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Kapsül ve/veya Zonül Yetmezlikli Olguların Cerrahi Tedavisinde Tek Parça Katlanabilir Arka Kamara Göz İçi Lenslerin İrise Sütürlü Olarak Kullanılması

Year 2022, Volume: 12 Issue: 4, 737 - 746, 28.12.2022
https://doi.org/10.31832/smj.1163160

Abstract

Amaç: Kapsül yetmezliğinde, katlanabilir arka kamara (AK) göz içi lenslerin irise sütürlü (İSGİL) implantasyonunun avantajları, dezavantajları, cerrahi tekniği ve postoperatif komplikasyonlar araştırıldı.
Gereç ve Yöntemler: Kapsül ve zonül yetmezliği nedeni ile kapsül içi GİL implantasyonu yapılamayan, bu nedenle katlanabilir AK GİL’i irise sütüre ederek implante ettiğimiz 30 hastanın 30 gözü retrospektif olarak incelendi. Hastalar 2,8 mm’lik kesiden primer İSGİL implantasyonu (Grup 1), 6 mm’lik kesiden primer İSGİL implantasyonu (Grup 2), sekonder İSGİL implantasyonu (Grup 3) ve GİL stabilizasyonu (Grup 4) olmak üzere 4 gruba ayrıldı. Olguların tümünde preoperatif ve postoperatif en iyi düzeltilmiş görme keskinliği (EDGK), göz içi basıncı (GİB), merkezi korneal kalınlık (MKK) ve postoperatif GİL-endotel arası mesafe ölçümleri yapıldı. Postoperatif komplikasyonlar kaydedildi.
Bulgular: Gruplarda EDGK preoperatif 0,58±0,20 /2,44±0,89 /0,53±0,26 /0,90±0,73 LogMAR iken postoperatif 0,33±0,57 /0,80±0,84 /0,50±0,62 /0,95±1,37 LogMAR seviyesinde idi. Postoperatif GİL-Endotel arası mesafe 3,11±0,28 /2,77±0,32 /3,09±0,37 /3,09±0,37 mm idi. Postoperatif dönemde, Grup 1’de 2 hastada kistoid maküler ödem (KMÖ), 1 hastada üveit, 1 hastada GİL desantralizasyonu; Grup 2’de 1 hastada KMÖ, 3 hastada GİL desantralizasyonu; Grup 3’te 2 hastada üveit ve KMÖ, 1 hastada retina dekolmanı (RD), 3 hastada GİL desantralizasyonu; Grup 4’te 1 hastada KMÖ, 1 hastada RD saptandı.
Sonuç: Kapsül yetmezliğinde, GİL implantasyon yöntemi seçiminde hastanın klinik özellikleri, mevcut ekipmanların durumu ve cerrahın tecrübesi önemlidir. Her GİL implantasyon yönteminin, kendine has avantaj ve dezavantajları mevcuttur. Uyguladığımız GİL implantasyon yönteminin kapsül yetmezlikli hastalarda nispeten kolay uygulanması, özellikli GİL gereksinimi olmaması gibi yönleriyle, GİL implantasyon yöntemlerine alternatif olacağını düşünmekteyiz.

