Flapless Trocar-Assisted Carlevale Iol Implantation Without Conjunctival Opening
Published 2026 - 44th Congress of the ESCRS
Reference: PP15.02 | Type: Poster | DOI: 10.82333/e2ee-w408
Authors: Dr Emmanouil Gkogkos* 1 , A/Prof. Petros Petrou 1 , Dr Stergios Ntiskos 1 , Dr Niki Zampogianni 1 , Dr Nikos Moraitis 1
1First University Department of Ophthalmology,G. Gennimatas General Hospital of Athens,Athens,Greece
Purpose
The original technique for Carlevale intraocular lens implantation requires conjunctival
opening and scleral flap creation. Several modifications have been described, including
scleral grooves, pockets, or subconjunctival haptic placement. The purpose of this study is to
present the long-term results of a novel flapless, trocar-assisted technique for Carlevale IOL
implantation with intact conjunctiva and scleral-buried haptics.
Setting
Setting
First University Department of Ophthalmology, G. Gennimatas General Hospital of Athens,
Greece.
Methods
Methods
Retrospective, non-comparative study of consecutive patients undergoing the described
technique. Patients older than 18 years with a minimum postoperative follow-up of two
years were included. Exclusion criteria were previous ocular surgery for retinal detachment
or glaucoma.
The technique consists of a flapless, trocar-assisted approach during pars plana vitrectomy.
The existing trocar-created scleral tunnels are used for externalization and intrascleral burial
of the Carlevale IOL haptics, without conjunctival opening or additional scleral flap
construction.
Results
Results
Sixty-one eyes of 61 consecutive patients were included. The cohort consisted of 55.74%
male patients with a median age of 76 years. The mean follow-up was 48.9.
A statistically significant improvement was observed between median preoperative visual
acuity (1.8 LogMAR, IQR: 1.0–1.8) and median postoperative visual acuity (0.05 LogMAR,
IQR: 0.0–0.1).
No intraoperative complications occurred. The Carlevale IOL was well centered in all cases.
No cases of haptic exposure were observed throughout the follow-up period.
Conclusions
The described flapless, trocar-assisted technique is a simplified, safe, and effective surgical
approach for Carlevale IOL implantation. Avoidance of additional scleral manipulation may
reduce surgical trauma while providing excellent long-term anatomical and functional
outcomes. Further prospective studies are warranted to validate these findings and assess
longer-term results.