A Novel Technique For Scleral Fixation Of An Intraocular Telescopic Device For Age-Related Macular Degeneration

Published 2023 - 41st Congress of the ESCRS

Reference: PO0049 | Type: Case report | DOI: 10.82333/88rf-ap73

Authors: Sofia Pacetti* ¹ , Marco Pellegrini ¹ , Davide Demaria ¹ , Nicolo Ciarmatori ¹ , Laura Sarti ¹ , Marco Mura ²

¹Department of Translational Medicine,University of Ferrara,Ferrara,Italy, ²Department of Translational Medicine,University of Ferrara,Ferrara,Italy;Azienda Ospedaliero-Universitaria di Ferrara – Arcispedale Sant’Anna,Ferrara,Italy

The Smaller-Incision New-Generation IMT (SING IMT) is an intraocular magnifying system designed to improve near and distance vision in individuals with end‐stage age-related macular degeneration (AMD). The SING IMT is implanted in the capsular bag following standard cataract extraction and currently, no surgical techniques are available for implanting the device in eyes with inadequate capsular support. Herein we present a novel technique for transscleral fixation of the SING IMT using 3 Gore-Tex sutures.

Ophthalmology Unit, S. Anna University Hospital, University of Ferrara, Italy

A 85-year-old female with bilateral late-stage atrophic AMD and a history of cataract surgery underwent IOL removal and SING IMT implantation in her left eye. The first postoperative day, however, dislocation of the SING IMT device was noted, with extrusion of one of the haptics through the pupil. Transscleral fixation of SING IMT was performed as follows: a 25-gauge trocar-cannula system with an infusion line was placed, a superior 8 mm limbal incision was created and the SING IMT was explanted. Both ends of 3 double armed 8-0 Gore-Tex sutures were passed through each of the 3 haptics of the device. A 27-gauge needle was used to create 6 sclerotomies 2.5 mm posterior to the limbus. Each end of the Gore-Tex sutures was passed into the anterior chamber through the main incision and pulled out of one of the 6 sclerotomies. The SING IMT was re-inserted through the main incision which was then closed with 10-0 nylon sutures, while the 3 Gore-Tex sutures were tied to secure the SING IMT to the sclera. Complete posterior vitrectomy was performed by visualizing the posterior segment through the spaces between the haptics. Postoperatively, the device remained well centered through 6 months of follow-up.

The technique herein described represents a safe and reliable method for implanting the SING IMT in eyes without adequate capsular support. This technique opens up the possibility of implanting the device in pseudophakic eyes, as well as in cases with zonular dialysis or capsular damage.