Flapless, Trocar-Assisted, Technique For Carlevale Iol With Intact Conjunctiva: A Novel Approach

The original technique for Carlevale IOL implantation requires the opening of the conjunctiva and sculpting of scleral flaps. Modifications of the original techniques have been described using grooves, pockets or subconjunctival haptic placement. The purpose of the present work is to present our results of a novel flapless, trocar-assisted technique for carlevale IOL placement with intact conjuntiva and scleral buried haptics. 

First Department of Ophthalmology, National and Kapodistrian University of Athens, Greece.

Retrospective study of patients undergoing this novel technique. Inclusion criteria consisted of age>18 years, post-operative follow-up>2 years, patients with dislocated IOL or crystalline lens requiring scleral fixation. Patietns were excluded from the analysis if they had undergone previous ocular surgery for retinal detachment or glaucoma.

Sixty one (61) patietns were included in the analysis. Baseline mean age was 73,3 years and male to female preponderance was 33/28. Mean follow-up was 48,9 months. Visual acuity improved from 1,42 LogMAR at baseline to 0,06 LogMAR at the end of the follow up (p<0,05). Mean spherical equivalent at the end of the follow-up was -0,77. One patient presented with haptic dislocation during the early post operative period (two weeks post operatively). No other complications were observed. 

The proposed surgical technique is less invasive, more efficient, aster and safe. This modified technique for Carlevale IOL implantation provides comparable outcomes with other techniques but with fewer potential side effects, which are reported for the first time in this report. Intrascleral burying of the haptics eliminate the risk of conjunctival erosion and minimizes the risk of postoperative hypotony, while providing stable fixation of the IOL.