Abstract
Purpose :
Surgical techniques vary significantly for Gortex sutured intraocular lenses (IOL) and fibrin-glued IOLs and the type of lens is often chosen based on surgeon preference. However, the sutured vs glued IOLs have 4 points vs 2 points of fixation, respectively, which may result in different positioning and stability of the IOL. The purpose of this retrospective chart review is to analyze the long-term stability of these IOL implantation techniques and their impact on best corrected visual acuity (BCVA), IOL tilt, and adverse events.
Methods :
This study examines 63 patients over a 2-year follow up period at the University of Florida from 1/1/2011 to 5/1/2020. Patients were included if they were implanted with a Gortex sutured B&L Akreos A060 or Alcon CZ70BD (with cow-hitch technique) or Alcon MA60AC fibrin-glued IOL. Patients were excluded if they had concurrent macular pathology, required a second surgery for any reason, or had less than one month follow up. The primary outcomes measured were BCVA, IOL tilt, as measured by change in cylinder on refraction over time, and adverse events, as listed in Table 1.
Generalized estimating equations and Wald Chi-squared test were used to compare logMAR VA between sutured and glued IOLs. An independent t-test was used to analyze lens tilt. A Chi-squared test was used to analyze the difference in adverse events measured as categorical variables.
Results :
There was no significant difference in BCVA between the Gortex sutured (M=0.73, 95% CI 0.59 – 0.87) and fibrin glued IOLs (M=0.74, 95% CI 0.55 – 0.93) with the Wald X2 = 0.01 and p=0.94. With “M” being marginal means of logMAR where 0.73 and 0.74 are equivalent to the Snellen values of 20/107.4 and 20/109.9, respectively. There was also no significant difference in IOL tilt between the Gortex 4-point and glued 2-point fixated IOLs (mean=0.409, 95% CI -1.08 – 2.63, p=0.225), nor significant differences in adverse events (Table 1).
Conclusions :
There was no significant difference in BCVA, IOL tilt, or adverse events between our studied IOLs. With a 2 year-follow up period, this study has the longest observational study to the authors’ knowledge. Clinically, this provides evidence that a surgeon may implant their preferred choice of studied IOL.
This is a 2021 ARVO Annual Meeting abstract.