Refractive Outcomes of Four-Point Scleral Fixation of Akreos AO60 Intraocular Lens Using Gore-Tex Suture

Patel, Nimesh A.; Fan, Kenneth C.; Yannuzzi, Nicolas A.; Fortun, Jorge A.; Haddock, Luis J.; Yoo, Sonia H.; Persad, Patrice J.; Vanner, Elizabeth A.; Read, Sarah P.; Williams, Basil K.; Sridhar, Jayanth; Albini, Thomas A.; Flynn, Harry W.; Donaldson, Kendall E.; Townsend, Justin H.

doi:10.2147/opth.s282094

Cited by 12 publications

(5 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Fixation of the Akreos IOL with Gore-Tex sutures is a relatively new technique. Short-term studies have reported the accuracy of biometric calculation and favorable visual results with the IOL sutured between 2 and 3 mm from the limbus [ 23 , 24 ] and a similar complication rate if compared to other scleral fixation techniques [ 3 , 8 , 25 ]. Studies reported good lens stability at long-term follow-up, good visual and refractive outcomes, and not a high rate of complications [ 14 , 26 ].…”

Section: Discussionmentioning

confidence: 99%

Comparison of Safety and Efficacy of Four-Point Scleral Intraocular Lens Fixation and the Yamane Technique

Błagun,

Krix-Jachym,

Rękas

2024

Ophthalmol Ther

View full text Add to dashboard Cite

Introduction:The purpose of our study was to compare the safety and efficacy of two scleral fixation intraocular lens (IOL) methods of fourpoint scleral fixation (Akreos AO60) and the Yamane technique (AcrySof MA60AC). Methods: This prospective, randomized study was conducted at the Military Institute of Medicine-National Research Institute in Warsaw between 2021 and 2023. We compared both groups for cause of aphakia, ocular history, refractive status, and complication. Results: Our study included 50 eyes from 47 patients. Four-point fixation was performed in 25 eyes (group 1), and the Yamane technique was used in 25 eyes (group 2). Surgical time was 24.1 min ± 8.9 in group 1 and 25.1 min ± 9.9 in group 2 (p > 0.05). The postoperative BCVA (best-corrected visual acuity) for group 1 and group 2 at 1 year's observation was 0.10 ± 0.15 and 0.09 ± 0.17 logMAR, respectively (p > 0.05). Postoperative total refractive error (RE) was − 0.06 ± 0.71 diopters (D) for four-point scleral fixation and 0.83 ± 0.70 D for Yamane technique (p < 0.05). Endothelial cell density (ECD) loss was 0.9% in group 1 and 3.5% in group 2 (p > 0.05). Bleeding into the anterior chamber and vitreous body was more frequent in the group of patients operated on with the use of the Yamane technique (10 cases, 20%, p = 0.01). IOL displacement was found in one case (2%) in group 2. Conclusions: Both analyzed techniques are well tolerated and ensure good refractive results (extremely predictable in four-point scleral fixation) and have a similar safety profile. Fourpoint scleral fixation of IOL would appear to be safe, effective and beneficial for young, active patients, especially after trauma or recurrent subluxation. Clinical Trial Registration: ClinicalTrials.gov identifier NCT06389643.

show abstract

Section: Discussionmentioning

confidence: 99%

Comparison of Safety and Efficacy of Four-Point Scleral Intraocular Lens Fixation and the Yamane Technique

Błagun,

Krix-Jachym,

Rękas

2024

Ophthalmol Ther

View full text Add to dashboard Cite

show abstract

“…13,14 The other studies assessing alternative sutured scleral fixation methods using Gore-Tex have reported complication rates of IOL tilt up to 45%. [15][16][17] However, most studies have reported good centration of IOL and pupillary capture was resolved spontaneously. Likewise, in this study, IOL capture occurred in 30.4% of the sutured group; however, all eyes exhibited good IOL centering and spontaneous improvement, except one eye.…”

