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At least 109 records · Page 6Linked to original sources
PubMed2004

Removal of silicone oil from aphakia: use of a self-sealing corneal incision.

PURPOSE: To report and illustrate a modified and simple technique for silicone oil removal from aphakic eyes. DESIGN: Interventional case series. METHODS: Eighteen eyes of 18 patients who once had pars plana vitrectomy and lensectomy combined with silicone oil tamponade underwent silicone oil removal using a self-sealing corneal incision. RESULTS: All of the 18 silicone oil removal procedures performed had clear corneal incisions, which did not require suturing. CONCLUSIONS: Silicone oil can be removed successfully from aphakia using the self-sealing corneal incision under local anesthesia.

Adolescent↗
PubMed2004

Artisan lens implantation to correct aphakia after vitrectomy for retained nuclear lens fragments.

PURPOSE: To report the results of pars plana vitrectomy (PPV) for retained lens fragments with implantation of an Artisan intraocular lens (IOL) (Ophtec) to correct aphakia. SETTING: University-based referral center. METHODS: In this retrospective case-controlled study, patients who had had a PPV to remove dislocated lens fragments and implantation of an Artisan IOL for pseudophakic correction during initial cataract surgery or PPV were reviewed. RESULTS: Thirteen patients were identified. The preoperative visual acuity was better than 20/200 in 5 patients and the intraocular pressure (IOP) was higher than 21 mm Hg in 8 patients; 3 patients had normal corneas. In 4 patients, an Artisan IOL was implanted during cataract surgery. Postoperative complications included recurrent erosion (1 eye), premacular fibrosis (2 eyes), and a retinal tear (1 eye). Elevation of the IOP occurred in 2 patients and was controllable with medication. Pupillary block developed in 1 patient and persistent cystoid macular edema in another. All but 2 patients gained more than 2 lines of visual acuity postoperatively, and all corneas remained clear during the follow-up (mean 28.9 months; range 2.5 to 69.0 months). CONCLUSIONS: After the removal of dislocated lens fragments with a PPV, Artisan IOL implantation in aphakic patients without capsule support led to few complications and good visual acuity. Placement of an Artisan IOL requires fewer manipulations than transscleral suture fixation of a posterior chamber IOL.

Aged↗
PubMed2005

Congenital cataract extraction with primary aphakia and secondary intraocular lens implantation in the ciliary sulcus.

PURPOSE: To evaluate the results of cataract extraction without primary intraocular lens (IOL) implantation in children. SETTING: Ophthalmology Unit, University Hospital, Strasbourg, France. METHODS: This retrospective study comprised 157 congenital cataract cases (55 bilateral and 47 unilateral) treated between 1985 and 2001. Evaluated were the functional results (visual acuity, binocular vision) and factors influencing the prognosis (age at surgery, stage of cataract development, associated pathology, postoperative complications). In all patients, cataract extraction was via the pars plana and anterior vitrectomy was performed, leaving a peripheral capsular collarette in place. Postoperatively, all the patients were fitted with glasses or contact lenses, after which they had secondary implantation of an IOL in the ciliary sulcus. RESULTS: The functional results were similar to those in the literature for eyes with or without an IOL. Nevertheless, the literature reports a 25% risk for reoperation in the first 2 years after implantation and secondary vitrectomy for reopacification of the visual axis in 20% of bilateral cases and 38% of unilateral cases. CONCLUSIONS: Our functional results indicate that in cases of bilateral congenital cataracts, initial rehabilitation with aphakic correction and secondary IOL implantation leads to a predictable postoperative refraction and fewer complications. Visual rehabilitation in unilateral aphakia was more difficult because of poor compliance with contact lenses, generally leading to a preference for early IOL implantation.

Aphakia, Postcataract↗
PubMed1997

Traumatic cataract in children: correction of aphakia by contact lens or intraocular lens.

