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Published in: Graefe's Archive for Clinical and Experimental Ophthalmology 9/2012

01-09-2012 | Cataract

Outcome of iris fixation of subluxated intraocular lenses

Authors: Adi Michaeli, Uri Soiberman, Anat Loewenstein

Published in: Graefe's Archive for Clinical and Experimental Ophthalmology | Issue 9/2012

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Abstract

Background

The aim of this study was to evaluate the efficacy of iris fixation of subluxated intraocular lenses (IOLs).

Methods

A retrospective study of 44 consecutive cases of subluxated IOLs that underwent iris fixation of the IOL. Demographic information, data regarding surgery, and follow-up were retrieved from patient files. All eyes were operated on in a similar fashion by the same anterior segment surgeon (A.M.) utilizing the McCannel suture technique and/or the Siepser slipknot technique. The main outcome measures were visual acuity improvement, surgically induced astigmatism, and assessment of complications.

Results

Ten eyes had a documented complication during primary cataract extraction. Pseudoexfoliation was present in 11 eyes (25 %). History of ocular trauma and high myopia were present in six eyes (each). Excluding eyes with macular disease and very low visual acuity, visual acuity improved from 0.4 (± 0.05) logMAR to 0.24 (± 0.05) logMAR (p = 0.047). Eyes with low pre-operative astigmatism did not worsen post-operatively (R square linear = 0.8, p < 0.01). Pupil ovalization was a major aesthetic complication (21 of 44 eyes). Major hemorrhagic complications were uncommon. One patient developed intermediate uveitis 1 year after IOL fixation.

Conclusions

In this study of 44 eyes, iris fixation was proven to be a an effective method for treating subluxated IOLs.
Literature
1.
go back to reference Mönestam EI (2009) Incidence of dislocation of intraocular lenses and pseudophakodonesis 10 years after cataract surgery. Ophthalmology 116:2315–2320CrossRef Mönestam EI (2009) Incidence of dislocation of intraocular lenses and pseudophakodonesis 10 years after cataract surgery. Ophthalmology 116:2315–2320CrossRef
2.
go back to reference Lorente R, de Rojas V, Vazquez de Parga P, Moreno C, Landaluce ML, Dominguez R, Lorente B (2010) Management of late spontaneous in-the-bag intraocular lens dislocation: retrospective analysis of 45 cases. J Cataract Refract Surg 36:1270–1282PubMedCrossRef Lorente R, de Rojas V, Vazquez de Parga P, Moreno C, Landaluce ML, Dominguez R, Lorente B (2010) Management of late spontaneous in-the-bag intraocular lens dislocation: retrospective analysis of 45 cases. J Cataract Refract Surg 36:1270–1282PubMedCrossRef
3.
go back to reference McCannel MA (1976) A retrievable suture idea for anterior uveal problems. Ophthalmic Surg 7:98–103PubMed McCannel MA (1976) A retrievable suture idea for anterior uveal problems. Ophthalmic Surg 7:98–103PubMed
4.
go back to reference Holladay JT (1997) Proper method for calculating average visual acuity. J Refract Surg 13:388–391PubMed Holladay JT (1997) Proper method for calculating average visual acuity. J Refract Surg 13:388–391PubMed
5.
go back to reference Schulze-Bonsel K, Feltgen N, Burau H, Hansen L, Bach M (2006) Visual acuities “hand motion” and “counting fingers” can be quantified with the Freiburg Visual Acuity Test. Invest Ophthalmol Vis Sci 47:1236–1240PubMedCrossRef Schulze-Bonsel K, Feltgen N, Burau H, Hansen L, Bach M (2006) Visual acuities “hand motion” and “counting fingers” can be quantified with the Freiburg Visual Acuity Test. Invest Ophthalmol Vis Sci 47:1236–1240PubMedCrossRef
6.
go back to reference Stark WJ, Michels RG, Bruner WE (1980) Management of posteriorly dislocated intraocular lenses. Ophthalmic Surg 11:495–497PubMed Stark WJ, Michels RG, Bruner WE (1980) Management of posteriorly dislocated intraocular lenses. Ophthalmic Surg 11:495–497PubMed
7.
go back to reference Chang DF (2004) Siepser slipknot for McCannel iris suture fixation of subluxated intraocular lenses. J Cataract Refract Surg 30:1170–1176PubMedCrossRef Chang DF (2004) Siepser slipknot for McCannel iris suture fixation of subluxated intraocular lenses. J Cataract Refract Surg 30:1170–1176PubMedCrossRef
8.
go back to reference Siepser SB (1994) The closed chamber slipping suture technique for iris repair. Ann Ophthalmol 26:71–72PubMed Siepser SB (1994) The closed chamber slipping suture technique for iris repair. Ann Ophthalmol 26:71–72PubMed
9.
go back to reference Osher RH, Snyder ME, Cionni RJ (2005) Modification of the Siepser slip-knot technique. J Cataract Refract Surg 31:1098–1100PubMedCrossRef Osher RH, Snyder ME, Cionni RJ (2005) Modification of the Siepser slip-knot technique. J Cataract Refract Surg 31:1098–1100PubMedCrossRef
10.
go back to reference Condon GP, Masket S, Kranermann C, Crandall AS, Ahmed II (2007) Small-incision iris fixation of foldable intraocular lenses in the absence of capsule support. Ophthalmology 114:1311–1318PubMedCrossRef Condon GP, Masket S, Kranermann C, Crandall AS, Ahmed II (2007) Small-incision iris fixation of foldable intraocular lenses in the absence of capsule support. Ophthalmology 114:1311–1318PubMedCrossRef
11.
go back to reference Chan CC, Crandall AS, Ahmed II (2006) Ab externo scleral suture loop fixation for posterior chamber intraocular lens decentration: clinical results. J Cataract Refract Surg 32:121–128PubMedCrossRef Chan CC, Crandall AS, Ahmed II (2006) Ab externo scleral suture loop fixation for posterior chamber intraocular lens decentration: clinical results. J Cataract Refract Surg 32:121–128PubMedCrossRef
12.
go back to reference Jakobsson G, Zetterberg M, Lundström M, Stenevi U, Grenmark R, Sundelin K (2010) Late dislocation of in-the-bag and out-of-the bag intraocular lenses: ocular and surgical characteristics and time to lens repositioning. J Cataract Refract Surg 36:1637–1644PubMedCrossRef Jakobsson G, Zetterberg M, Lundström M, Stenevi U, Grenmark R, Sundelin K (2010) Late dislocation of in-the-bag and out-of-the bag intraocular lenses: ocular and surgical characteristics and time to lens repositioning. J Cataract Refract Surg 36:1637–1644PubMedCrossRef
13.
go back to reference Assia EI, Nemet A, Sachs D (2002) Bilateral spontaneous subluxation of scleral-fixated intraocular lenses. Cataract Refract Surg 28:2214–2216CrossRef Assia EI, Nemet A, Sachs D (2002) Bilateral spontaneous subluxation of scleral-fixated intraocular lenses. Cataract Refract Surg 28:2214–2216CrossRef
Metadata
Title
Outcome of iris fixation of subluxated intraocular lenses
Authors
Adi Michaeli
Uri Soiberman
Anat Loewenstein
Publication date
01-09-2012
Publisher
Springer-Verlag
Published in
Graefe's Archive for Clinical and Experimental Ophthalmology / Issue 9/2012
Print ISSN: 0721-832X
Electronic ISSN: 1435-702X
DOI
https://doi.org/10.1007/s00417-012-2057-x

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