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Purpose: The purpose of this study was to report a case of Tourette syndrome, exacerbated in adulthood, that was diagnosed after bilateral lens luxation and recurrent retinal detachment due to self-injury. Methods: This was a case report. Results: A 35-year-old man presented with a sudden abnormality in vision and bilateral lens luxation. The patient successfully underwent bilateral lens extraction and intrascleral intraocular lens fixation; however, vitreous hemorrhage and retinal detachment occurred in the left eye. The retinal detachment was caused by a giant retinal tear and retinal dialysis. Vitrectomy was performed. However, retinal detachment recurred with proliferative vitreoretinopathy. Retinal detachment subsequently occurred in the right eye. Self-injury to the eye was observed before surgical treatment. The patient was consequently diagnosed with Tourette syndrome. Conclusion: Tourette syndrome, which may be accompanied by self-injurious behavior, is a disorder that typically develops in childhood but rarely exacerbates during adulthood. A diagnosis of Tourette syndrome should be considered in cases of unexplained retinal detachment with traumatic features. [ABSTRACT FROM AUTHOR]

Abstract Background To report a case of sutureless scleral-fixated hydrophilic intraocular lens (FIL SSF IOL, Soleko, Italy) opacification following pars plana vitrectomy surgery using sulfur hexafluoride (SF6) for traumatic lens luxation associated with retinal detachment. Case presentation A 77-year-old woman was referred to our emergency department after blunt trauma in her right eye. At the ophthalmic evaluation, visual acuity was hand movement, biomicroscopy showed pseudoexfoliation syndrome and a traumatic lens luxation in the vitreous chamber. The patient underwent pars plana vitrectomy, subluxated cataract explantation, and FIL SSF IOL implant. During surgery, an inferior retinal detachment was encountered, requiring 20% SF6 gas tamponade. No adverse events were encountered. One month postoperatively, visual acuity (BCVA) improved to 0,3 logMAR. At the 3-month follow-up, the patient presented with BCVA of 0,5 logMAR, and biomicroscopy showed a minimal IOL opacification. Six months postoperatively, BCVA decreased to 1.0 logMAR, and diffuse, IOL opacification was noted at slit lamp examination. The patient refused any other surgical intervention for IOL exchange. Conclusions Although hydrophilic IOL opacification gas related is known, to the best of our knowledge, this is the first case reported in the literature of FIL SSF IOL opacification after pars plana vitrectomy with gas tamponade for retinal detachment.

Background: To report a case of sutureless scleral-fixated hydrophilic intraocular lens (FIL SSF IOL, Soleko, Italy) opacification following pars plana vitrectomy surgery using sulfur hexafluoride (SF6) for traumatic lens luxation associated with retinal detachment. Case presentation: A 77-year-old woman was referred to our emergency department after blunt trauma in her right eye. At the ophthalmic evaluation, visual acuity was hand movement, biomicroscopy showed pseudoexfoliation syndrome and a traumatic lens luxation in the vitreous chamber. The patient underwent pars plana vitrectomy, subluxated cataract explantation, and FIL SSF IOL implant. During surgery, an inferior retinal detachment was encountered, requiring 20% SF6 gas tamponade. No adverse events were encountered. One month postoperatively, visual acuity (BCVA) improved to 0,3 logMAR. At the 3-month follow-up, the patient presented with BCVA of 0,5 logMAR, and biomicroscopy showed a minimal IOL opacification. Six months postoperatively, BCVA decreased to 1.0 logMAR, and diffuse, IOL opacification was noted at slit lamp examination. The patient refused any other surgical intervention for IOL exchange. Conclusions: Although hydrophilic IOL opacification gas related is known, to the best of our knowledge, this is the first case reported in the literature of FIL SSF IOL opacification after pars plana vitrectomy with gas tamponade for retinal detachment. [ABSTRACT FROM AUTHOR]

