Comparison Of Flanged Polypropylene Scleral Intraocular Lens Fixation With Scleral Sutured Fixation
Published 2024 - 42nd Congress of the ESCRS
Reference: PP04.03 | Type: Free paper | DOI: 10.82333/y24d-dr39
Authors: Shani Levy-Neuman* 1 , Liat Mendel 2 , Asaf Achiron 3 , Amir Bukelman 1 , Tamir Weinberg 1 , Haggay Avizemer 2 , Mor Shlezinger Shlezinger 1 , Arie L Marcovich 1 , Guy Kleinmann 2
1Ophthalmology ,Kaplan Medical Center,Rehovot,Israel, 2Ophthalmology ,E. Wolfson Medical Center,Holon,Israel, 3Ophthalmology ,Tel Aviv Sourasky Medical Center,tel aviv,Israel
Purpose
To compare the outcome of two intraocular lens (IOL) scleral fixation techniques: double-flanged polypropylene and Hoffman scleral pocket.
Setting
The Kaplan Medical Center and the Edith Wolfson Medical Center
Methods
Retrospective case series of all patients that underwent IOL scleral fixation by either Flange (FLANGE group) or Hoffman scleral pocket (HOFFMAN group) techniques at the Kaplan Medical Center and the Edith Wolfson Medical Center.
Results
140 cases were included (63 FLANGE, 77 HOFFMAN). The final distance-corrected visual acuity was similar between the FLANGE and HOFFMAN groups (0.42±0.5 and 0.51±0.5LogMAR, respectively [P=0.23]), but the spherical equivalent was less myopic in the FLANGE [(-)0.63±2 and (-)2.3±1.3 diopter respectively [p=0.003]). In the FLANGE there were more cases of elevated IOP (17.5% vs. 5.2%, p=0.02), corneal edema (11.1% vs. 1.3%, p=0.02), cystoid macular edema (15.9% vs. 2.6%, p=0.005) and IOL decentration (19% vs. 7.8%, p=0.07). FLANGE had a higher rate of combined additional procedures during the fixation surgery (68.3% vs. 32%, p<0.001), but surgery duration was not prolonged (70 vs. 77 minutes, p=0.29).
Conclusions
Comparison of scleral IOL fixations performed with the recently developed 'Flange technique' to the conventional Hoffman scleral pocket technique resulted in similar visual outcome and less myopization. There were more complications in the newly adopted Flange technique, that may be related to the higher rate of combined anterior vitrectomy and PPV. Flange is an effective surgical technique, with a shorter learning curve and similar surgical time. Therefore, it can become a viable method for scleral IOL fixation in the absence of zonular support.