Abstract
Purpose :
To report the analysis of clinical outcomes and postoperative complications of a new technique for performing sutureless intrascleral fixation of a posterior chamber intraocular lens (PCIOL).
Methods :
After 27G pars plana vitrectomy and the dislocated lens or artificial lens has been removed, a 3 mm sclerocorneal incision and two precisely 180 ° apart bilateral scleral dissections of 2 mm in length and about 0.5mm thickness were made 2 mm from the limbus. And at the tip of the left incision and bottom of the right incision, two sclera punctures were made.
After a 3-piece folded PCIOL implanted, two haptics was taken out through the sclera punctures by 27G intraocular forceps. Two 2.5-mm counterclockwise scleral tunnels were prepared by a 29G×1/2″needle from the sclera punctures parallel to the limbus. Finally both haptics were pulled into the scleral tunnel, and the IOL position was centered.
67 eyes of 67 patients who received the technique above were studied. The best-corrected visual acuity (BCVA), intraocular pressure (IOP), PCIOL tilt，PCIOL decentration and postoperative complications were determined.
Results :
Mean preoperative BCVA was 1.63 ± 1.24 logMAR units, and mean postoperative BCVA was 0.74 ± 0.59 logMAR units at 3 months (P=0.001). Mean preoperative IOP was 21.9 ± 12.6 mmHg, and mean postoperative IOP was 16.9 ± 4.5 mmHg at 3 months (P=0.001). Mean IOL tilt was 2.4 ± 1.7° and decentration was 0.35 ± 0.21 mm. There was no postoperative retinal detachment, endophthalmitis or PCIOL dislocation detected during the follow-up period. There were transient IOP rise (4.5%), hyphema (3.0%), vitreous hemorrhage (1.5%), macular edema (1.5%), haptic exposure (3.0%) and pupillary capture (4.5%) detected during the follow-up period.
Conclusions :
The 27-gauge sutureless intrascleral PCIOL implantation technique with 29G×1/2″ needle minimizes intraoperative injury, simplifies fixation and provides good posterior chamber IOL fixation with few postoperative complications without the use of sutures.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.