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Copyright of Turkiye Klinikleri Journal of Forensic Medicine & Forensic Sciences / Türkiye Klinikleri Adli Tıp ve Adli Bilimler Dergisi is the property of Turkiye Klinikleri and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The ideal location of intraocular lens implantation is the posterior chamber. The capsular bag is left during the cataract operations in order to implant the intraocular lens in the position of the crystalline lens and the artificial lens is applied inside this bag. When the capsular bag is not protected we think fixating the intraocular lens into the iridocorneal angle, iris or sclera. The scleral-fixated intraocular lens implantations have developed very much since the day the technique has been invented. Today there are a lot of scleral fixation techniques, sutured or sutureless, and they are used for a lot of different indications. In this review I will describe these techniques concisely.

Amaç: Bu çalışmanın amacı yeterli arka kapsüler desteği olmayan hastalarda primer iris-fiksasyonlu ve skleral fiksasyonlu arka kamara göz içi mercek implantasyonlarının sonuçlarını karşılaştırmaktır.Gereç ve Yöntem: Katarakt ameliyatı sırasında yetersiz arka kapsül desteği nedeniyle primer sütüre arka kamara göz içi mercek implantasyonu yapılan hastaların prospektif analizi yapıldı. En iyi düzeltilmiş görme keskinliği, görme keskinliği artışı ve gelişen komplikasyonlar değerlendirildi.Bulgular: Çalışmamızda 13 hastaya (%30,2) iris-fiksasyonlu ve 30 hastaya (% 69,8) skleral fiksasyonlu arka kamara göz içi mercek implantasyonu uygulandı. İris fiksasyonlu grupta 11 hastada (%84,6), skleral fiksasyonlu grupta 25 hastada (%83,3) görme keskinliği , Snellen eşeline göre en az 1 sıra arttı. İris fiksasyonlu grupta % 30,8 hastada (n = 4), skleral fiksasyonlu grupta % 50 hastada (n = 15) 0,5 ve üzerinde en iyi düzeltilmiş görme keskinliği mevcuttu. Sonuç: Primer iris-fiksasyonlu ve skleral fiksasyonlu arka kamara göz içi mercek implantasyonları tatmin edici görsel sonuçlar vermektedir. Sütüre arka kamara göz içi merceğin fikse edileceği bölgenin seçiminde altı çizilmesi gereken noktalar; gözünün ameliyat öncesi durumu, arka kamara göz içi merceğin fikse edilecek bölgenin durumu, lensin türü ve cerrahın tercihidir.

Copyright of Current Retina Journal / Güncel Retina Dergisi is the property of Anadolu Kitabevi Basim Yayim Medikal Turizm Kirtasiye Tic. Ltd. Sti. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Purpose: To evaluate the factors affecting visual prognosis in bilateral pediatric cataracts and the complications of surgery. Materials and method: The records of 40 patients operated for bilateral congenital cataract at GÜTF Eye Clinic between 2010-2018 were retrospectively analyzed. Peroperatively capsulotomy, lens aspiration, posterior capsulotomy and anterior vitrectomy were performed. Primary iol implantation was performed in cases over one year of age. Secondary IOL implantation was performed at 2 years of age unless contraindicated. Visual acuity, intraocular pressure, presence of strabismus, amblyopia, nystagmus and surgical complications were evaluated. Results: The mean follow-up period was 4 years (1 month-8 years). 22 of the cases were male (55%) and 18 were female (45%). Seventeen patients (42.5%) underwent surgery before 3 months of age, and 23 patients (57.5%) underwent surgery after 3 months of age. 8 out of 30 patients who left aphakic went for secondary IOL implantation at the mean age of 5 years. The mean postoperative BCVA was 0.4 logMAR±0.4 (P +/ - 0 logMAR). The BCVA of the group undergoing IOL implantation was statistically higher (p = 0.007). Nystagmus was present in 6 out of 22 patients who left aphakic where postoperative nystagmus was recorded 3 out of 18 patients with IOL implanted. Two cases showed posterior capsule opasification, where, 1 retinal detachment, 1 glaucoma and 1 IOL subluxation cases were recorded as complications. Conclusion: IOL implantation was associated with good visual prognosis and the presence of nystagmus was associated with poor visual prognosis in bilateral childhood cataracts. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the efficacy and safety of modified suture burial technique in scleral fi xation intraocular lens implantation in eyes with inadequate capsular support as a result of various etiologies. Material and Methods: The medical records of 52 eyes of 52 patients that underwent scleral fi xation intraocular lens implantation and followed at least 12 months were included, and medical charts were retrospectively reviewed. Demographical features of the patients, postoperative best corrected visual acuity, suture-related complications, and duration of follow up were recorded. The scleral fi xation sutures were buried in the scleral using modified Z Baykara technique. Results: Of the 52 patients, 32 were male and 20 were female. The mean age was 59.2±15.9 years (19-80 years). Mean follow-up was found as 26.7±6.8 months (12-38 months). The preoperative best corrected visual acuity (Snellen chart) was 0.24±0.17 (0.01-0.06), whereas it was found 0.53±0.29 (0.1-1.0) at the fi nal visit (p<0.0001). The mean astigmatism was found 3.1±2.5 D (0.50-9.25 D) at the end of 12 month. The main postoperative complications were suture erosion (2 patients, 4.5%), cystoid macular edema (2 patients, 4.5%), minimal tilted intraocular lens (1 patient, 2.2%) and retinal detachment (1 patient, 2.2%). Conclusion: For aphakic rehabilitation; scleral fi xation intraocular lens implantation was a favorable treatment option in eyes with inadequate capsular support as a result of various etiologies. The suture burial using modified Z Baykara technique was found to be safe and effective method to prevent postoperative complications. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate changes in anterior chamber depth (ACD) and postoperative refractive outcomes after combined phacovitrectomy. Materials and Methods: This study included 10 eyes of 10 patients that underwent combined phacovitrectomy (study group) and 14 eyes of 14 patients that underwent phacoemulsification surgery (control group) at İstanbul Medipol University Ophthalmology Department. Preoperative and 3-month postoperative best corrected visual acuity (BCVA), ACD, change in ACD and refractive outcomes were compared between the two groups. Results: Preoperative ACD, postoperative ACD at 3 months and change in ACD were similar between two groups (p=0.403, p=0.886, p=0.841). Postoperative mean refractive outcomes were 0.22±0.51 diopter in the phacovitrectomy group and -0.39±0.53 diopter in the phacoemulsification group (p=0.019). BCVA was increased in both groups (p=0.001). Conclusion: Postoperative refractive outcomes in eyes that underwent combined phacovitrectomy are different from those in eyes that underwent only phacoemulsification surgery. This is important in determining preoperative intraocular lens power before combined phacovitrectomy.

