Modified Trisection Technique: One-Trip Explantation for Foldable Intraocular Lens.

To describe a technique for intraocular lens (IOL) implantation that lessens the degree of surgical invasiveness by implanting a tightly rolled IOL through a small incision without touching the eye with the cartridge tip. An IOL was inserted through an incision by first allowing the leading haptic to protrude slightly from the cartridge tip. It was then injected through the incision without allowing any part of the cartridge to touch the eye during IOL implantation. In one eye, the entire circumference of the beveled portion of the cartridge tip was inserted into the anterior chamber to implant the IOL, whereas in the other eye, the IOL was inserted through the incision by first allowing the leading haptic to protrude slightly from the cartridge tip. It was then injected through the incision without allowing any part of the cartridge to touch the eye during IOL implantation. We analyzed the incision width before and after IOL implantation and the degree of surgically induced astigmatism on the day after surgery and at 1 and 3 months after surgery. Using our technique, both the amount by which the wound was enlarged and the hydration rate were significantly lower compared with conventional IOL implantation. Our method enables IOL implantation to be carried out through a small incision at a width that was only previously possible with forcible insertion. Our IOL implantation technique can be performed using both hands with no need to immobilize the eyeball.

Soft intraocular lenses (IOLs) have been developed to be folded during insertion to allow implantation through a small incision. The surface of the IOL is of great importance in postoperative inflammation and long-term acceptance of the implant. Rough and sharp edges can damage delicate intraocular tissues. The purpose of this study was to analyze new, foldable silicone IOLs for surface quality prior to and following folding. Eleven silicone IOLs of different types were included in this study (four one-piece plate-haptic silicone IOLs and seven three-piece silicone IOLs with polypropylene, PMMA or polyimid haptics). We performed scanning electron microscopy on brand-new IOLs prior to and following folding either with forceps or inserter. Special attention was given to the silicone optic surface, optic edges, haptic-optic junctions and the haptic itself. Photographs were taken at 5-350 times magnification. All IOLS demonstrated a smooth and homogeneous optic surface at low magnification. At high-power magnification (X 350), distinctive surface patterns were evident in some IOLs, which turned out to be artefacts. The edge finish showed surplus silicone material and molding flash in six of 11 IOLs. Positioning holes of the 4 plate-haptic IOLs were, except in one IOL, rounded and not rough. Photographs of the haptic-optic junctions revealed surplus material or clefts between the haptic and optic in six of the 7 three-piece IOLs; the loop ends of two IOLs showed a roughened or irregular surface. We did not detect any IOL changes produced by folding. The silicone IOLs tested demonstrated generally acceptable surface properties, but most IOLs had regional surface irregularities of varying magnitude. The clinical impact of these remains to be established, but surplus material or surface defects might result in deposition of inflammatory cells, protein or microorganisms and synechia formation. Folding of the IOLs did not produce superficial defects.

Foldable intraocular lenses and vitreoretinal surgery

Evaluation of a 3-piece silicone intraocular lens with poly(methyl methacrylate) haptics

Open-capsule intraocular lens to prevent posterior capsule opacification

Evaluation of a new scleral fixation foldable IOL in the absence of capsule support

Cataract surgical problem

Objective To evaluate the efficacy of anti-eyebrow-shaped small scleral tunnel incision non-phacoemulsification cataract extraction and intraocular lens implantation.Methods The surgery was performed on 266 eyes of 266 patients that suffered from cataract.The follw-up period was 6-12 months.Results The best corrected visual acuities (BCVA) of 99 eyes (37.22％) were at ≥1.0 and the BCVA of 146 eyes (54.88％) were at 0.5-0.8.No serious complication was found.Conclusion Anti-eyebrow-shaped small scleral tunnel incision non-phacoemulsification cataract extraction and intraocular lens implantation have a good effect. Key words: Cataract, incision, small, scleral tunnel, anti-eyebrow-shaped; Lens, intraocular

Phacoemulsification and Modern Cataract Surgery

IntroductionWe developed a new technique that uses two of the vitrectomy ports as intraocular lens (IOL) haptic fixation sites and compared that with a conventional T-fixation method.MethodsA total of 33 eyes were retrospectively divided into the port-fixation (n=21) and conventional (n=12) groups. For the port-fixation group, supranasal and inferotemporal trocars (25-gauge) were placed in the center of a T-shaped lamellar scleral incision 2 mm from the corneal limbus and a supratemporal trocar at 3.5 mm. Following a vitrectomy, along with lens or IOL extraction as needed, the infusion cannula was changed from an inferotemporal to supratemporal trocar. The first IOL haptic and trocar were then simultaneously withdrawn from the eye by grasping with vitreoretinal forceps, with the same performed for the second IOL haptic and trocar, after which the infusion cannula was removed. In the conventional group, 2 T-shaped scleral incisions and three trocars were separately placed.ResultsPostoperatively, transient ocular hypotension and hypertension were observed in a few eyes in both groups. At 6 months after surgery, astigmatism was 1.71±1.13 D in the port-fixation group and 2.21±1.78 D in the conventional group (p=0.40, t-test).ConclusionThis new technique may be effective because of the lower number of scleral wounds.

Small incision extracapsular cataract surgery with manual phacotrisection

To describe a modified scleral fixation technique for a 4-haptic foldable intraocular lens (IOL) using 10-0 looped polypropylene sutures, aimed at reducing suture exposure risks and enhancing centration stability in eyes with inadequate capsular support. This retrospective interventional study included 9 eyes of 9 patients, who underwent modified scleral fixation of a 4-haptic foldable IOL between January 2023 and January 2024. Over a mean follow-up period of 10.89 months, postoperative LogMAR best-corrected visual acuity (BCVA) improved significantly (20/43 vs. 20/130 preoperatively). The mean IOL tilt was 0.27 ± 0.09 µm, with acceptable endothelial cell loss (9.96%). No intraoperative or postoperative complications were observed. This technique performed through a small incision, achieves reliable IOL positioning and visual improvement via four-point fixation while effectively eliminating suture-related complications.

PurposeTo compare capsular bag stability and posterior capsule opacification (PCO) of a plate-haptic intraocular lens (IOL) and a standard three-piece open-loop-haptic IOL of the same acrylic material.MethodsIn this randomised bilateral...

Objective To investigate the effectiveness of small incision cataract surgery for acute an-gle-closure glaucoma.Methods Thirty-six cased (36 eyes)of acute angle-closure glaucoma which had the cataract and the angle of anterior chamber closes being smaller than 180° Range received small incision cataract surgery with IOL implantation alone.Postoperative IOP, the depth of anterior chamber, the width of the angle of anterior chambers and visual acuity were observed with 1～12 months follow up.Results IOP of 36 eyes was all under the control of 20 mmHg (1mmHg=0.133Kpa) 1 week after operation and the anterior chamber angles became wider.Best corrected visual acuity acquired increase in 34 eyes at different degrees.Two eyes had no changes.There was no serious operation complication.During the follow up time IOP of 35 eyes had no change compared to one week postoperative.Eye sight of 1 eye decreased because the fundus hemor-rhage.The postoperative and preoperative IOP, anterior chamber depth and sight difference had statistically sig-nificant differences.Conclusions Small incision cataract surgery with posterior chamber intaoocular lens(IOL) implantation is an simple, economic and effective means for acute angle-closure glaucoma which have the cataract and the angle of anterior chamber closes being smaller than 180°. Key words: Glaucoma; Shuts the angle type; Cataract; Small incision; Intraocular lens

Traumatic expulsive iridodialysis after small-incision sutureless cataract surgery