Results Of Secondary Implantation By Sutureless Scleral Fixation Carlevale Intra Ocular Lens: A Prospective Study Of 15 Cases.

Published 2023 - 41st Congress of the ESCRS

Reference: PP13.12 | Type: Free paper | DOI: 10.82333/prg6-0n15

Authors: Omar BENGEBARA* ¹ , IDRISS BENATIYA ANDALOUSSI ² , Meriem ABDELLAOUI ² , Fouad CHRAIBI ² , Ahmed BENNIS ² , Malek SLIM ³

¹OPHTHALMOLOGY,HASSAN II UNIVERSITARY HOSPITAL,FEZ,Morocco;OPHTHALMOLOGY,JACQUES COEUR HOSPITAL,BOURGES,France, ²OPHTHALMOLOGY,HASSAN II UNIVERSITARY HOSPITAL,FEZ,Morocco, ³OPHTHALMOLOGY,JACQUES COEUR HOSPITAL,BOURGES,France

Purpose

Implantation of an intraocular lens into the capsular bag is considered as the gold standard in cataract surgery. However, ophthalmologists are often confronted with patients with aphakia or insufficient capsular support after complicated cataract surgery, trauma, or various zonulopathies. In such cases, the placement of an IOL in the capsular bag can be risky or impossible.

The management of this type of patients is still a real challenge for surgeons despite the considerable evolution of secondary implantation techniques. In recent years, the Carlevale IOL has emerged as an attractive alternative for secondary implantation, offering good functional results and a low complication rate.

Setting

Ophthalmology department Jacques Coeur Hospital, Bourges, France.

Methods

We conducted a prospective interventional study that enrolled 15 eyes with aphakia, subluxation or dislocation of intraocular implant enrolled in Jacques Coeur Hospital in Bourges between November 2020 and November 2021. All our patients underwent a secondary implantation surgery by the sutureless scleral fixation (SSF) Carlevale lens (Soleko, Italy). During the personalized follow-up that lasted at least one year, we evaluated at each visit the best-corrected visual acuity (BCVA), the spherical equivalent (SE), the intraocular pressure (IOP), and the endothelial cell density (ECD). We also assessed the various peri and post-operative complications that occurred during the follow-up.

Results

The mean age of our patients was 76 years. The surgical indication was aphakia in 60% of cases, an IOL subluxation in 33% of the cases, and an IOL dislocation in the vitreous cavity in 6%. The mean BCVA was 0.7 ± 0.25 logMAR preoperatively and 0.15 ± 0.33 logMAR. As for the refractive results, the average preoperative SE was +5.34 Dpt ±4.93 and -0.68 Dpt ±0.93 at one year. The mean IOP went from 14.5 to 15.25mmHg and the mean ECD decreased from 1,928 to 1,683 at the end of the follow-up
We assessed one case of intravitreal hemorrhage, two cases of postoperative cystoid macular edema, and one case of haptic exposure.
No cases of reverse pupillary block, ocular hypotonia, subluxation or dislocation of the implant, or endophthalmitis were noted.

Conclusions

Secondary implantation by sutureless scleral fixation Carlevale IOL represents an attractive, reproducible, and minimally invasive surgical technique with very satisfying functional results.
By guaranteeing optimal refractive results and a low complication rate, this IOL has earned its place in the therapeutic arsenal to improve the prognosis of patients with insufficient capsular support.