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First Author: A.Gorbunov RUSSIA
Co Author(s): V. Kanyukov Y. Babkova
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Development and insertion in clinical practice of a new fixation method of soft intraocular lens to the iris at continuity disorder of capsular bag in lower segment using surgical incision 2.2 mm.
Orenburg Branch of Federal State Institution The acad. S.N.Fyodorov Intersectoral Research & Technology Complex Eye Microsurgery of the Ministry of Health of the Russian Federation, Orenburg, Russia.
Anesthesia - sub-tenon in eyeball inferior-internal part 2ml of 2% lidocain solution. Intraocular lens was implanted in capsular bag if there were its parts (if possible), or on it, after there had been carried out preliminary anterior vitrectomy using 1.8mm injector. One haptic was infringed in surgical wound with size of 2.2mm. and tied by polypropylene suture 10,0. The ligatured haptic was moved in capsular bag and rotated to the meridian at V hours and the iris at V hours was needled through the paracentesis formed there. The next puncture in the iris was made through that paracentesis with an external loop formation. The iris was needled and the needle was output through the incision, then it was inserted and the iris was once more needled in the meridian of V hours, and after that it was output through the paracentesis. So two ends of suture were formed and tied in a knot. Intraocular lens was centered. If it was necessary anterior vitrectomy was performed. After these manipulations viscoelastic was washed out of the anterior chamber, the edges of wound and paracentesis were hydrated. The surgery was finished by introduction of hormone with antibiotic and 0.5ml deprospan parabulbarly under conjunctiva.
According to the described method there were operated 15 patients with continuity disorder of capsular bag during the surgery and 10 patients with impaired lens ligamentous apparatus. In postoperative period the position of intraocular lens was correct and stable during all follow-up period. Vision acuity was from 0.3 to 1.0 depending on the state of macular area. At late postoperative period macular edema (Irvine-Gass syndrome) was observed in 2 cases. Complications were cut off medicamentally. Values of intraocular pressure were compensated in all cases. Long-term results were followed up to 1 year.
Outcome analysis of the given method of soft intraocular lens fixation to the iris shows simplicity and safety of performing the procedure, providing stability of intraocular lens position and the absence of severe intra- and postoperative complications, and also few complications in late postoperative period that affords ground for considering this method rather effective and less traumatic.