Retropupillary Iris-Claw Intraocular Lens Implantation: A Refractive and Safety Report
Autor(a) principal: | |
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Data de Publicação: | 2023 |
Outros Autores: | , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | https://doi.org/10.48560/rspo.28782 |
Resumo: | INTRODUCTION: Iris-claw intraocular lenses are one of the surgical alternatives to treat patients without capsular and zonular support after complicated cataract surgery, trauma, or diseases that disrupt the normal anatomy of the eye’s posterior chamber. Retropupillary fixation, through the enclavation of the lens to the posterior iris, constitutes a modification of the original technique, and is associated with fewer long-term complications, particularly regarding the loss of corneal endothelial cells. The purpose of this study was to evaluate the visual and refractive results and to report the associated complications of patients who underwent retropupillary implantation of the Artisan Aphakia IOL® (Ophtec). METHODS: A retrospective, observational, single-center study of consecutive eyes, including 26 patients who underwent surgery in Hospital Pedro Hispano, between 2012 and 2021. The outcome measures consisted of postoperative best-corrected visual acuity, spherical equivalent, intraocular pressure, and complications. RESULTS: The most common indication for surgery was previous complicated cataract surgery (50%), followed by trauma (26.9%) and spontaneous intraocular lens luxation (11.5%). The mean best-corrected visual acuity was 0.52 ± 0.62 logMAR and the mean spherical equivalent was 0.075 ± 1.46 diopters. Postoperative ocular hypertension occurred in 7.7% of the patients. The most common complication was the luxation of one of the haptics of the lens, which happened to 19.2%of patients. Cystoid macular edema was present in 11.5% of the patients. CONCLUSION: Retropupillary iris-claw intraocular lens implantation is a valid alternative for treating aphakia in the absence of capsular support. It is a safe technique, with decent functional outcomes. Most long-term complications are related to the status of the eye before surgery, as it is often performed in complex patients, with important comorbidities, and that should be con- sidered regarding the expected final outcome. Alternatives such as scleral fixation of intraocularlenses may provide a more predictable refractive outcome but are technically harder and depend on the surgeon’s experience. The surgical technique should be individualized according to the characteristics of the patient, and the preference and experience of the surgeon. |
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Retropupillary Iris-Claw Intraocular Lens Implantation: A Refractive and Safety ReportImplantação de Lentes Iris-Claw Retropupilares: Resultados Refractivos e de SegurançaArtigos OriginaisINTRODUCTION: Iris-claw intraocular lenses are one of the surgical alternatives to treat patients without capsular and zonular support after complicated cataract surgery, trauma, or diseases that disrupt the normal anatomy of the eye’s posterior chamber. Retropupillary fixation, through the enclavation of the lens to the posterior iris, constitutes a modification of the original technique, and is associated with fewer long-term complications, particularly regarding the loss of corneal endothelial cells. The purpose of this study was to evaluate the visual and refractive results and to report the associated complications of patients who underwent retropupillary implantation of the Artisan Aphakia IOL® (Ophtec). METHODS: A retrospective, observational, single-center study of consecutive eyes, including 26 patients who underwent surgery in Hospital Pedro Hispano, between 2012 and 2021. The outcome measures consisted of postoperative best-corrected visual acuity, spherical equivalent, intraocular pressure, and complications. RESULTS: The most common indication for surgery was previous complicated cataract surgery (50%), followed by trauma (26.9%) and spontaneous intraocular lens luxation (11.5%). The mean best-corrected visual acuity was 0.52 ± 0.62 logMAR and the mean spherical equivalent was 0.075 ± 1.46 diopters. Postoperative ocular hypertension occurred in 7.7% of the patients. The most common complication was the luxation of one of the haptics of the lens, which happened to 19.2%of patients. Cystoid macular edema was present in 11.5% of the patients. CONCLUSION: Retropupillary iris-claw intraocular lens implantation is a valid alternative for treating aphakia in the absence of capsular support. It is a safe technique, with decent functional outcomes. Most long-term complications are related to the status of the eye before surgery, as it is often performed in complex patients, with important comorbidities, and that should be con- sidered regarding the expected final outcome. Alternatives such as scleral fixation of intraocularlenses may provide a more predictable refractive outcome but are technically harder and depend on the surgeon’s experience. The surgical technique should be individualized according to the characteristics of the patient, and the preference and experience of the surgeon.INTRODUÇÃO: O implante de lentes intra-oculares de fixação à íris é uma das alternativas cirúrgicas para tratar doentes sem suporte capsular e zonular após cirurgia de catarata complicada, trauma, ou doenças que alteram a normal anatomia da câmara posterior do olho. A fixação retropupilar, através do enclavamento da lente à face posterior da íris, constitui uma modificação da técnica original, associada a menor taxa de complicações a longo prazo, sobretudo em relação à perda de células do endotélio corneano. O objectivo deste trabalho foi avaliar os resultados visuais e refractivos, e descrever as complicações associadas com a fixação retropupilar das lentes Artisan de Afaquia® (Ophtec). MÉTODOS: Foi feita uma análise retrospectiva, observacional, de olhos consecutivos, que incluiu 26 doentes submetidos à cirurgia no Hospital Pedro Hispano, entre 2012 e 2021. Foram analisadas a melhor acuidade visual corrigida, equivalente esférico, pressão intraocular e complicações pós-operatórias. RESULTADOS: A indicação cirúrgica mais comum foi a cirurgia de catarata complicada prévia (50%), seguida de trauma (26,9%) e de luxação espontânea da lente