References

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  • 2. Allen D, Vasavada A. Cataract and surgery for cataract. British Medical Journal; 333. Epub ahead of print 2006. DOI: 10.1136/bmj.333.7559.128.
  • 3. Dick HB, Augustin AJ. Lens implant selection with absence of capsular support. Current Opinion in Ophthalmology; 12. Epub ahead of print 2001. DOI: 10.1097/00055735-200102000-00009.
  • 4. Por YM, Lavin MJ. Techniques of intraocular lens suspension in the absence of capsular/zonular support. Survey of Ophthalmology; 50. Epub ahead of print 2005. DOI: 10.1016/j.survophthal.2005.06.010.
  • 5. Wagoner MD, Cox TA, Ariyasu RG, et al. Intraocular lens implantation in the absence of capsular support: A report by the American Academy of Ophthalmology. Ophthalmology; 110. Epub ahead of print 2003. DOI: 10.1016/S0161-6420(02)02000-6.
  • 6. Chan TCY, Lam JKM, Jhanji V, et al. Comparison of outcomes of primary anterior chamber versus secondary scleral-fixated intraocular lens implantation in complicated cataract surgeries. American Journal of Ophthalmology; 159. Epub ahead of print 2015. DOI: 10.1016/j.ajo.2014.10.016.
  • 7. Höh H, Ruprecht K, Nikoloudakis N, et al. Preliminary results following implantation of iris-suture-fixated posterior-chamber lenses. Ger J Ophthalmol; 2.
  • 8. Navia-Aray EA. Suturing a posterior chamber intraocular lens to the iris through limbal incisions: Results in 30 eyes. Journal of Refractive and Corneal Surgery; 10. Epub ahead of print 1994. DOI: 10.3928/1081-597x-19940901-16.
  • 9. Condon GP. Simplified small-incision peripheral iris fixation of an AcrySof intraocular lens in the absence of capsule support. Journal of Cataract and Refractive Surgery; 29. Epub ahead of print 2003. DOI: 10.1016/S0886-3350(03)00218-9.
  • 10. Holt DG, Young J, Stagg B, et al. Anterior chamber intraocular lens, sutured posterior chamber intraocular lens, or glued intraocular lens: Where do we stand? Current Opinion in Ophthalmology; 23. Epub ahead of print 2012. DOI: 10.1097/ICU.0b013e32834cd5e5.
  • 11. Lorenzi U, Parrat E, Grondin C, et al. Saving the Posterior Dislocated Intraocular Lens: The “air Support Technique” for Iris Fixation. Retina; 39. Epub ahead of print 2019. DOI: 10.1097/IAE.0000000000001712.
  • 12. Paris CL, Blinder KJ. Managing Dislocated IOLs. Ophthalmology; 99. Epub ahead of print 1992. DOI: 10.1016/S0161-6420(13)31800-4.
  • 13. Kirk TQ, Condon GP. Simplified ab externo scleral fixation for late in-the-bag intraocular lens dislocation. Journal of Cataract and Refractive Surgery; 38. Epub ahead of print 2012. DOI: 10.1016/j.jcrs.2012.08.018.
  • 14. Cheng H. Positive Correlation of Corneal Thickness and Endothelial Cell Loss. Archives of Ophthalmology; 106. Epub ahead of print 1988. DOI: 10.1001/archopht.1988.01060140066026.
  • 15. Ravalico G, Botteri E, Baccara F. Long-term endothelial changes after implantation of anterior chamber intraocular lenses in cataract surgery. Journal of Cataract and Refractive Surgery; 29. Epub ahead of print 2003. DOI: 10.1016/S0886-3350(02)02052-7.
  • 16. Güell JL, Velasco F, Malecaze F, et al. Secondary Artisan-Verysise aphakic lens implantation. Journal of Cataract and Refractive Surgery; 31. Epub ahead of print 2005. DOI: 10.1016/j.jcrs.2005.06.047.
  • 17. Carlson AN, Stewart WC, Tso PC. Intraocular lens complications requiring removal or exchange. Survey of Ophthalmology; 42. Epub ahead of print 1998. DOI: 10.1016/S0039-6257(97)00140-9.
  • 18. Escobar-Gomez M, Arthur SN, Apple DJ, et al. Evolution of surgical techniques and intraocular lens designs for the developing world. International Ophthalmology Clinics; 41. Epub ahead of print 2001. DOI: 10.1097/00004397-200107000-00014.
