Purpose: To introduce cases of intraocular lens (IOL) malposition after sutureless intrascleral fixation.
Methods: We retrospectively analyzed the medical records of patients who underwent sutureless intrascleral fixation. Cases with postoperative IOL requiring reoperation were analyzed further.
Results: Of the 48 eyes that underwent sutureless intrascleral fixation of their IOL, seven eyes had postoperative IOL malposition and underwent reoperation (14.6%). There was no difference in the clinical results between the intravitreal (33 eyes) and intracameral (15 eyes) techniques, but IOL malposition requiring reoperation was more frequent in the latter (2 cases [6.1%] vs. 5 cases [33.3%], P = 0.024). In the 7 eyes that required reoperation, the visual acuity before reoperation was 0.9 ± 0.6 logMAR (20/159), whereas astigmatism was -4.8 ± 3.2 diopters. The visual acuity and cylindrical error improved to 0.1 ± 0.2 logMAR (20/25) and -2.4 ± 2.3 diopters, respectively, at 6 months after the secondary operation.
Conclusion: In 14.6% of the patients who underwent sutureless intrascleral fixation of the IOL, IOL malposition developed and reoperation was performed. With the intravitreal technique, which uses a wider space than the intracameral technique, the frequency of postoperative IOL malposition could be reduced.
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http://dx.doi.org/10.1097/IAE.0000000000003279 | DOI Listing |
Eye Vis (Lond)
December 2024
Department of Ophthalmology, The Second Hospital of Jilin University, Changchun, China.
Over the past two decades, both suture and sutureless techniques for scleral fixation of intraocular lenses have seen significant advancement, driven by improvements in methodologies and instrumentation. Despite numerous reports demonstrating the effectiveness, safety, and superiority of these techniques, each approach carries with it its own drawbacks, including an elevated risk of certain postoperative complications. This article delves into various surgical techniques for scleral fixation of posterior chamber intraocular lenses, discussing their procedural nuances, benefits, drawbacks, postoperative complications, and outcomes.
View Article and Find Full Text PDFCurr Opin Ophthalmol
December 2024
Department of Research, Wills Eye Hospital, Philadelphia, PA.
Purpose Of Review: To describe recent evidence regarding surgical techniques for secondary scleral fixation of intraocular lenses (IOLs), with attention to information most relevant to the surgical practice of vitreoretinal surgeons.
Recent Findings: Recent studies have reported favorable outcomes in patients treated with scleral fixation of IOLs using Gore-Tex suture and flanged intrascleral haptic fixation (ISHF). ISHF can be achieved using trocar-cannulas or double needle-based techniques.
Surv Ophthalmol
December 2024
Juntendo University Graduate School of Medicine, Department of Ophthalmology, Tokyo 113-0033, Japan.
Our systematic review and meta-analysis elucidates the postoperative complication rates associated with 3 major surgical approaches, including the scleral tunnel, glued, and flanged techniques, for sutureless intrascleral intraocular lens (IOL) fixation. An online search was performed for articles published in PubMed and EMBASE between January 1, 1975, and January 7, 2023. Original studies reporting postoperative complications of sutureless intrascleral IOL fixation were included.
View Article and Find Full Text PDFEur J Ophthalmol
December 2024
St. Anna University Hospital, University of Ferrara, Ferrara, Italy.
Purpose: To report the visual and refractive outcomes of trocar-assisted sutureless intrascleral three-piece intraocular lens (IOL) fixation, and to compare the accuracy of different IOL power formulas in this setting.
Methods: Twenty eyes of 20 patients who underwent trocar-assisted sutureless three-piece IOL scleral fixation were included. Two trocar-cannula systems were placed at 3 and 9 o'clock position creating 2.
Am J Ophthalmol
January 2025
Department of Ophthalmology (M.S.), Selcuk University Faculty of Medicine, Konya, Turkey.
Purpose: To compare clinical outcomes, reverse pupillary block (RPB) findings, and anterior segment parameters in patients with and without intraoperative peripheral iridectomy during sutureless flattened flange intrascleral intraocular lens (IOL) fixation.
Design: Retrospective comparative case series.
Participants: This study included 94 eyes of 82 patients who underwent IOL explantation due to vitreous-dislocated IOL at our clinic between March 2020 and September 2023, followed by flattened haptic-tipped IOL intrascleral fixation combined with pars plana vitrectomy.
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