PURPOSE: To compare the postoperative complications, visual outcome, and incidence of strabismus in children suffering from traumatic cataract corrected with contact lens or intraocular lens and to follow up the refractive changes in these eyes for an extended period of time. METHODS: Forty children, 2 to 13 years old at time of surgery for unilateral traumatic cataract, were followed up for 1.5 to 11 years. Seventeen children were corrected with contact lenses and 23 with intraocular lenses. Thirty-two underwent a primary posterior capsulectomy and anterior vitrectomy. RESULTS: The mean follow-up after surgery was 7.4 years for the children with contact lenses and 6.2 years for those with intraocular lenses. The incidence of secondary surgical interventions was higher among the children corrected with contact lenses. The eight children (five with contact lenses, three with intraocular lenses) who did not undergo primary posterior capsulectomy had Nd:YAG capsulectomy within 1 year after surgery. Fifteen of the 23 children with intraocular lenses (65.2%) achieved a best-corrected visual acuity of 20/40, and 17 children (73.9%) had a final visual acuity of 20/50, but only five of 17 children with contact lenses (35.3%) achieved this level of visual acuity. CONCLUSIONS: Correction of unilateral aphakia by intraocular lens in children after traumatic cataracts results in better final visual acuities and binocularity with a smaller incidence of strabismus than when correction is carried out by contact lens. Intraocular lens implantation should be considered the primary aphakic correction in children with traumatic cataract.

Adolescent↗
PubMed1991

Epikeratoplasty with nonlyophilized tissue in children with aphakia.

We studied 75 epikeratoplasty procedures using nonlyophilized tissue performed by eight ophthalmic surgeons in 70 eyes (47 patients) to correct for aphakia in children less than 8 years of age (mean age, 3.4 +/- 2.1 years). Of the 47 patients in the study, 24 were girls and 23 were boys; 23 patients had bilateral surgery. Seven of the epigrafts required removal; two were not replaced, and five underwent successful repeat epikeratoplasty. Overall, the success rate (that is, the percentage of epigrafts that remained optically and functionally clear throughout the course of this study) for the epikeratoplasty procedure was 89% (62 of 70 eyes) for initial surgery and 96% (67 of 70 eyes) for repeat surgery. The average spherical equivalent was +14.4 +/- 3.7 diopters preoperatively and +0.3 +/- 2.9 diopters one year after the operation. One year after the final surgical procedure, 42 of 56 eyes (75%) were within 3 diopters of emmetropia. In the 29 verbal patients, best-corrected visual acuity was 20/100 or better in 25 (86.2%) one year after the operation.

Aphakia↗
PubMed1987

The nationwide study of epikeratophakia for aphakia in adults.

In the nationwide study of epikeratophakia, 154 ophthalmic surgeons who had attended a training course performed 519 procedures for the correction of aphakia in adults: 310 of the eyes had 30 or more days of follow-up after suture removal. Of 229 eyes, 172 (75%) were within 3 diopters of emmetropia after surgery. Of 259 eyes, 245 (95%) demonstrated improved uncorrected visual acuity; 138 (53%) improved by four or more Snellen lines. Of 265 eyes, 209 (78%) achieved within two lines or improved their best corrected visual acuity. Of the 119 patients who achieved or improved their preoperative best corrected visual acuity, 110 (92%) were within two Snellen lines or better by 30 to 60 days after suture removal. Of the 127 patients with more than three months of follow-up after suture removal, 124 (98%) of those between 18 and 70 years of age but only 13 of 23 (54%) of those between 81 and 87 years of age achieved within two lines or better of their best corrected visual acuity. Corneal astigmatism measured by keratometry changed from a preoperative mean (+/- S.D.) of 2.1 +/- 1.8 diopters to a postoperative mean of 2.7 +/- 2.6 diopters. Of the 519 tissue lenses, 22 (4%) were removed, and one third of these patients underwent a second, successful epikeratophakia procedure.

Adolescent↗
PubMed1987

Secondary intraocular lens implantation vs epikeratophakia for the treatment of aphakia.