intraocular (11,5%). A melhor acuidade visual corrigida média foi de 0,52 ± 0,62 logMAR e o equivalente esférico médio foi de 0,075 ± 1,46 dioptrias. Dos doentes, 7,7% tiveram hipertensão ocular no período pós-operatório. A complicação pós-operatória mais frequente foi a luxação de um dos hápticos da lente, que ocorreu em 19,2% dos doentes, seguida do desenvolvimento de edema macular cistóide, em 11,5% dos casos. CONCLUSÃO: O implante de lentes com fixação à íris em posição retropupilar é uma alternativa válida para tratar a afaquia, na ausência de suporte capsular. Trata-se de uma técnica segura, com resultados funcionais satisfatórios. A maioria das complicações a longo prazo estão relacionadas com o estado funcional do olho antes da cirurgia, uma vez que esta é frequentemente realizada em doentes complexos e com comorbilidades importantes, factores que devem ser considerados para o resultado final. Alternativas como a fixação escleral de lentes intraoculares podem proporcionar um resultado refractivo mais previsível, mas são tecnicamente mais difíceis e dependem da experiência do cirurgião. A escolha da técnica cirúrgica deve ser individualizada de acordo com as características do doente e com a preferência e experiência do cirurgião.Ajnet2023-06-29info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articlehttps://doi.org/10.48560/rspo.28782eng1646-69501646-6950Correia Barbosa, RenatoCarvalho, RuiMota, ÁgataBasto, RitaViana, Ana RitaSilva, AlexandreTenedório, Paulainfo:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2023-06-29T20:30:15Zoai:ojs.revistas.rcaap.pt:article/28782Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T18:01:44.129632Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
Retropupillary Iris-Claw Intraocular Lens Implantation: A Refractive and Safety Report Implantação de Lentes Iris-Claw Retropupilares: Resultados Refractivos e de Segurança |
title |
Retropupillary Iris-Claw Intraocular Lens Implantation: A Refractive and Safety Report |
spellingShingle |
Retropupillary Iris-Claw Intraocular Lens Implantation: A Refractive and Safety Report Correia Barbosa, Renato Artigos Originais |
title_short |
Retropupillary Iris-Claw Intraocular Lens Implantation: A Refractive and Safety Report |
title_full |
Retropupillary Iris-Claw Intraocular Lens Implantation: A Refractive and Safety Report |
title_fullStr |
Retropupillary Iris-Claw Intraocular Lens Implantation: A Refractive and Safety Report |
title_full_unstemmed |
Retropupillary Iris-Claw Intraocular Lens Implantation: A Refractive and Safety Report |
title_sort |
Retropupillary Iris-Claw Intraocular Lens Implantation: A Refractive and Safety Report |
author |
Correia Barbosa, Renato |
author_facet |
Correia Barbosa, Renato Carvalho, Rui Mota, Ágata Basto, Rita Viana, Ana Rita Silva, Alexandre Tenedório, Paula |
author_role |
author |
author2 |
Carvalho, Rui Mota, Ágata Basto, Rita Viana, Ana Rita Silva, Alexandre Tenedório, Paula |
author2_role |
author author author author author author |
dc.contributor.author.fl_str_mv |
Correia Barbosa, Renato Carvalho, Rui Mota, Ágata Basto, Rita Viana, Ana Rita Silva, Alexandre Tenedório, Paula |
dc.subject.por.fl_str_mv |
Artigos Originais |
topic |
Artigos Originais |
description |
INTRODUCTION: Iris-claw intraocular lenses are one of the surgical alternatives to treat patients without capsular and zonular support after complicated cataract surgery, trauma, or diseases that disrupt the normal anatomy of the eye’s posterior chamber. Retropupillary fixation, through the enclavation of the lens to the posterior iris, constitutes a modification of the original technique, and is associated with fewer long-term complications, particularly regarding the loss of corneal endothelial cells. The purpose of this study was to evaluate the visual and refractive results and to report the associated complications of patients who underwent retropupillary implantation of the Artisan Aphakia IOL® (Ophtec). METHODS: A retrospective, observational, single-center study of consecutive eyes, including 26 patients who underwent surgery in Hospital Pedro Hispano, between 2012 and 2021. The outcome measures consisted of postoperative best-corrected visual acuity, spherical equivalent, intraocular pressure, and complications. RESULTS: The most common indication for surgery was previous complicated cataract surgery (50%), followed by trauma (26.9%) and spontaneous intraocular lens luxation (11.5%). The mean best-corrected visual acuity was 0.52 ± 0.62 logMAR and the mean spherical equivalent was 0.075 ± 1.46 diopters. Postoperative ocular hypertension occurred in 7.7% of the patients. The most common complication was the luxation of one of the haptics of the lens, which happened to 19.2%of patients. Cystoid macular edema was present in 11.5% of the patients. CONCLUSION: Retropupillary iris-claw intraocular lens implantation is a valid alternative for treating aphakia in the absence of capsular support. It is a safe technique, with decent functional outcomes. Most long-term complications are related to the status of the eye before surgery, as it is often performed in complex patients, with important comorbidities, and that should be con- sidered regarding the expected final outcome. Alternatives such as scleral fixation of intraocularlenses may provide a more predictable refractive outcome but are technically harder and depend on the surgeon’s experience. The surgical technique should be individualized according to the characteristics of the patient, and the preference and experience of the surgeon. |
publishDate |
2023 |
dc.date.none.fl_str_mv |
2023-06-29 |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
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article |
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publishedVersion |
dc.identifier.uri.fl_str_mv |
https://doi.org/10.48560/rspo.28782 |
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https://doi.org/10.48560/rspo.28782 |
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eng |
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eng |
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1646-6950 1646-6950 |
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openAccess |
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Ajnet |
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