Clinical observation of a novel technique: transscleral suture fixation of a foldable 3-looped haptics one-piece posterior chamber intraocular lens implantation through scleral pockets with intact conjunctiva

Abstract

Background To present the follow-up outcomes of a modified technique of transscleral suture fixation of posterior chamber intraocular lens (PCIOL) in eyes with inadequate capsule support. Methods A retrospective chart review of 21 patients underwent transscleral suture fixation of a foldable 3-looped haptics one-piece PCIOL implantation through scleral pockets was conducted. Preoperative data and follow-up data for at least 3 months were collected for all patients. Results The mean operative duration was 36.62 ± 10.70 min. The mean pre- and post-operative LogMAR uncorrected distance visual acuity was (1.25 ± 0.50 vs. 0.41 ± 0.22, P < 0.01). The mean pre- and post-operative LogMAR best corrected visual acuity was (0.48 ± 0.25 vs. 0.33 ± 0.24, P < 0.01). The mean proportion of postoperative endothelial cell loss was 11.46 ± 4.78%. The mean postoperative anterior chamber depth was 3.05 ± 0.44 mm. The mean postoperative IOL tilt degree was 2.81 ± 1.41 ° , and the mean postoperative IOL decentration degree was 0.31 ± 0.13 mm. Four patients with transient corneal edema (19.0%) and three patients with transiently elevated IOP (14.3%) were observed after operation, and such complications were resolved within 1 week. No severe complications were observed. Conclusions The modified technique was a feasible method of PCIOL implantation. Electronic supplementary material The online version of this article (10.1186/s12886-019-1113-2) contains supplementary material, which is available to authorized users.

One-Year Outcomes of Modified Technique for Scleral Fixation of a Three-Piece Intraocular Lens Without Conjunctival Opening

“…Scleral fixation with the Hoffman pocket technique has been applied for various types of IOLs, while most of the IOLs are used with closed-loop haptics or designed eyelets on the haptics, through which sutures can easily be passed for IOL fixation ( 15 – 17 ). On the other hand, seldom had the 3-piece IOLs been reported to be fixated with this technique, except that Domingues et al ( 18 ) described a cupid technique to perforate and knot at the body of the 3-piece subluxated IOL with 10-0 polypropylene suture.…”

Efficacy of scleral-fixated 3-looped haptics intraocular lens implantation for surgical management of microspherophakia

“…Moreover, postoperative complications were also collected. Surgical Procedure All operations were performed according to the following procedure by Dr. Xu W (Figure 1) [20] . After a retrobulbar anesthetic block, a 20-G infusion cannula was put into the anterior chamber to maintain the IOP at the limbus at about 6 o'clock.…”

Scleral-fixated intraocular lens implants—evolution of surgical techniques and future developments

“…IOLs can be sutured to the sclera with 1, 2, 3, 4 or 6 fixation points [61,62]. The original technique described by Malbran employed a two-point fixation [56].…”