Novel use of an adjustable single 8-0 polypropylene suture of scleral fixation without conjunctival dissection.

BMC Ophthalmol

Beijing Tongren Eye Center, Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing Tongren Hospital, Capital Medical University, No. 1 Dong Jiao Min Xiang, Eastern District, Beijing, 100730, China.

Published: July 2020

AI Article Synopsis

  • - This report explores a new surgical method using an adjustable 8-0 polypropylene suture for scleral fixation of intraocular lenses (IOLs) without needing to dissect the conjunctiva, detailing the related clinical outcomes.
  • - The study involved 28 eyes from 27 patients, with a focus on visual acuity and postoperative complications over an average follow-up of about 10 months, showing significant improvement in vision post-surgery.
  • - Most complications encountered were temporary and minor, such as corneal edema and elevated intraocular pressure, while IOLs were stable and well-centered after the procedure with no serious issues noted.

Article Abstract

Background: This report serves to describe the use of a novel adjustable single 8-0 polypropylene suture for scleral fixation without conjunctival dissection, and to describe related clinical outcomes associated with this approach.

Methods: In this study, we retrospectively reviewed 28 eyes from 27 patients that underwent scleral fixation of the intraocular lens (IOL) without conjunctival dissection using an adjustable single 8-0 polypropylene suture at the Beijing Tongren Eye Center between April 2018 and April 2019. For this surgical approach, a 23-gauge infusion cannula was set, after which two Hoffmann scleral pockets were created. Next, 8-0 polypropylene sutures were inserted into the eye guided by 10-0 polypropylene sutures of a long straight needle. The 8-0 suture was then used to fix the haptic IOs. Finally, these 8-0 polypropylene sutures were removed from the scleral pockets, and knots were tightened with the adjustable single suture. Primary outcomes included visual acuity and postoperative complication incidence.

Results: For this study, outcomes for 28 eyes from 27 patients (9 female, 18 male) were assessed. Patients had a mean age of 54 ± 15.11 years-old and were followed for an average of 10.18 ± 2.76 months postoperatively. Uncorrected visual acuity in these patients improved significantly from a preoperative value of 1.269 ± 0.464 logMAR to a 3-month postoperative value of 0.409 ± 0.413 logMAR (p = 0.000). The majority of postoperative complications in these patients were temporary and self-limiting, including corneal edema (35.71%), hypotony (14.29%), elevated intraocular pressure (28.58%), and mild hyphema (7.14%). No evidence of exposure or erosion of the trimmed suture end was detected in any patients. An ultrasound biomicroscope was able to readily detect the IOL and all sutures, and IOLs were found to be well-centered without any dislocation, tilting, or subluxation upon follow-up.

Conclusions: An adjustable single 8-0 polypropylene suture can reliably and effectively be used for scleral fixation without conjunctival dissection for the treatment of patients with aphakia or inadequate posterior capsule support. The novel procedure described herein may therefore be an effective means of minimizing the risk of suture-related complications in patients undergoing scleral-fixated IOL implantation.

Trial Registration: Retrospective case series study, not applicable. NCT04476264 .

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7382057PMC
http://dx.doi.org/10.1186/s12886-020-01558-yDOI Listing

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