Objective Procedures Results Conclusions To describe a modified ab externo method of sulcus intraocular lens (IOL) fixation and report outcomes of eyes treated with this approach.Records of patients with lens instability or luxation that underwent a lensectomy and sulcus IOL implantation from January 2004 to December 2020 were reviewed.Nineteen eyes of 17 dogs had a sulcus IOL placed via a modified ab externo approach. The median follow‐up time was 546 days (range 29–3387 days). Eight eyes (42.1%) developed POH. A total of six eyes (31.6%) developed glaucoma and required medical management long term to control IOP. The IOL position was satisfactory in most cases. Nine eyes developed superficial corneal ulcers within 4 weeks following surgery, all of which healed without complication. At the time of the last follow‐up, 17 eyes were visual (89.5%).The technique described represents a potentially less technically challenging option for sulcus IOL implantation. The success rate and complications are similar to previously described approaches. [ABSTRACT FROM AUTHOR]

Nisa Silva,1,&ast; André Ferreira,1,2,&ast; Natália Ferreira,1 Bernardete Pessoa,1,3 Angelina Meireles1,3 1Department of Ophthalmology, Centro Hospitalar Universitário do Porto, Porto, 4099-001, Portugal; 2Unit of Anatomy, Department of Biomedicine, Faculty of Medicine of University of Porto, Porto, 4200-319, Portugal; 3Department of Ophthalmology, Instituto de Ciências Biomédicas Abel Salazar, University of Porto, Porto, 4050-313, Portugal&ast;These authors contributed equally to this workCorrespondence: Nisa SilvaDepartment of Ophthalmology, Centro Hospitalar Universitário do Porto, Largo do Prof. Abel Salazar, Porto, 4099-001, PortugalTel +351 22 207 7500Email nisapinhosilva@gmail.comBackground: The main options for intraocular lens (IOL) placement without capsular bag support and/or zonular weakness are iris-fixated IOL and scleral-fixated IOL (SFIOL).Purpose: To describe the surgical technique and the outcomes of intrascleral knotless zigzag suture fixation of Akreos AO60 foldable IOL.Methods: Retrospective cohort study of consecutive cases.Results: Ninety-nine eyes of 92 patients were retrospectively studied. The mean age was 72.1± 15.2 years (range 18– 94), and the median follow-up duration was 19.5 months (range 3– 81). The best-corrected visual acuity improved from a mean±SD of 1.34± 0.70 logarithm of the minimum angle of resolution (logMAR) units at baseline to 0.49± 0.56 logMAR at the end of follow-up (p< 0.001). The mean±SD final SE was − 1.24± 1.82 diopters. The mean±SD prediction error was − 0.51± 1.16 diopters. The overall perioperative complications rate was 44.4% (n=44). The rate of complications requiring invasive treatment was 19.2% (n=19). The most common perioperative complications were ocular hypertension (OHT, 20.2%, n=20), and cystoid macular edema (CME, 15.2%, n=15). The rate of IOL dislocation was 7% (n=7).Conclusion: This knotless technique avoids the risks of haptics fixation but is more prone to IOL dislocation in cases of suture deterioration. Past ophthalmic history needs to be carefully considered in candidates who underwent SFIOL implantation.Keywords: intraocular lens, scleral fixation, knotless, cataract, lens luxation

Objective: To compare effects of latanoprost, a topical prostaglandin analogue (PGA) commonly used to treat glaucoma and lens instability in dogs, and latanoprostene bunod, a novel PGA with a nitric oxide‐donating moiety, on intraocular pressure (IOP) and pupil diameter (PD). Animals studied: Ten ophthalmologically normal Beagle dogs. Procedures: Dogs were treated twice a day for 5 days in a randomly selected eye with either latanoprost or latanoprostene bunod. After a 6‐week washout period, dogs were treated with the opposite drug. IOP and PD were measured at treatment times, at midday on days 1 and 5, and for 6 days post‐treatment. Results: Both drugs significantly decreased IOP and PD. At midday on day 5 of treatment, mean IOP in eyes treated with latanoprost was 4.5 mmHg lower than the fellow eye and 3.0 mmHg lower than the same eye at baseline, while mean IOP in eyes treated with latanoprostene bunod was 5.5 mmHg lower than the fellow eye and 3.6 mmHg lower than baseline. Mean PD was 0.94 mm in eyes treated with latanoprost and 0.76 mmHg in eyes treated with latanoprostene bunod. There was no significant difference between the two drugs for either parameter at that time point (p =.372 and.619, respectively, for IOP relative to control and to baseline; p =.076 for PD) or when analyzed longitudinally. Significant diurnal variation in PD was noted and may have implications for treatment of lens' instability. Conclusions: Latanoprost and latanoprostene bunod produce similar IOP reduction and miosis in normal canine eyes. [ABSTRACT FROM AUTHOR]