  • 19. Gicquel JJ, Guigou S, Bejjani RA, et al. Ultrasound biomicroscopy study of the Verisyse aphakic intraocular lens combined with penetrating keratoplasty in pseudophakic bullous keratopathy. Journal of Cataract and Refractive Surgery; 33. Epub ahead of print 2007. DOI: 10.1016/j.jcrs.2006.11.017.
  • 20. Mura JJ, Pavlin CJ, Condon GP, et al. Ultrasound Biomicroscopic Analysis of Iris-Sutured Foldable Posterior Chamber Intraocular Lenses. American Journal of Ophthalmology; 149. Epub ahead of print 2010. DOI: 10.1016/j.ajo.2009.08.022.
  • 21. Loya N, Lichter H, Barash D, et al. Posterior chamber intraocular lens implantation after capsular tear: Ultrasound biomicroscopy evaluation. Journal of Cataract and Refractive Surgery; 27. Epub ahead of print 2001. DOI: 10.1016/S0886-3350(01)00786-6.
  • 22. Baykara M, Ozcetin H, Yilmaz S, et al. Posterior Iris Fixation of the Iris-Claw Intraocular Lens Implantation through a Scleral Tunnel Incision. American Journal of Ophthalmology; 144. Epub ahead of print 2007. DOI: 10.1016/j.ajo.2007.06.009.
  • 23. Stutzman RD, Stark WJ. Surgical technique for suture fixation of an acrylic intraocular lens in the absence of capsule support. Journal of Cataract and Refractive Surgery; 29. Epub ahead of print 2003. DOI: 10.1016/S0886-3350(03)00054-3.
  • 24. Condon GP, Masket S, Kranemann C, et al. Small-Incision Iris Fixation of Foldable Intraocular Lenses in the Absence of Capsule Support. Ophthalmology; 114. Epub ahead of print 2007. DOI: 10.1016/j.ophtha.2007.04.018.
  • 25. Lyle WA, Jin JC. Secondary intraocular lens implantation: Anterior chamber vs posterior chamber lenses. Ophthalmic Surgery; 24. Epub ahead of print 1993. DOI: 10.3928/1542-8877-19930601-04.
  • 26. Bellucci R, Morselli S. Optimizing higher-order aberrations with intraocular lens technology. Current Opinion in Ophthalmology; 18. Epub ahead of print 2007. DOI: 10.1097/ICU.0b013e3280121af1.
  • 27. Konstantopoulos A, Yadegarfar G, Madhusudhana K, et al. Prognostic factors that determine visual outcome following cataract surgery complicated by vitreous loss. European Journal of Ophthalmology; 19. Epub ahead of print 2009. DOI: 10.1177/112067210901900212.
  • 28. Onal S, Gozum N, Gucukoglu A. Visual Results and Complications of Posterior Chamber Intraocular Lens Implantation after Capsular Tear during Phacoemulsification. Ophthalmic Surgery Lasers and Imaging; 35. Epub ahead of print 2004. DOI: 10.3928/1542-8877-20040501-09.
  • 29. Mentes J, Erakgun T, Afrashi F, et al. Incidence of cystoid macular edema after uncomplicated phacoemulsification. Ophthalmologica; 217. Epub ahead of print 2003. DOI: 10.1159/000073070.
  • 30. Kleinmann G, Apple DJ, Mackool RJ. Recurrent iritis after implantation of an iris-fixated phakic intraocular lens for the correction of myopia. Case report and clinicopathologic correlation. Journal of Cataract and Refractive Surgery; 32. Epub ahead of print 2006. DOI: 10.1016/j.jcrs.2006.02.079.
  • 31. Schein OD, Kenyon KR, Steinert RF, et al. A Randomized Trial of Intraocular Lens Fixation Techniques with Penetrating Keratoplasty. Ophthalmology; 100. Epub ahead of print 1993. DOI: 10.1016/S0161-6420(93)31458-2.
  • 32. Lee J, Lee JH, Chung H. Factors contributing to retinal detachment after transscleral fixation of posterior chamber intraocular lenses. Journal of Cataract and Refractive Surgery; 24. Epub ahead of print 1998. DOI: 10.1016/S0886-3350(98)80269-1.
Year 2022, Volume: 12 Issue: 4, 737 - 746, 28.12.2022
https://doi.org/10.31832/smj.1163160

