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Yusef Yu.N.

Krasnov Research Institute of Eye Diseases;
I.M. Sechenov First Moscow State Medical University (Sechenov University)

Voronin G.V.

Research Institute of Eye Diseases

Yusef S.N.

Krasnov Research Institute of Eye Disease

Vvedenskiy A.S.

Krasnov Research Institute of Eye Disease

Shkolyarenko N.Yu.

Research Institute of Eye Diseases

Alkharki L.

Krasnov Research Institute of Eye Diseases

Shashorina S.A.

Research Institute of Eye Diseases

Sharnina T.V.

Research Institute of Eye Diseases

Comparative evaluation of positional stability of the «capsular bag + intraocular lens» complex in patients with lens subluxation

Authors:

Yusef Yu.N., Voronin G.V., Yusef S.N., Vvedenskiy A.S., Shkolyarenko N.Yu., Alkharki L., Shashorina S.A., Sharnina T.V.

More about the authors

Journal: Russian Annals of Ophthalmology. 2020;136(4): 105‑109

DOI: 10.17116/oftalma2020136041105

Views: 1135

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To cite this article:

Yusef YuN, Voronin GV, Yusef SN, et al. . Comparative evaluation of positional stability of the «capsular bag + intraocular lens» complex in patients with lens subluxation. Russian Annals of Ophthalmology. 2020;136(4):105‑109. (In Russ.)
https://doi.org/10.17116/oftalma2020136041105

Подписка 2025 (Russian Annals of Ophthalmology)
 
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Prevention of decentration and dislocation of the “capsular bag + intraocular lens” (IOL) complex in the late postoperative period is an actual problem of surgical treatment of patients with pronounced lens subluxation.

PURPOSE

To conduct a comparative clinical study of positional stability of the “capsular bag + IOL” complex in the late postoperative period after application of a combined technique of capsular bag fixation in patients with subluxation of the lens.

MATERIAL AND METHODS

Phacoemulsification (PE) with in-the-bag IOL implantation and postoperative observation was performed in 213 patients (234 eyes) with cataract and pronounced lens subluxation. The 1st group consisting of 138 patients (153 eyes) underwent capsular bag fixation of the combined technique with simultaneous use of 4 modified iris-retractors and one or two capsular tension rings (CTRs). The 2nd group included 75 patients (81 eyes) who in the course of PE had their capsular bag fixed beyond the edge of capsulorhexis with only 4 modified iris-retractors. Preoperative state of the lens and the evaluation of the frequency and degree of decentration of the «capsular bag + IOL» complex in the postoperative period were performed using data acquired with ultrasound biomicroscopy (UBM).

RESULTS

Significant (more than 1 mm according to UBM) IOL’s optic decentration was observed in the 1st group after applying the combined capsular bag fixation technique in 12 (7.8%) cases, and in the 2nd group after isolated use of modified iris-retractors in 48 (59.3%) cases.

CONCLUSION

The use of the combined capsular bag fixation technique not only improves the conditions for carrying out PE with in-the-bag IOL implantation in patients with pronounced lens subluxation, but also contributes to a substantial (an average of 8 times) reduction in the incidence of significant decentration of the «capsular bag + IOL» complex in the late postoperative period.

Keywords:

cataract
lens subluxation
phacoemulsification
IOL
complications

Authors:

Yusef Yu.N.

Krasnov Research Institute of Eye Diseases;
I.M. Sechenov First Moscow State Medical University (Sechenov University)

Voronin G.V.

Research Institute of Eye Diseases

Yusef S.N.

Krasnov Research Institute of Eye Disease

Vvedenskiy A.S.

Krasnov Research Institute of Eye Disease

Shkolyarenko N.Yu.

Research Institute of Eye Diseases

Alkharki L.

Krasnov Research Institute of Eye Diseases

Shashorina S.A.

Research Institute of Eye Diseases

Sharnina T.V.