AIM: To evaluate efficacy, safety and complications of 25G vitrectomy, phacoemulsification combined with intrascleral fixated intraocular lens(IOL)implantation for treatment of lens luxation.METHODS: Totally 20 patients(20 eyes)with complete lens luxation and the hardness of lens nucleus was grade 3 or above who underwent 25G vitrectomy, phacoemulsification combined with intrascleral fixated IOL implantation between May 2018 and December 2020 were analyzed retrospectively. The uncorrected visual acuity, best corrected visual acuity, intraocular pressure, the count of corneal endothelium cell, central corneal thickness and complications were observed. RESULTS: The uncorrected visual acuity and best corrected visual acuity after operation were improved than those before treatment(P0.05). There was no significant difference in central corneal thickness 2wk after operation compared with that before operation(P >0.05). There were 3 cases of low intraocular pressure and 2 cases of high intraocular pressure, but they all returned to normal at the end of follow-up. The IOL were all centered and there were no obvious eccentricity and inclination. No other complications such as vitreous hemorrhage and retinal detachment occurred.CONCLUSION: 25G vitrectomy, phacoemulsification combined with intrascleral fixated IOL implantation is a fast, safe and simple method for the treatment of complete lens luxation.

This article aims at the presentation of ocular emergency in small animal veterinary surgery. Lens luxation is the displacement of the lens from its normal position in the eye, which caused by breaking its contact with the zonular fibres equatorially. Etiology is diverse. The most common are two types of dislocation - primary lens luxation (PLL), found mainly in terrier type breeds and secondary, caused by many factors, e.g. glaucoma, cataracts or trauma. In general, the lens can fall backwards, what is known as posterior luxation or it can fall forwards into the eye, what is known as anterior luxation. Anterior luxation, which is extremely painful, treated as an emergency, due to the possibility of sudden blindness resulting from rapidly progressing glaucoma. Symptoms, in the form of corneal edema, severe pain and the aphakic crescent, visible in the pupillary aperture, are quite characteristic and do not provide much diagnostic difficulty. Treatment depends on the form of dislocation. In the case of anterior dislocation, surgical methods are recommended, while in the case of posterior dislocation, pharmacological treatment with mydriatics is advised. [ABSTRACT FROM AUTHOR]

Abstract: Objective: To describe the presentation of 15 rabbits with naturally occurring cataracts referred for phacoemulsification surgery, the procedure in 13 cases and the follow‐up in 12. Animals included: Fifteen rabbits (30 eyes), nine of which stopped following visual cues in association with cataract progression. Materials and Methods: Rabbits underwent preoperative ophthalmic and ocular ultrasound examination. Results: Thirteen rabbits (22 eyes) had mature cataracts. Ten were bilateral and three unilateral. Two rabbits had an anterior chamber abscess. The cataract in one of these was incipient. One rabbit had bilateral immature cataracts. One rabbit had a subluxated lens, and one had a retinal detachment. Thirteen rabbits (22 eyes) underwent phacoemulsification. Eighteen, 13.5‐mm capsular tension rings (CTRs) and seventeen, 13‐mm IOLs (Acrivet®, Berlin, Germany) were fitted including one 41D 60V‐model, and three 49D and thirteen 58D 20S‐models. Intraoperative complications included one unilateral posterior‐capsular tear, one lens subluxation, and one expulsive choroidal hemorrhage. One rabbit died during anesthetic recovery. Nine cases were PCR‐tested for Encephalitozoon cuniculi, and only three were positive. The median follow‐up time was 12 months (4‐24 months). Rabbits that were not following visual cues preoperatively did so postoperatively, and surgery resulted in a clear visual axis for the follow‐up period in every case except in two, due to reasons other than the surgery. Conclusions: Phacoemulsification with CTR and IOL implantation offers good long‐term results and can improve the quality of life of pet rabbits. Retinal detachment, lens luxation, expulsive choroidal hemorrhage, and anesthetic death are potential complications. [ABSTRACT FROM AUTHOR]

