Retropupillary Iris-Claw Intraocular Lens Implantation: A Refractive and Safety Report

Detalhes bibliográficos
Autor(a) principal: Correia Barbosa, Renato
Data de Publicação: 2023
Outros Autores: Carvalho, Rui, Mota, Ágata, Basto, Rita, Viana, Ana Rita, Silva, Alexandre, Tenedório, Paula
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.
id RCAP_1685e44896fffd137491216874d2ac4e
oai_identifier_str oai:ojs.revistas.rcaap.pt:article/28782
network_acronym_str RCAP
network_name_str Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
repository_id_str 7160
spelling 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
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv https://doi.org/10.48560/rspo.28782
url https://doi.org/10.48560/rspo.28782
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv 1646-6950
1646-6950
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv Ajnet
publisher.none.fl_str_mv Ajnet
dc.source.none.fl_str_mv reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
instacron:RCAAP
instname_str Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
instacron_str RCAAP
institution RCAAP
reponame_str Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
collection Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
repository.name.fl_str_mv Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
repository.mail.fl_str_mv
_version_ 1799131684650614785