For Publishers
DiscoveryMetadataPeer reviewHostingPublishing
For Researchers
JoinPublishReviewCollect
Register
Blog
About
Search
Advanced search
My ScienceOpen
Search
For Publishers
For Researchers
Blog
About
6
views
26
references
 Top references
cited by
14
    
0 reviews
 Review
0
comments
 Comment
0
recommends
+1 Recommend
0 collections
    0
    shares
      402
      similar
       All similar
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      Intraocular Lens Implantation In The Ciliary Sulcus: Challenges And Risks

      review-article

      Read this article at

      ScienceOpenPublisherPMC
      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Purpose

          This article reviews the current literature on the risks and challenges associated with intraocular lens (IOL) implantation in the ciliary sulcus.

          Recent findings

          The development of IOLs designed specifically for placement in the ciliary sulcus continues to be an area of interest for the ophthalmic industry. Currently the one-piece PMMA (polymethylmethacrylate) lens or a three-piece IOL are the best available options for IOL placement in the ciliary sulcus space. Single piece acrylic (SPA) IOLs are not designed for sulcus placement and there is growing evidence of chronic complications related to their use in the ciliary sulcus. Many of these eyes ultimately require surgical intervention, including lens exchange. Endoscopic imaging and ultrasound biomicroscopy (UBM) have enabled a better understanding of ciliary sulcus anatomy and measurements in the living eye.

          Summary

          When the capsular bag is compromised, IOL placement in the ciliary sulcus is a reasonable option. In these circumstances, appropriate choice of IOL, knowledge of the sulcus anatomy, and correct technique can improve results and reduce postoperative complications.

          Related collections

          Most cited references26

          • Record: found
          • Abstract: found
          • Article: not found

          Intraocular lens implantation in the absence of capsular support: a report by the American Academy of Ophthalmology.

          R Ariyasu, Christopher Karp, … (2003)
          This review was conducted to determine the safety and efficacy of open-loop anterior chamber, scleral-sutured posterior chamber, and iris-sutured posterior chamber intraocular lenses (IOLs) in eyes with inadequate capsular support for posterior chamber implantation in the capsular bag or ciliary sulcus. It also attempted to determine whether there is a preferred IOL or fixation site of choice in eyes with inadequate capsular support. A literature search conducted for the years 1980 to 2001 yielded 189 citations related to IOL implantation in the absence of capsular support. An update search, conducted in March 2002, yielded an additional 28 articles. The Anterior Segment Panel members reviewed these abstracts and selected 148 articles of possible clinical relevance for review. Of these, 89 were considered sufficiently clinically relevant for the panel methodologist to review and rate according to the strength of evidence. A level I rating was assigned to properly conducted, well-designed, randomized clinical trials; a level II rating was assigned to well-designed cohort and case-control studies; and a level III rating was assigned to case series. Articles comparing the safety and efficacy of the IOL type and fixation site were further evaluated for the quality of the statistical methods used in the study. Studies with a rating of A or B were considered acceptable, C was borderline, and D and F were considered unacceptable as medical evidence. Forty-three articles with data concerning outcome of IOL insertion in eyes with inadequate capsular support had an evidence rating of level III or higher and were used in the final review of the safety and efficacy of one or more lens types and/or fixation sites. Seven articles had data about more than one lens type. Six had a statistical method rating of C or higher and were used to evaluate differences in visual outcomes and complication rates between lens types and fixation sites. The literature supports the safe and effective use of open-loop anterior chamber, scleral-sutured posterior chamber, and iris-sutured posterior chamber IOLs for the correction of aphakia in eyes without adequate capsular support for placement of a posterior chamber lens in the capsular bag or ciliary sulcus. At this time, there is insufficient evidence to demonstrate the superiority of one lens type or fixation site. Precise determination of small differences in visual outcome or complication rates will require a large prospective, randomized clinical trial.
          Article 0 comments Cited 64 times – based on 0 reviews     Review now
            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            Complications of sulcus placement of single-piece acrylic intraocular lenses: recommendations for backup IOL implantation following posterior capsule rupture.