Section: Discussionmentioning

confidence: 99%

Long-Term Analysis of Intrascleral Fixation of Intraocular Lens

Byun¹,

Kim²,

Kong³

2023

Retina

View full text Add to dashboard Cite

Purpose: To compare the long-term outcomes of sutureless intrascleral fixation of the intraocular lens versus sutured scleral fixation.Methods: The authors retrospectively analyzed the medical records of patients who underwent intrascleral fixation of the intraocular lens using two different techniques: trocarcannula-based sutureless fixation and sutured scleral fixation. Clinical outcomes were compared before and 1-, 3-, 6-, and 12-month follow-ups after the operation.Results: A total of 51 patients were followed over a 12-month period after the operation, including 28 eyes in the sutureless group and 23 eyes in the sutured group. Best-corrected visual acuity and spherical equivalent values reached targeted values faster in the sutureless scleral fixation of the intraocular lens. However, no significant difference was observed between the two groups. For intraocular lens capture, there was a statistically significant difference observed in the incidence of postoperative complications, which was demonstrated by one eye in the sutureless group and seven in the sutured group (P = 0.009). To exclude the effect of corneal astigmatism, surgically induced astigmatism was calculated based on the astigmatism value 1 year after surgery. It was found that the sutureless technique significantly reduced the occurrence of astigmatism (2.43 6 1.42 vs. 1.65 6 0.94, P = 0.031). Conclusion:In a 1-year follow-up period, the trocar-cannula-based sutureless technique was reliable and effective. Sutureless fixation was associated with fewer postoperative complications and lower surgically induced astigmatism values than those with sutured fixation.

show abstract

“…[15][16][17][18][19] Attempts to mitigate these complications with polytetrafluoroethylene (Gore-Tex) sutures have shown acceptable refractive outcomes 20 but have also introduced new complications, such as granulation tissue formation into the ciliary body and sclera, IOL opacification, eyelet fractures with subsequent IOL dislocation, persistent corneal edema, and erosion of the suture through the conjunctiva. [21][22][23][24][25] Sutureless ISHF using fibrin glue has relatively lower rates of postoperative complications; however, glue-assisted techniques generally use the formation of a scleral flap, 8 which represents substantial surgical dissection. Although both glued and sutured techniques remain important methods of intrascleral fixation, our findings suggest that the sutureless flanged ISHF technique offers equivalent outcomes while avoiding the risk for complications and increased surgical manipulation inherent to these other techniques.…”

Section: Discussionmentioning

confidence: 99%

Clinical and Anatomic Outcomes of 3-Piece Poly(methyl methacrylate) Intraocular Lens Rescue and Needle-Assisted Transconjunctival Intrascleral Lens Fixation

Curran

Adam

2023

Journal of VitreoRetinal Diseases

View full text Add to dashboard Cite

Purpose: To report the clinical and anatomic outcomes of a single-stage rescue and sutureless 30-gauge needle-assisted transconjunctival intrascleral fixation of dislocated 3-piece rigid poly(methyl methacrylate) (PMMA) intraocular lenses (IOLs). Methods: This retrospective noncomparative single-surgeon interventional study comprised eyes that had concurrent 23- or 25-gauge pars plana vitrectomy and IOL rescue with sutureless transconjunctival needle-assisted flanged haptic intrascleral fixation. Lamellar scleral dissection for haptic fixation was performed 3 mm posterior to the surgical limbus with 30-gauge needles. Primary endpoints included visual acuity (VA), IOL tilt measured with ultrasound biomicroscopy (UBM), and postoperative complications. Results: The study evaluated 25 eyes of 24 patients. The IOL was successfully refixated in 24 of the 25 eyes. The mean preoperative logMAR VA of 1.21 ± 0.79 SD (median 1.3; Snellen equivalent 20/400) improved to 0.28 ± 0.35 (median 0.14; Snellen equivalent 20/30) postoperatively ( P < .0001). The mean IOL tilt measured by UBM (n = 7) was 3.79 ± 3.60 degrees. The mean postoperative follow-up was 348 ± 284 days (range, 7-979 days). Postoperative complications included self-clearing vitreous hemorrhage (n = 9), retinal detachment (RD) (n = 1), cystoid macular edema (n = 3), and corneal edema (n = 3). Three eyes (13%) required additional surgery, 1 for RD and 2 for delayed haptic slippage and secondary IOL tilt causing irregular astigmatism. Conclusions: Intrascleral needle-assisted fixation of dislocated or mobile 3-piece PMMA IOLs is an effective, safe method to restore VA.

show abstract

Refractive Outcomes of Four-Point Scleral Fixation of Akreos AO60 Intraocular Lens Using Gore-Tex Suture

Cited by 12 publications

References 22 publications

Comparison of Safety and Efficacy of Four-Point Scleral Intraocular Lens Fixation and the Yamane Technique

Comparison of Safety and Efficacy of Four-Point Scleral Intraocular Lens Fixation and the Yamane Technique

Long-Term Analysis of Intrascleral Fixation of Intraocular Lens

Clinical and Anatomic Outcomes of 3-Piece Poly(methyl methacrylate) Intraocular Lens Rescue and Needle-Assisted Transconjunctival Intrascleral Lens Fixation

Contact Info

Product

Resources

About