Masoomeh Mohebbi1, Mohammad-Reza Fallah-Tafti2, Kaveh Fadakar1, Ramon Katoozpour1, Seyed-Farzad Mohammadi1, Zahra Fallah-Tafti1, Azita Khorami1. 1. From the Eye Research Center (Mohebbi, M.-R. Fallah-Tafti, Fadakar, Katoozpour, Mohammadi), Farabi Eye Hospital, Tehran University of Medical Sciences, the Razi Eye Clinic (Z. Fallah-Tafti), and the Noor Eye Hospital (Khorami), Tehran, Iran. 2. From the Eye Research Center (Mohebbi, M.-R. Fallah-Tafti, Fadakar, Katoozpour, Mohammadi), Farabi Eye Hospital, Tehran University of Medical Sciences, the Razi Eye Clinic (Z. Fallah-Tafti), and the Noor Eye Hospital (Khorami), Tehran, Iran. Electronic address: mrft.ophtha@gmail.com.
Abstract
PURPOSE: To evaluate the best piggyback intraocular lens (IOL) implantation method and the outcomes in nanophthalmos eyes and to define the postoperative structural changes. SETTING: Farabi Eye Hospital, Tehran, Iran. DESIGN: Prospective case series. METHODS: Candidates for refractive surgery who were nanophthalmic were recruited. Patients had refractive lens exchange followed by implantation of both IOLs in the bag or 1 IOL in the bag and 1 IOL in the sulcus. The baseline and follow-up visual acuity, refractive status, and structural Scheimpflug imaging were evaluated. Ultrasound biomicroscopy (UBM) was performed 6 months postoperatively. RESULTS: The study comprised 9 nanophthalmic patients (18 eyes) with a mean preoperative uncorrected distance visual acuity (UDVA) of 1.53 logarithm of the minimum angle of resolution (logMAR) ± 0.3 (SD), mean corrected distance visual acuity (CDVA) of 0.34 ± 0.2 logMAR, and mean spherical equivalent (SE) of +13.55 ± 4.0 diopters (D). The mean postoperative UDVA improved from baseline. There was no significant difference in the mean UDVA and CDVA between the 2 IOL groups. Postoperatively, both groups had a significant improvement in SE, a significant rise in anterior chamber depth and angle, and similar UBM measurements. CONCLUSIONS: Piggyback IOL implantation was an effective refractive procedure in nanophthalmic eyes. Both implantation methods resulted in similar outcomes; however, the small number of patients in each group made it less likely that possible differences would be found. The increase in angle values might help prevent the development of closed-angle glaucoma.
PURPOSE: To evaluate the best piggyback intraocular lens (IOL) implantation method and the outcomes in nanophthalmos eyes and to define the postoperative structural changes. SETTING: Farabi Eye Hospital, Tehran, Iran. DESIGN: Prospective case series. METHODS: Candidates for refractive surgery who were nanophthalmic were recruited. Patients had refractive lens exchange followed by implantation of both IOLs in the bag or 1 IOL in the bag and 1 IOL in the sulcus. The baseline and follow-up visual acuity, refractive status, and structural Scheimpflug imaging were evaluated. Ultrasound biomicroscopy (UBM) was performed 6 months postoperatively. RESULTS: The study comprised 9 nanophthalmic patients (18 eyes) with a mean preoperative uncorrected distance visual acuity (UDVA) of 1.53 logarithm of the minimum angle of resolution (logMAR) ± 0.3 (SD), mean corrected distance visual acuity (CDVA) of 0.34 ± 0.2 logMAR, and mean spherical equivalent (SE) of +13.55 ± 4.0 diopters (D). The mean postoperative UDVA improved from baseline. There was no significant difference in the mean UDVA and CDVA between the 2 IOL groups. Postoperatively, both groups had a significant improvement in SE, a significant rise in anterior chamber depth and angle, and similar UBM measurements. CONCLUSIONS: Piggyback IOL implantation was an effective refractive procedure in nanophthalmic eyes. Both implantation methods resulted in similar outcomes; however, the small number of patients in each group made it less likely that possible differences would be found. The increase in angle values might help prevent the development of closed-angle glaucoma.