Abstract
Purpose :
To evaluate the refractive results of the modified surgical implantation technique of intraocular acrylic posterior chamber lenses (IOL) with intrascleral fixation Carlevale IOL (FIL SSF, Soleko, Italy).
Methods :
71 patients (72 eyes) were included in this non-randomized retrospective study. Carlevale IOL implantation with intrascleral fixation was performed in all cases. In 29 patients (29 eyes) the standard implantation technique with scleral flaps was preformed (group 1), while in 42 patients (43 eyes) a modified "scleral pocket" technique was used (group2). Standard examinations were carried out after 1, 4, 8 weeks and after 12 months. The modified technique consisted of the formation of 2.5 x 2.5 mm "scleral pockets" of ½ the scleral depth, in the meridian of 3 and 9 o’clock with an opening away from the limbus. Next, sclerotomies were performed with a 23G trocar inside the pockets 1.5 mm from the limbus. Then, Carlevale IOL was implanted through a sclero-corneal tunnel, followed by fixation in the intrascleral space of the "scleral pockets". Postoperative mean refractive error was analyzed in both groups.
Results :
The mean follow-up time was 11.8 months (1-30 months). The mean age of the 71 patients (72 eyes) was 75.7 years (28-95 years). The mean refractive error in group 1 was 0.47 (-2.39 - +3.11), while in group 2 it was 0.021 (-2.64 - +1.98). The minimum dioptric power of the implanted Carlevale IOL was +9.0 D, the maximum +25.5 D. The mean axial length was 23.76 mm (21.55-25.92 mm). The complications of the early postoperative period included fluctuations in intraocular pressure (IOP): 11 patients with a history of glaucoma developed an intraocular hypertension (30 to 45 mmHg) and 1 patient developed a transient hypotension. Mild corneal edema was observed in 30 patients. There were no complications associated with Carlevale IOL implantation within 12 months follow-up period.
Conclusions :
The new technique makes it possible to minimize the manipulation on the sclera by simplifying access to the sclera, reducing operating time and postoperative rehabilitation through more reliable sealing of sclerotomies. In all cases the correct and centered position of the IOL was achieved. The IOP fluctuation remains one of the most common complications in the postoperative period.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.