ESCRS - FPM12.03 - Z-Suture Scleral Fixation Intraocular Lenses: A Refractive And Safety Report

Z-Suture Scleral Fixation Intraocular Lenses: A Refractive And Safety Report

Published 2022 - 40th Congress of the ESCRS

Reference: FPM12.03 | Type: Free paper | DOI: 10.82333/m7bd-zw79

Authors: Renato Correia Barbosa* 1 , Ricardo Bastos 1 , Rita Basto 1 , Ana Rita Viana 1 , Alexandre Silva 1 , Rui Carvalho 1

1Ophthalmogy Department,ULS Matosinhos,Senhora da Hora,Portugal

Purpose

Scleral fixation of intraocular lenses constitutes a surgical option in cases where there is inadequate capsular support or zonular insufficiency. Knotless techniques, such as the z-suture technique, avoid complications related to the suture, such as conjunctival erosion or exposure. The purpose of this study was to evaluate the visual and refractive results of patients who underwent scleral z-suture fixation of Akreos Adapt Advanced-Optics intraocular lens, and report the associated short and long-term postoperative complications.

Setting

All surgeries, as well as the pre and postoperative follow-up, took place in the ophthalmology department of Hospital Pedro Hispano, in Matosinhos, Portugal.

Methods

A retrospective, observational study was conducted, including 14 eyes of 13 patients who underwent Akreos Adapt Advanced-Optics intraocular lenses using the z-suture scleral fixation technique. Data were collected through retrospective assessment of the clinical records, and statistical analysis conducted using Statistical Package for the Social Sciences 23.0.

Results

The mean age of the patients was 55,64 ± 28,47 years old, and the mean follow-up time was 25,64 months. The most common indication for surgery was aphakia, due to luxation or pseudo-luxation of the capsular bag and lens complex, after trauma. Mean postoperative spherical equivalent was +0,058D ± 0,79D, with values ranging from -1,50D to +1,00D. Mean best-corrected visual acuity was 0,178 ± 0,15 logMAR. No suture related complications were observed postoperatively in any patient. Slight inferonasal lens dislocation was observed in one patient (7,1%), without repercussion on visual function. One patient (7,4%) had a severe case of herpetic keratitis in the immediate postoperative period, with a long-term impact on visual acuity.

Conclusions

The z-suture knotless technique appears to be a reliable and safe way to fix an intraocular lens in the sclera, regardless of the patient’s age. Our results show good visual results and predictable refractive outcomes. The only case of slight lens dislocation did not affect the patient’s visual acuity. A follow-up period of decades may be necessary to evaluate the long-term risk of lens dislocation.