Foldable acrylic intraocular lens with distended haptics for transscleral fixation

Abstract

We describe a foldable acrylic intraocular lens (IOL) with distended haptics suitable for transscleral fixation and the insertion procedure. The IOL has an acrylic optic and poly(methyl methacrylate) haptics with a microscopic indentation 1.3 mm from the tip. Transscleral fixation of the IOL was performed through corneal incisions in 22 eyes, and surgical results were retrospectively assessed. The IOL was sutured firmly in position using the cow-hitch procedure, and there was no suture loosening to the distended haptic. The IOL design provided suitable fixation and may be indicated for bag fixation as well as transscleral fixation.

Transscleral fixation of single-piece foldable acrylic lens with eyelets at the optic-haptic junction

“…For this reason, serious complications after transscleral fixation of enVista IOL were rare, similar to the results of previous studies held by experienced surgeons. 3,5,7,11,16,17,25,37,38 As the visual acuity improved significantly after surgery and few postoperative refractive errors were noted, we speculate that the IOLs were well centred and stable in our study.…”

“…In addition, the small incision provides the advantage of operating in a relatively closed system that can prevent intraoperative complications such as transient hypotony and can help surgeons to operate comfortably during fixation with improved globe stability. 5,11,25 As a result, we observed no intraoperative globe instability during transscleral fixation and a low rate (7%) of postoperative transient hypotony. In addition, no serious complications related to globe instability, such as choroidal detachment or suprachoroid hemorrhage, were observed.…”

“…6,22,23 The transscleral fixation of PC IOL is a popular technique due to excellent postoperative visual acuity and lower rate of complications. [1][2][3]11,12,14,[24][25][26] Although transscleral fixation of a PC IOL has lower complication rate, there is still a risk for decentration, tilting, suture erosion, and dislocation. 12,25,[27][28][29] Various modified techniques and designs of IOLs have been introduced to attempt to decrease these complications.…”

“…The suture has been shown to be most secure when tied to the eyelets of the haptics. 2,11 The enVista IOL has eyelets that allow sutures to pass through the haptics. Tying sutures to the eyelets can reduce potential suture movement and slippage, and give stability to the IOL position.…”

“…[1][2][3][4][5][6] Although numerous publications have introduced several surgical methods of transscleral fixation using various types of IOL, ophthalmologists are often unsure which type of IOL to use and how it should be fixed. 3,[5][6][7][8][9][10][11][12][13][14][15][16][17][18] Maintaining proper lens position is one of the important factors for a successful transscleral fixation. However, IOL-related complications, including decentration, tilting, and dislocation, are major concerns for surgeons using the transscleral fixation method.…”