Top

Graefe's Archive for Clinical and Experimental Ophthalmology

Published in:

01-12-2017 | Refractive Surgery

Comparison of outcomes of scleral fixation with and without pars plana vitrectomy for the treatment of dislocated intraocular lens

Authors: Seung Yong Choi, You Sook Hwang, Mirinae Kim, Soon Il Choi, Young-Hoon Park

Published in: Graefe's Archive for Clinical and Experimental Ophthalmology | Issue 12/2017

Abstract

Purpose

To investigate the surgical outcomes of scleral fixation with either pars plana vitrectomy (ppV) or anterior vitrectomy (AV) for the treatment of dislocated intraocular lens (IOL).

Methods

By retrospective review of electronic medical records, patients with in-the-bag spontaneous IOL dislocation who underwent IOL exchange with scleral fixation were included and grouped according to the vitrectomy method: ppV (group 1) and AV (group 2). Post-operative surgical outcomes including visual acuity (log MAR), spherical equivalent, and surgically induced astigmatism (SIA) and complications were investigated and analyzed.

Results

After 6 months, post-operative measurements showed an average visual acuity of 0.16 ± 0.20, spherical equivalent of −1.48 ± 1.53D (diopters), and refractive shift of −0.19 ± 0.44D in group 1 (n = 19). There was no statistically significant difference between the measurements of group 1 and group 2 (n = 20) (0.10 ± 0.12, −2.00 ± 1.71D, −0.39 ± 0.57D, respectively) (p = 0.51, p = 0.29, p = 0.16, respectively). When analyzed by the algebraic and vector methods, group 1 did show a higher magnitude of surgically induced astigmatisms (1.61 ± 1.50D, 2.10 ± 1.03D, respectively) than did group 2 (0.49 ± 1.02D, 1.31 ± 0.83D respectively) (both p’s = 0.01). There was no significant difference in the incidence of complications except for vitreoretinal complications, which were higher in group 2 (25%), compared with group 1 (0%) (p = 0.047).

Conclusions

Both ppV and AV are appropriate options in patients who need IOL exchange with scleral fixation based on visual outcomes, refractive shifts, and complication rates. In terms of managing astigmatism, the AV procedure may be the better option.

Gimbel HV, Condon GP, Kohnen T, Olson RJ, Halkiadakis I (2005) Late in-the-bag intraocular lens dislocation: incidence, prevention, and management. J Cataract Refract Surg 31:2193–2204. https://doi.org/10.1016/j.jcrs.2005.06.053 CrossRefPubMed

Gross JG, Kokame GT, Weinberg DV (2004) In-the-bag intraocular lens dislocation. Am J Ophthalmol 137:630–635. https://doi.org/10.1016/j.ajo.2003.10.037 PubMed

Pueringer SL, Hodge DO, Erie JC (2011) Risk of late intraocular lens dislocation after cataract surgery, 1980-2009: a population-based study. Am J Ophthalmol 152:618–623. https://doi.org/10.1016/j.ajo.2011.03.009 CrossRefPubMedPubMedCentral

Davis D, Brubaker J, Espandar L, Stringham J, Crandall A, Werner L, Mamalis N (2009) Late in-the-bag spontaneous intraocular lens dislocation: evaluation of 86 consecutive cases. Ophthalmology 116:664–670. https://doi.org/10.1016/j.ophtha.2008.11.018 CrossRefPubMed

Fernandez-Buenaga R, Alio JL, Perez-Ardoy AL, Larrosa-Quesada A, Pinilla-Cortes L, Barraquer R, Alio JL 2nd, Munoz-Negrete FJ (2013) Late in-the-bag intraocular lens dislocation requiring explantation: risk factors and outcomes. Eye (Lond) 27:795–801; quiz 802. https://doi.org/10.1038/eye.2013.95 CrossRef

Johnston RL, Charteris DG, Horgan SE, Cooling RJ (2000) Combined pars plana vitrectomy and sutured posterior chamber implant. Arch Ophthalmol 118:905–910PubMed

Nabors G, Varley MP, Charles S (1990) Ciliary sulcus suturing of a posterior chamber intraocular lens. Ophthalmic Surg 21:263–265PubMed

Tsunoda K, Migita M, Nakashizuka T, Kohzuka T (1996) Treatment of anterior vitreous before suturing and intraocular lens to the ciliary sulcus. J Cataract Refract Surg 22:222–226CrossRefPubMed

Hannush SB (2000) Sutured posterior chamber intraocular lenses: indications and procedure. Curr Opin Ophthalmol 11:233–240CrossRefPubMed

10.

Vote BJ, Tranos P, Bunce C, Charteris DG, Da Cruz L (2006) Long-term outcome of combined pars plana vitrectomy and scleral fixated sutured posterior chamber intraocular lens implantation. Am J Ophthalmol 141:308–312. https://doi.org/10.1016/j.ajo.2005.09.012 CrossRefPubMed

11.

Bading G, Hillenkamp J, Sachs HG, Gabel VP, Framme C (2007) Long-term safety and functional outcome of combined pars plana vitrectomy and scleral-fixated sutured posterior chamber lens implantation. Am J Ophthalmol 144:371–377. https://doi.org/10.1016/j.ajo.2007.05.014 CrossRefPubMed

12.

