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Session Title: Subluxed IOLs and Scleral Fixation
Session Date/Time: Wednesday 09/10/2013 | 08:00-10:30
Paper Time: 08:31
Venue: E102 (First Floor)
First Author: : Z.Mazhry PAKISTAN
Co Author(s): : W. Kadri Artola
This study was focused on evaluation of simplified techniques of scleral fixation of hydrophobic single piece Acrylic posterior chamber IOLs in terms of visual outcome and complications.
WAPDA Teaching Hospital Complex and Acuity Eye Center Lahore Pakistan.
Prospective study was planned from January 2007 to December 2010. 40 aphakic eyes of 38 patients with deficient or absent capsular support were included in the study. Single or double haptic scleral fixation of foldable hydrophobic single piece IOL was performed under local anaesthesia or topical anaesthesia combined with local infiltration of Injection Xylocain. 10/0 polypropylene (Prolene) was used for transscleral fixation of the lens haptics. Trans-scleral suture passage was performed with Ab Externo (from outside in) technique in all the cases. Fixation suture was always buried beneath partial thickness scleral flap/tunnel. Anterior core vitrectomy was performed as a routine accompaniment.
The follow up ranged from 6-36 months and average follow up was 12 months. Visual outcome was quite good. Average visual acuity was in the range of 6/9-6/12, which is quite comparable to other kinds of implantations. The most common complication was vitreous hemorrhage and hyphaema, which resolved in all the patients with no residual complications. Temporary rise of IOP was noted in 10% cases and it was normalized with topical or systemic treatment within 1-6 weeks. Only one patient had persistently raised IOP and needed to continue anti glaucoma treatment on long term basis.
Scleral fixation of foldable IOL is an effective but surgically demanding technique. There is no reason to become somewhat over conscious about the slightly higher risk of complications with scleral-sutured PC IOL. Most of these complications can be avoided or minimized by proper selections of materials used and adopting the proper technique.
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