Dataset Information

Persistent Air Bubble Sequestered at the Silicone Oil-Silicone Intraocular Lens Interface as a Cause of Reversible Visual Distortion.

ABSTRACT:

Purpose

To report a novel cause of post-operative reversible visual distortion due to a persistent air bubble sequestered at the intraocular lens (IOL)-silicone oil interface.

Methods

Two cases of persistent, sequestered air at the IOL-silicone oil interface were identified and reviewed. Relevant clinical information, images and surgical videos were analyzed and described.

Results

Resolution of the visual distortion was achieved in both cases after silicone oil removal.

Conclusions

Silicone oil adhesion to the posterior surface of silicone IOLs is a known cause of visual degradation. The IOL-silicone oil interface can sequester air that persists and causes visual distortion until the oil is removed. We report the first cases, to our knowledge, of reversible visual distortion due to sequestered air at the IOL-silicone oil interface.

SUBMITTER: Agranat JS

PROVIDER: S-EPMC9976243 | biostudies-literature | 2021 Jul-Aug

REPOSITORIES: biostudies-literature

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Publications

Persistent Air Bubble Sequestered at the Silicone Oil-Silicone Intraocular Lens Interface as a Cause of Reversible Visual Distortion.

Agranat Joshua S JS Eliott Dean D

Journal of vitreoretinal diseases 20201109 4

<h4>Purpose</h4>To report a novel cause of post-operative reversible visual distortion due to a persistent air bubble sequestered at the intraocular lens (IOL)-silicone oil interface.<h4>Methods</h4>Two cases of persistent, sequestered air at the IOL-silicone oil interface were identified and reviewed. Relevant clinical information, images and surgical videos were analyzed and described.<h4>Results</h4>Resolution of the visual distortion was achieved in both cases after silicone oil removal.<h4> ...[more]

PMID: 37007595

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Project description:PurposeTo report two patients with a complication of Yamane intrascleral haptic fixation surgery (ISHF) with the Zeiss CT Lucia 602 lens: severely tilted intraocular lens (IOL) leading to significantly decreased vision in the early post-operative period.ObservationsWe report two patients presenting with severely tilted IOL implants one day and one month following Yamane ISHF. The first patient is a monocular 81-year-old woman referred for treatment of cornea edema. Initial surgery involved replacement of an anterior chamber lens with a CT Lucia 602 posterior chamber lens using Yamane technique and Descemet's stripping endothelial keratoplasty. The patient returned at one month follow-up with poor vision and IOL tilt observable at the slit lamp through a peripheral iridectomy site. Explanation of the Zeiss lens revealed haptic distortion at the optic-haptic insertion point such that each haptic was about 45° off axis to the plane of the optic in approximately equal and opposite directions. The second patient, a 75-year-old woman, was referred with a completely dislocated lens-bag complex in the right eye. The initial operative treatment for this patient included pars plana vitrectomy, retrieval and removal of the dislocated lens-bag complex, and placement of a Zeiss 602 lens via Yamane ISHF technique. On the first postoperative day, the patient was count fingers in the right eye with an intraocular pressure of 5 mm Hg and obvious IOL tilt on slit lamp examination. Explanation of the lens revealed severely distorted haptics relative to the optic by more than a 60-degree angle on both sides. In both cases, initial surgery was performed with an IOL inspected prior to implantation and found to have normal appearing haptics. At the end of each case, there was adequate centration and no tilt of the IOL. Management in both patients included removal of the defective lens and placement of a new, same power CT Lucia 602 lens via the Yamane technique. Visual acuity improved from CF to 20/30 best corrected after reoperation in both cases.Conclusions and importanceIn summary, we describe a complication of Yamane ISHF with the CT Lucia 602 lens in which there is lens tilting associated with distortion at the optic-haptic fastening zone in the early postoperative period. In the event of a titled lens following Yamane ISHF, awareness of this complication may help surgeons consider lens replacement, as the haptics may be permanently distorted or damaged.

Project description:PurposeAn increasing number of posterior segment disorders is routinely managed with pars plana vitrectomy (PPV). In older, phakic patients cataract formation is expected within the first two years after surgery. For younger patients its progression is individually fluctuating. This study uses an objective quantitative measurement for lens-status-monitoring after PPV with silicone oil to derive predictions for progression and severity of post-operative lens opacification evaluated in patients with rhegmatogenous retinal detachment (RRD).MethodsData acquisition was performed prospectively between March 2018 and March 2021. PentacamHR® Nucleus Staging mode (PNS) was used to objectively gather data about nuclear cataracts after PPV at different time points. Data was grouped into training and test sets for a mathematical prediction model. Via backward variable selection method a mathematical formula was set up by means of which predictions about lens densitometry (LD) can be calculated.Results20 males [58.8%] and 14 females [41.2%] matched the inclusion criteria (mean age 50.6 years [23-75; ±12.3]). Average follow-up was 8.1 months (3,4-17.4; ±3.4). Mean baseline LD of the treated and fellow eye before surgery was 11.1% (7.7%-17.6%; ±2.0) and 11.2% (7.7%-14.8%; ±1.5), respectively. Predicted LD values by the model for five pre-selected patients closely match the observed data with an average deviation of 1.06%.ConclusionsUsing an objective parameter like LD delivered by the PentacamHR® PNS mode additionally to the patient's age allows us to make an individual prediction for any time after PPV with silicone oil due to RRD for all ages. The accuracy of the model was stronger influenced by baseline LD as cofactor in the equation than patient's age. The application for the prediction lens opacification [which can be accessed for free under the following link (https://statisticarium.com/apps/sample-apps/LensDensityOil/)] can help vitreoretinal surgeons for patient consultation on the possibility to combine PPV with cataract surgery.

Dataset Information

Persistent Air Bubble Sequestered at the Silicone Oil-Silicone Intraocular Lens Interface as a Cause of Reversible Visual Distortion.

Purpose

Methods

Results

Conclusions

Publications

Persistent Air Bubble Sequestered at the Silicone Oil-Silicone Intraocular Lens Interface as a Cause of Reversible Visual Distortion.

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