Complications and visual outcome of sutureless, scleral fixated intraocular lens in cases with traumatic aphakia

Abstract

Purpose: The aim of this study is to describe the complications and outcome of sutureless scleral fixated intraocular lens (SFIOL) implantation in traumatic aphakia. Setting: The study was conducted in a tertiary eye care centre in South India. Design: The study involved a retrospective data analysis. Methods: Medical records of cases with traumatic aphakia who had undergone sutureless SFIOL implantation in the last 2 years were included in the study. Data on intraoperative and postoperative complications and visual outcome were collected and analysed. Results: In total, 45 cases were recruited. Mean logarithm of the minimum angle of resolution (logMAR) best-corrected visual acuity (BCVA) improved from preoperative 1.64 ± 0.45 to 0.63 ± 0.36 at last follow-up visit, and the difference was statistically significant ( p < 0.0001). Final logMAR BCVA was worse than one in three patients who had associated posterior segment pathology. There was no incidence of intraoperative haptic rebound into the vitreous cavity or intraocular lens (IOL) drop. Four cases had hypotony, two cases had choroidal detachment, four cases had raised intraocular pressure (IOP), eight cases had transient corneal oedema and six patients had mild dispersed vitreous haemorrhage during immediate postoperative period. Six patients had postoperative cystoid macular oedema (CME). Two cases developed glaucoma. None of the patients had postoperative haptic exposure, retinal detachment (RD), iris capture of IOL or SFIOL dislocation till the last follow-up. Conclusion: Final visual outcome of sutureless SFIOL implantation in traumatic aphakia may be affected by concomitant posterior segment pathology. The immediate and late postoperative complications noted in our study were comparable with other similar studies. However, longer follow-up is needed to detect RD and angle recession glaucoma at the earliest and initiate therapy.

Comparision of Sutured Versus Sutureless Scleral Fixated Intraocualr Lens at a Tertiary Eye Hospital, Nepal

“…It occurred in 15% sutured and 14 % in sutureless SFIOL. In a study by Deb A et al 19 Transient corneal edema was 17% which was similar to our study. Previous studies have shown corneal edema to be around 10% after scleral fixated intraocular lens.…”

Comparative analysis of outcomes of two (popular) techniques of haptic exteriorization in scleral fixation intra-ocular lens surgery – A retrospective study

“…Various intra-operative and post-operative complications have been reported in many studies following SFIOL implantation. [ 9 10 11 12 13 ] We observed that the anterior chamber was more stable during maneuvers in cases where pars plana infusion was established. To avoid anterior chamber distortion while operating using an anterior chamber maintainer, we recommend that the infusion be directed opposite to the main entry wound.…”

“…The HS technique is a time-tested method performed by surgeons all over the world since 2007. [ 9 ] The XNIT technique is a relatively newer concept introduced by our team in 2017 to minimize the most challenging intra-ocular maneuvers. [ 6 ] The results of our retrospective study show that both the HS and XNIT techniques achieved similar visual outcomes at 3 months with minimal complication rates.…”

Modified posterior assisted levitation of nucleus with infusion fluid from the anterior vitreous

“…A thorough anterior vitrectomy is then performed through the PPV and side ports (figure 2C). A rigid three-piece IOL is subsequently implanted using modified extraocular needle-guided haptic insertion technique 7 (figure 2D).…”