Purpose: The purpose of this study was to compare the results of primaryiris-fixated and scleral-fixated posterior chamber intraocular lens implantations in patients with in sufficient capsular support. Materials and Methods: A prospective analysis of patients who underwent primary sutured posterior chamber intraocular lens implantation secondary to insufficient posterior capsular support during cataract surgery was performed. Outcome measures were; best corrected visual acuity, change in visual acuity and complications. Results: In this study, 13 patients (30.2%) underwent irisfixated and 30 patients (69.8%) scleral-fixated posterior chamber intraocular lens implantations. The visual acuity improved by at least one Snellen line or remained unchanged in 11 patients (84.6%) in the iris-fixated group and i n 25 patients ( 83.3%) in the scleral-fixated group. Patients with best corrected visual acuity of 0.5 or higher were 30.8% (n = 4) in the iris-fixated group and 50% (n = 15) in scleral-fixated group postoperatively. Conclusion: Both primary iris- fixated and scleral-fixated posterior chamber intraocular lens implantations can provide favorable visual outcomes. The points to underline for the fixation of the sutured posterior chamber intraocular lens are; the preoperative condition of the patient's eye, the situation of the area to be fixed, the type of lens and the preference of the surgeon. [ABSTRACT FROM AUTHOR]

A 11-year-old female presented ocular findings like pupillary block, secondary angle-closure glaucoma and high myopic refraction due to bilateral microspherophakia and lens dislocation. In her right eye, we performed extraction of the microspheric lens with irrigation-aspiration (I/A), and implantation of a capsular tension ring and a hydrophobic acrylic foldable intraocular lens after posterior capsulorhexis were performed with pars plana intervention with 25-gauge vitrectomy and anterior vitrectomy. The same surgical procedures were performed for the left eye, except that Cionni capsule tension ring was used. Thus, pupillary block and secondary angle-closure glaucoma risk were eliminated and high myopic refractive error due to microspherophakia was corrected. [ABSTRACT FROM AUTHOR]

Traumatic cataract is a frequent consequence of trauma to the eye. Management of traumatic cataract and timing of surgery are based on location and morphology of the lens opacity, visual acuity, intraocular pressure control, presence of intraocular inflammation, and ability to examine the posterior segment. Modern advances in microsurgical techniques have enhanced the results of cataract surgery. Primary intraocular lens implantation has achieved good visual results in an increasingly large number of patients. Careful examination and accurate diagnosis are critical in surgical decision-making, both in the choice of the most appropriate timing for surgery and the selection of the best surgical technique. (Turk J Ophthalmol 2012; 42: Supplement 31-5)

Technical progress in cataract surgery has decreased the incidence of severe complications in this type of surgery. The introduction of micro incision cataract surgery (MICS) (sub- 2.0 mm incision) allow the surgeon to achieve better postoperative control of astigmatism and higherorder aberration (HOAs) with minimum induction of both. It is believed that multifocal lenses provide very successful results, however, there are limitations to these. Implantation of accommodating intraocular lenses (IOLs) is an option to treat presbyopia. The IOLs work by using the continued functionality of the ciliary muscle after cataract removal. Accommodating IOLs were designed to avoid the optical side effects of multifocal IOLs. Two main design concepts exist. First, axial shift concepts rely on anterior axial movement of one or two optics creating accommodative ability. Second, curvature change designs are designed to provide significant amplitudes of accommodation with little physical displacement. Accommodative IOLs to correct astigmatism and HOAs in the future are needed. (Turk J Ophthalmol 2012; 42: 288-93)

