RESUMEN
PURPOSE: A certain number of conditions can result in compromised anterior and/or posterior capsular integrity. Several surgical options have been employed for repositioning dislocated intraocular lenses in the absence of adequate capsular support. The purpose of this study is to assess the functional outcomes and complication profile of a modified surgical technique for replacing dislocated intraocular lenses. MATERIAL AND METHODS: All patients who had undergone the modified surgical procedure for dislocated intraocular lenses between 2012 and 2017 were retrospectively reviewed for visual outcomes and complications. Patient demographic characteristics, pre- and postoperative visual acuity, surgical indications, refractive outcomes, intraocular pressure and postoperative complications were recorded and analysed at baseline and at six months, which was the conclusion of the study. We also present our modified surgical technique. RESULTS: Sixty-eight eyes of sixty-eight patients (74% male) were included. Mean age at surgery was 58 years (range 4-89 years). Mean best-corrected visual acuity increased significantly from 0.80 (SD±0.2) LogMar to 0.40 (SD±0.1) LogMar (P<0.005). Median astigmatic error at the conclusion of follow-up remained stable. There were no intraoperative complications and a low postoperative complication rate (10.2%), mainly related to the surgical context. CONCLUSION: Sutureless intrascleral fixation of dislocated intraocular lenses is an option in case of deficient capsular support. Visual outcomes and complication rates are comparable to other case series.
Asunto(s)
Implantación de Lentes Intraoculares/métodos , Lentes Intraoculares , Esclerótica/cirugía , Técnicas de Sutura , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Afaquia Poscatarata/cirugía , Niño , Preescolar , Femenino , Humanos , Implantación de Lentes Intraoculares/efectos adversos , Masculino , Persona de Mediana Edad , Complicaciones Posoperatorias/etiología , Estudios Retrospectivos , Esclerótica/patología , Técnicas de Sutura/efectos adversos , Resultado del Tratamiento , Agudeza Visual , Adulto JovenAsunto(s)
Hematoma/diagnóstico , Enfermedades Orbitales/diagnóstico , Enfermedades de los Senos Paranasales/cirugía , Complicaciones Posoperatorias/diagnóstico , Anciano , Drenaje , Femenino , Hematoma/etiología , Hematoma/cirugía , Humanos , Enfermedad Iatrogénica , Síndromes de Compresión Nerviosa/diagnóstico , Síndromes de Compresión Nerviosa/etiología , Síndromes de Compresión Nerviosa/cirugía , Enfermedades del Nervio Óptico/diagnóstico , Enfermedades del Nervio Óptico/etiología , Enfermedades del Nervio Óptico/cirugía , Enfermedades Orbitales/etiología , Enfermedades Orbitales/cirugía , Enfermedades de los Senos Paranasales/diagnóstico , Complicaciones Posoperatorias/etiología , Complicaciones Posoperatorias/cirugía , Hemorragia Posoperatoria/complicaciones , Hemorragia Posoperatoria/diagnóstico , Hemorragia Posoperatoria/cirugíaAsunto(s)
Cuerpos Extraños en el Ojo/complicaciones , Cuerpos Extraños en el Ojo/diagnóstico , Cabello , Queratitis/diagnóstico , Queratitis/etiología , Lepidópteros , Adulto , Animales , Cuerpos Extraños en el Ojo/cirugía , Femenino , Humanos , Queratitis/cirugía , Lepidópteros/citología , Microscopía Confocal , Imagen Multimodal/métodos , Lámpara de Hendidura , Espectrofotometría Infrarroja , Tomografía de Coherencia ÓpticaAsunto(s)
Hemorragias Intracraneales/complicaciones , Hemorragia Retiniana/complicaciones , Trastornos de la Visión/diagnóstico , Trastornos de la Visión/etiología , Hemorragia Vítrea/complicaciones , Calcinosis/complicaciones , Calcinosis/diagnóstico , Diagnóstico Tardío , Femenino , Angiografía con Fluoresceína , Humanos , Hemorragias Intracraneales/diagnóstico , Persona de Mediana Edad , Hemorragia Retiniana/diagnóstico , Síndrome , Factores de Tiempo , Hemorragia Vítrea/diagnósticoAsunto(s)
Embolia por Colesterol/complicaciones , Embolia por Colesterol/diagnóstico , Imagen Multimodal/métodos , Oclusión de la Arteria Retiniana/diagnóstico , Oclusión de la Arteria Retiniana/etiología , Adulto , Femenino , Angiografía con Fluoresceína , Fondo de Ojo , Humanos , Arteria Retiniana/diagnóstico por imagen , Arteria Retiniana/patología , Tomografía de Coherencia Óptica/métodosAsunto(s)
Enfermedades de la Coroides/diagnóstico , Arteritis de Células Gigantes/diagnóstico , Isquemia/diagnóstico , Enfermedad Aguda , Anciano , Enfermedades de la Coroides/etiología , Diagnóstico Diferencial , Femenino , Angiografía con Fluoresceína/métodos , Francia , Arteritis de Células Gigantes/complicaciones , Humanos , Verde de Indocianina , Isquemia/etiologíaRESUMEN
INTRODUCTION: Keratoprostheses offer a therapeutic alternative to patients with bilateral corneal blindness who cannot undergo corneal allograft. The goal of this work was to evaluate the indications and limitations of Boston keratoprosthesis. MATERIALS AND METHODS: Seven patients underwent unilateral implantation of a Boston type I keratoprosthesis between December 2012 and November 2016. The following data were collected: surgical indication, preoperative visual acuity, postoperative visual acuity at D1, D7, D30, 6 months and 12 months, complications and postoperative treatment. RESULTS: The mean age of implantation was 58.7±23.4 years. The surgical indications included 1 case of congenital bilateral aniridia, 2 cases of chemical burn and 4 graft decompensations after multiple keratoplasties. Preoperative visual acuity was limited to "light perception" in 6 cases and "hand motion" in one case. A gain in visual acuity was observed in 4 patients, which corresponded to a mean gain of 1.53 logMAR at last follow-up. Postoperative visual acuity averaged 2.33 logMAR. All patients experienced an improvement in their quality of life and independence. DISCUSSION: Patients should be selected carefully, favoring patients with a remaining functional potential and able to engage in close postoperative follow-up, in order to ensure the best possible treatment success. CONCLUSION: Boston keratoprosthesis provides improved vision and improved quality of life for patients suffering from bilateral corneal blindness.