AI Article Synopsis
- The study investigates the clinical features and visual outcomes of eyelet fractures in scleral-sutured enVista MX60 intraocular lenses (IOLs), focusing on patients who experienced displacement either during or after surgery.
- Among 25 identified cases, 20 fractures occurred postoperatively, leading to various complications; most commonly, Gore-Tex sutures were used to repair these fractures.
- Visual acuity significantly improved after lens replacement, going from a poor average of 20/317 to a much better 20/63, suggesting that despite the complications, surgical interventions can lead to positive visual outcomes.
Article Abstract
Objective: To report clinical features and visual outcomes following eyelet fractures of scleral-sutured enVista MX60 (Bausch + Lomb) intraocular lenses (IOL).
Design: Retrospective, multi-center, multi-surgeon, observational case series.
Methods: Study Population: Patients with scleral-sutured enVista MX60 IOLs that experienced either an intraoperative or post-operative eyelet fracture associated with dislocation or subluxation.
Procedures: All records were reviewed for patients with a dislocated or subluxed scleral-sutured enVista MX60 IOL. Clinical features and outcomes were gathered. Main Outcome Measures: Clinical setting, surgical technique, complications, and visual acuity.
Results: A total of 25 scleral-sutured enVista MX60 IOLs displacements secondary to eyelet fractures in 23 eyes of 23 patients were included. There were 20 IOLs that sustained a postoperative fracture and 5 IOLs that sustained an intraoperative fracture. Of the postoperative fractures, 7 were dislocated and 13 were subluxed. Gore-Tex was the suture of choice for 19 of the postoperative fractures and all 5 of the intraoperative fractures, and Prolene was used for 1 postoperative fracture. The mean time until postoperative fracture was 96 ± 125 days, and the median time was 61 (IQR 48-144) days. Of the postoperative fractures, new MX60s were sutured in 10 patients, and 2 of them experienced repeat displacements due to a new eyelet fracture. In the intraoperative fracture group, new MX60s were sutured in 4 patients and an Akreos AO60 lens was placed in the 5th patient. The mean preoperative best-corrected logMAR visual acuity for all patients improved from 1.2 ± 0.8 (20/317 Snellen equivalent) to 0.5 ± 0.5 (20/63 Snellen equivalent) at most recent follow-up after lens replacement.
Conclusions: Scleral-sutured MX60 intraocular lenses can experience intraoperative or postoperative eyelet fractures, resulting in lens subluxation or dislocation. Surgeons should be aware of this complication when evaluating secondary intraocular lens options.
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| http://dx.doi.org/10.1016/j.ajo.2020.07.049 | DOI Listing |
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