Abstract
Purpose :
To evaluate the clinical outcomes and safety profile of secondary intraocular lens (IOL) implantation surgery using a scleral fixated Akreos AO60 IOL (Bausch + Lomb) with Gore-Tex suture in a patient population with ectopia lentis.
Methods :
A retrospective study of consecutive patients undergoing secondary IOL implantation surgery with scleral fixation of an Akreos AO60 using Gore-Tex suture at CUIMC by a single surgeon (RWC) between April 2016 and November 2022. The primary outcome measure was the occurrence of postoperative complications with a minimum follow-up of 30 days. We also evaluated visual acuity outcomes in surgical patients with and without glaucoma.
Results :
8 eyes in 4 patients (1 male, 3 female) aged between 23 and 51 years old were included in the study. All patients had hereditary ectopia lentis, while one patient had diagnostically confirmed Marfan Syndrome. One patient had pre-existing glaucoma in both eyes, and another patient had bilateral lens extraction in childhood. There were no cases of prior retinal pathology or previous posterior segment surgery. Indications for surgery included subluxated crystalline lens (75%, 6 eyes) and aphakia without capsular support following lens extraction (25%, 2 eyes). All eyes had pars plana vitrectomy performed concurrently. Mean intraocular pressure (IOP) was 11.75 mm Hg (range 2-27 mm Hg) on postoperative day (POD) one, 13.88 mm Hg (range 4-20) on postoperative week (POW) one, and 14.86 mm Hg (range 7-23) on postoperative month (POM) one. There was transient hypotony (IOP <7 mm Hg) that resolved within one month in 2 eyes (25%) and ocular hypertension (IOP>21 mm Hg) at POM one in 1 eye (12.5%). Two eyes of one patient with glaucoma developed cystoid macular edema at 6-12 months after surgery. There were no cases of postoperative suture erosion, retinal detachment, vitreous hemorrhage, lens tilt or dislocation, lens opacification, or endophthalmitis. Mean best corrected visual acuity three months after surgery was 0.09698 logMAR (range 0-0.301). After excluding eyes with glaucoma, mean best corrected visual acuity three months after surgery was 0.06165 logMAR (range 0-0.1761, 6 eyes).
Conclusions :
Secondary IOL implantation with a scleral fixated Akreos AO60 IOL using Gore-Tex suture is a safe and reproducible procedure that is generally well-tolerated in eyes with ectopia lentis.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.