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S. Guigou, M. Mercie, B. Briat, D. Denis; Ultrasound Biomicroscopy Study of the Posterior Iris-claw Verisyse® Intraocular Lens Associated With Penetrating Keratoplasty in Pseudophakic Bullous Keratopathy. Invest. Ophthalmol. Vis. Sci. 2008;49(13):406. doi: https://doi.org/.
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To study in situ, using the ultrasound biomicroscope (UBM), the anterior segment modifications and intra-ocular lens (IOL) position after penetrating keratoplasty (PK) and Verisyse® (AMO) implantation either fixed pre or retropupillary, for the treatment of pseudophakic bullous keratopathy (PBK)
Prospective randomised comparative case series: 36 referred eyes with PBK, underwent PK and Verisyse® implantation. 17 patients (Group A) had prepupillary implantation, and 19 (Group B) retropupillary implantation in a reversed position. Echograms, 3 months after surgery, measured the central anterior chamber depth (ACD), iris thickness (IT), distance of the haptics from the endothelium (CED) and from the ciliary body (CBD), the angle opening distance 500 µm from the scleral spur (AOD500) and irido-corneal angle θ° on the 4 clock meridian lines (AOD3, AOD9, AOD12, AOD6 / θ 12, θ 6, θ 3, θ 9)
Both follow up (26 months) and mean age (82.5 years old) were comparable. No significant difference was found for IT (p > 0.05). Mean ACD was deeper by about 1,1 mm namely 37% (p<0,01), and CED3 was larger by 61% (p<0.05), CED9 69% (p<0,05), AOD3 63% (p<0,05), AOD9 125% (p<0,01), AOD6 43% (p<0,05), AOD12 40% (p<0,05) and θ 3 was wider by 53% (p<0.05), θ 9 116% (p<0.01), θ 12 72% (p<0.05), θ 6 74% (p<0.05) in group B than in group A. Complications such as angular synechia or lens-cornea contact are less in group B than in group A (p<0,01)
The retropupillary upside down Verisyse® IOL fixation in combination with PK almost attains the characteristics of a true posterior chamber IOL: posterior translation of the iridal plane and absence of endothelium contact. This safe procedure may be an effective alternative to achieve pseudophakia without capsular support
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