Topical plus subconjunctival anaesthesia: foldable intraocular lens implantation in eyes without capsule support through a self‐sealing incision

Abstract

ABSTRACT.Purpose: To evaluate the clinical outcomes of topical plus subconjunctival anaesthesia for secondary implantation of foldable intraocular lens (IOL) (Ophtec PC 425Y) in eyes without capsule support through a self-sealing incision. Methods: We reviewed the medical records of 22 patients (22 eyes) who received topical plus subconjunctival anaesthesia for scleral fixation of a foldable IOL through small incision. The scleral incision technique was used for IOL scleral fixation. Twelve eyes had traumatic cataract, seven had postphacoemulsification complications and three were aphakic. We studied visual outcome, intraoperative complications and perioperative pain. Autorefractometry and keratometry measurements and central endothelial cell counts were evaluated 1 day preoperatively and 4 months postoperatively. The level of intraoperative pain was scored on a scale of 1-10, where 1 ¼ no pain and 10 ¼ severe pain. Results: Nineteen patients (86%) tolerated the procedure well, giving pain scores of 1-3, and none required supplemental anaesthesia. The mean age of the patients was 60 years. The postoperative best-corrected visual acuity (BCVA) ranged between 20 ⁄ 100 and 20 ⁄ 25. Four months postoperatively, the mean myopic shift by autorefractometry was )1.25 dioptre (D) and the mean postoperative astigmatism was 1.75 D. The mean central corneal endothelial loss at 4 months was 12.24% (range 4.5-17.2%). Five microscopic hyphaema occurred intraoperatively. Four cystoid macular oedema and four peripheral anterior synechia were the only complications, each occurring at the final follow-up. Conclusion: Topical plus subconjunctival anaesthesia and scleral fixation of foldable IOL (Ophtec PC 425Y) was safe, quick, required a small incision, led to favourable visual outcomes and minimized the risk of intraoperative and postoperative complications in eyes without capsule support. However, a longterm study of a large population is required to confirm these findings.

Comparison of clinical outcomes with three different aspheric intraocular lenses

“…2004), posterior capsular opacity (Kugelber et al. 2008), incision size (Monteiro et al. 2007), patient age (Owsley et al.…”

Asymptomatic oculocardiac reflex during phacoemulsification

“…Different combinations of anaesthetic drugs have reported either for PB blockade (Borazan et al. 2008) or as a combination of topical plus peribulbar anaesthesia (Monteiro et al. 2007).…”