10-year Clinical Outcomes after Implantation of a Posterior Chamber Phakic Lens for Myopia
To report the long-term clinical outcomes including efficacy and safety after intraocular collamer lens (ICL) implantation for myopia.
Conclusions: The present case is the first to describe the unusual presentation of pseudoexfoliation in a young individual along with presenile cataract. Simultaneous occurrence of pseudoexfoliation with cataract could be due to previous intraocular surgery, iris trauma, possible low-grade inflammation, and high myopia in a predisposed eye. The clinician should be aware that although a rare condition, pseudoexfoliation can occur in the young and may be associated with presenile cataract.
This case requires expertise in both ophthalmology and psychology. The patient is motivated to be spectacle free. Good distance vision is desirable for many individuals, but the patient also has an occupational need for good intermediate vision. Furthermore, the patient has myopia and is probably used to reasonably good UNVA. This patient shows bilateral inferior corneal steepening without apparent thinning. This irregular astigmatism will result in vertical coma that will influence his postoperative visual outcome.
This is a case of a 62-year-old man with decreased vision because of cataracts. He has myopia and astigmatism, and he refers to being very “phobic” regarding his eyes. Performing an eye examination and tests were difficult perhaps because of low cooperation by the patient. The RAM vision was 20/20 in both eyes, and the CCT was 628 μm and 613 μm in the right eye and left eye, respectively. Topographic analysis shows inferior corne al steepening, and there is incongruity regarding axis and amount of astigmatism between different studies done with different technologies.
In 2016, a then 62-year-old man presented with gradual painless reduction in vision. His medical history was unremarkable other than for the use of tamsulosin for benign prostatic hyperplasia (BPH). The patient's ocular history was positive for myopia and astigmatism for which he has used only spectacles; he has never worn contact lenses because he is very “phobic” regarding his eyes. He had not had an eye examination for several years and could not recall previous eyecare professionals. There was no significant ocular family history.
The frequency of late in-the-bag intraocular lens (IOL) dislocation has increased over the past decades. Important predisposing factors are pseudoexfoliation syndrome (PXF), myopia, previous vitreoretinal surgery, and trauma,1 –3 and there is also an association with glaucoma.1–4 Furthermore, some studies report high intraocular pressure (IOP) in eyes with IOL dislocation despite no known glaucoma.1–5 Accordingly, it has been speculated whether the dislocation can cause an IOP increase.
We present the technique used in a patient with high myopia in order to obtain rotational stability of a plated-haptic multifocal toric intraocular lens (AT LISA tri toric 939MP, ZEISS). Both patient ’s eyes had long axial lengths and large capsular bags. The first operated eye suffered from consecutive toric intraocular lens (IOL) malpositions. In the fellow eye toric IOL alignment was preserved by implanting a type 2L Cionni capsular tension ring. This was reversely inserted so the two eyele ts, which are positioned slightly anterior to the ring, pressed the IOL on the posterior capsule.
Patients with Artisan Myopia or Myopia Toric pIOLs showed an increase in axial length resulting in myopisation and a decrease of visual acuity 10 years after implantation.
A new toric extended depth of focus intraocular lens provides very good near and intermediate vision, with better near vision when the non-dominant eye is targeted for slight myopia.
This is a case of bilateral CCS.1 It occurs when capsular shrinkage remains unbalanced by pathologically weakened zonular fibers, as with high myopia. Shrinkage starts when the anterior capsule leaf touches down on the optic and terminates after 3 to 6 months.2 Polishing or resizing of a too small capsulorhexis at the end of surgery avoids CCS, whereas CTRs are ineffective.
This is a genuinely interesting case that should certainly be solved. Such a severe form of capsular phimosis is very seldom seen; however, when it is, then it presents with either high myopia, retinitis pigmentosa, or with pathologic zonula in general.