Research Institute of Eye Diseases

Received:

25.06.2019

Accepted:

24.10.2019

List of references:

  1. Avetisov SE, Yusef YuN, Mamikonyan VR, Vvedensky AS, Yusef SN, Mutonen NV. Original method of exocapsular nuclear phacofragmentation in phacoemulsification. Vestnik oftal’mologii. 2002;118(5):18-21. (In Russ.).
  2. Yusef SN, Yusef YuN, Ivanov MN. Some features of phacoemulsification in lens subluxation. Vestnik oftal’mologii. 2013;129(3):12-15. (In Russ.).
  3. Avetisov SE, Avetisov KS, Savochkina OA. Surgical correction of lens changes in Marfan’s syndrome. Klinicheskaya i eksperimental’naya hirurgiya. Zhurnal im. akad. B.V. Petrovskogo. 2015;2(8):41-46. (In Russ.).
  4. Canabrava S, Bernardino L, Batisteli T, Lopes G, Diniz-Filho A. Double-flanged-haptic and capsular tension ring or segment for sutureless fixation in zonular instability. Int Ophthalmol. 2018;38(6):2653-2662. https://doi.org/10.1007/s10792-017-0746-5
  5. Krasnov MM, Kasparov AA, Mamikonyan VR, Yusef YuN, Vvedensky AS, Yusef SN. A new modified phacoemulsification operation in lenticular subluxation. Vestnik oftal’mologii. 2000;116(1):10-12. (In Russ.).
  6. Assia E, Ton Y, Michaeli A. Capsule anchor to manage subluxated lenses: Initial clinical experience. J Cataract Refract Surg. 2009;35(8):1372-1378. https://doi.org/10.1016/j.jcrs.2009.02.046
  7. Fontana L, Coassin M, Iovieno A, Moramarco A, Cimino L. Cataract surgery in patients with pseudoexfoliation syndrome: current updates. Clin Ophthalmol. 2017;11:1377-1383. https://doi.org/10.2147/OPTH.S142870
  8. Cionni R, Osher R. Endocapsular ring approach to the subluxed cataractous lens. J Cataract Refract Surg. 1995;21(3):245-249.  https://doi.org/10.1016/S0886-3350(13)80126-5
  9. Ioshin IE. Intracapsular ring in cataract surgery in lens subluxation. Vestnik oftal’mologii. 2012;128(2):45-49. (In Russ.).
  10. Shingleton BJ, Neo YN, Cvintal V, Shaikh AM, Liberman P, O’Donoghue MW. Outcome of phacoemulsification and intraocular lens implantion in eyes with pseudoexfoliation and weak zonules. Acta Ophthalmol. 2017;95(2): 182-187.  https://doi.org/10.1111/aos.13110
  11. Zhao Y, Li J, Yang K, Li X, Zhu S. Combined Special Capsular Tension Ring and Toric IOL Implantation for Management of Astigmatism and High Axial Myopia with Cataracts. Semin Ophthalmol. 2018;33(3):389-394.  https://doi.org/10.1080/08820538.2016.1247181
  12. Rastogi A, Khanam S, Goel Y, Kamlesh S, Thacker P, Kumar P. Comparative evaluation of rotational stability and visual outcome of toric intraocular lenses with and without a capsulartension ring. Ind J Ophthalmol. 2018; 66(3):411-415.  https://doi.org/10.4103/ijo.IJO_875_1
  13. Srinivasan S. In-the-bag intraocular lens dislocation: A ticking time bomb. J Cataract Refract Surg. 2019;45(3):259-260.  https://doi.org/10.1016/j.jcrs.2019.02.004
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  16. Yusef YuN, Yusef SN, Avetisov KS, Vvedensky AS. Technique for surgical repositioning of in-the-bag dislocated intraocular lenses. Vestnik oftal’mologii. 2016;132(1):53-56. (In Russ.). https://doi.org/10.17116/ophthalma2016132153-56
  17. Yusef YuN, Yusef SN, Avetisov KS, Vvedenskiy AS, Shkolyarenko NYu, Reznikova EV, Akkhumidi K. Surgical technique of retropupillary iris-claw fixated IOL reimplantation. Vestnik oftal’mologii. 2018;134(3):95-98. (In Russ.). https://doi.org/10.17116/ophthalma2018134395

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