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Shunji Kusaka, Shohei Komoto, Akiko Fujii, Keiichi Aomatsu, Eiko Koike, Kuniko Tachibana, Shiro Higaki, Yoshikazu Shimomura; Comparison of surgical results between intrascleral posterior chamber intraocular lens (PC-IOL) fixation and transscleral suturing of PC-IOL in eyes without capsular support. Invest. Ophthalmol. Vis. Sci. 2013;54(15):1837. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
To implant a posterior chamber intraocular lens (PC-IOL) in aphakic eyes without capsular support, transscleral suturing of the intraocular lens (IOL) is commonly performed. However, this procedure is difficult and time-consuming. An intrascleral posterior chamber IOL fixation technique has recently been developed, and the purpose of this study was to compare the outcomes after the use of these two techniques.
The medical records of 18 consecutive aphakic eyes of 16 patients (mean age; 72.0±9.2 years) who had an intrascleral PC-IOL fixation (IS-IOL group) and 15 consecutive aphakic eye of 13 patients (72.6±18.5 years) who had transscleral suturing of the PC-IOL (TS-IOL group) were retrospectively reviewed. All surgeries were performed by a single surgeon (SK). The surgical time, changes in best-corrected visual acuities (BCVAs), changes in corneal endothelial cell density, surgical-induced astigmatism, and postoperative high-order aberrations (HOAs: assessed by Topcon KR-9000PW, Topcon Corporation, Tokyo Japan) were compared for the two groups
The postoperatively BCVAs improved by >0.2 logMAR units or were unchanged in all eyes in the 2 groups. Between the 2 groups there were no significant differences in the changes in the BCVAs, surgical-induced astigmatism, and different HOA values except for ocular total HOAs (0.221 μm root mean square (RMS) in IS-IOL group, 0.496 μm RMS in the TS-IOL group, P=0.031, unpaired t-test). The mean surgical time to fixate the IOL was significantly shorter in the IS-IOL group (28.3 min) than in the TS-IOL group (37.6 min, P=0.001, unpaired t-test). In the IS-IOL group, one fixated IOL dislocated 2 months after the surgery. The patients were followed for 2.8 months in the IS-IOL group and 4.5 months in the TS-IOL groups.
Although further investigations with larger number of patients and longer follow-up are necessary, intrascleral PC-IOL fixation may provide better PC-IOL fixation with shorter surgical time compared with transscleral suturing of a PC-IOL.
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