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R. P. Singh, C. Sonnie, D. Moshfeghi, P. K. Kaiser, J. E. Sears; Long-Term Outcomes of Scleral Sutured Posterior Chamber Lens Implantation versus Anterior Chamber Intraocular Lens Implantation for Aphakia. Invest. Ophthalmol. Vis. Sci. 2008;49(13):5991.
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To compare the long-term safety and efficacy outcomes of scleral sutured posterior chamber lens implantations (SSIOL) versus anterior chamber lens (ACIOL) implantation.
A comparative, retrospective evaluation was performed and patients were selected who underwent SSIOL or ACIOL from 1998-2004 for various indications with a minimum of 3 years follow-up. All cases had either a CZ70BD lens (Alcon) or a MTA3UO (Alcon) lens implanted.
A total of 53 eyes of 48 patients with SSIOL and 50 eyes of 49 patients with ACIOL implantation had appropriate follow-up and documentation. The average age of study subjects was 52 years (+/- 17.70) and the mean duration of follow-up was 69.3 months (+/- 18.45 months). The indications for surgery included cataract surgery complications (48.6%), traumatic zonular dehiscence (17.1%), vitreoretinal surgery rendered aphakia (8.6%), non-traumatic zonular dehiscence (8.5%), congenital dislocation (5.7%). Preoperative LogMar acuity for SSIOL was 0.42 and postoperative LogMar acuity was 0.33 (P=0.74). Preoperative LogMar acuity for ACIOL was 0.43 and posteroperative LogMar acuity was 0.36 (p=0.981). Postoperative spherical equivalent in the SSIOL group and ACIOL group were -1.19D (+/- 2.10) and -0.58 (+/- 0.99), respectively (p=0.232). Cylindrical astigmatism in the SIOL group changed from 0.87D (+/-1.10D) preoperatively to 1.63D (+/- 1.75D) postoperatively (p=0.623). There was no statistical significance between the astigmatism seen in the ACIOL and SSIOL groups (p=0.056). Complications included: transient vitreous hemorrhage (11.4%), epiretinal membrane formation (5.7%), high astigmatism (8.6%), dislocation of lens due to suture dehiscence (2.8%), cystoid edema (5.7%), and the development of glaucoma (2.8%).
SSIOL had equivalent efficacy outcomes to ACIOL cases and exhibited a low side effect profile with long term follow-up and should be considered in patients unsuitable for ACIOL implantation.
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