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Glenn J Oh, Raziyeh Mahmoudzadeh, Samir N Patel, Thomas Tien, Brandon D Ayres, Brenton D Finklea, M. Ali Ali Khan; Outcomes of combined pars plana vitrectomy and scleral fixation of intraocular lenses: comparison of Gore-Tex suture versus intrascleral haptic fixation (Yamane) techniques. Invest. Ophthalmol. Vis. Sci. 2022;63(7):1695 – F0013.
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This study compared clinical outcomes of combined pars plana vitrectomy (PPV) and secondary scleral fixation of an intraocular lens (IOL) using Gore-Tex suture versus the Yamane technique.
This study was a single-center, retrospective, consecutive case series conducted at Wills Eye Hospital (Philadelphia, PA, USA) between 12/01/2017 and 12/01/2021. Eyes that underwent scleral fixation of a Bausch and Lomb Akreos AO70 or enVista MX60E IOL using Gore-Tex suture or a Tecnis ZA9003 or Zeiss CT LUCIA 602 IOL using the Yamane technique were included. Primary outcome measures were change in visual acuity (VA) and occurrence of intraoperative and postoperative complications with minimum follow-up of 120 days.
Sixty-eight eyes of 64 patients (47% male, mean(± SD) age 72(±12) years) with the main surgical indication of dislocated IOL or retained lens material were included. Mean follow-up was 501 days (median 366 days, range 132-1254 days). Fifty-two eyes (76.5%) underwent Gore-Tex suture fixation and 16 eyes (23.5%) underwent Yamane fixation. Across all eyes, VA improved from 1.34±0.74 (20/437) preoperatively to 0.36±0.37 (20/46) at 3 months and 0.32±0.36 (20/42) at final follow-up (p<0.001 for both timepoints). VA improved in statistically significant fashion for each secondary IOL technique (Table 1). No intraoperative complications were noted. Postoperative complications are included in Table 2, and there was no statistically significant difference between groups. In the Gore-Tex group, 2/52 eyes (3.8%) required reoperation for conjunctival erosion with exposed suture (n=1) and for IOL decentration (n=1). In the Yamane group, 2/16 (12.5%) eyes required reoperation for epiretinal membrane formation (n=1) and for retinal detachment (n=1). There were no cases of postoperative endophthalmitis, suture breakage, or haptic breakage in the post-operative follow-up period.
Scleral fixation of IOLs with Gore-Tex suture and intrascleral haptic fixation (Yamane technique) resulted in improvement of VA. No significant difference in post-operative complication profiles was noted. Both techniques appear to be safe and effective for secondary IOL surgery in combination with PPV.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.
Table 1: Average Visual Acuity at Preoperative, 3-Month Postoperative, and Final Visit
Table 2: Postoperative Complications
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