Comparison of Different IOL Types in the Flanged IOL Fixation Technique

Abstract

Purpose. To compare short-term clinical outcomes between two different intraocular lens (IOL) types in the flanged IOL fixation technique. Methods. This study was a retrospective case series and included the patients who underwent flanged IOL fixation between June 2017 and July 2018 at the Hiroshima University Hospital. Two different 3-piece IOLs (NX-70 and PN6A) were used. Recipients of NX-70 and PN6A IOLs were classed into groups 1 (15 eyes) and 2 (25 eyes), respectively. Patient characteristics, surgical results, and postoperative complications were analyzed. We excluded patients with a postoperative follow-up of <1 month. Results. The mean follow-up period was 13.3 ± 11.7 weeks. The postoperative best corrected visual acuity, in logarithm of the minimum angle of resolution (logMAR), was 0.10 ± 0.33 in group 1 and 0.26 ± 0.42 in group 2. The mean operation times for groups 1 and 2 were 11.2 ± 4.54 minutes and 7.00 ± 2.20 minutes, respectively (p=0.0024). Detachment of the IOL haptic from the optic during surgery occurred in four eyes in group 2 (16%), but did not occur in group 1. Iris capture of the optic was observed in 3 of the 13 eyes (23%) without a peripheral iridotomy in group 2. No peripheral iridotomies were performed on group-1 eyes, but iris capture did not occur in that group. Conclusions. There was a trend to fewer intraoperative and postoperative complications when using NX-70 IOLs. On the other hand, PN6A IOLs was easy to maneuver within the anterior chamber, and the operation time was shorter when using PN6A IOLs. Selection of optimal IOLs for flanged IOL fixation necessitates an understanding of their characteristics in terms of intraoperative and postoperative complications.

Risk Factors for Pupillary Optic Capture Following Sutureless Flanged Intraocular Lens Fixation for Intraocular Lens Dislocation

“…It is interesting to note that in the earlier study by Yamane et al, use of 6-mm IOLs, including ZA9003, PN6A (Kowa, Tokyo, Japan), and MA60MA (Alcon laboratories, Fort worth, TX), resulted in a 7-times higher incidence of pupillary optic capture compared with X-70 (Santen, Osaka, Japan) IOLs, which have a 7-mm optic diameter (14% vs. 2% incidence, respectively). 4 Miura et al 10 also reported similar outcomes. Although the 7-mm optics could be more advantageous to avoid pupillary optic capture compared with 6-mm optics, the X-70 is available only in Japan.…”

“…Pupillary optic capture after flanged IOL scleral fixation is a relatively common postoper-ative complication, and its incidence in this study was similar to that of previous studies. 4,9,10 Although the mechanism of pupillary optic capture is not fully understood, axial length, ACD, and IOL tilt have been suggested as possible causes of the complication after sutured scleral IOL fixation. [12][13][14] For flanged IOL fixation, construction of the nasal and temporal scleral tunnels is a critical step because both haptics are directly fixed to the sclera instead of the suture thread.…”

“…8 Recent studies have reported that pupillary optic capture is also a complication of flanged IOL fixation, with complication rates ranging from 8% to 38.9%. 4,9,10 However, the risk factors for this complication have not been fully elucidated for flanged IOL fixation, a relatively new technique. The aim of this study is to determine the risk factors for pupillary optic capture following flanged IOL fixation in patients with IOL dislocation.…”

Long-Term Stability of Intraocular Lens with Trimmed or Untrimmed Haptics in Yamane Sutureless Intrascleral Fixation Technique

“…We marked off two 1-mm points from which the haptics passed through the sclera as the flanged positions to achieve better IOL centration. Given that the haptic length was different in varying models of IOLs, such as 8.6 mm in NX-70 (Santen, Osaka, Japan) and 8.2 mm in PN6A (Kowa, Tokyo, Japan) [ 18 ], the first step can be skipped when using IOLs with shorter haptics.…”

Outcomes of the flanged intrascleral haptic fixation with double-needle technique in patients with Marfan syndrome

“…Moreover, they stated that younger patients seemed to be more prone to movement of the iris; however, the reasons remain unclear. 8 Miura et al 13 reported that peripheral iridotomy may reduce the pressure difference between the anterior and posterior chambers, thus, making iris capture less likely to occur in 6-mm optic IOLs. Moreover, the 7-mm optic IOL may not need a peripheral iridotomy preventing for iris capture.…”