Divya Ramraika

Abstract

Aim: To evaluate post-operative opacification of hydrophobic, hydrophilic and polymethylmethacrylate intraocular lenses. Materials and Methods: We had performed a retrospective observational study on twenty-one patients in tertiary care hospital of North India and a private clinic from March 2020-January 2021. History of systemic diseases like diabetes mellitus, hypertension, gout, chronic obstructive pulmonary disease was noted. We had also evaluated the patients for ophthalmic conditions like recurrent uveitis, retinal surgery, paracentesis for hyphema, open globe injury repair. The diagnosis of intraocular lens opacification was made on careful slit lamp examination. The patients with severe loss of visual acuity had undergone intraocular lens exchange procedure. The explanted intraocular lenses were sent for light microscopy with special stain and scanning electron microscopy. Statistical analysis was performed using SPSS software, version 21 (SPSS, Inc.) Results: We found that mean age of patients with intraocular lens opacification was 62.5±6.82 years. The occurrence was 16(76.19%) in hydrophilic IOL, 4(19.05%) in hydrophobic IOL and only one (4.76%) was PMMA IOL which showed that the occurrence if IOL opacification is more in hydrophilic IOL. Light microscopy and scanning electron microscopy of the explanted IOLs did not show any deposits over IOL surface. Special stains were used and it was noted that Alizarin red was positive while Von Kossa for calcium was negative. Conclusion: We concluded that intraocular lens opacification can occur in any type of intraocular lens, but is predominantly seen with hydrophilic acrylic intraocular lenses. Also we came to a conclusion that various ophthalmic pathologies and systemic comorbidities accelerated the process of opacification.   Keywords: Acrylic intraocular lenses, Opacification, Polymethylmethacrylate.

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Abstract

Aim: To compare results of early intra-operative versus post-operative Descemet’s membrane detachment (DMD) detection and descemetopexy. Materials and Methods: Data was collected retrospectively for patients who developed DMD from December 2018 to March 2020 and underwent air descemetopexy. Results : The study comprised of 85 eyes of 85 patients. (which 4 were excluded.) There were 41 males and 39 females. Mean age was 66.93 years (SD ± 12.21). 4 eyes had mild DMD which were excluded from final analysis. 55 eyes had moderate & 26 had severe DMD. 68 eyes had intraoperative descemetopexy (Group 1) and 13 had late detection of DMD with late post-operative descemetopexy (Group 2). Median final BCVA in group 1 was 0.17 logMAR(IQR 0.13) & in group 2 was 0.60 logMAR(IQR 0.22). Conclusion: Air descemetopexy gives acceptable results in cases of DMD. However early detection of DM detachment during primary surgery with early descemetopexy yields better results in visual outcome of patients. Hence, carefulness in detection of intra-operative complications should be kept and early descemetopexy should be considered to prevent severe visual loss due to DMD.   Keywords: Descemet’s membrane detachment, Descemetopexy, Cataract surgery.

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