Purpose: To investigate safety and effectiveness of phacoemulsification (PE) intraocular lens (IOL) implantation in patients with cataract and in patients with cataract and silicone oil endotamponade. Material and Methods: Patients with cataract and SO endotamponate (Group I) and senile cataract (Group II) were included in this study. Patients had PE-IOL implantation operation. Two groups were compared for corrected visual acuity (CVA), intraocular pressure (IOP) measurements and complications at preoperative, postoperative 3th and 6th month controls. Results: In Group I 15 eyes of the 15 patients [M/F=9/6, age=63.53±4.74 years] and in Group II 15 eyes of the 15 patients [M/F=7/8, age=62.86±4.74 years] were included in this study. The follow-up after PE-IOL implantation operation was 7.13±0.99 months (6-9 months) in Group I and 7.03±1.18 months (6-9 months) in Group II. With Group I and Group II turn, CVA measurements were 2.03±0.74 LogMar (1.0-3.0 LogMar) and 0.58±0.15 LogMar (0.43-1LogMar) before PE-IOL implantation operation, 1.61±0.84 LogMar (0.5-3.0 LogMar) and 0.02±0.04 LogMar (0-1 LogMar) 3 months after operation, 1.5±0.70 LogMar (0.2-3.0 LogMar) and 0.02±0.03 LogMar (0-1 LogMar) 6 months after operation. In both groups there were significant improvement for CVA at postoperative 3th and 6th months controls with respect to preoperative CVA. There was not a significant change in IOP at postoperative 3th and 6th months controls with respect to preoperative IOP. Posterior capsule opacification was observed significantly more in Group I (40%) than Group II (13%) patients. Conclusion: PE-IOL implantation operation is safe and effective in patients with in patients with cataract and silicone oil endotamponade. [ABSTRACT FROM AUTHOR]

Objective: To assess the outcomes of pars plana vitrectomy (PPV) and scleral-fixated intraocular lens (SFIOL) implantation which posteriorly dislocated intraocular lens (IOL) and nucleus drop. Methods: Twenty four eyes of 24 patients that were implanted by PPV and SFIOL between January 2013 and January 2015 were retrospectively evaluated. Pre-and postoperative findings and complications were evaluated. Results: The mean age was 65.75±13.44 (32-87). The mean follow-up time was 21.29±7.17 (9-33) months. Fourteen patients were operated by IOL dislocation and 10 by nucleus or partial nucleus drop. Six dislocated lOLs were fold-able one part, 6 foldable three parts, and 2 PMMA lenses. In IOL dislocations, 7 patient's own lOLs; in 7 patients, a new IOL is fixed to the sclera. One-sided scleral fixation was applied to 9 patients. IOL implementation was applied to 9 patients by opening the scleral flap and to 15 patients by not opening the scleral flap. When the postoperative corrected visual acuities of the patients were compared with the preoperative corrected visual acuities, the mean visual acuity increased by 0.2 or more in 12 patients (50%) with Snellen acuity card, remained the same in 8 patients (33.30%), and decreased in 4 patients (16.6%). Postoperatively retinal detachment was noted 1 patient (4.15%), increased intraocular pressure in 2 (8.30%), suture exposure in 4 (16.66%), and cystoid macular edema in 2 (8.30%). Hypotonia, choroid detachment, and endophthalmitis were not detected. Conclusion: In nucleus drop and IOL dislocation, PPVand SFIOL implementation should be attentively performed by taking into account serious complications in patients lacking capsular support. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the effect of using customized A-constant on reaching target refraction in cataract patients. Materials and Methods: The study included patients whose cataract stage was determined prior to surgery and who had no additional ocular disease. The same physician measured contact A-scan axial length and corneal strength using an A-scan ultrasonic biometry device (HiScan, Optikon, Italy) and a keratometry device (Ophthalmometer, CSO, Italy), respectively. Results: Of the 52 patients with complete medical files accepted to the study, 32 were women and 20 were men. The average cataract grade was 2.66±0.52 (1 to 4); mean target spheric equivalent was -0.70±0.24 diopter (D) and mean final refraction was -1.28±0.66 D at the 2 month post-operative examination. Mean absolute deviation from target refraction was found to be 0.65±0.45 D (0.04 to 2.51), mean net deviation was -0.58±0.54 D (+0.85 to -2.51). Using standard A-constant, 38.4% (21/52) of the eyes were within ±0.50 D of the target refraction and 82.7% (43/52) of eyes were within ±1.00 D. When the customized A-constants based on mean net deviation were used, these levels increased to 69.2% (36/52) for within ±0.50 D of the target refraction and 96.2% (50/52 eyes) for within ±1.00 D. Conclusion: Contact with the eye during contact ultrasonic biometry results in a short axial length measurement and causes deviation in the final refraction toward myopia. Through the use of customized A-constant, this habitual measurement error can be corrected effectively. [ABSTRACT FROM AUTHOR]

