Sutureless scleral fixation Carlevale IOL: a review on the novel designed lens

Carlà, Matteo Mario; Boselli, Francesco; Giannuzzi, Federico; Caporossi, Tomaso; Gambini, Gloria; Mosca, L.; Savastano, Alfonso; Rizzo, Stanislao

doi:10.1007/s10792-022-02579-w

Cited by 19 publications

(6 citation statements)

References 50 publications

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“…In general, the type and incidence of surgical complications encountered in our group were in line with those reported in the salient CIL literature [ 19 ]. The most common complications observed (transient IOP elevation and macular oedema in 8.3% of our patients) were each managed successfully with topical therapy.…”

Section: Discussionsupporting

confidence: 87%

A New Technique with Scleral Grooves for Sutureless Scleral Fixation of the Carlevale Intraocular Lens

Giannopoulos,

Panagiotou,

Giannoukaki

et al. 2024

Ophthalmol Ther

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Introduction A novel technique is described employing scleral grooves to facilitate sutureless scleral fixation of the Carlevale intraocular lens (CIL). We describe its use in a series of 47 patients with aphakia. Methods A retrospective study of all patients with aphakia who underwent CIL implantation with the new technique by a single surgeon during 1 year. The novelty of this technique consists in the creation of two partial-thickness linear sclerotomies (grooves), 180° apart, 2 mm from and parallel to the limbus. In the middle of each groove a full-thickness sclerotomy is performed to facilitate externalization of the CIL anchors. The groove allows the anchor to plug the full-thickness sclerotomy and to rest within the sclera without protrusion. Reported outcomes include pre-operative/post-operative visual acuity, post-operative spherical equivalent and surgical complications. Follow-up was a minimum of 6 months. Results Forty-eight eyes of 47 patients with aphakia with a mean age of 74 years (range 31–90 years) are included. The commonest causes of aphakia were intraocular lens (IOL) subluxation,with or without exfoliation (54.2%), complicated cataract surgery (29.2%), crystalline lens luxation (6.3%) and trauma (4.1%). All CILs inserted with the new technique stayed successfully in situ during follow-up. Median pre-operative best-corrected visual acuity (0.75 logMAR; range 0.1–2.7) significantly improved to 0.5 logMAR post-operatively ( p < 0.001). Moreover, 78% and 65% of the operated cases were within 1.0 and 0.5 diopters, respectively, from intended refraction. The most common complications were transient cystoid macular oedema (8.3%) and transient intraocular pressure rise (8.3%), all of which resolved within 2 months. Conclusions The proposed modification of sutureless scleral fixation of the CIL appears safe and effective. In our experience it is less time consuming and easier to perform than previous techniques and may therefore offer a useful future option. Supplementary Information The online version contains supplementary material available at 10.1007/s40123-024-00986-z.

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Section: Discussionsupporting

confidence: 87%

A New Technique with Scleral Grooves for Sutureless Scleral Fixation of the Carlevale Intraocular Lens

Giannopoulos,

Panagiotou,

Giannoukaki

et al. 2024

Ophthalmol Ther

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“…The post-operative evaluation of astigmatisms did not show differences from the pre-operative data. In this regard, a small corneal incision appears to induce less astigmatism than ACIOLs, iris claw lenses [ 26 , 36 , 52 ] or three-piece fixed-scleral IOLs [ 28 ].…”

Section: Discussionmentioning

confidence: 99%

Current Evidence for a New Surgical Technique for Scleral Fixation: The Implantation of a Carlevale Lens, a Systematic Review

