Trocar-assisted flanged transconjunctival intrascleral sutureless intraocular lens fixation

Abstract

Purpose To study the safety and efficacy of 25-gauge trocar-assisted flanged intrascleral sutureless IOL fixation in patients with insufficient posterior capsular support. Methods Five aphakic eyes with capsular insufficiency were included in this prospective interventional case series study, at Dar El Oyoun Hospital, Cairo, Egypt. Twenty five-gauge trocar-assisted flanged intrascleral sutureless technique was used for IOL fixation, in which retinal microforceps were used to capture and externalize both haptics through a scleral tunnel. CDVA, IOP measurements and IOL centralization were reported pre- and one day, one & 3 months postoperatively. Any intra- or postoperative complications were recorded. Results The mean LogMAR CDVA had significantly improved one day, 1 & 3 months postoperatively (0.74 ± 0.1, 0.42 ± 0.07 and 0.26 ± 0.08 respectively, p < 0.001) compared to the preoperative value (1.7 ± 0.17). The mean IOP showed no significant changes along the follow-up period (16.9 ± 0.1; 16.2 ± 1.1; 16.3 ± 0.9 mmHg, p = 0.68, 0.58, 0.89) respectively at 1st day, 1 & 3 months postoperatively) compared to the preoperative measurement (16.4 ± 1.8 mmHg). The IOL was found to be centralized in all cases. No intra- or postoperative complications were encountered. Conclusion 25-gauge trocar-assisted flanged intrascleral sutureless IOL fixation is found to be a reliable and effective technique that overcomes Yamane technique's challenges for IOL fixation in cases with posterior capsular insufficiency.

Sutured scleral fixation of existing subluxated/dislocated acrylic one-piece intraocular lenses

“…Trauma, pseudoexfoliation, or zonular dehiscence may dislocate any style of IOL. Sutureless scleral fixation of IOLs with various modified techniques has been reported [3][4] . However, the techniques cannot be applied to acrylic one-piece PCIOLs including externalization and intrascleral embedding of the haptics [10][11] .…”

“…However, trauma, pseudoexfoliation, or zonular dehiscence may dislocate any style of IOL. Sutureless scleral fixation of IOL techniques [3][4] such as embedding haptics of IOLs cannot be applied to most acrylic one-piece PCIOLs. In addition, the position of existing subluxated or dislocated IOLs with or without medium opacity may interfere with the predicted refraction for IOL exchange.…”