Lens injury due to traumas may present as loss of capsule integrity, cataract, lens subluxation, or lens luxation. In addition, lens subluxation and lens luxation may occur in pseudophakic patients due to trauma. Clear corneal, scleral or sclero-corneal phacoemulsification surgery, pars plana vitrectomy, pars plana vitrectomy with phaco-fragmentation, or pars plana vitrectomy with removal through corneal incision techniques are used in the treatment of lens injury due to traumas. Intraocular lens can be implanted in the bag, sulcus, or anterior chamber during the surgery. Depending on the circumstances, scleral fixated intraocular lenses or iris-claw lenses may also be preferred. Rehabilitation of such patients is not of a great concern today, with the advanced level of vitreoretinal surgery and cataract surgery techniques and with the current state of technology. (Turk J Ophthalmol 2013; 43: 51-4)

Background: We encountered a rare patient with lens luxation in which the lens had become stuck on the optic disc. Findings obtained during vitreous surgery suggested that the luxated lens had become stuck on the optic disc via residual vitreous gel.Case Presentation: An 88-year-old Japanese man experienced lens luxation into the inferior vitreous cavity while undergoing treatment for glaucoma in his left eye. Because no inflammation was present upon examination, we observed the patient without prescribing any additional medications except for the eye drop treatment for glaucoma. Two years later, the patient revisited our clinic after suddenly noticing a visual disturbance in his left eye. A fundus examination revealed that the luxated lens had become stuck on the optic disc and displayed no changes in relation to the patient's head position or eye movement. Subsequently, vitreous surgery was performed to remove the luxated lens. During the surgery, we observed an aggregation of vitreous gel between the luxated lens and the optic disc. The luxated lens was successfully mobilized by pushing with a vitreous cutter and then extracted through a corneoscleral incision using perfluorocarbon liquid. At 4 months after surgery, the patient's visual acuity had improved to 20/25.Conclusions: The findings of this study suggest that the luxated lens had become stuck on the optic disc via residual vitreous gel on the optic disc. The surgical procedure of extracting the luxated lens through a corneoscleral incision using perfluorocarbon liquid was found to be both safe and effective. [ABSTRACT FROM AUTHOR]

An adult, female, captive, Matshchie's tree kangaroo was diagnosed with an anterior lens luxation in the right eye and a lens subluxation in the left eye. Both eyes were treated surgically with intracapsular lens extractions. A 360° rhegmatogenous retinal detachment was diagnosed 6 months postoperatively in the left eye. Aphakic vision was maintained in the right eye 9 months postoperatively. Based on family history and the lack of antecedent ocular disease, the lens luxations were presumed to be inherited and veterinarians should be aware of this condition within the captive tree kangaroo population. [ABSTRACT FROM AUTHOR]

Background: A 71-year-old female presented on 3 occasions with escalating pain in a congenitally blind eye. Examination revealed hypertensive uveitis with morning glory optic disc dysplasia and absence of a crystalline lens. There was no previous intraocular surgery or trauma. Intensive anti-hypertensive agents and topical steroids did not control intraocular pressure (IOP) or inflammation. Results: Dilated fundus examination on the third clinical review revealed a luxated cataractous lens on the retina. Pars plana vitrectomy and fragmatome lensectomy controlled inflammation and IOP, with resolution of ocular pain. Discussion: This is an exceptional case of phacogenic uveitis with secondary glaucoma occurring years after spontaneous crystalline lens luxation in a patient with morning glory syndrome. The embryological pathogenesis of morning glory syndrome and the significance of accelerated cataractogenesis and zonular weakness are discussed. Hypertensive uveitis with unexplained absence of a crystalline lens in a blind eye must prompt suspicion of delayed phacogenic uveitis following asymptomatic lens luxation. [ABSTRACT FROM AUTHOR]

