the diagnosis of bilateral superior oblique overaction to be made.- - - - - - - - - - ranking = 6keywords = aphakia (Clic here for more details about this article) |
10/33. The correction of unilateral aphakia in children treated for orbital rhabdomyosarcoma.The survival rate of children with localized orbital rhabdomyosarcoma is now greater than 90% 3 years after diagnosis as a result of advances in radiation and chemotherapy. Ninety percent of these children develop cataracts within 1 to 4 years after the completion of radiotherapy. The correction of aphakia in these children is complicated by the concurrent keratoconjunctivitis and dryness associated with radiotherapy. Three patients with a diagnosis of orbital rhabdomyosarcoma underwent treatment for uniocular cataract. Two of the patients were unable to use extended wear contact lenses. Both underwent epikeratophakia with poor results. One patient who had clinically significant ocular drying prior to cataract extraction underwent successful implantation of an intraocular lens as a primary procedure, with excellent visual results. Clinicians should be aware of the difficulties associated with contact lens wear and epikeratophakia tissue lenses in children who have had high doses of radiation for orbital rhabdomyosarcoma. Such patients are probably best served by primary intraocular lens implantation or by preservation of the posterior capsule at the time of cataract extraction to allow secondary lens implantation if contact lens wear is unsuccessful.- - - - - - - - - - ranking = 5keywords = aphakia (Clic here for more details about this article) |
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