Abstract

References

  • 1. Vargas LG, Peng Q, Escobar-Gomez M, et al. Overview of modern foldable intraocular lenses and clinically relevant anatomy and histology of the crystalline lens. International Ophthalmology Clinics; 41. Epub ahead of print 2001. DOI: 10.1097/00004397-200107000-00003.
  • 2. Allen D, Vasavada A. Cataract and surgery for cataract. British Medical Journal; 333. Epub ahead of print 2006. DOI: 10.1136/bmj.333.7559.128.
  • 3. Dick HB, Augustin AJ. Lens implant selection with absence of capsular support. Current Opinion in Ophthalmology; 12. Epub ahead of print 2001. DOI: 10.1097/00055735-200102000-00009.
  • 4. Por YM, Lavin MJ. Techniques of intraocular lens suspension in the absence of capsular/zonular support. Survey of Ophthalmology; 50. Epub ahead of print 2005. DOI: 10.1016/j.survophthal.2005.06.010.
  • 5. Wagoner MD, Cox TA, Ariyasu RG, et al. Intraocular lens implantation in the absence of capsular support: A report by the American Academy of Ophthalmology. Ophthalmology; 110. Epub ahead of print 2003. DOI: 10.1016/S0161-6420(02)02000-6.
  • 6. Chan TCY, Lam JKM, Jhanji V, et al. Comparison of outcomes of primary anterior chamber versus secondary scleral-fixated intraocular lens implantation in complicated cataract surgeries. American Journal of Ophthalmology; 159. Epub ahead of print 2015. DOI: 10.1016/j.ajo.2014.10.016.
  • 7. Höh H, Ruprecht K, Nikoloudakis N, et al. Preliminary results following implantation of iris-suture-fixated posterior-chamber lenses. Ger J Ophthalmol; 2.
  • 8. Navia-Aray EA. Suturing a posterior chamber intraocular lens to the iris through limbal incisions: Results in 30 eyes. Journal of Refractive and Corneal Surgery; 10. Epub ahead of print 1994. DOI: 10.3928/1081-597x-19940901-16.
  • 9. Condon GP. Simplified small-incision peripheral iris fixation of an AcrySof intraocular lens in the absence of capsule support. Journal of Cataract and Refractive Surgery; 29. Epub ahead of print 2003. DOI: 10.1016/S0886-3350(03)00218-9.
  • 10. Holt DG, Young J, Stagg B, et al. Anterior chamber intraocular lens, sutured posterior chamber intraocular lens, or glued intraocular lens: Where do we stand? Current Opinion in Ophthalmology; 23. Epub ahead of print 2012. DOI: 10.1097/ICU.0b013e32834cd5e5.
  • 11. Lorenzi U, Parrat E, Grondin C, et al. Saving the Posterior Dislocated Intraocular Lens: The “air Support Technique” for Iris Fixation. Retina; 39. Epub ahead of print 2019. DOI: 10.1097/IAE.0000000000001712.
  • 12. Paris CL, Blinder KJ. Managing Dislocated IOLs. Ophthalmology; 99. Epub ahead of print 1992. DOI: 10.1016/S0161-6420(13)31800-4.
  • 13. Kirk TQ, Condon GP. Simplified ab externo scleral fixation for late in-the-bag intraocular lens dislocation. Journal of Cataract and Refractive Surgery; 38. Epub ahead of print 2012. DOI: 10.1016/j.jcrs.2012.08.018.
  • 14. Cheng H. Positive Correlation of Corneal Thickness and Endothelial Cell Loss. Archives of Ophthalmology; 106. Epub ahead of print 1988. DOI: 10.1001/archopht.1988.01060140066026.
  • 15. Ravalico G, Botteri E, Baccara F. Long-term endothelial changes after implantation of anterior chamber intraocular lenses in cataract surgery. Journal of Cataract and Refractive Surgery; 29. Epub ahead of print 2003. DOI: 10.1016/S0886-3350(02)02052-7.
  • 16. Güell JL, Velasco F, Malecaze F, et al. Secondary Artisan-Verysise aphakic lens implantation. Journal of Cataract and Refractive Surgery; 31. Epub ahead of print 2005. DOI: 10.1016/j.jcrs.2005.06.047.
  • 17. Carlson AN, Stewart WC, Tso PC. Intraocular lens complications requiring removal or exchange. Survey of Ophthalmology; 42. Epub ahead of print 1998. DOI: 10.1016/S0039-6257(97)00140-9.
  • 18. Escobar-Gomez M, Arthur SN, Apple DJ, et al. Evolution of surgical techniques and intraocular lens designs for the developing world. International Ophthalmology Clinics; 41. Epub ahead of print 2001. DOI: 10.1097/00004397-200107000-00014.