Lens injury due to traumas may present as loss of capsule integrity, cataract, lens subluxation, or lens luxation. In addition, lens subluxation and lens luxation may occur in pseudophakic patients due to trauma. Clear corneal, scleral or sclero-corneal phacoemulsification surgery, pars plana vitrectomy, pars plana vitrectomy with phaco-fragmentation, or pars plana vitrectomy with removal through corneal incision techniques are used in the treatment of lens injury due to traumas. Intraocular lens can be implanted in the bag, sulcus, or anterior chamber during the surgery. Depending on the circumstances, scleral fixated intraocular lenses or iris-claw lenses may also be preferred. Rehabilitation of such patients is not of a great concern today, with the advanced level of vitreoretinal surgery and cataract surgery techniques and with the current state of technology. [ABSTRACT FROM AUTHOR]

Background The implantation of scleral fixated sutured posterior chamber lenses enables lens implantation in the absence of adequate lens capsule support. Anterior chamber lenses and their side effects can also be avoided, particularly in cases of unilateral aphakia and contact lens incompatibility. Methods This study is a retrospective analysis of 119 scleral fixated sutured posterior chamber lenses implanted in 115 patients. Seventy-nine cases of damaged zonula or damaged lens capsule and 17 cases of corneal decompensation secondary to anterior chamber lenses were the main indications for the suture fixation. The mean follow-up was 23 months (6–83 months). Results In 50% of all cases, improved visual acuity was achieved. Twenty-four percent of patients showed unchanged visual acuity, while 26% had poorer vision postoperatively, mainly because of corneal decompensation following anterior chamber lens explantation. The main postoperative complication was transient rise of intraocular pressure, occurring in 44% of the cases. Conclusions In most cases improved or comparable postoperative visual acuity was achieved. The main complication observed was postoperative glaucoma, especially in patients with pre-existing glaucoma. [ABSTRACT FROM AUTHOR]

Objective: To examine ultrasonographic abnormalities in eyes with traumatic hyphema obscuring intraocular structures. Design: Retrospective clinical study. Setting: The ophthalmology services of a private practice and university veterinary teaching hospital. Animals: Twenty-two dogs, 6 cats, 3 horses, and 2 birds. Measurements and main results: Medical records were reviewed for signalment, history, ophthalmic examination, ultrasonographic findings, treatment, and outcome in all patients that presented to the ophthalmology service with trauma-induced hyphema obscuring intraocular structures. Thirty-three patients were included and there were 35 affected eyes (17 left and 18 right). Abnormalities noted on ophthalmic examination included hyphema obscuring intraocular details beyond the iris (100%), corneal laceration (23%), iris prolapse (23%), fibrin clotting within the anterior chamber (17%), and subconjunctival and periocular bruising (17%). Ocular ultrasonography revealed the presence of either vitreous hemorrhage or a retinal detachment in 32 of 35 eyes (91%) with traumatic hyphema. Of the remaining 3 eyes, ocular ultrasonography revealed a lens luxation with posterior eye wall rupture in 1 eye and collapsed globes in the other 2 eyes. Twelve eyes were enucleated and 23 were treated medically. Ten of the medically treated eyes were lost to follow-up. Blindness was noted in all the affected eyes upon their final discharge and recheck examination. Conclusions: Ocular ultrasonography revealed vitreous hemorrhage or a retinal detachment in 32 eyes (91%) with traumatic hyphema. Blindness was noted on the last available examination of every eye. The prognosis for vision in an eye with traumatic hyphema obscuring intraocular detail is poor. [ABSTRACT FROM AUTHOR]

