Refractive Results After Secondary Iol Implantation: A Comparison Between Three-Piece Scleral Sutured Iol And Sutureless Carlevale Lens.

To compare the refractive results, as tilt and astigmatism, between sutureless scleral fixation (Carlevale lens, Soleko) and conventional three-piece IOL sutured (AR40, Johnson & Johnson) for secondary IOL implantation in patients with IOL dislocation.

Department of Ophthalmology, AOU Careggi

Largo Palagi 1, Florence, Italy

This is a monocentric retrospective study on 16 eyes with sutureless scleral fixation and 20 eyes with conventional scleral fixation. All surgeries were performed by the same surgeon (FF). Best-corrected visual acuity (BCVA) and refractive measures (Autorefractor Keratometer, Nidek) were acquired at month 1, month 3, month 6 and month 12.  Tilt was evaluated on swept source anterior segment OCT (CSO, Italy) images at month 1, month 3 and month 6. Point Spread Function (PSF) and High Order Aberrations (HOA) were measured using a total ocular aberrometer (Osiris, CSO Italy). Post-operative complications were observed for 12 months.

BCVA in both groups improved since the postoperative visit at month 1. Tilt occurred at the same percentage within the two groups (4 eyes with sutureless scleral fixation and 5 eyes with conventional scleral fixation - 25% both). PSF (0,16 vs 0,14) and Spherical Aberrations (-0,07 vs -0,05) did not show a difference. The refractive measures and post-operative complications didn’t differ between the two groups.

Our results show that the surgery for secondary IOL implantation has similar visual and surgical outcome when sutureless scleral fixation and conventional three-piece IOL sutured are used.

We can assume that the two techniques are similar, and the surgeon can liberally choose the one to which he is more confident.