            David Chang, Samuel Masket, Kevin Miller … (2009)
            To describe complications arising from sulcus placement of single-piece acrylic (SPA) intraocular lenses (IOLs), evaluate IOL options for eyes that lack adequate capsule support, and examine the appropriateness of various IOL designs for sulcus placement. University and private anterior segment surgery practices. Patients referred for complications of SPA IOLs in the ciliary sulcus from 2006 and 2008 were identified. Demographic information, examination findings, and complications of the initial surgery were recorded. Details of surgical interventions and the most recent corrected distance visual acuity (CDVA) were noted. A thorough review of the literature was undertaken to analyze options for IOL placement. Complications of sulcus SPA IOLs included pigment dispersion, iris transillumination defects, dysphotopsia, elevated intraocular pressure, intraocular hemorrhage, and cystoid macular edema. Two patients in the series of 30 patients experienced 1 complication; 8 experienced 2 complications; 13 experienced 3 complications; 4 experienced 4 complications; and 2 experienced 5 complications. Twenty-eight eyes (93%) required surgical intervention; IOL exchange was performed in 25 (83%). Postoperatively, the mean CDVA improved, with most eyes attaining 20/20. Intraocular lenses designed solely for the capsular bag should not be placed in the ciliary sulcus. Backup IOLs in appropriate powers, sizes, and designs should be available for every cataract procedure. The development, investigation, and supply of IOLs specifically designed for placement in eyes that lack adequate capsule support represent clinically important endeavors for ophthalmology and the ophthalmic industry.
            Article 0 comments Cited 36 times – based on 0 reviews     Review now
              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

              Direct measurement of the ciliary sulcus diameter by 35-megahertz ultrasound biomicroscopy.

              Jong-Suk Song, Hyo-Myung Kim, Jaeryung Oh … (2007)
              To measure the ciliary sulcus diameters in 4 different axes and to determine the correlation with white-to-white distance.
              Article 0 comments Cited 29 times – based on 0 reviews     Review now
                Bookmark
                All references

                Author and article information

                Journal
                Journal ID (nlm-ta): Clin Ophthalmol
                Journal ID (iso-abbrev): Clin Ophthalmol
                Journal ID (publisher-id): OPTH
                Journal ID (pmc): clinop
                Title: Clinical Ophthalmology (Auckland, N.Z.)
                Publisher: Dove
                ISSN (Print): 1177-5467
                ISSN (Electronic): 1177-5483
                Publication date (Electronic): 27 November 2019
                Publication date Collection: 2019
                Volume: 13
                Pages: 2317-2323
                Affiliations
                [1 ]Illinois Eye and Ear Infirmary , Chicago, IL, USA
                Author notes
                Correspondence: Ahmad A Aref Illinois Eye and Ear Infirmary , 1855 W. Taylor Street, M/C 648, Chicago, IL60612, USATel +1312-996-7030Fax +1312-413-8574 Email aaref@uic.edu
                Article
                Publisher ID: 205148
                DOI: 10.2147/OPTH.S205148
                PMC ID: 6885568
                PubMed ID: 31819356
                SO-VID: 0a878116-dd75-4561-9646-1e25295d0b64
                Copyright © © 2019 Mehta and Aref.
                License:

                This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms ( https://www.dovepress.com/terms.php).

                History
                Date received : 05 August 2019
                Date accepted : 05 November 2019
                Page count
                Figures: 3, Tables: 1, References: 28, Pages: 7
                Categories
                Subject: Review

                ScienceOpen disciplines: Ophthalmology & Optometry
                Keywords: ciliary sulcus,capsule rupture,intraocular lens,complications,surgical technique
                Data availability:
                ScienceOpen disciplines: Ophthalmology & Optometry
                Keywords: ciliary sulcus, capsule rupture, intraocular lens, complications, surgical technique

                Comments

                Comment on this article

                scite_

                Similar content402

                See all similar

                Cited by14

                See all cited by

                Most referenced authors217

                See all reference authors