Purpose: To describe the clinical features and visual outcomes of eyes with conjunctival haptic erosion after sutureless intrascleral (SIS) fixated intraocular lens (IOL) placement.
Design: Retrospective case series.
Subjects: Patients experiencing haptic erosion after SIS fixation between January 1, 2013, and March 1, 2022.
Methods: A multicenter, multisurgeon, retrospective review.
Main Outcome Measures: Clinical features, visual outcomes, and treatment options following haptic erosions after SIS fixation.
Results: Nineteen eyes with haptic erosion were identified. The mean age at initial SIS fixation was 64 ± 12 years (range, 38-81 years). There were 5 (26%) eyes with a history of conjunctiva involving ocular surgery, including scleral buckle surgery and tube shunt surgery. Trocar-assisted fixation was performed in 15 (79%) eyes, whereas needle fixation was used in 4 (21%) eyes. Eighteen (95%) sets of haptics were flanged with a low temperature cautery. Seventeen (90%) sets of haptics were externalized superiorly and inferiorly, and 2 (10%) sets of haptics were externalized nasally and temporally. Haptics were covered by conjunctiva in 14 (74%) eyes and by scleral flap in 5 (26%) eyes. All patients experienced a single haptic erosion, of which 8 (43%) were located superiorly, 9 (47%) inferiorly, and 2 (10%) temporally. The mean interval between the initial SIS fixation and haptic erosion was 278 ± 437 days. After correction of the erosion, 18 (95%) eyes had a stable IOL at the last follow-up, with no recurrence of haptic erosion. In this series, there were no cases of endophthalmitis.
Conclusions: Haptic erosion is a notable complication after SIS fixated IOL surgery but may be repaired with favorable visual outcomes. Careful evaluation of the conjunctiva should be considered before the surgery.
Financial Disclosure(s): Proprietary or commercial disclosure may be found after the references.
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http://dx.doi.org/10.1016/j.oret.2022.10.015 | DOI Listing |
Retina
June 2023
Department of Ophthalmology and Vision Science, University of Arizona College of Medicine, Tucson, Arizona; and.
Purpose: To describe the vitreoretinal surgical technique and report the outcomes of our method of sutureless flanged intrascleral haptic fixation of dislocated 1-piece polymethyl methacrylate intraocular lenses with rigid haptics.
Methods: Ciliary sulcus-based scleral tunnels were created by placing valved 27-gauge (g) trocar cannulas limbus parallel with conjunctival displacement. After complete vitrectomy, the rigid haptics were then externalized using 27g forceps.
Ophthalmol Retina
November 2023
Mayo Clinic, Department of Ophthalmology, Rochester, Minnesota. Electronic address:
Objective: To identify changes in secondary lens techniques over time and to determine common complications of each technique.
Design: Retrospective cohort study.
Participants: All patients in the database from January 2015 to December 2021 who underwent secondary lens placement (anterior chamber intraocular lens [IOL, ACIOL], scleral-fixated IOL [SFIOL], or scleral-sutured IOL [SSIOL]).
Ophthalmol Retina
April 2023
Bascom Palmer Eye Institute, Miller School of Medicine, University of Miami, Miami, Florida. Electronic address:
Purpose: To describe the clinical features and visual outcomes of eyes with conjunctival haptic erosion after sutureless intrascleral (SIS) fixated intraocular lens (IOL) placement.
Design: Retrospective case series.
Subjects: Patients experiencing haptic erosion after SIS fixation between January 1, 2013, and March 1, 2022.
Proc SPIE Int Soc Opt Eng
April 2022
Kitware Inc., Carrboro, NC.
Interactive multimodal surgical simulators are powerful tools that allow efficient and objective assessment of surgical skills. Bilateral Sagittal Split Osteotomy (BSSO) requires precise cutting of the mandible with a motorized saw that cannot afford a high margin of error. Surgeons rely on visual and haptic cues that are hard to train for through existing curricula without training directly on patients.
View Article and Find Full Text PDFJ Cataract Refract Surg
July 2022
From the Ningbo Eye Hospital, Ningbo, Zhejiang, China (Yi, S.-J. Wu, G.-H. Wu, Wang, Gong); The School of Medicine, Ningbo University, Ningbo, Zhejiang, China (Ying); Eye Center, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China (Su).
A technique using the single-string, closed-loop fixation method to reposit dislocated triple-looped haptic intraocular lens (IOL)-capsular bag complex is described. The long needle or curved needle with a 10-0/8-0 polypropylene suture and a 27/30-gauge needle were used as the guide needle to pass through the fenestrated haptics twice. The scleral interlaminar course was used as the fixed point.
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