IOL RESCUE, SUTURELESS-TRANSCONJUNCTIVAL-TROCAR-CANNULA-BASED FLANGED INTRASCLERAL IOL FIXATION AND SINGLE-PASS 4-THROW PUPILLOPLASTY AFTER COMLICATED CATARACT SURGERY
Published 2024 - 28th ESCRS Winter Meeting
Reference: P022 | Type: Presented Poster & Poster | DOI: 10.82333/54ek-dp09
Authors: Paraskevi Fanara* 1 , Lampros Pantsios 1 , Paraskevas Kapis 1 , Ioannis Tzamichas 1
1Department of Ophthalmology, Hippokrateio General Hospital of Thessaloniki,Thessaloniki,Greece
Purpose
To report our surgical intervention/technique and the outcomes after complicated cataract surgery in a patient who presented with dropped IOL, absence of sufficient zonular/capsular support and iatrogenic traumatic mydriasis.
Setting
Department of Ophthalmology, Hippokrateio General Hospital of Thessaloniki, Thessaloniki, Greece
Methods
The patient underwent 23G pars plana vitrectomy (PPV), rescue of the 3-piece intraocular lens (IOL) and sutureless-transconjunctival-intrascleral fixation of the same 3-piece IOL (SSFIOL) with incarceration of flanged haptics in scleral tunnels through 25G-trocar-cannulas. After that, the patient underwent a single-pass 4-throw pupilloplasty (SFT) with 10-0 prolene at 2 sides of the iris to restore the configuration of the iris/pupil contour. Postoperative status (BCVA, complications) was recorded at 6 months.
Results
There were no intraoperative complications. At 6 months the postoperative BCVA (logMAR) was 0.1 (decimal equivalent 0.8) and there were no postoperative complications such as cystoid macular edema, vitreous hemorrhage, corneal edema, retinal detachment or endophthalmitis. Additionally, there were no IOL dislocation/decentration and haptic-exposure-related complications such as foreign body sensation, or discomfort. No prolene suture loosening due to degradation regarding SFT pupilloplasty was observed. The patient had no complaints of glare and photophobia. The iris/pupil showed a good postoperative cosmetic appearance.
Conclusion
PPV combined with sutureless-transconjunctival, trocar-cannula-based flanged intrascleral IOL fixation is an effective surgical option in cases of a dropped 3-piece IOL. The technique results in significant visual improvement with simultaneous IOL repositioning considering the low cost of a 3-piece IOL. SFT pupilloplasty is easy to perform, requiring minimal intervention inside the anterior chamber and seems to be safe at 6-month follow-up period, improving the quality of vision.