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Session Title: Subluxed IOLs and Scleral Fixation
Session Date/Time: Wednesday 09/10/2013 | 08:00-10:30
Paper Time: 08:37
Venue: E102 (First Floor)
First Author: : R.Sinha INDIA
Co Author(s): : M. Bansal N. Sharma R. Tandon J. Titiyal
To evaluate and compare the stability of trans-scleral suture fixation and intrascleral glued haptic fixation of posterior chamber intraocular lens (IOL) using ultrasound biomicroscope (UBM).
Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi.
Scleral fixation of posterior chamber IOL was performed in 40 eyes of 40 patients. Of these, 20 eyes underwent intrascleral haptic fixation with fibrin glue and 20 eyes underwent trans-scleral suture fixation of IOL in the posterior chamber. Ultrasound biomicroscopy was performed at 3 months following surgery to look for the stability of IOLs. The visual outcome and presence of any intraoperative or postoperative complication in both the procedures were also compared.
The patients in both the groups were comparable preoperatively. The mean pre-operative uncorrected visual acuity (UCVA) in logMAR was 1.59 ±0.24 and 1.63 ±0.26 in the sutured and glued group respectively (Mann Whitney U test, p=0.45). The mean post-operative UCVA at 6 months was 0.33 ± 0.17 in sutured and 0.22 ±0.10 in the glued group. There was significant improvement in UCVA in both groups (Wilcoxon signed-rank test, p=0.001). Mean UCVA and BCVA at 6 months were more in the glued group which was statistically significant (p<0.05). UBM showed greater pseudophakodonesis in the sutured group in comparison to glued group (Chi-square test, p=0.046). The degree and range of movement of IOL in sutured group was higher. Mean central macular thickness (CMT) in micrometers was 250.95 ±23.98 in sutured and 225.85 ±21.13 in glued group (Mann Whitney U test, p=0.009). Vision and CMT were found to have inverse correlation [Pearson correlation -0.475 (p=0.01)].
Intrascleral glued haptic fixation of a posterior chamber IOL provides greater stability of IOL with lesser pseudophacodonesis thereby possibly resulting in lesser chance of macular edema in comparison with sutured trans-scleral fixation of IOL.
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