Short Term Safety and Visual Outcomes of Transscleral Sutured Posterior Chamber Intraocular Lenses (SS-PCIOL) using GORE-TEX® Suture.

Abstract

Purpose: To evaluate the short term outcomes of patients who underwent combined pars plana vitrectomy (PPV) and trans-scleral sutured posterior chamber intraocular lens (SS-PCIOL) implantation using GORE-TEX® suture.

Methods: Retrospective, consecutive case series of all patients who underwent combined 23-gauge PPV and SS-PCIOL using GORE-TEX® suture at Wills Eye Hospital, Philadelphia, PA between January 1, 2013 and June 30, 2013.

Results: 10 eyes in 10 patients (5 male, 5 female) were reviewed. Indications for PPV/SS-PCIOL included dislocated IOL (6), traumatic cataract (2), and zonular weakness due to pseudoexfoliation syndrome (1) or prior ocular surgery (1). All 10 eyes had successful scleral fixation of the IOL at mean follow-up of 3 months (range: 1-6 months). Overall, mean visual acuity improved, with 70% of patients improving at least 3 lines of Snellen acuity at final follow-up (range: loss 2 lines - gain 9 lines). Anterior segment complications included hyphema (6 eyes), corneal edema (4 eyes), and intraocular pressure spike (1 eye), all of which were treated and resolved with topical therapy. Posterior segment complications included vitreous hemorrhage (1 eye), serous choroidal detachment (1 eye), and epiretinal membrane (1 eye). Infectious endophthalmitis, prolonged sterile ocular inflammation, cystoid macular edema, retinal tear and/or detachment, suture erosion, or suture breakage were not observed in any patient in this series.

Conclusions: Scleral fixation of IOLs with GORE-TEX® suture led to improvement in visual acuity and was not associated with significant intraoperative or postoperative complications. The technique may be an effective option for patients undergoing combined PPV and IOL implantation for a variety of surgical indications.

Keywords: 762 vitreoretinal surgery • 567 intraocular lens