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Peter Yuwei Chang, Felix Yan-Fay Chau, Jennifer I Lim, Yannek Isaac Leiderman; Indications and Outcomes of Sutureless Scleral-Fixated Intraocular Lens Implantation in a University-Based Referral Retina Practice. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):5063.
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Implantation of an intraocular lens (IOL) via sutureless scleral-fixation in the absence of capsular support is most commonly performed as an isolated procedure to address aphakia, or for luxation of a pre-existing IOL. We report the indications for and results of sutureless scleral-fixation of an intraocular lens (IOL) in a large university-based ophthalmology department.
Retrospective multi-surgeon single-center consecutive case series. Clinical data including the indications for intervention, pre- and post-operative visual acuity, intraocular pressure, examination findings, surgical techniques, and any intra- or post-operative complications were recorded for each patient.
23 eyes of 23 patients were included. The indications for IOL implantation included traumatic dislocation of the crystalline lens, surgical aphakia following complex vitreoretinal procedures, traumatic dislocation or expulsion of a pre-existing IOL, IOL dislocation following complicated cataract surgery, and IOL dislocation from other causes. Concurrent procedures performed included pars plana vitrectomy, lensectomy, explant of pre-existing IOL, membrane peeling, internal limiting membrane peeling, endolaser photocoagulation, and endotamponade with gas. Kinking or avulsion of an IOL haptic during surgical manipulation was the only intraoperative complication. Postoperative complications included conjunctival cyst (1) IOL dislocation (2), ocular hypertension (1), uveitis-glaucoma-hyphema syndrome (1), and pupillary-optic capture with pigment dispersion (1). No cases of endophthalmitis or postoperative retinal detachment occurred.
IOL implantation via sutureless scleral-fixation may be performed in conjunction with most commonly employed vitreoretinal surgical techniques, including endotamponade with gas, for a variety posterior segment pathologies. Postoperative complications requiring reoperation are uncommon.
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