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      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 references 9

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          Detachment of Descemet's membrane.

          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
                Case Rep Ophthalmol
                Case Rep Ophthalmol
                COP
                Case Reports in Ophthalmology
                S. Karger AG (Allschwilerstrasse 10, P.O. Box · Postfach · Case postale, CH–4009, Basel, Switzerland · Schweiz · Suisse, Phone: +41 61 306 11 11, Fax: +41 61 306 12 34, karger@karger.com )
                1663-2699
                Jan-Apr 2021
                30 April 2021
                30 April 2021
                : 12
                : 1
                : 283-287
                Affiliations
                Department of Ophthalmology, Jichi Medical University, Tochigi, Japan
                Article
                cop-0012-0283
                10.1159/000514068
                8138190
                34054471
                Copyright © 2021 by S. Karger AG, Basel

                This article is licensed under the Creative Commons Attribution-NonCommercial-4.0 International License (CC BY-NC) (http://www.karger.com/Services/OpenAccessLicense). Usage and distribution for commercial purposes requires written permission.

                Page count
                Figures: 1, References: 9, Pages: 5
                Categories
                Case Report

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