Surgical Outcomes Of Carlevale Intraocular Lenses: 2 Year Outcomes

The Carlevale intraocular lens (IOL) is a single-piece sutureless scleral-fixated lens that adds to the armamentarium of secondary IOLs available for eyes with complex pathologies when in-the-bag implantation of IOL is not suitable or possible. We aimed to evaluate the functional outcomes and the intra- and post-operative complications of Carlevale IOLs implanted at a tertiary unit in the United Kingdom (UK).  

Royal Hallamshire Hospital, Sheffield, United Kingdom.  

We undertook a retrospective study of 50 consecutive eyes that had insertion of Carlevale IOLs over a 2-year period from 01/01/2023 to 31/12/2024, identified from electronic patient records. We collected data on age, sex, laterality, indication, co-morbidities, pre-operative visual acuity (VA), vitrectomy gauge, the method of externalising haptics, intra- and post-operative complications, post-operative VA and duration of follow up. The data was collected and analysed on Microsoft Excel.  

Median age was 69 years with 29 males and 21 females. Indications were aphakia (21), dislocated / subluxed IOLs (19) or crystalline lenses (7) and uveitis-glaucoma-hyphaema syndrome (3). Of these, 24 (48%) were post trauma or complicated cataract surgeries. Median pre- and post-operative VAs were 1.50 and 0.30 logMAR, respectively. 40 (80%), 6 (12%) and 4 (8%) patients had better, worse and no change to VA over a median follow up period of 7 months, respectively. 14 cases (28%) had intra-operative complications; 11 of these (79%) had broken or damaged haptics. 34 cases (68%) had post-operative complications; 24 of these (71%) had medically managed cystoid macular oedema and/or ocular hypertension.  

Our results show that the Carlevale IOLs provide a good functional outcome with 80% of patients having an improvement to their vision. Majority of the intra-operative complications were related to damaged or broken haptics. Our cohort of patients experienced a higher rate of post-operative complications albeit majority of these resolved with medical management. This may underscore the complex nature of our cohort of patients with almost 50% having a history of trauma or complicated cataract surgeries. The current study has allowed the evaluation of our experience with Carlevale IOLs and we consider it to be a promising secondary IOL in eyes with complex pathologies giving patients good visual recovery.