ASSESSING SCLERAL POCKET THICKNESS CHANGES AFTER SUTURELESS INTRASCLERAL FIXATION OF THE CARLEVALE INTRAOCULAR LENS.

 To assess changes in scleral pocket thickness above the trans-scleral plugs after sutureless Intrascleral fixation of the Carlevale intraocular lens (sSFIOL).

Single-center, single surgeon, prospective clinical trial, Department of Ophthalmology, Medical University of Vienna.

Thirty six eyes of 36 consecutive patients were imaged during follow up at multiple time points using the anterior optical coherence tomography (AS-OCT) imaging system Tomey CASIA 2 in the bleb mode. The OCT scan pattern was orientated parallel to the T-shaped haptic of the IOL. Subsequently, images were manually analysed and scleral pocket thickness was measured for each patient, both on the temporal and the nasal haptic. To compensate for image distortions and non-perpendicular image acquisition, we additionally measured the distal T-haptic thickness, in order to calculate the relative scleral pocket thickness. For the purpose of statistical evaluation, a linear mixed model was used, where we corrected for multiple measurements.

The study involved 36 patients with a mean age of 70 ± 12.4 years, equally divided between males and females. A total of 141 measurements were obtained and analysed over a 4-year period. The analysis of a linear mixed model revealed a statistically significant relationship between the passage of time and the relative scleral thickness (p<0.001). A decrease of the relative scleral thickness annually by 0.17 for the temporal side and 0.15 for the nasal side was indicated.

Our findings suggest a significant decrease of scleral pocket thickness above the t-haptic over time. The observed risk of haptic exposure beneath the conjunctiva raises concerns regarding potential complications.