Barbieri,

Maglionico,

Casini

et al. 2024

JCM

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Background: The Carlevale lens (FIL SSF, Soleko IOL Division, Italy) is a new lens for suture-less scleral fixation. This paper aimed to systematically review articles on this lens, the surgical techniques used for its implantation, complications and outcomes. Methods: This systematic review was performed following the PRISMA guidelines. The search string used was “Carlevale” AND “scleral fixation” from inception until March 2024. For completeness, either case-control studies, case reports or case series written in English were included. The authors used the Newcastle–Ottawa scale for the case-control studies and the JBI Critical Appraisal Checklist for case reports and case series. Results: Twenty-nine articles were included. Scleral fixation with Carlevale lens can be performed by creating scleral flaps or, alternatively, by using scleral pockets. The two sclerotomies must be diametrically opposed, and are preferably created by 25-gauge trocars. A pars plana vitrectomy should be performed every time, and the design of the lens should be suitable for self-anchoring to the sclera; the most accredited strategy to achieve this is to avoid scleral sutures. There were only a few intraoperative and postoperative complications reported; vitreous hemorrhages were the most frequent intraoperative events, while the most relevant postoperative complications were vitreous hemorrhages, cystoid macular oedema and transient variations in the intraocular pressure. Excellent results have been obtained in terms of BCVA, IOL centration and stability, mean intraocular pressure, postoperative spherical equivalent, separation between anterior and posterior chamber and the distance of the IOL from anterior chamber structures. Conclusions: The foldable hydrophilic design of the Carlevale lens has shown good effectiveness, IOL stability and few intra and post-operative complications.

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“…Centration and tilting of the IOL were evaluated at the slit-lamp before and after pupil dilation. As already described in literature, the specific design of the IOL and the large dimensions of the optic plate make it especially stable and less prone to tilting [ 4 , 12 ]. Despite these satisfactory results, a precise evaluation of IOL tilting can only be performed using anterior segment OCT, a Scheimpflug camera, or ultrasound biomicroscopy, as described in literature [ 13 ].…”

Section: Discussionmentioning

confidence: 99%

A mini-invasive surgical technique for Carlevale IOL implantation: case series study and description of concomitant surgery

Danese,

Di Bin,

Lanzetta

2023

Graefes Arch Clin Exp Ophthalmol

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Purpose To examine the feasibility and outcomes of a modified technique for the implantation of scleral fixated Carlevale intraocular lens (IOL) (I71 FIL SSF. Soleko IOL Division, Pontecorvo, Italy), and to analyze the occurrence of adverse events. Methods This is a retrospective observational study conducted revising patients charts from 2018 to 2023. Thirty-five eyes of 33 patients were included. Patients requiring IOL explantation had either IOL dislocation or opacification. The implantation of the Carlevale IOL was performed with the subconjunctival positioning of the anchors without any scleral flap. All maneuvers were performed transconjunctivally. The anatomical outcomes considered were IOL positioning, and the absence of postoperative complications. The functional outcomes analyzed were best correctedvisual acuity (BCVA) and refraction. Results In all the cases, the IOL was well positioned and centered postoperatively. No cases of conjunctival erosion were recorded. The best corrected visual acuity (BCVA) was 0.9±0.6 logMar (mean±standard deviation) preoperatively and 0.5±0.5 logMar (mean±standard deviation) postoperatively. The mean preoperative spherical equivalent was +6.8±7.7 dioptres, while postoperatively it was -1.1±1.6 dioptres. The most frequent procedure associated to secondary IOL implantation was posterior vitrectomy (25 eyes, 71.4%), which was performed with 25-gauge transconjunctival cannulas in the ciliary sulcus. The follow-up period was 24.5±16.9 months (mean±standard deviation). Conclusion The described mini-invasive technique for Carlevale IOL implantation is safe and effective. It can be recommended either as a stand-alone operation or associated to concurrent surgical procedures.

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Sutureless scleral fixation Carlevale IOL: a review on the novel designed lens

Cited by 19 publications

References 50 publications

A New Technique with Scleral Grooves for Sutureless Scleral Fixation of the Carlevale Intraocular Lens

A New Technique with Scleral Grooves for Sutureless Scleral Fixation of the Carlevale Intraocular Lens

Current Evidence for a New Surgical Technique for Scleral Fixation: The Implantation of a Carlevale Lens, a Systematic Review

A mini-invasive surgical technique for Carlevale IOL implantation: case series study and description of concomitant surgery

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