Initial Experience And Outcomes Of Carlevale Lens Implantation
Published 2024 - 42nd Congress of the ESCRS
Reference: PO299 | Type: Free paper | DOI: 10.82333/cr4y-zv88
Authors: Inês Coelho Da Costa* 1 , Joana Oliveira 1 , Ana Gama-Castro 1 , Rita Teixeira-Martins 1 , Ana Faria-Pereira 1 , Amandio Rocha-Sousa 2 , Pedro Alves-Faria 2
1Ophthalmology,ULS São João,Porto,Portugal, 2Ophthalmology,ULS São João,Porto,Portugal;Department of Surgery and Physiology,Faculdade de Medicina da Universidade de Porto,Porto,Portugal
Purpose
The CarlevaleTM IOL hi-tech was introduced as an unique scleral fixation IOL with a small (2.2mm) injector, that uses self-blocking, anti-extrusion plugs inserted into a scleral pocket for use in eyes with no capsular support. It’s slender T shaped extremities (300mm), elastic material composition (Polyhema) and the difficulties associated with a novel sutureless scleral fixation IOL implantation technique pose a challenge for its introduction into a surgeons arsenal. The purpose of this work was to evaluate the outcomes and challenges encountered in the initial utilization of Carlevale lenses for scleral fixation in cases requiring intraocular lens (IOL) implantation.
Setting
Ophthalmology department, Hospital de São João, Porto, Portugal
Methods
Retrospective, consecutive, case series of the first four patients who underwent Carlevale IOL implantation between August 2023 and February 2024, by the same experienced vitreo-retinal surgeon, at Hospital de São João. Clinical records were analysed and data on demographics, pre operative ophthalmic exam, surgical report and post operative (PO) ophthalmic appointments were collected. In all cases the same technique was used with the creation of two scleral flaps 3.5mmx3.5mm, 180º from each other and underflap sclerotomies using a 23G needle. IOL introduction was made using a 2.2mm injector and a non-serrated 23G endgrasping forceps was used to advance the T shaped anchors through the sclerotomies.
Results
The first case, a 57-year-old man with luxated crystalline lens underwent pars plana vitrectomy with phacofragmentation, followed by +22D Carlevale IOL placement. BCVA at one month was 20/25 with -0.25 residual error. The second patient, aged 76, had a subluxated IOL-Bag complex and received a +25.00D Carlevale IOL. Despite hyphema and vitreous hemorrhage which resolved within a month, BCVA at two months was 20/20 with -2.00 residual error at 80º. Patient three, with a dislocated IOL-Bag complex, had successful +14.00D Carlevale IOL placement. Post-op, BCVA was 20/25 with +0.75 -1.00 at 120º. The final patient, an 87-year-old man with PEX glaucoma, experienced a broken haptic, requiring sclerotomy enlargement for sucessfull IOL placement.
Conclusions
Carlevale lens implantation demonstrates promising outcomes across diverse ocular pathologies. Despite encountering complications such as transient hypotension, hyphema, and haptic breakage, satisfactory visual acuity was achieved. Notably, the procedure necessitates a learning curve even for experienced surgeons, yet they prove to be invaluable additions to a surgeon's armamentarium.