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Sutureless scleral intraocular lens fixation: report of nine cases and literature review

, : Sutureless scleral intraocular lens fixation: report of nine cases and literature review. Journal Francais D'ophtalmologie 36(8): 658-668

To report the results of a technique of sutureless intrascleral fixation of a three-piece foldable hydrophobic acrylic posterior chamber intraocular lens (PC IOL) in the absence of capsular support and to compare our results to those reported in the literature. We report a single-center (Limoges University Medical Center) retrospective series of nine patients with deficient posterior capsular support who underwent sutureless sulcus fixation of a hydrophobic acrylic Tecnis Aspheric(®) model ZA9003 (AMO, Inc.) PCIOL using permanent incarceration of the haptics in scleral tunnels parallel to the limbus, between November 2010 and November 2011. All patients were evaluated for surgical indications, pre- and postoperative refractive status (visual acuity and corneal cylinder), and intra- and postoperative complications. We included six men and three women with post-traumatic subluxed IOL's in three cases and lack of iris and capsular support secondary to traumatic corneoscleral wounds in six cases. Mean age was 63.22 ± 18.79 years. Posterior vitrectomy was performed in all cases. Mean 3-month postoperative visual acuity was 0.42 ± 0.16 LogMAR, and mean corneal postoperative astigmatism was 1.39 ± 0.78 diopters. Complications included IOL decentration of 1.5mm in one case, haptic rupture requiring intraoperative IOL exchange in one case, and transitory postoperative macular edema in two cases. Artificial intraocular lens implantation in the absence of capsular support is always a surgical challenge. Currently, the two most widely used approaches include fixation to the iris by suturing or iris claw, and fixation to the sclera with sutures. However, these techniques require wide corneal or scleral incisions resulting in significant postoperative astigmatism. Furthermore, iris fixation is impossible in cases of significant iris trauma, and scleral sutures are often technically difficult and expose the patient to late IOL dislocation or tilt. Sutureless intrascleral fixation of foldable hydrophobic acrylic three-piece IOL's inserted through a conventional sub-2.8mm clear corneal incision is a recent technique. This technique is compatible with cases of iris trauma and allows sutureless fixation of the haptics in scleral tunnels parallel to the limbus, while minimizing the risk of postoperative astigmatism. In addition, it allows the repositioning of IOL's dislocated into the vitreous without re-opening the corneal incision. Complications are mainly related to IOL manipulation and positioning. Results obtained after sutureless intrascleral PCIOL implantation showed good visual outcomes with minimal complications in eyes with deficient capsular support.


PMID: 23891322

DOI: 10.1016/j.jfo.2012.09.009

Other references

Pardo, O.; Beser, M.Isabel.; Yusà, V., 2014: Probabilistic risk assessment of the exposure to polybrominated diphenyl ethers via fish and seafood consumption in the Region of Valencia (Spain). The study was carried out to estimate the dietary intake of polybrominated diphenyl ethers (PBDEs) in the Region of Valencia (Spain) in order to evaluate the resultant risk. The PBDE levels in fish and seafood (a total of 206 samples) were determi...

Kersnic, B.; Iglic, A.; Kralj Iglic, V.; Jaklic, A.; Srakar, F.; Antolic, V., 1996: Determination of the geometrical parameters of the healthy human hip. Pfluegers Archiv European Journal of Physiology 431(6 SUPPL 2): R166

Dekker, J.; van der Ende, A.; Aelmans, P.H.; Strous, G.J., 1991: Rat gastric mucin is synthesized and secreted exclusively as filamentous oligomers. Oligomeric gastric mucin was isolated from the fundic part of the rat stomach. Previously we have shown by biochemical analysis that this oligomeric mucin consists of disulphide-linked homo-oligomers, which contain no other covalently attached pro...

Kobayashi, M.; Watanabe, M.; Do, S.; Koyama, Y.I.hi, 1997: Heterogeneous reactivity of epidermal Langerhans cells after topical application of contact sensitizer Histochemical evaluation. Journal of Investigative Dermatology 109(2): 258

Shimkin M.B., 1973: Evaluation of recent results. Journal of the American Medical Association 223(2): 169-170

Bailey, S.W.; Hooker, S.B.; Antoine, D.; Franz, B.A.; Werdell, P.Jeremy., 2008: Sources and assumptions for the vicarious calibration of ocean color satellite observations. Spaceborne ocean color sensors require vicarious calibration to sea-truth data to achieve accurate water-leaving radiance retrievals. The assumed requirements of an in situ data set necessary to achieve accurate vicarious calibration were set fort...

Deutsch E., 1982: Technetium chemistry and technetium radio pharmaceuticals. Abstracts of Papers American Chemical Society 183: INOR-125

Oparah, S.S.; Mandal, A.K., 1976: Penetrating stab wounds of the chest: experience with 200 consecutive cases. The incidence of penetrating wounds of the chest is rising rapidly. Opinions continue to differ on their management. Our experience with 200 consecutive cases of stab wounds of the chest between 1972 and 1975 were reviewed. There were 176 males an...

Plimmer, R.H.; Bayliss, W.M., 1906: The separation of phosphorus from caseinogen by the action of enzymes and alkali. Journal of Physiology 33(6): 439-461

Mercier Jacques, 1961: Sur l'age senonien superieur de certaines formations detritiques dans le massif du Pakon (Macedoine, Grece). In the Paikon massif, between the Moglena and Axios valleys (Vardar, Greece), an upper Senonian age (Cretaceous) can be assigned to the detrital beds which resemble flysch interbedded in the Senonian rudistid limestone. This assignment is based on...