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Secondary intraocular lens implantation with Yamane double needle technic in eyes with scarred bullous keratopathy

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First Author: Y.Cay TURKEY

Co Author(s):    Y. Cay   C. Degirmenci   F. Afrashi   M. Palamar           

Abstract Details

Purpose:

Inadequate capsular support can occur due to complicated cataract surgery, dislocation of previously implanted intraocular lens (IOL), trauma and connective tissue diseases. Corneal problems such as corneal scar and bullous keratopathy usually accompany these cases. In these cases IOL can be implanted or relocated simultaneously with keratoplasty (combined procedure) or gradually (stepwise approach). The aim of the present study is to evaluate the effectivity and complications of stepwise approach of Yamane double needle technic with penetrating keratoplasty (PK) in eyes with scarred bullous keratopathy (SBK).

Setting:

The patients with SBK who underwent secondary IOL implantation with Yamane double needle technic between September 2018 and December 2019 in Ege University, Department of Ophthalmology were retrospectively reviewed. Twenty-four patients who did not have prior keratoplasty were included in the study after obtaining informed consents.

Methods:

Visual evoked potential evaluation, A- and B-scan ocular ultrasonography were performed to all patients. Before and after the surgery, best corrected visual acuity (BCVA) assessment, intraocular pressure (IOP) measurement, detailed anterior and posterior segment examinations were performed. The axial length measurements of the eyes were obtained with ultrasonic biometry. Secondary IOL implantation was performed as described by Yamane previously. PK was performed to patients who had visual acuity less than 0.7 logMAR at least one month after IOL implantation.

Results:

Mean age was 57.33±16.71. Indications for IOL implantation were trauma related aphakia (13), anterior chamber IOL related corneal endothelial dysfunction (6), trauma related IOL subluxation (4), and trauma related crystalline lens subluxation (1). Mean BCVA improved significantly after secondary IOL implantation (1.66±0.44 vs 1.15±0.71; p=0.01). PK was postponed in 11 patients due to increased visual acuity. Mean BCVA of the patients with PK indication was significantly worse than the patients whose transplantation schedules were postponed (1.68±0.53 vs 0.83±0.61; p=0.006). Complications were temporary IOP elevation (4), transient hyphema (2), cystoid macular edema (2), vitreus hemorrhage (1), and sarcoidosis uveitis recurrence (1).

Conclusions:

Secondary IOL implantation with Yamane double needle technic is an effective method for visual rehabilitation in patients with SBK. The implantation of IOL prior to open sky PK surgery might be more secure than combined technic in these patients.

Financial Disclosure:

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