Abstract
Purpose: :
Aphakia management is still an ongoing topic due to the lack of consensus: some surgeons prefer to perform an anterior chamber implantation while others prefer posterior chamber implantation.Despite rather frequent retina complications, it seems more « physiological » to use posterior chamber implantation in order to limit the corneal complications caused by anterior chamber intraocular lens.This survey intends to assess both visual outcomes and the occurrence of complications after iris-sutured posterior chamber intraocular lens.
Methods: :
Monocentric retrospective study of 76 eyes (65 patients) between 2005 and 2010.The survey included patients operated upon with the modified McCannel technique, and whose initial surgical treatment took place a minimum 12 months prior.The patients were divided into 5 groups according to the operative indication, 2 groups according to operative procedure and 2 groups according to the axial eye length. Visual acuity, refraction, as well as the occurrence of various post-operative complications such as retinal detachment (RD), vitreous haemorrhage (VH), macular edema (ME), luxation and intraocular pressure (IOP) were all evaluated.
Results: :
The final mean visual acuity was 67 letters and 75% of the patients’ visual acuity became better or equal to the initial. Ectopia lentis is associated with a better visual recovery (final visual acuity of 75 letters, visual acuity superior to 70 letters for 88% of the subjects) and with a higher risk of secondary luxation of the suture-fixated implant (p<0,01) but without affecting the final visual acuity. The obtained results were RD=2%, luxation=6%, ME=6%, VH=8% and elevated IOP=10%. The occurrence of complications is neither related to the operative procedure nor to the axial eye length. The refraction is not related to the operative indication.
Conclusions: :
Iris sutured posterior chamber intraocular lens not only offers visual outcomes as good as those obtained with other techniques but it also minimizes side effects with low complication rate. The conclusion of the survey shows that it is a first-rate technique in the aphakia management.