Purpose: To investigate safety and effectiveness of combined phacoemulsification (PE), intraocular lens (IOL) implantation and transpupiller silicone oil (SO) removal. Material and Method: Thirty patients having pars plana vitrectomy (PPV), SO endotamponate, without need for additional vitreoretinal surgery had combined PE-IOL implantation and transpupiller silicone oil (SO) removal. Preoperative, postoperative corrected visual acuity (CVA), intraocular pressure (IOP), complications were investigated. Results: Before combined PE-IOL implantation and SO removal operation mean CVA was 1.71±0.87 (0.56-3.0) LogMar and mean CVA following the operation, at 3th months control, was 1.08±0.90 (0.15-2.65) LogMar (p=0.001).The mean IOP before the operation was 19.21±2.19 (16-21) mmHg and the mean IOP following the operation, at 3th months control, was 17.32±2.45 (15-20) mmHg (p=0.001). Retinal redetachment rate was 6.66% following the operation. Conclusion: "Combined PE-IOL implantation and transpupiller SO removal" is an effective and safe procedure, for patients having no need of additional vitreoretinal surgery. [ABSTRACT FROM AUTHOR]

Pseudophakic pseudoexfoliation is the accumulation of pseudoexfoliation material on the intraocular lens. Most of the cases have showed scattered flecks of pseudoexfoliation material on the surface of the intraocular lens. However, the phakic pattern consisting of classic three-zone on the intraocular lens is rarely observed. In this case report, we describe a phakic pattern pseudoexfoliation material on the intraocular lens surface 8 years after cataract extraction. (Turk J Ophthalmol 2014; 44: 156-7)

In cases with proliferative vitreoretinopathy (PVR), for a successful surgical goal, while releasing of tractions by removing proliferative tissues, closing tears and ensuring of retinal adhesion, our primary target should be correcting the disadvantages caused by the lens.To prevent from anterior proliferative vitreoretinopathy, the most common cause of relapsed detachment, phakic and pseudophakic patients should be addressed separately depending on preoperative evaluation and intraoperative requirements. Also cornea, iris, lens, ciliary body and choroid should be evaluated carefully because they affect the sugical prosess. Attempts to lens, facilitate surgical imaging ,ensure clear visualization, allow better approach to the anterior vitreus and so provide the convenience of manipulation of tissue. In cases with PVR, if there is no indication of lensectomy for clear lens then lens should not be removed but if situations require removal of the lens then refractive rehabilitation concerns should not take precedence over lensectomy. After a surgery that is considered successfully finalized, the formation of cyclitic membrane due to the vitreous base is not completely cleaned, ciliary detachment develops because of contraction of these membranes and this brings hipotony or relapsed detachments that may cause undesirable outcomes we don't want to encounter. Therefore, in these cases phacoemulsification surgery can be applied in combination with pars plana vitrectomy and also applicable to sequential surgery. Although not a classic surgical approach, pars plana vitrectomy combined with pars plana lensectomy, especially in phakic patients with PVR and in patients with retinal detachment due to giant tear complicated by PVR, may be a second surgical option. [ABSTRACT FROM AUTHOR]