We analyzed retrospectively the results of 30 consecutive secondary intraocular lens implantations and 30 epikeratophakia procedures performed by one surgeon for adult aphakia. Specific indications for epikeratophakia were criteria that excluded patients as candidates for intraocular implants. Follow-up of all patients was at least six months. Preoperative and postoperative uncorrected and best corrected visual acuity and endothelial cell counts, as well as power predictability and complications rates, were compared. Preliminary results indicated that postoperative visual acuity, power predictability, and endothelial cell counts were comparable for the two groups. There were, however, fewer sight threatening complications associated with epikeratophakia, and complications in these patients were successfully reversed by removal and replacement of the lenticule.

Adult↗
PubMed1979

Soft lens design in aphakia.

Because of their size and mass, weight is a major concern in the fitting of soft gel lenses. Lenticular design is necessary, and there are essentially two lens designs for aphakia: the spin-cast lens of Bausch & Lomb and the lathe-cut lenses of the other manufacturers. A solution to the problem of weight in a single cut soft contact lens is presented.

Aphakia↗
PubMed1980

Which lens: contact lenses currently available for extended wear in aphakia.

To date, a number of specific materials have been used for extended wear lenses in aphakia. While none of the materials are ideal, reasonable results have been achieved with three types of materials: thin hydrophilics, silicone, and high water content hydrophilics. The various available lenses are described, and their physical properties are related to the process of extended wear. The authors' techniques for fitting, follow-up, evaluation, and prevention of complications are presented.

Aphakia, Postcataract↗
PubMed1982

Extended-wear contact lenses in patients with corneal grafts and aphakia.

Extended-wear contact lenses (EWCL) were fitted successfully on 61 aphakic eyes with penetrating corneal grafts. In two- to 32-months follow-up there were 26 eyes that had varying amounts of superficial neovascularization of the grafts and one Staphylococcus epidermidis corneal graft ulcer. There were five homograft rejections, all occurring in severely diseased eyes. Variable vision and visual acuity less than that with hard contact lenses or aphakic spectacles were the most frequent problems. Both were due to the high corneal astigmatism present in many patients. The results indicate that EWCLs may be used safely by patients with penetrating corneal grafts and aphakia, particularly if there is no host corneal edema, scarring, or vascularization, if these are no synechias to the graft wound, and if the astigmatism is less than 3.0 diopters.

Adolescent↗
PubMed1986

Extended wear hydrogel and daily wear hard contact lenses for aphakia. Success and complications compared in a longitudinal study.

The success and complications of extended wear hydrogel (EWSCL) and daily wear hard contact lens (DWHCL) correction for aphakia were evaluated retrospectively in two comparable groups of unilaterally aphakic patients (64 with EWSCL, 86 with DWHCL). At the end of the follow-up period, 55% of patients in each group were still using contact lenses. Suppurative keratitis occurred in two (3%) patients using EWSCL and none with DWHCL. The relative risk to all patients of a complication developing severe enough to result in a loss of wearing time was 9.8 times higher for the EWSCL users compared with the DWHCL group; this risk increased to 11.4 times for the patients still using lenses at the end of the follow-up period. The EWSCL patients had 1.9 times more visits for routine care and 5 times more unplanned visits to deal with complications than the DWHCL patients.

Aged↗
PubMed1992

Which is better? One or two? A randomized clinical trial of single-plate versus double-plate Molteno implantation for glaucomas in aphakia and pseudophakia.

