Karolina Krix-Jachym

The aim of the study was to evaluate the visual outcomes, safety and efficacy of the surgical technique used for repositioning and scleral fixation of the capsular bag - intraocular lens (IOL) complex in the surgical treatment of subluxated lenses. The study was prospective and performed between 2021 and 2025. Study included patients with different degrees of lens subluxation in cases of zonular dialysis. All patients underwent surgery using a capsular tension ring (CTR) and iris retractors, which were externalized through the sclera and cauterized to provide permanent scleral fixation of the capsular bag. Clinical and refractive outcomes were analyzed to evaluate intraocular lens stability, including tilt and decentration measurements at one year postoperatively. Safety analysis consisted of complication assessment. This study included 36 eyes from 32 patients. Mean follow-up was 396.72 ± 98.26 SD days. Mean surgical time was 40.08 ± 12.9 min. Postoperative BCVA was 0.09 ± 0.18 logMAR at one year follow-up. Postoperative total refractive error (RE) was + 0.68 ± 1.21D. Endothelial cell loss was 4.96% (123.94 cells/mm²) at one year follow-up. Mean vertical and horizontal tilt were 3.84° ± 1.78° and 4.23° ± 2.98° (p = 0.61). Mean vertical and horizontal decentration were 0.29 ± 0.14 and 0.30 ± 0.18 mm, respectively (p = 0.83). No cases of displacement capsular bag - IOL complex were reported. Long-term follow-up data suggest that simultaneously using CTR and iris retractors for permanent scleral fixation of the capsular bag - IOL complex demonstrates good visual and refractive outcomes in lens subluxation. This technique provides safe and effective long-term stabilization.Trial registration: ClinicalTrials.gov identifier, NCT07257172. Retrospectively registered, registration date 20.11.2025.

Background: To compare tilt and decentration results of two scleral fixation intraocular lens (IOL) methods of four-point scleral fixation (Akreos AO60) and the Yamane technique (AcrySof MA60AC). Methods: Two groups were compared in terms of IOL decentration and tilt at day 30 and 2 years after surgery. Correlations between IOL tilt and decentration and previous pars plana vitrectomy (PPV), axial length (AL), refractive error (RE), astigmatism, and spherical equivalent (SE) were also analyzed. Results: This study included 50 eyes from 47 patients: four-point fixation in 25 eyes (group 1) and Yamane technique in 25 eyes (group 2). The mean horizontal tilt was 1.66° ± 1.45° in group 1 and 5.06° ± 4.65° in group 2. The horizontal tilt value was significantly higher (p < 0.05) in group 2. The mean vertical tilt for group 1 and group 2 at two year’s observation was 1.74° ± 2.16° and 3.09° ± 2.79° respectively (p = 0.02). The mean horizontal IOL decentration was 0.35 ± 0.32 mm in group 1 and 0.34 ± 0.26 mm in group 2 (p > 0.05). The mean vertical IOL decentration in group 1 was 0.34 ± 0.33 mm and in group 2 it was 0.27 ± 0.20 mm respectively (p = 0.45). No statistically significant changes in tilt and decentration time were demonstrated in both groups (p > 0.05). There was no statistically significant correlation between IOL tilt and decentration and previous PPV in both groups. Conclusions: Both techniques provide good centration and stability IOL in aphakic eyes in the absence of capsular support.

Nowadays many patients are choosing EDOF or multifocal lenses for replacement of natural lens in cataract surgery. This can result in issues such as presence of dysphotopsias, namely halo and glare. In this work, we propose a new perimetry method to describe dysphotopsias in far-field region in a presence of bright, point-like light source. We constructed a custom device and designed measurement procedure for quantitative measurement of dysphotopias in the center of visual field and used it to examine patients with mild cataracts or implanted IOLs. Our approach may help in establishing an objective method to study and compare dysphotopsias.