Purpose: To determine reasons of IOL extraction and evaluate the prognosis of the patients that had IOL extraction. Materials and Methods: We evaluate 29 patients that had anterior segment IOL extraction in Ankara Education and Research Hospital, between 2006-2010. We divide the patients into 3 groups Group 1; IOL extraction because of pseudophakic bullous keratopathy, Group 2; IOL extraction because of dislocation, Group 3; IOL extraction because of high intraocular pressure (IOP). Before and after IOL extraction, best corrected visual acuity (BCVA) was detected, biomicroscopic, posterior segment examination were done, IOP and corneal thickness were measured. Follow up periods were 1. day, 1. week, 1. month, 3. month, 6. month after operation. Then the patients were followed every 6 months. Results: The most common symptom was visual loss in group 1 (68.2%) and group 2 (100%), visual loss (50%) and pain (50%) in group 3. The most frequently explanted IOL in group 1 was angle supported anterior chamber PMMA IOL (86.4%), one piece hydrophilic acrylic IOL (66.6%) in group 2, angle supported anterior chamber PMMA IOL (50%) in group 3. Preoperative and postoperative corneal thickness was thicker in group 1, compared with other groups (p<0.001). In group 3, preoperative IOP was higher then other groups (p<0.001). There wasn't any statistical difference between groups, after operation. In group 1, preoperative and postoperative BCVA was lower then other groups (p<0.001). Conclusion: The most common patient symptom is visual loss in patients that had IOL extraction. IOL extraction doesn't change the level of keratopathy in pseudophakic bullous keratopathy patients. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate foldable scleral fixation and iris-claw intraocular lens (IOL) implantations in aphakic eyes without capsular support. Materials and Methods: Scleral fixation of a monoblock hydrophobic acrylic IOL was performed in group 1. Monoblock polymethyl-methacrylate IOL was used as the iris-claw IOL in group 2. Pre-and postoperative best-corrected-visual acuity (BCVA), astigmatism and other findings were compared among groups. Results: Group 1 included twenty-one patients, while group 2 eighteen. Follow-up time (months) was 10.54±4.15 (6-20) and 12.13±6.28 (6-25), in group 1 and 2, respectively. Mean age (years) was 61.81±11.48 (39-78) and 57.17±13.57 (11-78) in group 1 and 2, respectively. Preoperative BCVA (logMAR) was 0.45±0.17 (0.15-1.0) and 0.48±0.19 (0.05-1.0) in group 1 and 2, respectively. Postoperative BCVA (logMAR) was 0.37±0.18 (0.15-1.0) and 0.38±0.21 (0.15-1.0) in group 1 and 2, respectively. Preoperative mean astigmatism (diopters) was 1.75±1.21 (0.25-4.00) and 1.81±1.34 (0.25-3.75) in group 1 and 2, respectively. Postoperative mean astigmatism (diopters) was 1.79±1.29 (0.25-4.00) and 1.93±1.53 (0.25-4.25) in group 1 and 2, respectively (p=0.83). Transient postoperative intraocular pressure rise developed in two eyes and three eyes in group 1 and 2, respectively. Cystoid macular edema was observed in two eyes in each group. IOL decentralization after mydriasis occurred in three eyes and one eye in group 1 and 2, respectively. Conclusion: Foldable scleral fixation or iris-claw IOLs are alternative treatments for aphakia in eyes without capsular support. Although the difference failed to reach a statistical significance, astigmatism was higher with iris-claw IOLs compared to astigmatism with scleral fixation IOLs. [ABSTRACT FROM AUTHOR]

We planned to evaluate the results of scleral fixation with modified Siepser method in the treatment of subluxated posterior chamber intraocular lenses (IOL). Four patients who were referred to our clinic for decreased vision some time after cataract surgery and diagnosed as IOL subluxation were included in this study. Existing IOLs were hanged on to sclera from one of their haptics with 10-0 polyprolein pc 9 suture. Preoperative and postoperative visual acuities were measured and patients were followed up for the sustained centralization of IOLs. Mean age of the patients were 41.25±21.69 years (range:15-69 years), and they were followed up for 5.75±3.30 months (range: 2-9 months). The best corrected visual acuities according to Snellen chart were 0.14±0.08 rows (range: 0.05-0.2 rows) preoperatively and 0.53±0.15 rows (range: 0.4-0.7 rows) postoperatively. There were no intraoperative complications. Three of four patients (75%) have maintained centralized IOLs, but one with nystagmus have again developed decentralized IOL in the postoperative period. In decentralized posterior chamber IOLs; hanging on from one haptic of subluxated IOL to sclera is an alternative surgery to IOL exchange and scleral or iris fixated IOL implantation. In selected patients, with this technique for preserving the existing IOLs, visually successful results can be obtained. [ABSTRACT FROM AUTHOR]

Traumatic cataract is a frequent consequence of trauma to the eye. Management of traumatic cataract and timing of surgery are based on location and morphology of the lens opacity, visual acuity, intraocular pressure control, presence of intraocular inflammation, and ability to examine the posterior segment. Modern advances in microsurgical techniques have enhanced the results of cataract surgery. Primary intraocular lens implantation has achieved good visual results in an increasingly large number of patients. Careful examination and accurate diagnosis are critical in surgical decision-making, both in the choice of the most appropriate timing for surgery and the selection of the best surgical technique. [ABSTRACT FROM AUTHOR]

