Simple Technique for Transscleral Fixation of a Foldable Posterior Chamber Intraocular Lens Using a Single Suture.

Objective: To explore the simplified technique for transscleral fixation of a foldable posterior chamber intraocular lens (IOLs) in patients with aphakia or inadequate posterior capsule support. Methods: A review was conducted of 18 eyes of eighteen patients with the absence of-or inadequate-capsule support, after the simplified technique of using a foldable posterior chamber intraocular lens (PC IOLs) with stable four-point transscleral fixation, as performed by a skilled surgeon. This technique uses only a single suture and a knot to fix a PC IOL firmly without creating a scleral flap. The mean follow-up time was 18 ± 5.8 months (ranging from 12 to 24 months). Results: All patients exhibited improved visual acuity. No IOL tilt or dislocation or iris capture was observed, and all patients exhibited stable and centered IOL after surgery. No complex complications, such as suture shedding and exposure, corneal endothelial decompensation, persistent uveitis, or retinal detachment and endophthalmitis were observed. Conclusion: The simplified technique proposed here is a reliable, economical, and reproducible method of treating patients with aphakia or inadequate posterior capsule support. It provides excellent IOL stability, reduces surgical duration and complexity, and prevents certain complications.

Rapid epidemiologic assessment of cataract blindness. The Aravind Rapid Epidemiologic Assessment Staff.

A major constraint to obtaining reliable information about blindness and its causes in developing countries is the limited availability of ophthalmologists for diagnosis in population-based surveys. This study in rural south India assessed the feasibility of using non-ophthalmologists to make diagnoses in a population-based survey. Ten men in their early twenties with 12 years of schooling were recruited and trained as ophthalmic assistants through a six week course in basic ophthalmology. All people aged 40 and older in households in 24 villages were enumerated and invited to have an eye examination. At a central site, 1309 subjects were independently examined by an ophthalmologist and two different ophthalmic assistants. Ophthalmic assistant cataract diagnosis is both sensitive and specific relative to the ophthalmologist's diagnosis. Sensitivity and specificity estimates were used to adjust prevalence estimates obtained from ophthalmic assistant examinations conducted at the central site as well as at the doorstep of sample households. The findings indicate that epidemiologic assessment of cataract blindness can be completed using non-ophthalmologists to diagnose cataract.

A case of spontaneous dislocated lenses.

There are a great number of causes of dislocated lenses. One such cause is the spontaneous dislocation of a mature or hypermature cataractous lens. The case of an 80-year-old black female with spontaneously dislocated lenses is reported. Because the woman was not aphakic from surgery, but rather from spontaneous dislocation of her lenses, she was not eligible for eyeglasses from Medicare.