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Ashwinee Ragam, Julia Padiyedathu, Emily Waisbren, Yijie Lin, Kevin Lai, John Seedor, David Ritterband; A comparison of outcomes after scleral-sutured versus scleral-glued intraocular lens insertion.. Invest. Ophthalmol. Vis. Sci. 2016;57(12):1295.
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© ARVO (1962-2015); The Authors (2016-present)
To compare the visual outcomes and complications following scleral-sutured and scleral-glued intraocular lens (IOL) insertion in eyes with inadequate capsular support or abnormal iris architecture.
A retrospective chart review of all patients undergoing scleral-fixated IOL insertion using either 10-0 prolene sutures (scleral-sutured) or fibrin glue (scleral-glued) between 2002 and 2015 with a minimum of 3 months postoperative follow-up was conducted. Preoperative data recorded included patient age, gender, indications for surgery, and other ocular comorbidities. Operative data collected included fixation technique, additional operative procedures, and intraoperative complications. Postoperative data collected included best-corrected visual acuity (BCVA), IOL-related complications, additional ocular problems unrelated to the IOL, and manifest refraction. Data were analyzed using two-tailed Fischer’s exact tests with statistical significance accepted at p < 0.05.
105 eyes (48 scleral-sutured and 57 scleral-glued) of 103 patients (48% female) were included. The average age at time of surgery was 66.5 years for scleral-sutured and 70.6 years for scleral-glued patients. The mean ± standard deviation follow-up time was 34.9 ± 31.4 months for scleral-sutured and 12.7 ± 8.4 months for scleral-glued eyes. Final BCVA was equal to or improved from pre-operative measurements in 35/48 (73%) scleral-sutured and 51/57 (89%) scleral-glued eyes (p=0.04). Final BCVA was 20/40 or better in 9/48 (19%) scleral-sutured and 26/57 (46%) scleral-glued eyes (p=0.004). Postoperative complications through final follow-up included optic capture (1 sutured, 7 glued, p=0.07), IOL subluxation (3 sutured, 3 glued, p=1.00), and haptic exposure (1 sutured, 3 glued, p=0.62). Postoperative complications through the first postoperative year only included anterior chamber inflammation (1 sutured, 6 glued, p=0.12), vitreous hemorrhage (5 sutured, 8 glued, p=0.77), cystoid macular edema (4 sutured, 3 glued, p=0.70), and elevated intraocular pressure (26 sutured, 23 glued, p=0.17).
In our study, scleral-glued IOLs more frequently led to improved visual outcomes than scleral-sutured IOLs. There was no significant difference in postoperative complications between the subgroups.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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