retropupillary fixation of iris claw iol in phaco complication
TRANSCRIPT
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Mikhail Aleksandrovich Frolov , Vinod Kumar, Isufaj Edmond
Department of ophthalmology, Russian peoples friendship university, Moscow
Ophthalmic unit of Skhodnya city hospital, Moscow region, Russia
LONG TERM RESULTS OF RETROPUPILLARY FIXATION OF AN IRIS-CLAW INTRAOCULAR LENS
(ICIOL) IN MANAGEMENT OF COMPLICATIONS DURING PHACOEMULSIFICATION.
FINANCIAL DISCLOSURE: none.Innovative educational program of the university
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Department of ophthalmology, Russian peoples friendship university, Moscow
INTRODUCTION
The ideal and best place for IOL implant is in the capsular bag.
However in the presence of an unstable capsule-zonule complex or its absence, endocapsular fixation of an IOL is a difficult target to achieve and the surgeon has four following options:
to implant an ACIOL; to fixate a PCIOL in the iris;to fixate a PCIOL in the sclera;to leave the eye aphakic.
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Department of ophthalmology, Russian peoples friendship university, Moscow
Purpose: To evaluate long term results of retropupillary fixation of ICIOLs in management of intraoperative complications during phacoemulsification.
Setting: Department of ophthalmology, Russian People’s Friendship University, Moscow Ophthalmic unit of Skhodnya city hospital, Moscow region, Russia.
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MATERIAL AND METHODS
Department of ophthalmology, Russian peoples friendship university, Moscow
• The study was done under the innovative educational program of the university.
• Retropupillary fixation of an ICIOL in 21 eyes of 20 patients (9 male and 11 females).
• The patients age varied from 38 to 87yrs. (average age: 71,4+/-11,8 yrs.)
• Follow-up period from 1 year to 4 years.
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MATERIAL AND METHODS
Department of ophthalmology, Russian peoples friendship university, Moscow
ICIOL was implanted during following intraoperative complications :
•Posterior capsule rupture with vitreous prolapsed into anterior chamber - 7 eyes.
•Zonular dehiscence - 14 eyes.
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Department of ophthalmology, Russian peoples friendship university, Moscow
• Visual acuity
• Refraction
• Intraocular pressure (IOP) measured by Maklakov method
• IOL stability
MAIN OUTCOME MEASURES
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SURGICAL TECHNIQUE
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RESULTS• Visual acuity of 0.5 or more was achieved in 15 cases (71.4%)
• During follow-up position of IOL remained stable in all cases.
• No new case of glaucoma was diagnosed.
• Iridopseudophacodonesis was prevalent in all cases.
• 5 cases (23.8%) with pupil deformation in the form of “cat pupil” complained of glare.
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RESULTS
• Depigmentation areas at enclavation site, observed in most of the cases (16 cases, 76.2%) were related to surgical trauma while enclaving the iris.
• Ultrasound biomicroscopy showed contact between IOL and iris only at enclavation site. IOL optic was well away from iris tissue.
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CONCLUSION
Department of ophthalmology, Russian peoples friendship university, Moscow
Analysis of long term results indicates safety and effectiveness of retropupillary fixation of an ICIOL in management of complications during phacoemulsification.