Technical progress in cataract surgery has decreased the incidence of severe complications in this type of surgery. The introduction of micro incision cataract surgery (MICS) (sub- 2.0 mm incision) allow the surgeon to achieve better postoperative control of astigmatism and higherorder aberration (HOAs) with minimum induction of both. It is believed that multifocal lenses provide very successful results, however, there are limitations to these. Implantation of accommodating intraocular lenses (IOLs) is an option to treat presbyopia. The IOLs work by using the continued functionality of the ciliary muscle after cataract removal. Accommodating IOLs were designed to avoid the optical side effects of multifocal IOLs. Two main design concepts exist. First, axial shift concepts rely on anterior axial movement of one or two optics creating accommodative ability. Second, curvature change designs are designed to provide significant amplitudes of accommodation with little physical displacement. Accommodative IOLs to correct astigmatism and HOAs in the future are needed. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the results of knotless Z-suture scleral fixation intraocular lens (IOL) implantation technique to ciliary sulcus. Materials and Methods: Twenty subjects whom Z- suture scleral fixation IOL implantation was performed, were included in the study. Visual acuity, intraocular pressure, operative and postoperative complications were recorded. Results: Best corrected visual acuity at postoperative 2. month was significantly higher compared to the best corrected visual acuity at preoperative period (p=0.037). Best corrected visual acuity remained the same at 6 subjects and increased at 14 subjects and except 1 case all subjects achieved a visual acuity of logMAR 0.3 or better. Only in 1 subject, hyphema was seen during operation. At the postoperative period, suture exposure was seen at 1 subject at 1. month and 2 subjects developed secondary open angle glaucoma which was controlled by medical treatment. No intraocular lens dislocation or tilt was seen. Conclusion: Complications of Z-suture scleral fixation IOL implantation technique are minimal and it can be performed in short duration, easily and safely. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate anterior chamber depth (ACD) and spherical refractive changes in patients undergoing phacoemulsification surgery and in the bag implantation of different types of intraocular lens (IOL). Materials and Methods: This prospective study included 80 eyes of 80 patients undergoing phacoemulsification surgery and implantation of 4 different types of IOL between June 2011 and May 2012. Patients were divided into four groups according to the type of implanted IOL (Acriva UD 613, Alcon Acrysof MA60BM, Eyecryl HS AS600, Zaraccom F 260). There were 20 patients in each group. Patients were examined on the postoperative first week, first month and third month. Measurements of intraocular pressure, axial length, ACD and calculation of IOL diopters with SRK II formula were carried out preoperatively. Measurements of ACD and refraction were carried out on postoperative first week, first month and third month. Significance of ACD and refraction changes between preoperative and postoperative first week, first month and third month were investigated. Results: We determined increase in ACD values for all patients. Comparison of the preoperative ACD and the postoperative first week ACD measurements revealed greatest ACD increase in Alcon IOL implanted group. Comparison of the postoperative first week ACD and the postoperative first and third month ACD measurements revealed greatest ACD decrease, which was also statistically significant in Zaraccom IOL implanted group (p=0.003). We did not determine statistically significant differences in the spherical refraction of any group between the first postoperative week and the first postoperative month (p values for Acriva, Alcon, Eyecryl and Zaraccom were 0.178, 0.154, 0.153 and 0.206, respectively). Conclusion: It is important to be aware of the factors affecting the target refraction other than ACD associated with IOL to improve refractive outcomes. [ABSTRACT FROM AUTHOR]

Technical progress in cataract surgery has decreased the incidence of severe complications in this type of surgery. The introduction of micro incision cataract surgery (MICS) (sub- 2.0 mm incision) allow the surgeon to achieve better postoperative control of astigmatism and higherorder aberration (HOAs) with minimum induction of both. It is believed that multifocal lenses provide very successful results, however, there are limitations to these. Implantation of accommodating intraocular lenses (IOLs) is an option to treat presbyopia. The IOLs work by using the continued functionality of the ciliary muscle after cataract removal. Accommodating IOLs were designed to avoid the optical side effects of multifocal IOLs. Two main design concepts exist. First, axial shift concepts rely on anterior axial movement of one or two optics creating accommodative ability. Second, curvature change designs are designed to provide significant amplitudes of accommodation with little physical displacement. Accommodative IOLs to correct astigmatism and HOAs in the future are needed. (Turk J Ophthalmol 2012; 42: 288-93) [ABSTRACT FROM AUTHOR]

The life expectancy of elderly cataract patients is increasing and intraocular lens (IOL) implantation is performed in pediatric cataract patients who will have an even longer life expectancy. Longer life expectancy has increased the implantation of blue-filtering IOLs, which are more protective against the harmful effects of light. Studies showed that these IOLs have no negative effect on visual acuity, contrast sensitivity, color vision, scotopic vision, or circadian rhythm. [ABSTRACT FROM AUTHOR]

The use of single-use material for cataract surgery with the phacoemulsification (PE) method is constantly increasing. The reuse of single-use material following sterilization can cause many problems, including loss of vision. The sterilization of single-use material has been forbidden by the Ministry of Health in our country and relevant notifications have been sent to healthcare providers. We report snail-track deposits at the back surface of the intraocular lens (IOL) that caused visual problems following the sterilization by ethylene oxide and reuse of an IOL cartridge in two cases. We postulate the deposits that caused symptoms of postoperative blurred vision and glare in both cases were residue of the viscoelastic substance that had undergone denaturation. Single-use material should only be used once to avoid such problems. [ABSTRACT FROM AUTHOR]

Phacoemulsification and a monoblock intraocular lens implantation into the capsular bag were planned in a 70 years old male patient's right eye. After an uneventful phacoemulsification, the posterior capsule perforation and zonular dialysis occurred at seven o'clock position during the lens implantation with cartridge. In this case, lower haptic of the intraocular lens was sutured to the iris with 10/0 prolene suture without removing the lens from the eye. Any lens related complication was not observed at six months follow-up period and 10/10 vision was achieved with -0.75 diopter correction. Spherical -0.75 and - 0.50 diopter astigmatism was measured with the auto-refractometer. In patients with the perforation of the posterior capsule and zonular dialysis on one side, but capsular support available on the other side, anatomical and functional success may be achieved with the monoblock soft lens haptic via sutured to the iris. [ABSTRACT FROM AUTHOR]