  • 19. Gicquel JJ, Guigou S, Bejjani RA, et al. Ultrasound biomicroscopy study of the Verisyse aphakic intraocular lens combined with penetrating keratoplasty in pseudophakic bullous keratopathy. Journal of Cataract and Refractive Surgery; 33. Epub ahead of print 2007. DOI: 10.1016/j.jcrs.2006.11.017.
  • 20. Mura JJ, Pavlin CJ, Condon GP, et al. Ultrasound Biomicroscopic Analysis of Iris-Sutured Foldable Posterior Chamber Intraocular Lenses. American Journal of Ophthalmology; 149. Epub ahead of print 2010. DOI: 10.1016/j.ajo.2009.08.022.
  • 21. Loya N, Lichter H, Barash D, et al. Posterior chamber intraocular lens implantation after capsular tear: Ultrasound biomicroscopy evaluation. Journal of Cataract and Refractive Surgery; 27. Epub ahead of print 2001. DOI: 10.1016/S0886-3350(01)00786-6.
  • 22. Baykara M, Ozcetin H, Yilmaz S, et al. Posterior Iris Fixation of the Iris-Claw Intraocular Lens Implantation through a Scleral Tunnel Incision. American Journal of Ophthalmology; 144. Epub ahead of print 2007. DOI: 10.1016/j.ajo.2007.06.009.
  • 23. Stutzman RD, Stark WJ. Surgical technique for suture fixation of an acrylic intraocular lens in the absence of capsule support. Journal of Cataract and Refractive Surgery; 29. Epub ahead of print 2003. DOI: 10.1016/S0886-3350(03)00054-3.
  • 24. Condon GP, Masket S, Kranemann C, et al. Small-Incision Iris Fixation of Foldable Intraocular Lenses in the Absence of Capsule Support. Ophthalmology; 114. Epub ahead of print 2007. DOI: 10.1016/j.ophtha.2007.04.018.
  • 25. Lyle WA, Jin JC. Secondary intraocular lens implantation: Anterior chamber vs posterior chamber lenses. Ophthalmic Surgery; 24. Epub ahead of print 1993. DOI: 10.3928/1542-8877-19930601-04.
  • 26. Bellucci R, Morselli S. Optimizing higher-order aberrations with intraocular lens technology. Current Opinion in Ophthalmology; 18. Epub ahead of print 2007. DOI: 10.1097/ICU.0b013e3280121af1.
  • 27. Konstantopoulos A, Yadegarfar G, Madhusudhana K, et al. Prognostic factors that determine visual outcome following cataract surgery complicated by vitreous loss. European Journal of Ophthalmology; 19. Epub ahead of print 2009. DOI: 10.1177/112067210901900212.
  • 28. Onal S, Gozum N, Gucukoglu A. Visual Results and Complications of Posterior Chamber Intraocular Lens Implantation after Capsular Tear during Phacoemulsification. Ophthalmic Surgery Lasers and Imaging; 35. Epub ahead of print 2004. DOI: 10.3928/1542-8877-20040501-09.
  • 29. Mentes J, Erakgun T, Afrashi F, et al. Incidence of cystoid macular edema after uncomplicated phacoemulsification. Ophthalmologica; 217. Epub ahead of print 2003. DOI: 10.1159/000073070.
  • 30. Kleinmann G, Apple DJ, Mackool RJ. Recurrent iritis after implantation of an iris-fixated phakic intraocular lens for the correction of myopia. Case report and clinicopathologic correlation. Journal of Cataract and Refractive Surgery; 32. Epub ahead of print 2006. DOI: 10.1016/j.jcrs.2006.02.079.
  • 31. Schein OD, Kenyon KR, Steinert RF, et al. A Randomized Trial of Intraocular Lens Fixation Techniques with Penetrating Keratoplasty. Ophthalmology; 100. Epub ahead of print 1993. DOI: 10.1016/S0161-6420(93)31458-2.
  • 32. Lee J, Lee JH, Chung H. Factors contributing to retinal detachment after transscleral fixation of posterior chamber intraocular lenses. Journal of Cataract and Refractive Surgery; 24. Epub ahead of print 1998. DOI: 10.1016/S0886-3350(98)80269-1.
There are 32 citations in total.

Details

Primary Language Turkish
Subjects Health Care Administration
Journal Section Articles
Authors

Ali Altan Ertan Boz 0000-0001-7740-5821

Mahmut Atum 0000-0001-8230-8137

Erkan Çelik 0000-0002-8681-7868

Gürsoy Alagöz 0000-0002-7614-5690

Publication Date December 28, 2022
Submission Date August 17, 2022
Published in Issue Year 2022 Volume: 12 Issue: 4

Cite

AMA Boz AAE, Atum M, Çelik E, Alagöz G. Kapsül ve/veya Zonül Yetmezlikli Olguların Cerrahi Tedavisinde Tek Parça Katlanabilir Arka Kamara Göz İçi Lenslerin İrise Sütürlü Olarak Kullanılması. Sakarya Tıp Dergisi. December 2022;12(4):737-746. doi:10.31832/smj.1163160

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