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Ching J. Chen, James Shipp, Alan Penman, Zachary Robertson, Cassie Nabors, Suzanne Hoadley; Surgical Outcomes of Small Incision Scleral Sutured Foldable Posterior Chamber Intraocular Lens Implant. Invest. Ophthalmol. Vis. Sci. 2011;52(14):6195.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate the results of scleral sutured posterior chamber lens implantation (SSPCIOL) following pars plana vitrectomy (PPV) performed by a single surgeon (CJC) from April 2000 to May 2010.
This was a retrospective chart review of 285 patients (301 eyes). Conditions evaluated for each patient included preoperative and postoperative visual acuities, preoperative diagnosis, and surgical and postoperative complications. Postoperative final best-corrected visual acuity (BCVA) was compared in two groups of patients with (group 1, 107 eyes) and without (group 2, 194 eyes) preexisting conditions that limited VA. In addition, complication rates were compared between patients receiving lens fixation at 1.7mm (55 eyes) and those with fixation at 1.5mm (246 eyes) posterior to the limbus.
The age range of the study sample was 1-93 years with a mean of 56.6 years. Overall, visual acuity improved in 222 eyes (75.5%) and worsened in 36 eyes (12.2%). In group 1, logMAR visual acuity improved from 1.8 to 1.15 (P<.0001). In group 2, logMAR visual acuity improved from 1.17 to 0.40 (P<.0001). Adjustment for group differences in preoperative visual acuities resulted in final logMAR BCVA of .91 and .41 in groups 1 and 2, respectively. A total of 83 postoperative complications were reported for all eyes, including 35 with vitreous hemorrhage, 13 with retinal detachment, 7 with pupillary capture, and 4 with dislocated lens implant. In the 1.7mm group, compared to the 1.5mm group, the frequencies of vitreous hemorrhage (3.6% vs. 13.4%, P=0.04) and any complication (18.2% vs. 29.7%, P=0.08) were reduced.
PPV and small-incision SSPCIOL with foldable lens implantation provided good visual outcomes for a vast patient population. Despite the condition of operative eyes, BCVA is improved in most patients while allowing for lens position at the natural nodal point of the eye. Potential complications could be minimized with a minor posterior adjustment in scleral fixation point.
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