Ultrasonography (US) and computed tomography (CT) were performed after routine ophthalmologic and ophthalmoscopic examinations in 190 eyes of six various diurnal (common buzzard [ Buteo buteo L., 1758], n=20; common kestrel [ Tinnunculus tinnunculus L., 1758], n=20) and nocturnal raptor species (barn owl [ Tyto alba L., 1758], n=22; tawny owl [ Strix aluco L., 1758], n=8; long-eared owl [ Asio otus L., 1758], n=5; horned owl [ Bubo bubo L., 1758], n=1); and domestic pigeons ( Columba livia, Gmel., 1789; n=19), with a total of 95 individuals. Pathologic findings such as lens subluxation and luxation, intravitreal hemorrhage, detached retina, post-traumatic partial sequestration, or malformation of the pecten could be demonstrated with diagnostic imaging tools, while opacities of cornea or lens constrained direct ophthalmoscopic examination. The results proved US to be a quick noninvasive imaging technique for detailed ocular diagnoses. CT provided detailed information of the bony skull and bony scleral rings as well as adequate visualization of shape, size, and margination of the eye and lens. Nevertheless, CT was unable to differentiate subtle structures within the vitreous like the pecten oculi or hemorrhage. Biometric measurements were carried out to objectify imaging results. Results showed good correlation of depth and width of the anterior eye chamber, lens and vitreous, length of the bulbus, and the pecten but no correlation of cornea and posterior wall thickness was found. [ABSTRACT FROM AUTHOR]

Congenital and inherited ocular diseases are reported less frequently in the cat than the dog. The 2 species also differ in their array of disorders, with familiar canine abnormalities like cataracts overshadowed by unique feline diseases such as eyelid agenesis and corneal sequestration. Organized according to the primary ocular structure affected and commingling congenital and inherited disorders in each section, the review begins with multiple ocular anomalies and their impact on globe-orbit relationship. Adnexal disorders include eyelid agenesis, entropion, dermoid, and nictitans gland protrusion. Corneal abnormalities range from the routine sequestrum and PPM-related opacity to those rare infiltrates accompanying inborn errors of metabolism. Brief descriptions of uveal anomalies, primary glaucoma, cataracts, and lens luxations follow. Retinal dysplasia and progressive retinal atrophy complete the summary. Suspicions of heritability are often based on small numbers of animals in sporadic reports of ocular disease, but the Persian, Burmese, and Siamese are among the breeds repeatedly linked with one or more of these disorders. [Copyright &y& Elsevier]

Abstract The objective of this retrospective study was to evaluate transscleral cyclophotocoagulation (TSCP) using a diode laser for treating aphakic glaucoma that developed after intracapsular lens extraction (ICLE) had been performed for displaced lenses. Records of 15 dogs (21 eyes) were reviewed. The intraocular pressure (IOP) and the presence of vision were recorded at the time of ICLE and TSCP and at 1, 3, 6–9, 12 and 24 months post TSCP. The glaucoma was considered controlled if the IOP was less than 25 mmHg. The results indicated that the effectiveness of TSCP using a diode laser for treating aphakic glaucoma was of a short-term duration (1–3 months), with three patients needing repeat TSPC. In addition, adjunctive antiglaucoma medications were often required to maintain an adequately controlled IOP. Over the 24-month period the number of dogs requiring intrascleral prosthesis, intraocular gentamicin or enucleation, or that were lost to follow-up, increased. [ABSTRACT FROM AUTHOR]

In a twenty five-year-old female patient, we observed bilateral lens dislocation into the vitreous body that occurred spontaneously as a result of Marfan’s syndrome and megalocornea, when she was 8 years old. Corneal diameters were 14 mm in the right eye and 13.5 mm in the left eye. Slit-lamp examination revealed miosis and iridodonesis. Fundus examination revealed bilateral inferior lens dislocation into the vitreous body. There was no lens induced posterior uveitis in either eye. This patient demonstrated that lens dislocation into the vitreous body can be present for a long time without causing any intraocular inflammation. [ABSTRACT FROM AUTHOR]

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., (Copyright © 2020. Published by Elsevier Masson SAS.)