Clinical Outcomes and Intraocular Pressure Control after Scleral-glued Intraocular Lens Insertion in Eyes with Pseudoexfoliation

Ashwinee Ragam, David C. Ritterband, Emily C. Waisbren, Julia Mathew-Padiyedathu, Joann J. Kang, John A. Seedor

Research output: Contribution to journalArticle

Abstract

Purpose: To analyze clinical outcomes and intraocular pressure control following scleral-glued intraocular lens (IOL) fixation in eyes with pseudoexfoliation (PXF). Methods: A retrospective chart review and outcome analysis was performed on a series of eyes undergoing glue-assisted, scleral-fixated (scleral-glued) IOL insertion in the setting of PXF and poor or absent capsular support. Results: In total, 28 eyes were included in the study. The indications for scleral-glued IOL fixation included late endocapsular IOL dislocation (21/28, 75%), exchange for iris-fixated IOL due to complication (4/28, 14%), subluxed crystalline lens (2/28, 7%), and aphakia after complicated cataract surgery (1/28, 4%). In total, 15/28 (54%) eyes had diagnosed preexisting glaucoma at the time of scleral-glued surgery. The most common postoperative complication was ocular hypertension requiring escalation of medical management, which occurred in 8/28 (29%) eyes. At final follow-up, corrected distance visual acuity was equivalent to or improved from preoperative measurements in 25/28 (89%) eyes. Conclusions: The scleral-glued surgery is a good option for fixating an IOL in eyes with PXF and poor zonular integrity or absent capsular support. Special attention should be placed on intraocular pressure control following surgery, which can be less predictable in PXF eyes with or without preexisting glaucoma.

Original languageEnglish (US)
Pages (from-to)164-169
Number of pages6
JournalJournal of Glaucoma
Volume27
Issue number2
DOIs
StatePublished - Jan 1 2018

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Intraocular Lenses
Intraocular Pressure
Glaucoma
Lens Subluxation
Aphakia
Ocular Hypertension
Crystalline Lens
Iris
Adhesives
Cataract
Visual Acuity

Keywords

  • glue-assisted
  • intraocular lens
  • pseudoexfoliation
  • scleral-fixated
  • scleral-glued
  • secondary IOL

ASJC Scopus subject areas

  • Ophthalmology

Cite this

Clinical Outcomes and Intraocular Pressure Control after Scleral-glued Intraocular Lens Insertion in Eyes with Pseudoexfoliation. / Ragam, Ashwinee; Ritterband, David C.; Waisbren, Emily C.; Mathew-Padiyedathu, Julia; Kang, Joann J.; Seedor, John A.

In: Journal of Glaucoma, Vol. 27, No. 2, 01.01.2018, p. 164-169.

Research output: Contribution to journalArticle

Ragam, Ashwinee ; Ritterband, David C. ; Waisbren, Emily C. ; Mathew-Padiyedathu, Julia ; Kang, Joann J. ; Seedor, John A. / Clinical Outcomes and Intraocular Pressure Control after Scleral-glued Intraocular Lens Insertion in Eyes with Pseudoexfoliation. In: Journal of Glaucoma. 2018 ; Vol. 27, No. 2. pp. 164-169.
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abstract = "Purpose: To analyze clinical outcomes and intraocular pressure control following scleral-glued intraocular lens (IOL) fixation in eyes with pseudoexfoliation (PXF). Methods: A retrospective chart review and outcome analysis was performed on a series of eyes undergoing glue-assisted, scleral-fixated (scleral-glued) IOL insertion in the setting of PXF and poor or absent capsular support. Results: In total, 28 eyes were included in the study. The indications for scleral-glued IOL fixation included late endocapsular IOL dislocation (21/28, 75{\%}), exchange for iris-fixated IOL due to complication (4/28, 14{\%}), subluxed crystalline lens (2/28, 7{\%}), and aphakia after complicated cataract surgery (1/28, 4{\%}). In total, 15/28 (54{\%}) eyes had diagnosed preexisting glaucoma at the time of scleral-glued surgery. The most common postoperative complication was ocular hypertension requiring escalation of medical management, which occurred in 8/28 (29{\%}) eyes. At final follow-up, corrected distance visual acuity was equivalent to or improved from preoperative measurements in 25/28 (89{\%}) eyes. Conclusions: The scleral-glued surgery is a good option for fixating an IOL in eyes with PXF and poor zonular integrity or absent capsular support. Special attention should be placed on intraocular pressure control following surgery, which can be less predictable in PXF eyes with or without preexisting glaucoma.",
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