Lentes plegables suturadas a iris / Iris-sutured foldable lenses

Para la corrección quirúrgica de la afaquia existen en la actualidad varias técnicas quirúrgicas que permiten fijar los lentes intraoculares plegables o rígidos en cámara posterior suturados al iris o al sulcus ciliar. En estas circunstancias el cirujano determinará cuándo, dónde y el tipo de lente mejor a implantar. Se presenta un paciente con una afaquia traumática del ojo izquierdo, con agudeza visual sin corrección de movimiento de mano a 1 m. Se le realizó implante secundario de lente intraocular plegable de cámara posterior suturada al iris. En el examen biomicroscópico en lámpara de hendidura del ojo izquierdo se observó midriasis media paralítica, refracción dinámica de +11,00 (0,6) y tensión ocular normal. Se le realizó examen por bimicroscopía indirecta sin alteración. Al mes de operado la agudeza visual mejor corregida alcanzó la unidad de visión. Las complicaciones presentadas fueron ovalización de la pupila y depósitos de pigmentos de iris en el lente intraocular(AU)

There are several surgical techniques for the surgical correction of aphakia, which allow fixing foldable or rigid intraocular lenses in the posterior chamber by suturing them to iris or to ciliary sulcus. Under these circumstances, the surgeon will determine the time, the place and the type of lenses that is better to be implanted. This is a patient with traumatic aphakia in his left eye, with visual acuity without correction equals to hand movement at 1 m distance. He was performed a secondary implantation of a iris-sutured posterior chamber foldable intraocular lens. In the biomicroscopic exam of the left eye using the slit lamp, there was observed mean paralytic midriasis, dynamic refraction of +11,00 (0.6) and normal ocular pressure. He also underwent an indirect biomicroscopy with no alteration. After a month of his surgery, the best corrected visual acuity reached the vision unit. The complications found were ovalization of pupil and iris pigment depots in the intraocular lens(AU)

Aniridia associated with congenital aphakia and secondary glaucoma.

We report a case of aniridia associated with congenital aphakia and secondary glaucoma. A 35-year-old male presented with aniridia, congenital aphakia and secondary glaucoma in both eyes. After an unsuccessful medical management, he underwent trabeculectomy with mitomycin C and anterior vitrectomy under local anesthesia in his left eye. Postoperatively, at the end of six months, intraocular pressure (IOP) in his left eye was controlled without medications. This case highlights the rare association of aniridia with congenital aphakia and secondary glaucoma.

Comparison of intraocular lens power calculation using the binkhorst and SRK formulae: a clinical study

Comparison of results of intraocular lens implants with IOL powers obtained by Binkhorst and SRK Linear Regression formulae was done using various models and brands of intraocular lenses. Of 887 pseudophakic patients, 415 patients received IOL's with their powers calculated for planned emmetropia, by means of theoretic formula devised by R.D. Binkhorst and in the remaining 472 eyes the IOL power was calculated with the SRK Linear Regression method. No significant difference [P<0.05] was found between visual acuities, obtained with IOL's alone or after postoperative overcorrection of residual refractive errors between the two groups

Implantation of posterior chamber intraocular lenses by suture fixation without capsular and zonular support

We implanted sulcus-fixated posterior chamber intraocular lenses (PCL) in three cataractous, six aphakic, and four eyes during penetrating keratoplasty due to corneal opacity in the absence of capsular and zonular support. This technique has been successfully performed in all cases and produced good visual outcome in 12 eyes (93%). In four eyes which had penetrating keratoplasty and the fixation of PCL, one developed vitreous hemorrhage and one developed corneal graft rejection.

Vitreous dynamic in cystoid macular edema

Eyes suffering from various conditions, such as aphakia, diabetic retinopathy, peripheral uveitis, branch vein occuluslon, or retinitis pigmentosa, are predisposed to vitreous detachment. When vitreous detachment occurs, the vitreous can remain attached to the macula due to a frim vitreomacular adhesion. This partial posterior vitreous detachment associated with continuous vitreous traction to the macular area can lead to the development of cystoid macular edema. Two types of vitreous traction have been observed: traction with narrow vitreous strand, and traction with broad vitreoretianal adhesion. Another suggested mechanism by which the posterior vitreous can cause cystoid macular edema is vitreous contraction without vitreous detachment, producing tractional forces at sites of firm vitreoretinal adhesions that are located at the optic disc and macula. Cystoid macular edema is often accompanied by leakage from dilated retinal capillaries at the optic disc