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      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      Accidental Corneal Intrastromal Intraocular Lens Implantation with the Wound-Assisted Technique and Clinical Course with Anterior Segment Optical Coherence Tomography

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          Abstract

          Accidental intraocular lens (IOL) implantation into the corneal stroma is a rare clinical entity that can occur during the wound-assisted technique. In this report, we describe a case of an 81-year-old man who underwent cataract surgery in which the IOL was implanted into the corneal stroma with the wound-assisted technique, and we present changes in anterior segment optical coherence tomography. The IOL was removed and reinserted after widening the incision. Air tamponade was created by intracameral injection. An anterior chamber tap was performed 10 h later to reduce increased intraocular pressure. Interlayer separation of the corneal stroma was confirmed 30 min postoperatively but was corrected 4 days later. The patient’s best-corrected visual acuity (BCVA) was logMAR 0.30, and he had been diagnosed with age-related macular degeneration before surgery. Although the opacity of the corneal stroma persisted, BCVA improved to logMAR 0. When using the wound-assisted technique for IOL insertion, surgeons should take care not to implant the IOL into the corneal stroma.

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          Most cited references9

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          To determine predisposing factors, best method of treatment, and the final outcome in cases of Descemet's membrane detachment.
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            Healing changes in clear corneal cataract incisions evaluated using Fourier-domain optical coherence tomography.

            To evaluate the long-term wound-healing changes in clear corneal cataract incisions using Fourier-domain optical coherence tomography (OCT).
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              Ultrasmall-incision bimanual phacoemulsification and AcrySof SA30AL implantation through a 2.2 mm incision.

              Phacoemulsification and aspiration were performed with a sleeveless ultrasound tip through an ultrasmall incision (1.2 to 1.4 mm) using a 20-gauge irrigating hook through a side port to infuse the anterior chamber. After the lens was extracted, the incision was enlarged to 2.2 mm and a single-piece intraocular lens (AcrySof SA30AL, Alcon) with an optic diameter of 5.5 mm was inserted. By modifying the new injector system, the AcrySof SA30AL could be inserted through a 2.2 mm incision in 100% of cases (63 eyes) in which it was feasible to use a thin lens having a central thickness of less than 20 diopters (D). A 2.2 mm incision was also used successfully in 54% of cases (42 of 78 eyes) that required a lens with a central thickness of 20 D or higher.
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                Author and article information

                Journal
                COP
                COP
                10.1159/issn.1663-2699
                Case Reports in Ophthalmology
                S. Karger AG
                1663-2699
                2021
                January - April 2021
                30 April 2021
                : 12
                : 1
                : 283-287
                Affiliations
                Department of Ophthalmology, Jichi Medical University, Tochigi, Japan
                Author information
                https://orcid.org/0000-0001-5331-4730
                Article
                514068 Case Rep Ophthalmol 2021;12:283–287
                10.1159/000514068
                7a272ded-c7f3-4d87-b535-8c348e5bd8b2
                © 2021 The Author(s). Published by S. Karger AG, Basel

                This article is licensed under the Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC). Usage and distribution for commercial purposes requires written permission. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

                History
                : 04 September 2020
                : 27 December 2020
                Page count
                Figures: 1, Pages: 5
                Categories
                Case Report

                Vision sciences,Ophthalmology & Optometry,Pathology
                Phacoemulsification,Wound-assisted technique,Anterior optical coherence tomography,Corneal intrastromal implantation

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