VISUAL REHABILITATION IN LOW VISION PATIENTS WITH AGE-RELATED MACULAR DEGENERATION

Using optical visual aids, visual rehabilitation was performed in 14 low vision patients(25 eyes) with age-related macular degeneration. With distance aids, visual acuity improvement appeared in 24 eyes(95%) out of the 25 eyes. Twelve eyes(48%) obtained a visual acuity equal to or better than 0.4. With near visual aids, near acuity of all eyes(100%) was improved. Thirteen eyes(52%) got the near vision equal to or better than 0.5. Ten patients could read No.5 Chinese Reading Card. The reading success rat...

Implantation of Iakymenko keratoprosthesis in patients with severe ocular injury

AIM: To present the results of implantation of Iakymenko keratoprosthesis in five patients with vascularized corneal leukoma caused by severe ocular injury. METHODS: Iakymenko keratoprosthesis was implanted into 5 eyes of 5 patients: 4 patients were suffered from chemical burns and 1 patient from explosive injury. The preoperative visual acuity ranged from light perception to hand motion. The implantation surgery was composed of two-stage procedures. The follow-up period was from 9 months to 11 years. The outcome measures were visual acuity, retention, and complications of the keratoprosthesis. RESULTS: Vision improvements were achieved in most patients. All keratoprosthesis were retained within the follow-up period. Corneal melting occurred in one patient and fibrous closure in another patient, both of which were successfully treated. Retinal detachment occurred in one patient after surgery. CONCLUSION: Iakymenko keratoprosthesis seems to be a promising alternative for the patients with severe corneal injury, but further investigation is needed to evaluate the role of Iakymenko keratoprosthesis.

Introduction of longstanding complicated sulcus intraocular lens into the intact capsular bag

AIM:To propose a surgical technique that successfully reopened the empty and intact capsular bag after long periods of closure,with repositioning of the intraocular lens(IOL)from the ciliary sulcus into its preferred habitat inside the capsular bag.METHODS:This is a case series,prospective,and interventional study.The technique was first performed on an aphakic high myope with a closed posterior capsule for 18 y.Afterwards,five patients with recurrently displaced sulcus IOLs for a range of 1 mo to 7 y were performed for the same technique.During surgery,identifying a"telltale white line"was an important landmark for detecting the site of major adhesions between the edge of the capsulorhexis and the posterior capsule.These adhesions were freed using combined manual and viscoelastic dissection,followed by an easier freeing of adhesions along the whole capsular bag.The IOL was safely implanted,exchanged,or introduced from the sulcus into the fibrotic and closed capsular bag.Patients were followed up for a period ranging from 6 to 17 mo postoperatively.RESULTS:All the patients experienced a remarkable improvement in their subjective refraction.Slit lamp examination showed a postoperative centralized IOL in the bag.The follow up visits confirmed visual and IOL stability.CONCLUSION:This newly-introduced surgical technique facilitates the reopening of the empty yet intact capsular bag that has been closed by fibrotic proliferations,with secured implantation of the IOL inside the capsular bag.Patients with inadvertent implantation of IOLs into the ciliary sulcus,yet having an intact capsular bag,can benefit from this technique.