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M. Chakrabarti, A. J. Singh, A. K. Tyagi; A Study of Indications, Complications and Short Term Visual Outcome of Scleral Sutured Intra Ocular Lens Implants (SSIOL). Invest. Ophthalmol. Vis. Sci. 2007;48(13):5431.
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To investigate the short-term visual outcome and complication rate of Scleral sutured Intra ocular lens implants. The study also sought to find any significant association of the sutured implants.
A retrospective descriptive case-series of patients with SSIOL by a single surgeon over five years was carried out by the department for Vitreoretinal Surgery, Birmingham and Midland Eye Centre. Birmingham, United Kingdom, A University of Birmingham undertaking, tertiary level Teaching hospital, NHS, UK. Implantation of SSIOL was done by suturing the implant haptics with 8/0 prolene sutures and implanted via a 6.5mm stepped clear corneal incision. The haptics were sutured by passing the needle through the corneal incision and then posterior to the iris; exiting through the pars plana 2 mm posterior to the limbus. The suture knots were covered with a preformed half thickness scleral flap. Records of patients with a minimum of three months follow-up were analysed on a standardised Microsoft excel Proforma for visual outcome and recorded postoperative complications.
Twenty three eyes of 22 patients were included. Seventeen cases had additional procedures depending on pre operative ocular pathology. The mean final postoperative best-corrected visual acuity was better than or equal to the preoperative acuity in 21, but had decreased in 2 cases. No suture or implant related complications were noted except for mild decentration in 2 cases (8.7%).The major recorded complications were post-operative OCT confirmed cystoid macular oedema (21.7%) which resolved with topical steroid treatment and transient rise of Iintra ocular pressure (17.4%). Other recorded complications included iris trauma (4.35%) and intra operative retinal breaks (8.7%) (treated with laser or cryotherapy).
Ninety two percent of cases had favourable visual and anatomical outcome at 3 months. However, in our study there was an unexpectedly high incidence of cystoid macular oedema. We propose that use of Intravitreal Triamcinolone be considered as an adjunct to this type of surgery. A randomised controlled study will be needed to confirm this.
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