Management of aphakia with low corneal endothelial cell count after complicated cataract surgery in a middle-age patient

Management of aphakia with low corneal endothelial cell count

Penulis

DOI:

https://doi.org/10.59747/smjidisurabaya.v1i2.15

Kata Kunci:

Retropupil iris claw, intraocular lens, low corneal endothelial cell, aphakia

Abstrak

Background: secondary intraocular lens implantation becomes more challenging due to pre-existing conditions. Objective: To report the outcome of retropubic iris-claw intraocular lens (RP-ICIOL) to corrects aphakia with low corneal endothelial cell count following previous complicated cataract surgery. Case: A 32-year-old male was referred to Undaan Eye Hospital with a chief complaint of blurred vision in his left eye (LE). Previously, the patient was diagnosed with a mature subluxated cataract and has undergone cataract extraction on the LE. Visual acuity of LE was 1/60 with raised intraocular pressure (31,8 mmHg with Schiotz Tonometry). On anterior segment examination, there was a clear cornea with an oval pupil and aphakia. The examination of the posterior segment was within normal limits. Specular microscopy of LE was 1140 cells/mm2. After IOP was controlled by medication, the patient then underwent retropubic iris-claw intraocular lens implantation. Post-operatively, the visual acuity of the LE was 2/10 and the IOP was 11 mmHg using non-contact tonometry. Six weeks post-op, the best visual acuity (BCVA) was 9/10 and the IOP was 15 mmHg and the CECD was 1110 cells/mm2 on the LE. Discussion: The RP-ICIOL was maintaining the physiological condition of the IOL location posteriorly, thus minimizing the risk of corneal decompensation and increased postoperative intraocular pressure, while at the same time trying to achieve a good refractive outcome. Conclusion: The implantation of RP-ICIOL is safe and effective management of aphakia with a low corneal endothelial cell coun secondary intraocular lens implantation becomes more challenging.

Referensi

endothelial safety study. Eur. J. Ophthalmol. 25, 208–213.

Brunin, G., Sajjad, A., Kim, E.J., Montes de Oca, I., Weikert, M.P., Wang, L., Koch, D.D., Al-Mohtaseb, Z., 2017. Secondary intraocular lens implantation: Complication rates, visual acuity, and refractive outcomes. J. Cataract Refract. Surg. 43, 369–376.

Chen, Yueqin, Liu, Q., Xue, C., Huang, Z., Chen, Yin, 2012. Three-year follow-up of secondary anterior iris fixation of an aphakic intraocular lens to correct aphakia. J. Cataract Refract. Surg. 38, 1595–1601.

Drolsum, L., Kristianslund, O., 2021. Implantation of retropupillary iris-claw lenses: A review on surgical management and outcomes. Acta Ophthalmol. 99, 826–836.

Forlini, M., Soliman, W., Bratu, A., Rossini, P., Cavallini, G.M., Forlini, C., 2015. Long-term follow-up of retropupillary iris-claw intraocular lens implantation: A retrospective analysis Cataract and refractive surgery. BMC Ophthalmol. 15, 4–9.

Fouda, S., Al Aswad, M., Ibrahim, B., Bori, A., Mattout, H., 2016. Retropupillary iris-claw intraocular lens for the surgical correction of aphakia in cases with microspherophakia. Indian J. Ophthalmol. 64, 884–887.

Gonnermann, J., Amiri, S., Klamann, M., Maier, A.K.B., Joussen, A.M., Rieck, P.W., Torun, N., Bertelmann, E., 2014. Endothelzellverlust nach retropupillar fixierter Irisklauen-Linse. Klin. Monbl. Augenheilkd. 231, 784–787.

Hazar, L., Kara, N., Bozkurt, E., Ozgurhan, E.B., Demirok, A., 2013. Intraocular lens implantation procedures in aphakic eyes with insufficient capsular support associated with previous cataract surgery. J. Refract. Surg. 29, 685–691.

Helvaci, S., Demirduzen, S., Oksuz, H., 2016. Iris-claw intraocular lens implantation: Anterior chamber versus retropupillary implantation. Indian J. Ophthalmol. 64, 45–49.

Jare, N., Kesari, A., Gadkari, S., Deshpande, M., 2016. The posterior iris-claw lens outcome study: 6-month follow-up. Indian J. Ophthalmol. 64, 878–883.

Jing, W., Guanlu, L., Qianyin, Z., Shuyi, L., Fengying, H., Jian, L., Wen, X., 2017. Iris-claw intraocular lens and scleral-fixated posterior chamber intraocular lens implantations in correcting aphakia: A meta-analysis. Investig. Ophthalmol. Vis. Sci. 58, 3530–3536.

Khan, M.J., Al-Mohtaseb, Z.N., Kim, D.B., 2018. Secondary IOLs: ACIOL vs Iris Sutured vs Scleral Fixated vs Phakic IOL in Aphakic Settings. Curr. Ophthalmol. Rep. 6, 217–225.

Kounser, S., Ahmad, R., Ganaie, K.A., 2019. Retropupillary Iris-Claw Lens Implantation in Aphakic Eyes without Capsular Support : Our Five Years Experience 6, 202–205.

Madhivanan, N., Sengupta, S., Sindal, M., Nivean, P.D., Kumar, M.A., Ariga, M., 2018. Comparative analysis of retropupillary iris claw versus scleral-fixated intraocular lens in the management of post-cataract apha. Indian J. Ophthalmol. 67, 59–63.

Tejero, M.E., Cai, G., Göring, H.H.H., Diego, V., Cole, S.A., Bacino, C.A., Butte, N.F., Comuzzie, A.G., 2007. Linkage analysis of circulating levels of adiponectin in Hispanic children. Int. J. Obes. (Lond). 31, 535–42.

Thulasidas, M., 2021. Retropupillary iris-claw intraocular lenses: A literature review. Clin. Ophthalmol. 15, 2727–2739.

Touriño Peralba, R., Lamas-Francis, D., Sarandeses-Diez, T., Martínez-Pérez, L., Rodríguez-Ares, T., 2018. Iris-claw intraocular lens for aphakia: Can location influence the final outcomes? J. Cataract Refract. Surg. 44, 818–826.

Vounotrypidis, E., Schuster, I., Mackert, M.J., Kook, D., Priglinger, S., Wolf, A., 2019. Secondary intraocular lens implantation: a large retrospective analysis. Graefe’s Arch. Clin. Exp. Ophthalmol. 257, 125–134.

Woo, J.H., Arundhati, A., Chee, S.P., Tong, W., Li, L., Ti, S.E., Htoon, H.M., Choo, J.Q.H., Tan, D., Mehta, J.S., 2022. Endothelial keratoplasty with anterior chamber intraocular lens versus secondary posterior chamber intraocular lens. Br. J. Ophthalmol. 106, 203–210.

Yazdani-Abyaneh, A., Djalilian, A.R., Fard, M.A., 2016. Iris fixation of posterior chamber intraocular lenses. J. Cataract Refract. Surg. 42, 1707–1712.

Diterbitkan

2023-11-10

Terbitan

Bagian

Case report/Case series/Image article

Kategori