Purpose: Evaluation of micro-coaxial phacoemulsification and implantation of a blue light-filtering, aspheric, singlepiece, acrylic, hydrophobic intraocular lens. Materials and Methods: In this prospective study, micro-coaxial phacoemulsification has been performed in 36 eyes with senile cataract, using the Intrepid System (Alcon®) through 2.4 mm clear corneal incision. A blue light-filtering, aspheric, single-piece, acrylic, hydrophobic intraocular lens (Acrysof IQ®, Alcon®) has been inserted via an injector without enlarging the incision. In the first postoperative month, routine ophthalmological examination is followed by contrast sensitivity tests (Vector Vision® CSV- 1000), wavefront examination and patient questionnaire. Results: Thirtysix eyes of 32 patients (14 male and 18 female), with a mean age of 71.28±10.09 years were included in the study. The preoperative uncorrected visual acuity (UCVA) improved from 0.25±0.22 to 0.91±0.17. There was no statistically significant difference between the postoperative photopic and mesopic contrast sensitivity measurements with and without glare (p=0.068 ve p=0.068). The postoperative mean higher order aberrations and mean aspheric aberrations were found to be low. Statistically significant results were detected from the questions related to daily activities and night vision (p<0.001). Conclusion: Cataract operation with micro-coaxial technique induces less stress and trauma. Narrow tunnel incision together with the aspheric design of Acrysof® IQ improve the postoperative vision quality. The results of the questionnaire support patient satisfaction. [ABSTRACT FROM AUTHOR]

Purpose: To compare the clinical outcome of penetrating traumatic cataract cases that underwent simultaneous penetration repair with intraocular lens (IOL) implantation or penetration repair followed by cataract extraction with IOL implantation in a second session. Materials and Methods: Eighteen eyes of 18 patients with primary IOL implantation (Group 1, mean age 36.4±7.9 years) and 23 eyes of 23 patients with secondary IOL implantation (Group 2, mean age 31.9±8.9 years) were retrospectively evaluated. There were no foreign bodies or posterior capsule perforation in any of the eyes. In Group 1, after primary repair, extracapsular cataract extraction was performed. Monoblock polymethylmethacrylate IOL was implanted and the power calculation was performed according to the fellow eye. In Group 2, cataract extraction was performed with phacoemulsification two months after the primary repair. Postoperative findings were evaluated in the first week every day, in the first month every week, and then every month until the sixth month after surgery. Results: The mean follow-up was 18.8±4.2 months in Group 1 and 20.8±5.9 months in Group 2. Thirteen eyes in Group 1 and 17 eyes in Group 2 achieved a final spectacle-corrected visual acuity of 20/40 or better, and 5 eyes in Group 1 and 8 eyes in Group 2 achieved 20/20 visual acuity. The major causes of limited visual acuity were central corneal scars, irregular astigmatism, posterior capsule opacification, and traumatic maculopathy. Fifteen eyes in Group 1 and 9 eyes in Group 2 developed posterior capsule opacification. Conclusions: Cataract extraction and IOL implantation with primary repair in selected patients with penetrating injury may provide visually satisfying results. However, the posterior capsule opacification rate was higher in cases in which cataract extraction with IOL implantation was performed in a second session. In ideal cases, secondary cataract extraction and IOL implantation after penetrating ocular trauma may be preferable, with low refractive error and a low rate of postoperative complications. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate contrast sensitivity after hydrophilic acrylic single-piece intraocular lens (Zaraccom) implantation after uncomplicated phacoemulsification cataract surgery. Materials and Methods: Twenty eyes of 20 patients after hydrophilic acrylic single-piece intraocular lens implantation (Zaraccom B155, Sivas, Turkey) were compared with 20 eyes of 20 patients after hydrophobic acrylic three-piece intraocular lens implantation (Sensar AR40e, AMO, Santa Ana, CA, USA) and 20 eyes of 20 age-matched normal subjects. All patients were operated on according to the standardized phacoemulsification procedure. The best corrected visual acuity and contrast sensitivity were measured at 3 months postoperatively. Contrast sensitivity at five spatial frequencies (1.5, 3, 6, 12, and 18 cycles per degree) was measured by Functional Acuity Contrast Test (Stereo Optical Co., Chicago, USA) under photopic conditions (85 cd/m2). Results: Postoperative BCVA was -0.002±0.01 logMAR in the Zaraccom group. There were no statistically significant differences in BCVA between the groups (p>0.05). In the Zaraccom group, contrast sensitivity scores at 6, 12, and 18 cycles per degree were lower than those in the Sensar AR40e group at 3 months but there was no statistically significant difference in spatial frequencies between the groups (p>0.05). Conclusion: Zaraccom intraocular lens implantation provided contrast sensitivity comparable to that obtained with the Sensar AR40e 3 months after implantation. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the incidence of intraocular pressure (IOP) elevation in the early period after phacoemulsification (PE) and intraocular lens implantation (IOL) in nonglaucoma patients with and without pseudoexfoliation syndrome (PES), and to determine the effectiveness of different types of management. Materials And Methods: In this prospective study, 120 nonglaucoma patients who underwent PE+IOL implantation in Ankara Education and Research Hospital from April 2004 to May 2004 were included. Patients with PES (Group 1) and patients without PES (Group 2) were examined on the day of surgery (3rd-7th hour), on the 1st and 7th postoperative days. The main outcome measures were the incidence and management of complications, including IOP elevation, wound leaks, uveitis and endophthalmitis. Results: There was a significant elevation in IOP from the baseline values, in postoperative 3rd-7th hours, in all patients (p<0.01). This elevation was greater in Group 1 (p<0.05). IOP was more than 28 mmHg in four patients (3.3%) on the 1st postoperative day. On the 7th post-operative day, 50% of these patients had an IOP≤21 mmHg, after topical anti-glaucomatous medication and anterior chamber paracentesis. The elevation in IOP on the 1st day and 7th postoperative day did not differ between Group 1 and 2. None of the patients had uveitis, endophthalmitis or wound leak. Conclusion: All of the patients had a rise in IOP in the 3rd-7th postoperative hours. It is emphasized thatV patients with PES are more prone to early rises in IOP after PE, and they should be carefully monitored after surgery. [ABSTRACT FROM AUTHOR]

