The influence of intraocular lens dislocation surgical correction method on corneal endothelium

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Abstract

BACKGROUND: Intraocular lens (IOL) dislocation is a rare but serious complication of surgical treatment of patients with cataract. Among the factors contributing to its development, the main ones are pseudoexfoliation syndrome (PEX), high axial myopia, chronic uveitis, history of eye injury and age. There is no universal IOL dislocation correction technique.

PURPOSE: To evaluate the impact on corneal endothelium of two different methods of IOL dislocation correction: IOL repositioning with transscleral suture fixation or IOL exchange to iris-claw one.

MATERIALS AND METHODS: Within the study, 78 patients were examined and operated. All patients were divided into two groups: in the first group, IOL was repositioned with transscleral suture fixation, and in the second group IOL was exchanged to iris-claw IOL. Groups were equal by gender and age. Key estimated indicators were endothelial cell density and coefficient of variation reflecting the degree of polymegatism.

RESULTS: Endothelial cell density was significantly lower both before surgery and at any term after it, in the group with IOL exchange, and coefficient of variation was significantly higher in the group with IOL exchange throughout this study.

CONCLUSION: The choice of technique for IOL dislocation correction is the basis of success in surgical treatment. Certain preoperative examination data should be definitely considered, including the degree of dislocation, IOL type, IOP level, endothelial cell density and presence of concomitant ocular conditions.

About the authors

Vitaly V. Potyomkin

Pavlov First St. Petersburg State Medical University; City Multidiscipline Hospital No. 2

Email: potem@inbox.ru
ORCID iD: 0000-0001-7807-9036

Cand. Sci. (Med.)

Russian Federation, 6–8 L’va Tolstogo str., Saint Petersburg, 197022; 5 Uchebniy pereulok, Saint Petersburg, 194354

Sergey Yu. Astakhov

Pavlov First St. Petersburg State Medical University

Email: astakhov73@mail.ru
ORCID iD: 0000-0003-0777-4861
SPIN-code: 7732-1150

MD, PhD, Dr. Sci. (Med.), Professor

Russian Federation, 6–8 L’va Tolstogo str., Saint Petersburg, 197022

Elena V. Goltsman

City Multidiscipline Hospital No. 2

Email: ageeva_elena@inbox.ru
ORCID iD: 0000-0002-2568-9305

ophthalmologist

Russian Federation, 5 Uchebniy pereulok, Saint Petersburg, 194354

Xiaoyuan Wang

Pavlov First St. Petersburg State Medical University

Email: wangxiaoyuan20121017@gmail.com

PhD student

Russian Federation, 6–8 L’va Tolstogo str., Saint Petersburg, 197022

Yulduz Sh. Nizametdinova

City Multidiscipline Hospital No. 2

Author for correspondence.
Email: yulduzik55@gmail.com
ORCID iD: 0000-0002-6789-5780
SPIN-code: 7482-5163

ophthalmic surgeon

Russian Federation, 5 Uchebniy pereulok, Saint Petersburg, 194354

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Supplementary files

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1. JATS XML
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2. Fig. 1. Formation of limbal mini-pockets

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3. Fig. 2. IOL fixation to the sclera

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4. Fig. 3. Intrascleral pass of the needle

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5. Fig. 4. Endothelial cell density in groups within 1 year

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6. Fig. 5. Biomicroscopy of the patient’s cornea before (а) and 3 months (b) after surgery

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Copyright (c) 2021 Potyomkin V.V., Astakhov S.Y., Goltsman E.V., Wang X., Nizametdinova Y.S.

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This work is licensed under a Creative Commons Attribution 4.0 International License.
 


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