Introduction The purpose of our study was to compare the safety and efficacy of two scleral fixation intraocular lens (IOL) methods of four-point scleral fixation (Akreos AO60) and the Yamane technique (AcrySof MA60AC). Methods This prospective, randomized study was conducted at the Military Institute of Medicine—National Research Institute in Warsaw between 2021 and 2023. We compared both groups for cause of aphakia, ocular history, refractive status, and complication. Results Our study included 50 eyes from 47 patients. Four-point fixation was performed in 25 eyes (group 1), and the Yamane technique was used in 25 eyes (group 2). Surgical time was 24.1 min ± 8.9 in group 1 and 25.1 min ± 9.9 in group 2 (p > 0.05). The postoperative BCVA (best-corrected visual acuity) for group 1 and group 2 at 1 year’s observation was 0.10 ± 0.15 and 0.09 ± 0.17 logMAR, respectively (p > 0.05). Postoperative total refractive error (RE) was − 0.06 ± 0.71 diopters (D) for four-point scleral fixation and 0.83 ± 0.70 D for Yamane technique (p < 0.05). Endothelial cell density (ECD) loss was 0.9% in group 1 and 3.5% in group 2 (p > 0.05). Bleeding into the anterior chamber and vitreous body was more frequent in the group of patients operated on with the use of the Yamane technique (10 cases, 20%, p = 0.01). IOL displacement was found in one case (2%) in group 2. Conclusions Both analyzed techniques are well tolerated and ensure good refractive results (extremely predictable in four-point scleral fixation) and have a similar safety profile. Four-point scleral fixation of IOL would appear to be safe, effective and beneficial for young, active patients, especially after trauma or recurrent subluxation. Clinical Trial Registration ClinicalTrials.gov identifier NCT06389643.

The study is aimed at describing a technique for scleral fixation of toric intraocular lens (TIOL) in the eyes without capsular support coexisting with corneal astigmatism. A monofocal toric hydrophobic lens with eyelets at the optic-haptic junction (enVista One-Piece Hydrophobic Acrylic MX60T Toric IOL; Bausch Lomb) was fixated to the sclera using two fragments of 60 polypropylene monofilament, the ends of which were brought out through the sclera and cauterized. The astigmatic axis of a TIOL was adjusted according to the corneal astigmatic axis of the patient. The surgery was performed in the 5 eyes of 5 patients without capsular support. The method was safe and effective in fixing the lens to the sclera, and it ensured good centration of TIOL with predictable refractive outcomes. No conjunctival sutures, glue, or flap formation was required during the surgery. There were no relevant complications related to the procedure.

Urazy oczu stanowią 10-15% wszystkich schorzeń narządu wzroku. Do ich standaryzacji służy klasyfikacja The Birmingham Eye Trauma Terminology. Wskutek urazu może dojść do uszkodzenia rogówki, twardówki, tęczówki, soczewki lub nawet całej gałki ocznej. Jednocześnie uraz jest najczęstszą przyczyną podwichnięcia soczewki, które wymaga zaopatrzenia chirurgicznego. W takim przypadku konieczne jest wybranie odpowiedniej, skutecznej metody leczenia. W Klinice Okulistyki WIM – PIB stosowana jest autorska metoda bezszwowej fiksacji kompleksu torebka-soczewka wewnątrzgałkowa z zastosowaniem pierścienia napinającego torebkę oraz retraktorów tęczówkowych.

A new sutureless technique used for repositioning and scleral fixation of the capsular bag–intraocular lens (IOL) complex in the surgical treatment of subluxated lenses is described. Iris retractors were used not only to induce a tent effect on the capsule but also to permanently fix the capsular bag to the sclera in this method, without the need to prepare scleral or conjunctival flaps. Surgery with the use of a capsular tension ring (CTR) and iris retractors, the ends of which were brought out through the sclera and cauterized, was performed in 7 eyes of 7 patients with moderate or severe subluxation of the crystalline lens. In all cases, simultaneous use of a CTR and iris retractors ensured good centration of the capsular bag–IOL complex. The method was safe and effective in fixing the capsule to the sclera in the case of significant damage to the ligamentous apparatus of the lens.