Clinical Results of Modified Ab Externo and One-Knot Technique

Jung, Mu O; Koh, Jai‐Kyoung

doi:10.3341/jkos.2012.53.12.1783

J Korean Ophthalmol Soc

2012

DOI: 10.3341/jkos.2012.53.12.1783

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Clinical Results of Modified Ab Externo and One-Knot Technique

Mu O Jung

Jai‐Kyoung Koh

Abstract: Purpose: To introduce a more efficient and time-saving scleral fixation technique for a posterior chamber foldable intraocular lens and to report the clinical results. Methods: A foldable acrylic 3-Piece IOL was sutured to the sclera via a small corneal incision. The guiding hollow needle was not used, which differs from other ab externo techniques. Instead, the curved long needle was directly pulled out through the cornea. The scleral flap was not used to bury the scleral suture knot; Instead, the scleral sut… Show more

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Cited by 4 publications

References 23 publications

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Modified Surgical Technique for Transscleral Fixation and Clinical Outcomes

Chung

Jeong

2023

J Retin

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Purpose: To introduce a modified four-point transscleral intraocular lens fixation method and evaluate its safety and clinical outcomes. Methods: We retrospectively reviewed the medical records of patients who underwent transscleral fixation from March 2015 to February 2020. Vitrectomy was performed, and a foldable intraocular lens was inserted through the corneal wound and fixed at four scleral points 2.0 mm posterior from the limbus. We analyzed the visual acuity, best corrected visual acuity, spherical equivalent, intraocular pressure, and complications at preop and 1 day, 1 month, 2 months, and 6 months postoperatively. Results: In this study, 61 eyes of 59 patients were enrolled, and the mean follow up period was 12.68 ± 8.10 months. Best corrected visual acuity (logarithm of the minimal angle resolution) was improved and statistically significant at 1 month, 2 months, and 6 months postoperatively compared to preoperative values (all p < 0.001, paired t-test). Spherical equivalent changed to myopic and was significantly different at all periods compared to preoperative values (all p < 0.001, paired t-test). Prediction error was -0.77 ± 0.82 diopters at 6 months after the operation and tended to shift toward myopia. Macular edema occurred at one eye, but no retinal detachment, endophthalmitis, suture erosion, optic capture, intraocular lens tilt, or decentration was detected. Conclusions: This modified four-point transscleral intraocular lens fixation surgical method is an easy procedure with excellent clinical outcomes and minimal complications.

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Modified Surgical Technique for Transscleral Fixation and Clinical Outcomes

Chung

Jeong

2023

J Retin

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Astigmatic Changes and Clinical Outcomes after Scleral Fixation of IOL

Kim

2014

J Korean Ophthalmol Soc

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Purpose:To evaluate the clinical outcomes, complications and surgically induced astigmatism (SIA) after scleral fixation in patients with intraocular lens (IOL) or crystalline lens dislocation. Methods: The present study retrospectively investigated the postoperative best corrected visual acuity (BCVA), refractory change, corneal astigmatism, clinical outcomes, and influencing factors of SIA in 57 eyes of 55 patients with a follow-up of 6 months after the IOL scleral fixation. Results: In comparison of preoperative and postoperative 6 months, BCVA, spherical equivalent and astigmatism were significantly improved but corneal astigmatism was not and SIA (diopter, D) improved from 2.10 ± 1.88 D to 0.86 ± 0.73 D (p = 0.002). 4 eyes having redislocation were repositioned and 4 eyes having tilted IOL, 6 eyes having elevated intraocular pressure, 3 eyes having exposure scleral knots, 1 eye having endophthalmitis, and 1 eye showing macular edema were observed. At postoperative 3 months, the SIA of a large incision size (>3 mm) and small incision size (≤3 mm) was significantly differented (p = 0.041). According to the location of scleral fixation, SIA at postoperative 1 month was significantly different but, was not different at postoperative 6 months. Conclusions: Surgical management of dislocated IOLs or crystalline lens resulted in significant improvement of visual acuity and absence of influencing SIA factors. However, location of scleral fixation and small incision size influenced corneal astigmatism.

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Long-Term Results of Transscleral Fixation of Posterior Chamber Intraocular Lens

Ohn

2016

J Korean Ophthalmol Soc

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Purpose:To investigate the long-term results of transscleral fixation of posterior chamber intraocular lens (IOL) for unstable posterior capsular supporting structure. Methods: We performed a retrospective review of 67 patients (67 eyes) with unstable posterior capsular supporting structure who underwent transscleral fixation at Soonchunhyang University Bucheon Hospital from March 2005 to January 2013. Transscleral fixation without scleral flap was performed by a single surgeon. We analyzed the causes of transscleral fixation and compared postoperative best-corrected visual acuity (BCVA) and spherical diopter. Results: Among the 67 eyes of 67 patients, the causes of transscleral fixation included IOL subluxation (33 cases, 49.2%), IOL dislocation (11 cases, 16.4%), intraoperative posterior capsule rupture (8 cases, 11.9%), aphakia associated with previous intraocular surgery (7 cases, 10.4%), crystalline lens disorder with zonular dialysis (4 cases, 5.9%) and IOL opacity (4 cases, 5.9%). The mean BCVA before surgery was 1.26 ± 0.94 (log MAR) and the visual acuity improved to 0.59 ± 0.71, 0.60 ± 0.69, 0.58 ± 0.70, 0.55 ± 0.70, 0.60 ± 0.58 and 0.66 ± 0.70 (1 week, 1 month, 3 months, 1 year, 3 years and 5 years, respectively, after the surgery; p < 0.05). Conclusions: Posterior chamber IOL transscleral fixation in unstable posterior capsular supporting structure is effective for increasing visual acuity and spherical diopter. Specifically, the most improvement was observed at one month after surgery. Transscleral fixation is an adequate surgical procedure for fast improvement of visual acuity with long-term effects.

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Clinical Results of Modified Ab Externo and One-Knot Technique

Cited by 4 publications

References 23 publications

Modified Surgical Technique for Transscleral Fixation and Clinical Outcomes

Modified Surgical Technique for Transscleral Fixation and Clinical Outcomes

Astigmatic Changes and Clinical Outcomes after Scleral Fixation of IOL

Long-Term Results of Transscleral Fixation of Posterior Chamber Intraocular Lens

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