Song Hee Park

Long-term stability and visual outcomes of a single-piece, foldable, acrylic intraocular lens for scleral fixation.

Purpose: To report long-term visual outcomes and complications of a new foldable, one-piece, acrylic posterior chamber intraocular lens with closed-loop haptics (C-flexTM, Rayner, UK) for scleral fixation. Study Design: Retrospective interventional case series of 29 eyes of 29 patients who underwent scleral fixation with the C-flex intraocular lens in the absence of capsular support. Methods: Review of 29 consecutive cases from January 2001 to December 2005 in which scleral fixation was performed with the C-flex intraocular lens. All cases were performed by a single surgeon (S.J.L.) and with an ab externo two-point scleral fixation technique. Preoperative status, intraoperative complications, and postoperative outcomes were analyzed. Results: Mean best corrected visual acuity improved from 20/150−1 to 20/40−1 (P < 0.001) at 1 month and to 20/50+1 (P < 0.001) at mean follow-up of 41 months. Complications included clinically insignificant decentration [1 (3%)], mild intraoperative vitreous hemorrhage [1 (3%)], postoperative hyphema [2 (7%)], and transient elevated intraocular pressure [2 (7%)]. All complications were mild and resolved without the need for reoperation. Conclusion: Scleral fixation of the closed-loop, foldable, acrylic C-flex intraocular lens appeared to reduce operative time, was associated with minimal postoperative complications, and resulted in long-term visual improvement.

Intraocular lens exchange with removal of the optic only

PURPOSE: To evaluate the clinical outcomes of intraocular lens (IOL) exchange in patients with an opacified ACRL‐C160 intraocular lens (IOL) using an optic‐only removal technique. SETTING: Department of Ophthalmology, Soonchunhyang University Hospital, Seoul, Korea. METHODS: The study comprised eyes with previous phacoemulsification and implantation of a single‐piece hydrophilic acrylic IOL in the capsular bag and subsequent development of severe late opacification of the IOL. In all eyes, the IOL optic was explanted; any haptic with firm adhesions was left in the capsular bag. This was followed by placement of a new IOL. The perioperative complications were evaluated, and the best corrected visual acuity (BCVA) before surgery and after surgery was compared. RESULTS: Twenty‐three eyes of 20 patients were evaluated. Uneventful IOL exchange and placement of a new IOL in the bag was achieved in 9 eyes (39.1%) and in the sulcus in 13 eyes (56.5%), with posterior capsule rupture in 2 eyes (8.7%). One eye (4.3%) developed zonular dehiscence, and scleral IOL fixation was performed. The mean BCVA was 0.64 ± 0.35 logMAR before IOL exchange and 0.24 ± 0.20 logMAR after IOL exchange. During 41 months of follow‐up, 1 eye (4.3%) each was affected by recurrent anterior uveitis and delayed zonular dehiscence. The final mean BCVA was 0.38 ± 0.40 logMAR. There was no corneal decompensation or infectious keratitis. CONCLUSION: The optic‐only removal technique was a safe and helpful procedure that allowed recovery of visual acuity because it decreased the intraoperative complication of zonular dehiscence.