Traumatic dislocation and successful re-enclavation of an Artisan phakic IOL with analysis of the endothelium.
ABSTRACT To present a case of traumatic dislocation of an Ophtec Artisan phakic intraocular lens (PIOL) and an analysis of the endothelial cell count.
The patient presented with blurred vision in his left eye after sustaining a brow laceration. History included uncomplicated bilateral implantation of an Artisan PIOL to correct myopia.
The brow laceration was sutured and topical dexamethasone 0.1% qid was prescribed. One week after presentation, the PIOL was relocated. Postoperatively, endothelial cell count analysis was performed in both eyes.
A decrease in the hexagonality of the endothelial cells was noted in both eyes, which was substantially lower in the injured eye.
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ABSTRACT: Background To purpose of this study was to establish the prevalence of re-enclavation of iris-fixated phakic intraocular lens (pIOLs) in our centre, and evaluate outcomes following re-enclavation of dislocated/subluxed iris-fixated phakic intraocular lens (pIOLs). DesignRetrospective observational case series. Single surgeon,hospital setting. ParticipantsSix hundred and nine patients (1218 eyes) implanted with iris-fixated pIOLs between 2000-2011. Methods Eyes requiring re-enclavation were identified and outcome measures evaluated 12 months following re-enclavation. Main Outcome MeasuresRate of re-enclavation, uncorrected distance visual acuity (UCDVA), manifest refractive spherical equivalent (MRSE) measured 12 months following re-enclavation. ResultsTwenty-five eyes (2% of eyes overall) of 20 patients required re-enclavation of a dislocated or subluxed pIOL. Eight cases (32%) dislocated secondary to trauma and 17 (68%) subluxed spontaneously. No significant difference was detected (p=0.59) in UCDVA (logMAR equivalent) 12 months post re-enclavation (0.18 +/- 0.04) compared to that recorded 6 months post initial uneventful pIOL implantation (0.10 +/- 0.06). No significant difference was detected (p=0.95) in mean MRSE 12 months post re-enclavation (-0.59D +/- 0.29D) compared to that recorded 6 months post initial pIOL implantation (-0.57D +/- 0.17D). Following re-enclavation, mean endothelial cell count was 2627 +/- 101 cells/mm2 12 months postoperatively in 16 eyes. This did not differ significantly from that recorded 6 months post initial pIOL implantation in these eyes (p=1). Conclusion Dislocation and subluxation of iris-fixated pIOLs may occur secondary to trauma or spontaneously due to inadequate iris enclavation. Re-enclavation can be carried out successfully with no significant adverse effect on clinical outcomes. RClinical and Experimental Ophthalmology 03/2014; · 1.96 Impact Factor
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ABSTRACT: To evaluate the effect of intraoperative complications during iris-claw phakic intraocular lens (pIOL) implantation on endothelial cell survival. Retrospective cohort study. Fifty-two eyes of 26 patients with high myopia treated with the iris-claw pIOL. The patients were divided as group 1 (no intraoperative events) and 2 (intraoperative events) according to the intraoperative events such as intraoperative bleeding, postoperative intraocular pressure (IOP) rise, and late resolution of the chamber inflammation. Endothelial cell density was compared at 1, 2, 6, 12, and 24 months after the operation prospectively. Group 1 showed mean percentage of individual change of -0.04%±7.90% at 1 month, -0.01%±8.67% at 2 months, -0.02%±10.33% at 6 months, 0.05%±9.81% at 12 months, and 0.05%±5.33% at 24 months postoperatively. In group 2, mean percentage individual cell change was -0.17%±8.57% at 1 month, -0.13%±12.14% at 2 months, -0.13%±15.07% at 6 months, -0.17%±11.94% at 12 months, and -0.28%±13.54% at 24 months postoperatively. Two groups showed a significant differences in every visit. Even transient events, such as intraoperative bleeding, postoperative IOP rise, and late resolution of the chamber inflammation, would affect the survival of endothelial cells.Canadian Journal of Ophthalmology 08/2013; 48(4):259-64. · 1.15 Impact Factor
- Eye (London, England) 02/2010; 24(7):1292. · 1.97 Impact Factor