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.
[Show abstract][Hide abstract] ABSTRACT: A 27-year-old woman had implantation of an angle-supported phakic intraocular lens (pIOL) for myopia in the left eye in 2003. Moderate iris atrophy and pupil ovalization were noted in 2005. In 2006, the eye was hit by a plastic bullet shot from a toy gun. The pupil became distorted as the inferior haptic engaged the pupil edge. Visual acuity was not affected. Surgical repositioning was uneventful, yielding a round pupil with no damage to the iris sphincter or the lens. The endothelium was not affected by the trauma or surgery. Previous iris atrophy may have facilitated pupillary capture because of reduced iris elasticity and pupil ovalization by the haptic. Blunt trauma can dislocate angle-supported pIOLs. Implantation of these IOLs should be discouraged in patients who perform activities that put them at risk for eye trauma.
Journal of Cataract and Refractive Surgery 01/2007; 32(12):2133-4. DOI:10.1016/j.jcrs.2006.05.037 · 2.72 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: At a time when some of the limitations of photoablation have been defined, such as worry concerning secondary ectasia, a renewed interest in phakic implantation has arisen. This is driven by the goal of avoiding correcting high ametropia with LASIK and is based on the development of soft foldable biomaterials. When all phakic IOLs are in front of the natural lens, two varieties of lenses can be distinguished, depending on whether it is located in the anterior or posterior chamber. The various models available in 2006 and those under current evaluation are reviewed. We do not report details of clinical studies that vary in cohort size and follow-up. The advantages and limitations are discussed for each type of phakic IOL. Adequate although not exclusive indications are deduced. There is no phakic lens that has proved to be superior to the others in terms of safety. All have the ability to provide a visual benefit with a gain in best corrected visual acuity. The difference is based on anatomical effects, requiring long-term follow-up in the evaluation of angles, lens, iris, and endothelium.
[Show abstract][Hide abstract] ABSTRACT: To document severe visual symptoms due to the dislocation of an iris-fixated aphakic anterior chamber lens using wavefront aberrometry.
A patient complaining of severe visual blur and distortion due to a decentered Artisan iris-fixated anterior chamber lens was evaluated pre- and postoperatively after recentration. The patient underwent complete ophthalmic evaluation including the measurement of corneal topography and wavefront aberrations using the NIDEK OPD-Scan. OPD Station software was used to correlate and simulate the patient's symptoms.
After the repositioning procedure, the visual symptoms resolved, and high magnitudes of tilt (7.536 microm) and high order aberrations (5.129 microm) were dramatically reduced by simple lens repositioning (4.40-mm pupil). The cylinder magnitude was reduced from 6.25 to 0.75 diopters.
These are the first diagnostic images of this kind in a highly aberrated eye with iris-fixated anterior chamber lens dislocation. The images documented the optical effect and visual consequences of IOL decentration and subsequent recentration.
Journal of refractive surgery (Thorofare, N.J.: 1995) 12/2007; 23(9 Suppl):S1005-10. · 3.47 Impact Factor
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