Scleral Fixation Technique Using 6/0 Prolypropylene And A 30G Ultra-Thin Wall Needle For The Repositioning Of In-The-Bag Iol Subluxation
Published 2024 - 42nd Congress of the ESCRS
Reference: FP13.06 | Type: Free paper | DOI: 10.82333/4hek-dj72
Authors: María Victoria De Rojas* 1 , Mercedes Rodríguez 1 , Antia Maceira 1 , Andrea Álvarez-Novoa 1 , Noelia Moraña 1
1Ophthalmology,Complexo Hospitalario Universitario A Coruña,A Coruña,Spain
Purpose
To analyze the results of an intrascleral fixation technique using 6/0 prolypropylene flanges and a 30G ultra-thin wall needle for the repositioning of in-the-bag IOL subluxation
Setting
Tertiary referral public hospital Department of Ophthalmology Complexo Hospitalario Universitario A Coruña, Spain
Methods
Retrospective case series of patients that underwent this technique for repositioning in-the-bag dislocated IOLs between March 2020 and December 2023 by the same surgeon (VDR). Fixation is based on creating a loop of prolypropylene suture around the haptic, and IOL eyelet or a capsular tension ring, or between two pairs of IOL eyelets. The prolypropylene sutures are externalized by threading them into the lumen of a 30G ultrathin wall needle which is then removed from the eye. Flanges are then created and buried into the sclera. Medical records were reviewed and data collected: pre and postoperative intraocular pressure (IOP), number of hypotensive drugs, corrected distance visual acuity (CDVA), endothelial cell density and complications
Results
41 eyes were included. Mean follow-up: 14,2 ± 9,3 months. Mean age was 83,7±6,2 years. Pseudoexfoliation was present in 25 eyes. Three were traumatic subluxations. CDVA increased (p=0.002) and IOP decreased significantly after surgery (p=0.005) without a significant change in the number of glaucoma drugs (p=0.9). Preoperative and postoperative endothelial cell count was 1949,4 and 1845,4 respectively (p=0.01). Complications: ocular hypertension in 2 cases, 5 mild IOL decentration, 3 pseudophakic cystoid macular edema, 1 vitreous hemorrhage. No complication of flange exposure of internalization was detected. A second surgery was necessary in 5 eyes (3 glaucoma surgeries, 1 keratoplasty (Fuchs endothelial dystrophy), 1 IOL repositioning)
Conclusions
Repositioning of in-the-bag subluxated IOL using scleral fixation with 6/0 prolypropylene and a 30G ultra-thin wall needle is a simple, minimally invasive and safe technique.
FINANCIAL DISCOUSURE: The authors have no financial or industrial interest in the matter or have received remuneration from any company mentioned.