Kim SS, Smiddy WE, Feuer W, Shi W (2008) Management of dislocated intraocular lenses. Ophthalmology 115:1699–1704. https://doi.org/10.1016/j.ophtha.2008.04.016 CrossRefPubMed

13.

Kim SW, Kim MJ, Yang KS, Sohn JH, Huh K (2009) Risk factors for pseudophakic retinal detachment after intraocular lens scleral fixation with or without pars plana vitrectomy. Retina 29:1479–1485. https://doi.org/10.1097/IAE.0b013e3181aade61 CrossRefPubMed

14.

Cho BJ, Yu HG (2014) Surgical outcomes according to vitreous management after scleral fixation of posterior chamber intraocular lenses. Retina 34:1977–1984. https://doi.org/10.1097/iae.0000000000000168 CrossRefPubMed

15.

Olsen T, Dam-Johansen M (1994) Evaluating surgically induced astigmatism. J Cataract Refract Surg 20:517–522CrossRefPubMed

16.

Alpins NA (1993) A new method of analyzing vectors for changes in astigmatism. J Cataract Refract Surg 19:524–533CrossRefPubMed

17.

Alpins N (2001) Astigmatism analysis by the Alpins method. J Cataract Refract Surg 27:31–49CrossRefPubMed

18.

Holladay JT, Dudeja DR, Koch DD (1998) Evaluating and reporting astigmatism for individual and aggregate data. J Cataract Refract Surg 24:57–65CrossRefPubMed

19.

Hayashi K, Hayashi H, Nakao F, Hayashi F (1999) Intraocular lens tilt and decentration, anterior chamber depth, and refractive error after trans-scleral suture fixation surgery. Ophthalmology 106:878–882. https://doi.org/10.1016/s0161-6420(99)00504-7 CrossRefPubMed

20.

Jeoung JW, Chung H, Yu HG (2007) Factors influencing refractive outcomes after combined phacoemulsification and pars plana vitrectomy: results of a prospective study. J Cataract Refract Surg 33:108–114. https://doi.org/10.1016/j.jcrs.2006.09.017 CrossRefPubMed

21.

Asatryan SV, Surguch VK, Kharlap SI, Shchegoleva TA (2016) Biometric parameters of vitrectomized eyes. Vestn oftalmol 132:49–53CrossRefPubMed

22.

Ma DJ, Choi HJ, Kim MK, Wee WR (2011) Clinical comparison of ciliary sulcus and pars plana locations for posterior chamber intraocular lens transscleral fixation. J Cataract Refract Surg 37:1439–1446. https://doi.org/10.1016/j.jcrs.2011.02.032 CrossRefPubMed

23.

Naeser K (2001) Popperian falsification of methods of assessing surgically induced astigmatism. J Cataract Refract Surg 27:25–30CrossRefPubMed

24.

Wirbelauer C, Hoerauf H, Roider J, Laqua H (1998) Corneal shape changes after pars plana vitrectomy. Graefes Arch Clin Exp Ophthalmol 236:822–828CrossRefPubMed

25.

Weinberger D, Lichter H, Loya N, Axer-Siegel R, Muzmacher L, Gabbay U, Yassur Y (1999) Corneal topographic changes after retinal and vitreous surgery. Ophthalmology 106:1521–1524. https://doi.org/10.1016/s0161-6420(99)90447-5 CrossRefPubMed

26.

Yuen CY, Cheung BT, Tsang CW, Lam RF, Baig NB, Lam DS (2009) Surgically induced astigmatism in phacoemulsification, pars plana vitrectomy, and combined phacoemulsification and vitrectomy: a comparative study. Eye (Lond) 23:576–580. https://doi.org/10.1038/eye.2008.57 CrossRef

27.

Johnston RL, Charteris DG (2001) Pars plana vitrectomy and sutured posterior chamber lens implantation. Curr Opin Ophthalmol 12:216–221CrossRefPubMed

28.

Oh SY, Lee SJ, Park JM (2015) Comparision of surgical outcomes of intraocular lens refixation and intraocular lens exchange with perfluorocarbon liquid and fibrin glue-assisted sutureless scleral fixation. Eye (Lond) 29:757–763. https://doi.org/10.1038/eye.2015.22 CrossRef

Title: Comparison of outcomes of scleral fixation with and without pars plana vitrectomy for the treatment of dislocated intraocular lens
Authors: Seung Yong Choi
You Sook Hwang
Mirinae Kim
Soon Il Choi
Young-Hoon Park
Publication date: 01-12-2017
Publisher: Springer Berlin Heidelberg
Published in: Graefe's Archive for Clinical and Experimental Ophthalmology / Issue 12/2017
Print ISSN: 0721-832X
Electronic ISSN: 1435-702X
DOI: https://doi.org/10.1007/s00417-017-3802-y

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Comparison of outcomes of scleral fixation with and without pars plana vitrectomy for the treatment of dislocated intraocular lens

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 12/2017

Corneal features in ocular graft-versus-host disease by in vivo confocal microscopy

Impact of corneal donor lens status on two-year course and outcome of Descemet membrane endothelial keratoplasty (DMEK)

Signal reduction in choriocapillaris and segmentation errors in spectral domain OCT angiography caused by soft drusen

Ocular anatomic changes for different accommodative demands using swept-source optical coherence tomography: a pilot study

The relation of somatotypes and stress response to central serous chorioretinopathy

Functional and morphological outcome in patients with chronic central serous chorioretinopathy treated by subthreshold micropulse laser