PURPOSE: Previous studies have suggested that primary double-plate Molteno implantation may be beneficial. Therefore, the authors performed a randomized clinical trial to evaluate the relative effectiveness and safety of single- versus double-plate Molteno implantation. METHODS: From March 1988 to February 1990, 132 patients who underwent Molteno implantation for medically uncontrollable non-neovascular glaucomas in aphakia or pseudophakia were randomly assigned to receive either single- or double-plate implants. RESULTS: The 1- and 2-year life-table success rates (success [survival] defined as 6 mmHg < or = final intraocular pressure [IOP] < or = 21 mmHg without additional glaucoma surgery or devastating complication) were 55% and 46% with single-plate implantation and 86% and 71% with double-plate implantation, respectively. The final postoperative visual acuities were within one line of the preoperative visual acuities or had improved in 73% and 80% of patients, respectively. Choroidal hemorrhages and/or effusions, corneal decompensation, flat anterior chambers, and phthisis bulbi were more common in the patients who had undergone double-plate Molteno implantation; however, transient elevations of IOP during the first few postoperative months were more common in the patients who had undergone single-plate Molteno implantation. CONCLUSIONS: Double-plate Molteno implantation more frequently affords IOP control than single-plate Molteno implantation; however, double plates are associated with greater risks of choroidal hemorrhages and/or effusions, corneal decompensation, flat anterior chambers, and phthisis bulbi.

Adolescent↗
PubMed1993

Long-term visual results and complications in children with aphakia. A function of cataract type.

PURPOSE: Previous studies of outcome in children with aphakia have approached the data by grouping patients according to features such as age at surgery, type of procedure, or some other common attribute. The purpose of this study is to identify factors predictive for visual outcome and complications in pediatric patients with cataracts. METHOD: One hundred seventy-four eyes in 118 patients underwent lensectomy and anterior vitrectomy for congenital or juvenile cataracts. All received early optical correction, occlusion therapy when necessary, and follow-up for at least 6 months. Visual outcome and complications were analyzed statistically to determine predictive factors. Features analyzed included cataract type, laterality, age at onset, follow-up, and corneal size. RESULTS: Statistical analysis showed that the most important predictor of long-term visual outcome and complications is cataract type. Visual outcome differed significantly by cataract type, with best results in the lamellar and posterior lentiglobus groups. Unilateral cases had a mean acuity lower than bilateral cases. Other factors, such as age at surgery and corneal size, were less predictive but closely linked to cataract type. Complications, such as aphakic glaucoma, also were more closely linked to the type of cataract than to other variables. CONCLUSION: The results indicate that an important determinant of long-term outcome and complications in aphakic children is cataract type. Other features were found to be closely correlated to cataract type and were not independently significant.

Age Factors↗
PubMed1998

Morphology of M-cell axon arbors in striate cortex of monkeys reared with monocular aphakia.

Although the effects of visual deprivation on the development of ocular dominance columns have been well described in primates, nothing is known in primates about the impact of the deprivation on the axonal profiles that make up the ocular dominance columns. We now show that the effects of monocular deprivation on the morphology of geniculostriate axons involve not only shifts in terminal arbor sizes, much as would be expected from the ocular dominance data, but also changes in the proliferation of terminal arbor branches. In macaque monkeys reared from birth with unilateral lens removal (aphakia), terminal arbors of geniculostriate axons were bulk-filled with horseradish peroxidase (HRP) in brain-slice preparations and reconstructed from serial sections through striate cortex (area 17). Our focus was on the arbors that terminate in the upper tier of layer IV, the target of cells in the magnocellular (M) layers of the LGN. Of the 26 M-cell arbors reconstructed from three aphakic monkeys, eight were unique in having few very simple terminal arbor branches. These also tended to be smaller in total extent than the average M-cell axons reconstructed from 1 normal monkey. In contrast, eight arbors had very rich terminal branching patterns, and seven of these were larger than any of those from the normal monkey. We propose that the small, sparse axon arbors are related to the deprived eye, and the large, dense arbors are related to the non-deprived eye. These morphological changes reflect abnormalities in the growth patterns of geniculostriate inputs that undoubtedly have important persisting consequences for visual performance.

Animals↗
PubMed2003

Four-point fixation of posterior chamber intraocular lenses in children with unilateral aphakia.

