ABSTRACT
PURPOSE: To describe the safety and stability of sulcus placement of the MA50 intraocular lens (IOL). PATIENTS AND METHODS: Consecutive patients with MA50 IOLs placed in the sulcus at the University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA, from 1997 to 2012 were identified. Inclusion criteria included patients with over 4 weeks of follow-up data. AEL was compared with incidence of IOL decentration using at two-tailed Student's t-test. RESULTS: Fifty eyes of 49 patients meeting the inclusion criteria were identified. Four weeks post-operatively, the average best-corrected visual acuity was 20/30. IOL decentration occurred in 14% of patients; patients with decentered IOLs had a significantly longer average AEL (25.37 mm) than patients whose IOL remained centered (23.94 mm, P=0.017). Other complications included uveitis-glaucoma-hyphema syndrome (12%), iritis (8%), and glaucoma (6%). There were no cases of pigment dispersion syndrome or need for lens exchange. Twelve eyes (24%) had intra-operative optic capture by the anterior capsule, none of which had post-operative decentration. CONCLUSION: The MA50 IOL is a reasonable, stable option for placement in the sulcus, with a low-risk profile; however, in eyes with longer AEL and presumably larger anterior segment, surgeons should consider placing an IOL with longer haptic distance than the MA50 to maintain centration. Optic capture of the MA50 IOL by the anterior capsule should be considered for longer eyes, as it is protective against decentration.
Subject(s)
Ciliary Body , Lens Implantation, Intraocular/methods , Lenses, Intraocular , Phacoemulsification/methods , Adolescent , Adult , Aged , Aged, 80 and over , Axial Length, Eye , Child , Child, Preschool , Female , Humans , Lens Capsule, Crystalline/injuries , Male , Middle Aged , Postoperative Complications , Prosthesis Design , Retrospective StudiesABSTRACT
Intraoperative capsule striae are commonly seen after implantation of the AcrySof model MA60BM posterior chamber intraocular lens (IOL). Although the striae generally have no visual significance and tend to disappear with remodeling of the capsule-haptic interface, we report a series of patients who developed linear posterior capsule opacification (PCO) along persistent striae. The striae appear to create a channel that allows endothelial cells to bypass the barrier created by the squared-edge design of the IOL and migrate posteriorly in a linear pattern. The observation of linear PCO along channels created by capsule striae provide strong support for the theory that a sharp-edge design creates a barrier to posterior epithelial cell migration.
Subject(s)
Acrylic Resins/adverse effects , Cataract/etiology , Lens Capsule, Crystalline/pathology , Lenses, Intraocular/adverse effects , Cataract/pathology , Humans , Lens Implantation, IntraocularABSTRACT
We report a case of traumatic phacocele in a 42-year-old patient with a history of congenital glaucoma and bilateral goniotomies as an infant. Her left eye had little vision and poorly controlled intraocular pressure but was comfortable until her presentation after blunt trauma. Phacocele or subconjunctival dislocation of the crystalline lens is a rare consequence of blunt trauma, particularly in a patient whose only previous ocular surgery was goniotomy more than 40 years ago.
Subject(s)
Eye Injuries/etiology , Lens Subluxation/etiology , Lens, Crystalline/injuries , Wounds, Nonpenetrating/etiology , Adult , Eye Enucleation , Eye Injuries/diagnosis , Eye Injuries/surgery , Female , Humans , Intraocular Pressure , Lens Subluxation/diagnosis , Lens Subluxation/surgery , Visual Acuity , Wounds, Nonpenetrating/diagnosis , Wounds, Nonpenetrating/surgeryABSTRACT
We report the first case of indocyanine green (ICG) being used in an eye with an anterior capsule that was not completely intact. We found that ICG seems to have a selective affinity for the anterior capsule over cortical lens material. The patient had a corneal perforation with a wire and developed endophthalmitis requiring pars plana vitrectomy with intravitreal antibiotics. He subsequently developed a white traumatic cataract with an anterior capsule tear. Five months after the injury, he had cataract extraction. Indocyanine green was used to better visualize the anterior capsule before capsulotomy. The anterior capsule stained green, but the cortical material exposed to ICG did not stain.
Subject(s)
Cataract/diagnosis , Coloring Agents , Eye Injuries, Penetrating/complications , Indocyanine Green , Lens Capsule, Crystalline/pathology , Anterior Chamber , Cataract/etiology , Coloring Agents/administration & dosage , Corneal Injuries , Eye Injuries, Penetrating/diagnosis , Humans , Indocyanine Green/administration & dosage , Injections , Lens Capsule, Crystalline/surgery , Male , Middle Aged , Monitoring, Intraoperative/methods , RuptureABSTRACT
The role of magnesium ions in the inhibitory effect of ethanol on NMDA receptor-mediated population synaptic potentials (pEPSPs) in area CA1 of the hippocampus of the adult rat, was studied. The excitatory amino acid (non-NMDA) receptor antagonist, DNQX and the GABAA channel antagonist, picrotoxin, were used to pharmacologically isolate NMDA-mediated pEPSPs. In the presence of a physiological concentration of magnesium (1.0 mM), ethanol (25-100 mM) inhibited NMDA-mediated pEPSPs, with an apparent EC50 of approximately 50 mM. The ability of ethanol to inhibit NMDA-mediated pEPSPs was reduced when the slices were incubated in the absence of magnesium. Concentrations of ethanol, in the range of 50-200 mM (apparent EC50 100 mM), were required to inhibit NMDA-mediated pEPSPs, in the absence of added magnesium. Combination studies of these two antagonists indicated that the sensitivity of NMDA-mediated pEPSPs to one antagonist was not altered by the presence of the other. This finding suggests that the affinity of each antagonist binding site is not affected by the presence of the other antagonist. In the case of ethanol, its low maximum antagonist efficacy may require larger concentrations of ethanol to inhibit NMDA-mediated pEPSPs, in the absence of other non-competitive antagonists such as magnesium.