Purpose: To compare two groups of patients who underwent implantation of blue filtering-yellow-pigmented intraocular lens (IOL) (Alcon AcrySof SN60AT-Natural) and nonpigmented IOL (Alcon AcrySof SA60AT) in terms of: Color perception under mesopic and photopic conditions and contrast sensitivity under mesopic conditions. Materials and Methods: Pseuodophakic patients with a visual acuity better than +0.1 LogMAR and successful color vision test with Ishihara plates in the post-operative 3rd month were included in this study: 16 eyes of 15 patients (8 male, 7 female) with yellow-pigmented IOL and 8 eyes of 8 patients(4 male, 4 female) with non-pigmented IOL were tested. Mesopic (2.4-3.1 cd/m²) and photopic (82-86 cd/ m²) conditions were standardized and patients were tested with Farnsworth-Munsell (FM) 100-Hue test under these conditions. Tri-Va contrast sensitivity test was performed under mesopic conditions. Results: The contrast sensitivity results of both groups were similar. The error scores and the square root of the error scores of FM-100 Hue tests were lower in patients with yellow-pigmented IOLs. However these differences were not statistically significant. Conclusion: The patients with yellow-pigmented IOLs have a similar contrast sensitivity performance compare to patients with non-pigmented IOLs, under mesopic conditions. The color vision performance of patients with yellow-pigmented IOLs is as good as patients with non-pigmented IOLs, both under mesopic and photopic conditions. The visual performance with the yellow-pigmented IOLs is similar to nonpigmented IOLs under non-ideal conditions. [ABSTRACT FROM AUTHOR]

Hydrophilic acrylic intraocular lenses are commonly used because of higher uveal biocompatibility, low cost and ease of implantation following small incision phacoemulsification surgery. A rarely encountered postoperative complication of these lens materials are delayed opacification. Herein, we report an extreme case of delayed intraocular lens opacification 16 years after an uneventful phacoemulsification surgery and implantation of hydrophilic acrylic intraocular lens. [ABSTRACT FROM AUTHOR]

Intraocular lens (IOL) opacification is exact cause is unknown rare complication which occurs after many years of cataract surgery. In this report that is intended to present a case of foldable IOL opacity. A 65 year old woman presented with decreased vision in her left eye that increased over time. In the examination of the patient who had undergone cataract surgery in the left eye 14 years ago, IOL optic portion was viewed completely opacified. The IOL parts which removed from the eye were examined in scanning electron microscope to illuminate the cause of opacity. As a result of research shows that the deposition of calcium and phosphate just below the optical part surface which shows radial alignment. [ABSTRACT FROM AUTHOR]

Pseudophakic pseudoexfoliation is the accumulation of pseudoexfoliation material on the intraocular lens. Most of the cases have showed scattered flecks of pseudoexfoliation material on the surface of the intraocular lens. However, the phakic pattern consisting of classic three-zone on the intraocular lens is rarely observed. In this case report, we describe a phakic pattern pseudoexfoliation material on the intraocular lens surface 8 years after cataract extraction. [ABSTRACT FROM AUTHOR]

We report a rare clinical condition in a 65-year-old woman who had undergone an extracapular cataract extraction 5 months ago. The patient admitted with foreign body sensation in the right eye. On examination, one haptic of a single piece, polymethylmethacrylate posterior chamber intraocular lens (PC-IOL) fixated in the ciliary sulcus was protruding from the corneal surgical scar. Migration of PC-IOL haptic into the surgical wound is a very rare complication of cataract surgery. Surgeon should check for the positioning of the haptics during lens implantation to avoid further complications. [ABSTRACT FROM AUTHOR]