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Outcomes associated with an intraocular lens designed for sutureless scleral fixation
First Author: J. Pérez Zaballos SPAIN
Co Author(s): L. Such Irusta R. Burggraaf Sánchez de las Matas A. Pastor Roux P. Martínez López-Corell J. Badia Palmero J. Zarco Bosquet
The aim of this study is to describe surgical complications and refractive outcomes of a novel surgical technique of sutureless scleral fixation using the foldable intraocular lens (IOL) Carlevale.
This study was performed in the Ophtalmology unit of Sagunto�s Hospital, Valencia, Spain.
This is a retrospective observational case series study, including 8 eyes of 8 patients with ages ranging from 69 to 83 years old, with a mean follow-up of 7 months. They underwent pars plana vitrectomy and secondary intraocular lens implantation with the single piece Carlevale lens for aphakia, subluxated lens or lens-bag dislocation. Two different surgical techniques were used. Limbus-hinged scleral flaps were performed on 3 patients while scleral pockets were performed on the remaining 5. All patients underwent complete preoperative and postoperative eye examination. Refractive outcomes and complications during or after surgery were recorded.
Mean pre-operative corrected distance visual acuity was 2.37 � 0.84 logMAR and improved to 0.46 � 0.19 logMAR. 1 vitreous bleeding (12.5%) was registered as unique intraoperative complication. Postoperative complications included: 1 patient (12.5%) suffering from retinal detachment at month 3, who posteriorly presented IOL central opacification; 1 patient (12,5%) developping macular edema at month 1; and 1 patient (12.5%) experiencing protrusion of the haptic due to inadequate scleral flap carving and poor conjunctival covering. No further unfavorable events were recorded during the follow-up.
This novel technique provides good fixation without postoperative astigmatism as it allows the use of small corneal incisions for its introduction. Visual acuity has been demonstrated to improve after surgery for the evaluated cohort of patients. It seems to be a safe technique although it has a learning curve and requires surgical skills. Furthermore a close patient monitoring is necessary for early detection of postoperative complications. To conclude, in the absence of sufficient capsular support, the authors believe that this technique should be considered as an optimal approach. Nevertheless, more patients and longer-term studies are needed to confirm these results.
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