PURPOSE: To evaluate the results of 4-point scleral fixation of posterior chamber intraocular lenses (PC IOLs) in children. SETTING: Mansoura Ophthalmic Center, Mansoura University, Mansoura, Egypt. METHODS: This retrospective study comprised 20 aphakic eyes of 20 children. Preoperative investigations proved the absence of adequate posterior capsule support. All patients had ab externo 4-point scleral fixation of a PC IOL. All preoperative and postoperative data were studied and analyzed. RESULTS: The mean preoperative age was 7.7 years (range 4 to 11 years). The mean follow-up was 19.35 months (range 13 to 30 months). The preoperative findings included a best corrected visual acuity of 6/18 or better in 8 eyes (40%), corneal scarring in 18 eyes, sector iridectomy in 7 eyes, and after-cataract in 4 eyes. The intraoperative complications included vitreous hemorrhage in 2 eyes and slippage of 1 suture in 1 eye. Postoperative complications included mild anterior uveitis in 12 eyes and severe fibrinoid reaction in the anterior chamber in 8 eyes. There were no cases of suture exposure, IOL malpositioning, or infection. Twelve patients (60%) had a visual acuity of 6/18 or better. The cause of the poor visual outcome in many patients was preexisting amblyopia. CONCLUSIONS: The results suggest that 4-point scleral fixation is an option to correct aphakia in children. However, long-term follow-up is important to assess the procedure's safety.

Aphakia, Postcataract↗
PubMed1993

Ocular axial length changes in a pediatric patient with aphakia and pseudophakia.

Excessive eye elongation can be induced in experimental animals by visual deprivation. A tendency toward myopic refraction or shift in pediatric aphakia has been recorded in some children. In this report, we present the case of an 18-year-old patient who had developmental cataracts treated at seven years of age with bilateral cataract extraction and implantation of an intraocular lens in one eye only. Axial length of the eye with a contact lens increased compared with the eye with the intraocular lens.

Adolescent↗
PubMed1996

Epikeratophakia to correct traumatic aphakia after penetrating keratoplasty.

A 19-year-old man with keratoconus sustained ocular trauma and became aphakic in his operated left eye 2 months after penetrating keratoplasty. Original corneal wound repair was performed without intraocular lens implantation. Attempts to correct his aphakia with a contact lens failed when the patient became intolerant to its use. As an alternative, the patient had elective epikeratophakia. A standard 8.5 mm lenticule was placed over existing corneal graft. This operation resulted in +12.25 diopters of correction and a best corrected visual acuity of 20/25 at 30 months postoperatively. There was no sign of abnormalities at the host cornea or the transplanted lenticule. This case indicates that epikeratophakia may be successfully performed over existing corneal grafts.

Adult↗
PubMed1996

Comparison of fluorine-surface-modified and unmodified lenses for implantation in pediatric aphakia.

PURPOSE: To compare the postoperative reaction in pediatric aphakic eyes to intercapsular intraocular lens (IOL) implantation with fluorine-modified poly(methyl methacrylate) (PMMA) IOLs and with unmodified IOLs. SETTING: Pediatric Ophthalmology Unit, Purpan University Hospital, Toulouse, France. METHODS: In this retrospective study, 107 consecutive eyes in 82 children were operated on for cataracts and intercapsular implantation. From January 1985 to December 1993, 87 eyes (Group 1) received an all-poly(methyl methacrylate) (PMMA), single-piece IOL; during 1994, 20 eyes (Group 2) received an IOL of the same design that had been fluorine surface modified. Mean age of the patients was 64.5 months (range 15 days to 16 years). Postoperatively, each group was monitored for immediate inflammatory response from the first to the eighth day and for secondary cicatricial response from 6 months to 1 year. RESULTS: There was no significant difference between the two groups in the early inflammatory response. Secondary cicatricial reaction was found more often in Group 1 in all age subgroups (P < .01), but especially 1 to 4 years (P < .02). CONCLUSION: Fluorine modification of PMMA IOLs is an effective and safe method to reduce the cicatricial response when IOL implantation is used to correct pediatric aphakia.

Adolescent↗