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Nathan Farley, Elizabeth Marlow, Mavis Gappy, Hamzeh Omar, Jeremy Wolfe; Sutureless Intrascleral Fixation of Intraocular Lenses: Three-Year Clinical Outcome Review. Invest. Ophthalmol. Vis. Sci. 2019;60(9):476.
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© ARVO (1962-2015); The Authors (2016-present)
To report three year clinical outcomes on suturelss intrascleral intraocular lens surgery.
A retrospective chart review of ninety-seven sutureless intrascleral implant surgeries resulted in thirty-one cases that satisfied criteria. Prior to implantation of the three-piece intraocular lens all patients underwent a pars plana vitrectomy. Post-surgical data assessed included: visual acuity, automatic refraction, intraocular pressure spike greater than 24mmHg, intraocular pressure less than 4mmHg, vitreous hemorrhage, haptic erosion, haptic dislocation, intraocular lens dislocation and tilt, pupillary-haptic capture, corneal edema, macular edema and endophthalmitis. Visual acuity was converted to Log MAR from Snellen.
Thirty-one surgical cases were reviewed, (15 males and 16 females, average age was 71 years old, 16 right eyes and 15 left eyes). The average follow up was 49.4 months (37.3 - 75.5 months). Post-operative visual acuity measurements demonstrated improvement and were maintained at most recent follow up, visual acuity of 20/32 (LogMAR = 0.2). The most common post-operative complications were corneal edema (10/31, all resolved without surgical intervention), vitreous hemorrhage (8/31, 2 recurrent), macular edema and exacerbation of diabetic macular edema (7/31) and IOL dislocation-tilt (6/31). No episodes of endophthalmitis nor hypotony.
Our review demonstrates maintained visual acuity at greater than 36 months. Of the more common complications, vitreous hemorrhage and corneal edema were found to be self-limited and resolved in all but one case. Sutureless intrascleral fixation of lenses can be an effective and safe technique to fixate dislocated three piece intraocular lenses or in cases with insufficient capsule support.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.
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