Beyoglu Eye Training and Research Hospital, University of Health Sciences, Istanbul, Turkey.
Purpose: To investigate the effect of scleral-fixated intraocular lens (IOL) tilt on visual outcomes.
Methods: Ninety-four eyes of consecutive 94 patients who underwent scleral-fixated IOL implantation with Z-suture technique were included in this prospective study. The values of pre- and postoperative 12th month uncorrected visual acuity (UCVA), cylindrical refractive error, best-corrected visual acuity (BCVA) and corneal and lenticular astigmatism were recorded. The position of the implanted IOL was evaluated with anterior segment optical coherence tomography (AS-OCT). The relationships between the AS-OCT measurements and the visual acuity or refractive errors were investigated.
Results: The IOL position was evaluated as tilted in 68 (72.3%) patients: 29 (30.8%) in both vertical?+?horizontal axes, 30 (31.9%) in the horizontal axis and 9 (9.6%) in the vertical axis. There were no significant differences between patients with and without tilt IOL position in terms of the UCVA, BCVA, cylindrical refractive error and lenticular astigmatism (p?>?0.05, for each). The mean BCVA was significantly higher in the no-tilt group than in the both horizontal?+?vertical tilt and the vertical tilt groups (p?=?0.03, p?=?0.04, respectively). The mean lenticular astigmatism was significantly higher in the vertical tilt group than the other groups (p?=?0.04).
Conclusion: Tilting in IOL position occurs commonly; however, IOLs with tilting on any of the axes do not have significantly worse outcomes when compared with IOLs with no tilt, in terms of visual results and refractive errors. On the other hand, tilting on the vertical axis is observed less commonly, yet is more effective on visual results and refractive errors, when compared with tilting on the horizontal axis.
a Department of Ophthalmology, University of Health Sciences, Beyoglu Eye Training and Research Hospital , Istanbul , Turkey.
: The aim of this study was to describe the clinical outcome of Descemet's membrane endothelial keratoplasty (DMEK) performed with split corneal grafts and to evaluate the influence of tamponade material and endothelial storage time on DMEK success. : The records of 43 patients who underwent DMEK surgery with a split corneal graft were reviewed. Diagnosis of the patients, preoperative and postoperative best-corrected visual acuity (BCVA), corneal and endothelial storage time, tamponade material, complications, and success rates were specifically tabulated. : The most common indication for DMEK was pseudophakic bullous keratopathy (n = 25, 58.2%). Re-bubbling was needed in 10 cases (23.2%), and a re-DMEK was scheduled in 2 cases and penetrating keratoplasty in 4 cases (9.3%). BCVA improved significantly postoperatively ( < .001). There was an insignificant trend towards a lower re-bubbling rate and better long-term anatomic outcome in favor of 20% SF6 group compared to air tamponade ( = .18 and = .25). There was no significant difference between the early endothelial transplant (<24 h) and delayed endothelial transplant (3 to 14 days) groups for anatomic success, corneal thickness or BCVA ( = .94, = .13 and = .35). : The success rate of DMEK was satisfactory with split corneal grafts. There was no adverse influence of delayed endothelial transplantation on clinical outcome. The success rate of 20% SF6 tamponade was slightly better than room air.
Department of Ophthalmology (H.Ç.), Türkiye Hospital, Eye Clinic, İstanbul, Turkey; Department of Ophthalmology (S.G.), Prof. Dr. N. Reşat Belger Beyoğlu Eye Training and Research Hospital, İstanbul, Turkey; and Department of Ophthalmology (E.G.), Medipol University Medical School, İstanbul, Turkey.
Department of Ophthalmology (S.G.), Lütfi Kirdar Kartal Eye Training and Research Hospital, İstanbul, Turkey; Eye Clinic (H.C., E.G.), Türkiye Hospital, İstanbul, Turkey; and Department of Ophthalmology (Ü.Ç.), Ümraniye Training and Research Hospital, İstanbul, Turkey.