9 research outputs found
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Outcomes of implantation of modified capsule tension rings with multiple black occluder paddles for eyes with congenital and acquired iris defects: Report 3.
PurposeTo evaluate the safety and efficacy of Morcher 50F iris diaphragm implantation to manage moderate to large defects of the human iris.SettingStein Eye Institute, UCLA, Los Angeles, California, USA.DesignProspective nonrandomized interventional case series.MethodsThe demographic, preoperative, and postoperative data of patients who had implantation of modified capsular tension rings and followed to 1 year were reviewed. Safety measures included loss of corrected distance visual acuity (CDVA), surgical complications, adverse events, and secondary surgical interventions. Efficacy measures included CDVA with glare, daytime and nighttime glare symptom scores, and subjective cosmesis scores.ResultsThe study comprised 12 patients. The median CDVA was 20/70 before surgery and 20/20 after surgery. There were no lost lines of CDVA and no intraoperative complications. The most common postoperative complication was posterior capsule opacification. Two adverse events were unrelated to the device. Four patients had secondary surgical interventions, the most common of which was laser capsulotomy. The median CDVA with glare improved from less than 20/400 before surgery to 20/50 after surgery. One patient worsened. The median subjective daytime glare symptom score improved from 9 to 3 on a 10-point scale (P = .001). The median nighttime subjective glare symptom score improved from 8 to 2 (P = .001). The subjective cosmetic appearance of the eye stayed the same or improved for all patients (P = .031).ConclusionIris diaphragm implantation was relatively safe and effective for reducing light and glare sensitivity in eyes with iris defects when combined with cataract extraction and intraocular lens implantation.Financial disclosureNone of the authors has a financial or proprietary interest in any material or method mentioned
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Outcomes of implantation of modified capsule tension rings with multiple black occluder paddles for eyes with congenital and acquired iris defects: Report 3.
PurposeTo evaluate the safety and efficacy of Morcher 50F iris diaphragm implantation to manage moderate to large defects of the human iris.SettingStein Eye Institute, UCLA, Los Angeles, California, USA.DesignProspective nonrandomized interventional case series.MethodsThe demographic, preoperative, and postoperative data of patients who had implantation of modified capsular tension rings and followed to 1 year were reviewed. Safety measures included loss of corrected distance visual acuity (CDVA), surgical complications, adverse events, and secondary surgical interventions. Efficacy measures included CDVA with glare, daytime and nighttime glare symptom scores, and subjective cosmesis scores.ResultsThe study comprised 12 patients. The median CDVA was 20/70 before surgery and 20/20 after surgery. There were no lost lines of CDVA and no intraoperative complications. The most common postoperative complication was posterior capsule opacification. Two adverse events were unrelated to the device. Four patients had secondary surgical interventions, the most common of which was laser capsulotomy. The median CDVA with glare improved from less than 20/400 before surgery to 20/50 after surgery. One patient worsened. The median subjective daytime glare symptom score improved from 9 to 3 on a 10-point scale (P = .001). The median nighttime subjective glare symptom score improved from 8 to 2 (P = .001). The subjective cosmetic appearance of the eye stayed the same or improved for all patients (P = .031).ConclusionIris diaphragm implantation was relatively safe and effective for reducing light and glare sensitivity in eyes with iris defects when combined with cataract extraction and intraocular lens implantation.Financial disclosureNone of the authors has a financial or proprietary interest in any material or method mentioned
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Outcomes of a modified capsular tension ring with a single black occluder paddle for eyes with congenital and acquired iris defects: Report 2.
