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One-year outcomes of transcleral dislocated 1-piece IOL fixation without their explantation

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Session Details

Session Title: Presented Poster Session: Cataract Complications Management

Venue: Poster Village: Pod 1

First Author: : P.Kalouda GREECE

Co Author(s): :    I. Tzamichas   C. Keskini   T. Paschaloglou   E. Zopounidou   C. Kampos   G. Sakkias

Abstract Details

Purpose:

To present one-year outcomes of transcleral dislocated one-piece intraocular lenses (IOLs) fixation without their explantation in the absence of sufficient zonular/capsular support.

Setting:

Department of Ophthalmology, Hippokrateio General Hospital of Thessaloniki, Thessaloniki, Greece

Methods:

Retrospective consecutive series of patients. Assessment parameters evaluated were: follow up period, pre- and postoperative Snellen corrected distance visual acuity, refractive error (pre- and postoperative), intraocular pressure (pre- and postoperative), postoperative complications (retinal detachment, malpositioned IOL, secondary glaucoma, vitreous hemorrhage, postoperative hyphema, cystoid macular edema) and knots’ integrity (undamaged /eroded / not detectable). The technique included anterior vitrectomy and the creation of scleral pockets after conjunctival dissection. The lens haptics were knotted and secured with a 10-0 prolene suture. The one-piece dislocated IOLs were not explanted. The IOL stability, in terms of centration and tilting, was assessed using slit-lamp.

Results:

A total of 15 patients were included in the study population. The average age was 77 years (range, 49-90). Mean visual acuity improved from logMAR 1.30 to 0.20 at 1 year. Short-term complications were few and included elevated intraocular pressure (n = 1) and cystoid macular edema (n = 2). Long-term complications included visually insignificant intraocular lens tilt (n = 3). No serious ocular complications were detected such as retinal detachment, vitreous hemorrhage or secondary glaucoma. No suture-related complications, including breakage, erosion, IOL dislocation, endophthalmitis, or persistent postoperative inflammation were presented during the follow-up period.

Conclusions:

Scleral fixation of one-piece IOLs is well-tolerated 1 year after surgery. The technique is not technically difficult to master, it can be performed in a time efficient manner and it requires less complicated surgical maneuvers without the need of IOLs explantation. Intraocular lenses are positioned more physiologically in the posterior chamber, and standard IOLs can be used with good cosmetic and functional result. Finally, this technique results in favorable long-term visual outcomes with low rates of intraoperative and postoperative complications.

Financial Disclosure:

NONE

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