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Atsushi Kawasaki, Shunji Kusaka, Tomoko Asai, Yasushi Ikuno, Kawasaki Eye Clinic; COMPARISON OF SUTURELESS INTRASCLERAL AND CONVENTIONAL SUTURING TECHNIQUES FOR FIXATING INTRAOCULAR LENSES WITHOUT CAPSULAR SUPPORT. Invest. Ophthalmol. Vis. Sci. 2014;55(13):2525.
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© ARVO (1962-2015); The Authors (2016-present)
To compare the superiority of sutureless scleral fixation of a three-piece foldable acrylic posterior chamber intraocular lens (PC-IOL) in the absence of capsular support and the conventional scleral fixation technique with suturing.
This was a single-center retrospective series of 10 patients without posterior capsular support who underwent either sulcus fixation of an acrylic PC-IOL into scleral tunnels parallel to the limbus (5 eyes, intrascleral group) or the conventional IOL suturing technique behind the iris (5 eyes, suturing group) between May 2012 and August 2013. Factors including age, gender, preoperative and postoperative corneal endothelial cell density, refractive status (visual acuity [VA] and corneal cylinder), and intraoperative and postoperative complications were studied in the medical records and compared. P<0.05 was considered significant.
Six men and four women (mean age, 81.0 ± 1.4 years) were eligible. A posterior vitrectomy was performed in all cases. Transitory postoperative macular edema developed in one case in the IOL suturing group. There were no significant differences between the groups in mean age (P=0.84), mean preoperative VA (P=0.94), mean preoperative (P=0.89) and postoperative (1 month) (P=0.52) refractive errors, or mean preoperative (P=0.94) and postoperative (1 month) (P=0.42) corneal endothelial cell density. The intrascleral group had a significantly shorter mean surgical time (44.0 vs. 55.8 minutes, respectively, P=0.02), greater VA gain (-0.87 vs. -0.66 logarithm of the minimum angle of resolution unit, P=0.04), and less loss of corneal endothelial cell density (-33 vs. -227 cells/mm2, P=0.03).
The intrascleral PC-IOL technique had a better visual outcome, shorter surgical time, and better maintenance of corneal endothelial cell density, suggesting that it is safer and more effective than the conventional method.
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