ESCRS - PO0380 - Preferred Surgical Techniques For Secondary Intraocular Lens Implantation In Adults With Aphakia

Preferred Surgical Techniques For Secondary Intraocular Lens Implantation In Adults With Aphakia

Published 2023 - 41st Congress of the ESCRS

Reference: PO0380 | Type: Free paper | DOI: 10.82333/4bz8-v232

Authors: Rafah Fairaq* 1 , Mohammed Alshehri 2 , Halah Bin Helayel 1 , José Manuel Vargas 3 , Mohammed Almutlak 1

1Anterior Segment Division,King Khaled Eye Specialist Hospital,Riyadh,Saudi Arabia, 2Anterior Segment Division,King Faisal Medical City,Abha,Saudi Arabia, 3Ophthalmology Division,King Abdullah Bin Abdulaziz University Hospital,Riyadh,Saudi Arabia

Purpose

To identify the current different surgical techniques for management of aphakia and the outcomes and complications of each technique.

Setting

An online questionnaire based study, with single response opportunity for each participant, distributed over e-mail and Ophthalmic Societies platforms in Saudi Arabia and other countries.  

Methods

This is a cross-sectional study including ophthalmic surgeons with at least one-year experience in surgical management of aphakia. Ophthalmologists under training were excluded.
A study questionnaire, using Google Forms, was formulated to collect data in Saudi Arabia and other countries. The questionnaire included 22 questions on demographics, preferred surgical techniques for secondary intraocular lens (IOL) implantation, complications and the factors related to surgeons' decision and their choice for managing aphakia.

Results

The study included 145 participants (111; 76.6% were males) with mean age of 46.7±11.5 years. The mean duration of cataract surgery experience was 17.6±11.1 years. Most participants (86.2%) were trained in cataract surgery. Scleral fixation of intraocular lens (SFIOL) was the most commonly preferred technique, followed by iris fixation IOL (IFIOL), and anterior chamber IOL (ACIOL) (75.2%, 9%, and 15.9%, respectively). The main determinants for selection of a surgical technique were, simplicity (56.6%), surgical instrument availability (48.3%), and training on the technique (47.6%). The most frequent postoperative complications were pupil distortion, high intraocular pressure (IOP), pupillary capture of the IOL, and IOL decentration.

Conclusions

Scleral Fixated IOL (SFIOL) is the preferred surgical technique for secondary intraocular lens (IOL) fixation in managing aphakia among our study participents.
The decision to choose one technique over another is complex and is based on several factors, including technical difficulty, previous training, anatomical variations, ocular comorbidities, and the potential complications. The most frequent complications after surgical correction of aphakia are pupil distortion, high IOP, pupillary capture of the intraocular lens (IOL), and decentered IOLs.