Abstract
Purpose::
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.
Methods::
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.
Results::
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).
Conclusions::
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.
Keywords: intraocular lens • vitreoretinal surgery • treatment outcomes of cataract surgery