Preferred surgical techniques for secondary intraocular lens implantation in adults with aphakia

Alshehri, Mohammed; Helayel, Halah Bin; Vargas, José Manuel; AlMutlak, Mohammed; Fairaq, Rafah

doi:10.1007/s10792-023-02761-8

Cited by 3 publications

(1 citation statement)

References 27 publications

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“…IFIOLs are considered more technically challenging than ACIOLs but have been associated with the increased risk of an anatomic distortion of the pupil, uveitis from the pigment release, as well as vitreous hemorrhage [ 1 , 5 , 10 ]. Scleral-fixated IOLs are considered the most technically challenging technique and offer a significantly lower risk of damage to the anterior segment structures [ 11 ]; however, suture-related complications, such as suture erosion and breakage, can occur, which can potentially lead to the dislocation of the IOL [ 11 , 12 , 13 , 14 ].…”

Section: Introductionmentioning

confidence: 99%

Clinical Outcomes in Scleral Fixation Secondary Intraocular Lens with Yamane versus Suture Techniques: A Systematic Review and Meta-Analysis

Zhang,

Palka,

Zhu

et al. 2024

JCM

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Background: The purpose of the study is to compare the visual outcomes and complications of sutured scleral fixation (SSF), a traditional and conservative surgical approach, and the newer and faster Yamane technique for secondary intraocular lens placement. Methods: A literature search was performed on PubMed, Embase, and Scopus on studies published between 1 July 2017 to 29 September 2023. Outcomes analyzed included the final best corrected visual acuity (BCVA) between 3 and 12 months to assess the effectiveness of the procedure, post-operative month (POM) 1 BCVA to assess the speed of visual recovery, endothelial cell count (ECC), absolute refractive error, surgical duration, and complication rates. Additional subgroup analyses were performed based on surgeon experience with the technique. Single-surgeon studies had an average of 26 procedures performed, whereas multiple-surgeon studies averaged only 9 procedures performed; these were then used to delineate surgeon experience. A sample-size weighted mean difference (MD) meta-analysis was performed across all variables using RevMan 5.4.1; p < 0.05 was considered statistically significant. Results: Thirteen studies with 737 eyes were included: 406 eyes were included in the SSF group, and 331 eyes were included in the Yamane group. There was no significant difference in the final BCVA between groups in both the single-surgeon versus multiple-surgeon studies (MD = −0.01, 95% CI: [−0.06, 0.04], p = 0.73). In the single-surgeon studies, the BCVA at POM1 was significantly improved in the Yamane group compared to SSF (MD = −0.10, 95% CI: [−0.16, −0.04], p = 0.002). In the multiple-surgeon studies, there was no significant difference in BCVA at POM1 (MD = −0.06, 95% CI: [−0.16, 0.04], p = 0.23). The Yamane group had a shorter surgical duration than SSF in both single-surgeon and multiple-surgeon studies (MD = −24.68, 95% CI: [−35.90, −13.46], p < 0.0001). The ECC, refractive error, and complication rates did not significantly differ amongst all groups. Conclusions: The Yamane technique demonstrated similar long-term visual outcomes and complication rates to the traditional SSF. Visual recovery was significantly faster in the Yamane group in the single-surgeon studies. The operative times were shorter across all Yamane groups. Based on these findings, it is advisable to consider the Yamane technique as a viable, and perhaps preferable, option for patients requiring secondary IOL placement, alongside traditional SSF methods.

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Section: Introductionmentioning

confidence: 99%

Clinical Outcomes in Scleral Fixation Secondary Intraocular Lens with Yamane versus Suture Techniques: A Systematic Review and Meta-Analysis

Zhang,

Palka,

Zhu

et al. 2024

JCM

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New Device for the Correction of Aphakia Without Capsular Support

Bergamasco,

dos Santos,

Moscovici

et al. 2024

Current Eye Research

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Cross-Sectional Survey of Vitreoretinal Surgery Fellowship Training in Secondary Intraocular Lens Placement

Ghalibafan,

Cai,

Chou

et al. 2024

Journal of VitreoRetinal Diseases

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Purpose: To assess current trends in vitreoretinal surgical fellowship training for placement of secondary intraocular lenses (IOLs). Methods: A cross-sectional survey was administered to vitreoretinal surgical fellowship graduates who completed their program between 2019 and 2023. Results: Completed responses were obtained from 70 (22.5%) of 311 eligible recipients. Training settings included academic (80%), hybrid academic/private practice (15%), and private practice (5%). During their fellowship, the majority of respondents reported 10 or fewer cases using anterior chamber (AC) IOLs (69%), 5 to 50 cases using scleral-sutured IOLs (64%), and 5 to 25 cases using sutureless scleral-fixated IOLs (52%). Most fellows (79%) did not have exposure to iris-fixated IOL placement during fellowship training. The Akreos AO60 (78%) and Envista MX60 (10%) IOLs were the most common choice for scleral-sutured placement. Most fellows (67%) placed fewer than 10 secondary IOLs through scleral tunnels. Overall, scleral-sutured IOL placement (Akreos Gore-Tex [polytetrafluoroethylene] sutured, 49%) and scleral-fixated IOLs (modified Yamane, 45%) were the preferred and most comfortable surgical techniques for recent graduates after completing training. There was a significant association between surgical case volume during fellowship training and self-reported competency for each type of secondary IOL ( P ≤ .005). Conclusions: The majority of vitreoretinal surgical fellows receive limited training in the placement of AC IOLs or construction of scleral tunnels during their fellowship. Aligned with their experience during fellowship, recent graduates generally prefer implanting scleral-fixated or scleral-sutured IOLs. Analysis of trainees’ exposure to various techniques and postgraduate surgical preferences may identify areas for improvement in surgical education.

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Preferred surgical techniques for secondary intraocular lens implantation in adults with aphakia

Cited by 3 publications

References 27 publications

Clinical Outcomes in Scleral Fixation Secondary Intraocular Lens with Yamane versus Suture Techniques: A Systematic Review and Meta-Analysis

Clinical Outcomes in Scleral Fixation Secondary Intraocular Lens with Yamane versus Suture Techniques: A Systematic Review and Meta-Analysis

New Device for the Correction of Aphakia Without Capsular Support

Cross-Sectional Survey of Vitreoretinal Surgery Fellowship Training in Secondary Intraocular Lens Placement

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