Peripheral Intravascular Catheter-Assisted Sutureless Scleral Fixation of Three-Piece Intraocular Lenses: A Novel Technique

Abstract

To describe and report the anatomical and functional outcomes of a novel sutureless peripheral intravascular catheter (PIVC)-assisted scleral fixation of three-piece IOL.Methods: A retrospective chart review of all patients who underwent scleral fixation surgery performed by a single surgeon was conducted. In all cases, a novel scleral fixation technique of three-piece IOL was performed with the aid of a 24-gauge PIVC cannula. Patients were followed up at postoperative months 1, 3, and 6.Results: Thirteen eyes of 12 patients were included in the analysis. Preoperatively, mean best-corrected visual acuity was 1.26 6 0.82 LogMar (20/364 Snellen Equivalent), and it improved significantly at all follow-up endpoints being of 0.52 6 0.25 LogMar at 1 month (20/66 Snellen Equivalent, P = 0.02), 0.4 6 0.22 LogMar at 3 months (20/50 Snellen Equivalent, P = 0.007) and 0.37 6 0.2 LogMar (20/47 Snellen Equivalent, P = 0.008) at 6 months postoperatively. No serious intraoperative or postoperative complications were registered. Postoperatively, there were no cases of conjunctival erosions. Over the follow-up period, in all the included cases, the IOL remained centered and stable. Conclusion:The PIVC-assisted scleral fixation technique may be a safe and reliable surgical option for secondary IOL placement in cases of insufficient capsular support.

Long-term outcomes of sutureless intrascleral IOL fixation in children and adults: single surgeon case series with and without haptic flanging with up to 11 years of follow-up

“…16,22 A SFIOL technique using 24-g peripheral intravascular catheter was recently described, with no reported IOL dislocations in 6-month follow-up in 13 eyes. 23 Our practice of haptic flanging of PMMA or polyvinylidene fluoride-based haptics represents off-label use of three-piece IOLs. Our study demonstrated a relatively low rate (3.3%) of haptic exposure or erosion in comparison with a recent published report, which used a scleral flap technique as prophylaxis against haptic exposure.…”