Abstract
Purpose: :
To report the results and safety of a sutureless technique of transcleral lens implantation in traumatized aphakic eyes with severely damaged iris and capsular support.
Methods: :
Patients presenting a traumatic cataract with severely damaged capsular bag and iridodialysis preventing a bag, sulcus, or iris-claw lens implantation were included. Lens extraction was performed with an immediate or delayed sutureless, transcleral three-piece acrylic intraocular lens implantation. Each patient underwent periodical measurement of best corrected visual acuity (BCVA), keratometry, biomicroscopy, fundus examination, and intraocular pressure measurement together with a spectral OCT imaging of the macula at 1,3, 6, and 12 months. The main outcome was the final visual acuity. Rate and type of complications were also reported. The induced astigmatism was calculated by the vectorial method. Wilcoxon matched-pairs signed-ranks test was used for the statistical analysis.
Results: :
A total of 8 patients were studied. The mean follow-up was 7.7 months (from 6 to 16 months). Mean BCVA (logMAR) was 1.67±0.15 before the surgery vs 0.55±0.9 after (p=0.03).Visual acuity improved in all eyes but two which displayed vision threatening conditions not related to the surgery (i.e., AMD, corneal edema). Surgically induced astigmatism was 2±1.8 D. There were no intra-operative complications. During the follow-up, three eyes displayed resolutive cystoid macular edemas.
Conclusions: :
This surgical procedure corected the aphakic state and restored a satisfying visual acuity. The induced corneal astigmatism was acceptable and the procedure appeared to be safe. It should be considered after severe trauma when other techniques of implantation are not possible.
Keywords: trauma • cataract • intraocular lens