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Nimesh Patel, Nicolas Alessandro Yannuzzi, Ajay E. Kuriyan, Harry W Flynn; Clinical Results After Scleral Fixation of Akreos AO60 Lens Using Gore-Tex suture. Invest. Ophthalmol. Vis. Sci. 2017;58(8):1162.
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© ARVO (1962-2015); The Authors (2016-present)
Scleral fixated intra-ocular lenses (IOL) have been shown to be effective as a secondary lens. There have been concerns with high rates of suture erosion with the use prolene sutures. Many ophthalmic clinicians are now using Gore-Tex suture for scleral fixation due to increased tensile strength. Outcomes for this procedure have not been widely described. The purpose of this retrospective interventional case series study was to evaluate the outcomes using Gore-Tex sutured scleral secondary intraocular lenses.
A review was performed of surgical cases at the Bascom Palmer Eye Institute from August 2015 to October 2016. Cases were found using CPT code for Akreos AO60 lens (Bauch and Lomb). Inclusion criterion was the use of the lens fixated to the sclera with Gore-Tex suture as a secondary IOL. Primary outcome measures were indications for scleral IOL, visual acuity at last follow up, and complications.
21 eyes of 20 patients were identified for inclusion. Causes for secondary IOL surgery were dislocated IOL (38%), complicated cataract surgery (29%), subluxed IOL(24%), and dislocated or subluxed crystalline lens (10%). Mean logarithm of the minimum angle of resolution (LogMAR) visual acuity improved from 1.0±0.62 (20/197 Snellen equivalent) preoperatively to 0.60±0.61 (20/87 Snellen equivalent) on last follow up. Mean follow up post-surgery was 5.6 months (range 0.2-12.9).There were no intraoperative complications noted. Postoperative complications included corneal edema in three eyes (14.5%), ocular hypertension in two eyes (9.5%), hypotony in two eyes (9.5%), macular edema two eyes (9.5%), lens tilt two eyes (9.5%), hyphema in 2 eyes (9.5%), vitreous hemorrhage in one eye (4.8%). There was one eye (4.8%) with an erosion of the Gore-Tex suture through the conjunctiva leading to a purulent scleritis. This occurred 6 months after the initial surgery and required removal of the IOL, debridement and cryotherapy. There were no cases of postoperative endophthalmitis, uveitis–glaucoma–hyphema syndrome or persistent postoperative inflammation during the follow up period.
Scleral fixation of Akeros AO60 lens with Gore-Tex suture as a secondary IOL was generally well tolerated and produced an improvement in visual acuity. There was one patient with a suture related infection which required removal of the IOL and the suture.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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