Dislocated Intraocular Lens
Conditions
Keywords
intraocular lens, dislocation
Brief summary
A prospective randomized study on patients with late in the bag intraocular lens (IOL) dislocation after cataract surgery. Two surgical techniques of suturing of IOL to the sclera will be compared in the study. IOL position will be compared between those two groups, as well to a control group consisting of ordinary pseudophakia where only measurement of IOL position will be performed.
Detailed description
In this prospective randomized study 60 patients will be included with late intraocular lens (IOL) dislocation and 60 patients in a control group with ordinary pseudophakia. Traditional surgery includes a capsular-IOL complex fixation to sclera by looping a prolene suture not only around haptics but also through capsular tissue. Such a suture may cut through the bag, which may result in a decentered IOL. A modification of the traditional method was created at S:t Eriks Eye Hospital in order to achieve better centration of the IOL. The study will evaluate the efficacy of these two methods. Additionally, the impact of fibrosis of capsular bag on IOL stability postoperatively will be evaluated.
Interventions
PROCEDUREIntraocular lens (IOL) ab externo scleral suture fixation
traditional IOL scleral suture fixation
PROCEDUREModified IOL ab externo scleral suture fixation
Modified IOL scleral suture fixation
Sponsors
Umeå University
St. Erik Eye Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Intervention model description
1 arm included 56 patients, the other arm included 61 patients. Sixty controls with ordinary pseudophakia.
Eligibility
Sex/Gender
ALL
Healthy volunteers
No
Inclusion criteria
* patients with in-the-bag dislocated IOL who agree to participate in the study * Inclusion criteria for the control group: pseudophakic eyes 7-10 years after uneventful cataract surgery.
Exclusion criteria
* patients with dislocated IOL that is not visible in the pupillary plane * IOL design not suitable for suturing using capsular bag * patients who are not able to cooperate under measurements * patients with Marfan syndrome and ectopia lentis * exclusion criterion for the control group: other eye surgery.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| IOL position | through study completion, an average of 1,5 years | Measured at 3 time points: 1 month, 6 months and 1.5 years postoperatively, with anterior optical coherence tomography (OCT). |
| Capsular thickness | preoperatively or as soon as possible postoperatively | Measured with OCT and photographed on slit-lamp examination. |
| Astigmatism | through study completion, an average of 1,5 years | Measured with corneal topography, autorefractometer and keratometer. Corneal and IOL related astigmatism measured in diopters.Measured at 3 time points: 1 month, 6 months and 1.5 years postoperatively, |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Number of participants with postoperative complications | through study completion, an average of 1,5 year | Number of patients with retinal detachment, macular edema and other. |
| Best Corrected Visual Acuity (BCVA) | through study completion, an average of 1,5 years | Measure for visual function. Measured in logMAR. Measured preoperatively, 1 month, 6 months and 1.5 years postoperatively |
| inflammation in anterior chamber | through study completion, an average of 1,5 years | Measured at 2 time points: 6 months and 1.5 years postoperatively, with laser flare meter. |
| Precision of the IOL position measurement with OCT | 1 month or any other postoperative control through study completion, an average of 1,5 year | Measurements of IOL position with OCT will be done 3 times by the same investigator in both mydriatic and non-mydriatic pupil status. |
| Intraocular Pressure (IOP) | through study completion, an average of 1,5 years | Measure for the pressure inside the eye measured with Goldman applanation tonometer and iCare, both in mmHg. Measured preoperatively, 1 month, 6 months and 1.5 years postoperatively |
| administration of IOL lowering therapy | through study completion, an average of 1,5 years | number of patients who used IOL lowering therapy |
Countries
Sweden
Outcome results
None listed