PurposeTo evaluate the safety and efficacy of Morcher 96F iris diaphragm implantation to manage small defects of the human iris.SettingJules Stein Eye Institute, UCLA, Los Angeles, California, USA.DesignProspective nonrandomized interventional case series.MethodsDemographic, preoperative, and postoperative data of patients who had implantation of the modified capsular tension ring (CTR) and followed to 1 year were reviewed. Safety measures included loss of corrected distance visual acuity (CDVA), perioperative complications, adverse events, and secondary surgical interventions. Efficacy measures included CDVA with glare, daytime and nighttime glare symptom scores, and subjective cosmesis scores.ResultsSixteen patients had CTR implantation. There was a statistically significant improvement in the median CDVA of 2.5 Snellen lines (P < .01), with 4 patients having minor decreases in CDVA for reasons unrelated to the device. There were no intraoperative complications. Three adverse events were reported: 1 ocular hypertension, 1 postoperative retinal detachment, and 1 25-degree rotation of the CTR. There were 4 secondary surgical interventions. There was a statistically significant improvement in the median CDVA with glare of 8 Snellen lines (P < .01), but 2 patients had a decrease in CDVA with glare for reasons unrelated to the device. There were statistically significant improvements in the median daytime and nighttime glare symptom scores of 5 points and 4 points, respectively (both P < .01). There was no change in cosmesis for most patients.ConclusionIris diaphragm CTR implantation was relatively safe and effective at reducing light and glare sensitivity in eyes with small iris defects.Financial disclosureNo author has a financial or proprietary interest in any material or method mentioned
Complications of sulcus placement of single-piece acrylic intraocular lenses Recommendations for backup IOL implantation following posterior capsule rupture SPECIAL REPORT
for the ASCRS Cataract Clinical Committee PURPOSE: To describe complications arising from sulcus placement of single-piece acrylic (SPA) intraocular lenses (IOLs), evaluate IOL options for eyes that lack adequate capsule support, and examine the appropriateness of various IOL designs for sulcus placement. SETTING: University and private anterior segment surgery practices. METHODS: RESULTS: Complications of sulcus SPA IOLs included pigment dispersion, iris transillumination defects, dysphotopsia, elevated intraocular pressure, intraocular hemorrhage, and cystoid macular edema. Two patients in the series of 30 patients experienced 1 complication; 8 experienced 2 complications; 13 experienced 3 complications; 4 experienced 4 complications; and 2 experienced 5 complications. Twenty-eight eyes (93%) required surgical intervention; IOL exchange was performed in 25 (83%). Postoperatively, the mean CDVA improved, with most eyes attaining 20/20. CONCLUSIONS: Intraocular lenses designed solely for the capsular bag should not be placed in the ciliary sulcus. Backup IOLs in appropriate powers, sizes, and designs should be available for every cataract procedure. The development, investigation, and supply of IOLs specifically designed for placement in eyes that lack adequate capsule support represent clinically important endeavors for ophthalmology and the ophthalmic industry. J Cataract Refract Surg 2009; 35:1445-1458 Q 2009 ASCRS and ESCRS Single-piece acrylic (SPA) intraocular lenses (IOLs) currently account for approximately one half of the IOLs implanted concurrent with cataract surgery in the United States (Alcon, Inc.; data on file). Given the large annual volume of cataract surgery performed worldwide, a significant number of SPA IOLs may be inadvertently or intentionally placed in the ciliary sulcus; eg, following posterior capsule rupture. This raises the question of whether this strategy is appropriate and the larger issues of which IOL designs are suitable as backup IOLs in the absence of secure capsular bag support. The growing popularity of accommodating, multifocal, toric, and aspheric monofocal IOLs raises additional concerns about whether these IOLs are appropriate for placement in the ciliary sulcus. Finally, the debate continues over whether an anterior chamber IOL (AC IOL) or a sutured posterior chamber IOL (PC IOL) is the best long-term option in the absence of adequate capsule support. To help answer these questions, members of the American Society of Cataract and Refractive Surgery (ASCRS) Cataract Clinical Committee conducted a retrospective survey of patients referred for complications associated with SPA IOLs implanted in the ciliary sulcus. We also reviewed the literature with respect to recommendations for backup IOL design and placement