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Jesus Abraham Acosta-Leyva, Ana B Medina-Perez, Claudia Palacio, Laura L Arroyo-Muñoz, Oscar Guerrero-Berger, Jaime Lozano-Alcazar, Carolina Orea; Outcomes of transscleral fixation of intraocular lens in absence of partial or complete capsular support.. Invest. Ophthalmol. Vis. Sci. 2014;55(13):2523.
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© ARVO (1962-2015); The Authors (2016-present)
To describe the results of transscleral fixated posterior chamber intraocular lens (SF-PCIOLs) in patients without adequate capsular support, in the Hospital de la Luz, from 2008-2013
Was performed in 48 eyes of patients who underwent primary or secundary implantation of ab externo SF-PCIOLs in period from January 2008 to June 2013. The Primary cases included those undergoing surgery for traumatic cataract (3 eyes), and secondary cases included those after surgery for Marfan’s syndrome (2 eyes), previous complicated cataract surgery (13 eyes), congenital cataract (14 eyes), traumatic cataract (10 eyes), or dislocated/ subluxated IOL (6 eyes). Part 1. Review of electronic file from January 2008 to March 2013. Part 2. Complete ophthalmological examination for each patient. Main outcomes was IOL position, early, medium and late term complications and visual acuity.
The mean age of patients was 45.33 (range 4-87) years of age at the time of surgery. The most frequent indication was congenital cataract in 29.2%. 87.5% of the IOL was fixed to one handle, 12.5% 2 handles. 43.8% of eyes were not vitrectomized. The most commonly used IOL was MA 60 acrylic 3 pieces (60.4%). Mean (± standard deviation) logMAR visual acuity before surgery was 0.84 ± 0.77 (n=48 eyes) vs 2 weeks after surgery 0.54 ± 0.54 (n=48 eyes), and 0.59 ± 0.34 at the end of the study (n=14 eyes). Of the 14 patients who attended the final review, the mean duration of follow-up was 32.79 ± 23.28 months (range 3-60). 45.7% had complications. The most common complication endpoint was glaucoma 14.3% at 12 months of follow-up, cystoid macular edema 7.1% at 36 months of follow-up, IOL subluxated 7.1% at 3 months of follow-up, and IOL dislocated 7.1% at 36 months of follow-up. The final best corrected visual acuity was better than 20/40 in 64% of patients.
The number of complications in the short and medium term is low. Often the onset of complications occurs in late time. Most patients achieve a proper visual rehabilitation with a sulcus fixation PCIOL suitable when there is no capsular support.
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