June 2023
Volume 64, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2023
Axial Instability of The Zeiss CT Lucia 602 Intraocular Lens with Transconjunctival Intrascleral Haptic Fixation
Author Affiliations & Notes
  • Dipen Kumar
    Ophthalmology, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States
  • Jeffrey Tan
    Retina-Vitreous Associates Medical Group, Los Angeles, California, United States
  • Yingna Liu
    Ophthalmology, Tufts New England Medical Center/Ophthalmic Consultants of Boston, Massachusetts, United States
  • Chirag Shah
    Ophthalmology, Tufts New England Medical Center/Ophthalmic Consultants of Boston, Massachusetts, United States
  • Inna Stroh
    Consulting Ophthalmologists PC, Farmington, Connecticut, United States
  • Neepa Shah
    Kaiser Permanente Riverside Medical Center, Riverside, California, United States
  • Edward H. Wood
    Austin Retina Associates, Austin, Texas, United States
  • Amy Yuan
    Pacific Northwest Retina, Washington, United States
  • Rishi Gupta
    Ophthalmology and Visual Sciences, Dalhousie University, Halifax, Nova Scotia, Canada
  • Zachary Kroeger
    Ophthalmology, Oregon Health & Science University Casey Eye Institute, Portland, Oregon, United States
  • Merina Thomas
    Ophthalmology, Oregon Health & Science University Casey Eye Institute, Portland, Oregon, United States
  • David Ehmann
    Alberta Retina Consultants, Alberta, Canada
  • Murtaza K Adam
    Colorado Retina Associates/Retina Consultants of America, Colorado, United States
    Rocky Vista University, Parker, Colorado, United States
  • Alice Zhang
    Ophthalmology, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States
  • Footnotes
    Commercial Relationships   Dipen Kumar None; Jeffrey Tan None; Yingna Liu None; Chirag Shah None; Inna Stroh None; Neepa Shah None; Edward Wood None; Amy Yuan None; Rishi Gupta None; Zachary Kroeger None; Merina Thomas None; David Ehmann None; Murtaza Adam None; Alice Zhang None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2023, Vol.64, 5270. doi:
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      Dipen Kumar, Jeffrey Tan, Yingna Liu, Chirag Shah, Inna Stroh, Neepa Shah, Edward H. Wood, Amy Yuan, Rishi Gupta, Zachary Kroeger, Merina Thomas, David Ehmann, Murtaza K Adam, Alice Zhang; Axial Instability of The Zeiss CT Lucia 602 Intraocular Lens with Transconjunctival Intrascleral Haptic Fixation. Invest. Ophthalmol. Vis. Sci. 2023;64(8):5270.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : To report clinical features, management, and visual outcomes following observed lens tilt of the Zeiss CT Lucia 602 intraocular lens (IOL) with intrascleral haptic fixation (ISHF).

Methods : A retrospective, multi-center, observational case series of patients who underwent ISHF with the CT Lucia 602 IOL was performed between May 2021 and October 2022. Haptic fixation was achieved via thermal cautery to create terminal haptic flanges. Surgical indication, technique for haptic externalization (needle-assisted versus trocar-assisted), need for vitrectomy, visual acuity, timeline for observed IOL tilt, estimated degree of tilt from iris plane, status of the haptic-optic junction, axial length, and white-to-white measurements were analyzed.

Results : A total of 24 cases (mean age 70.40 ± 16.94 years) of 21 eyes were included with 6 cases of intraoperative tilt and 18 cases of postoperative tilt. The mean angle of IOL tilt was 66.2 ± 26.7 degrees. Mean axial length was 24.3 ± 1.31 mm and mean white-to-white was 12.1 ± 0.4 mm respectively. In 6 cases, the IOLs had a normal haptic optic junction. In 16 cases, the haptic was either separated from the optic (N=3), warped immediately proximal to the optic junction (N=7), or rotated within the junction (N=6). Of the 18 cases of postoperative tilt, 15 cases were noted on postoperative day 1 (POD1), 2 cases were noted on postoperative week 1 (POW1) and 1 case was noted postoperative 1 month (POM1). Among the cases with intraoperative tilt, a new CT Lucia lens was placed (N=3), refixation was done using the same lens (N=1), an Akreos lens was sutured (N=1), the eye was left aphakic (N=1) or the haptic ends were sutured to the sclera to correct observed tilt (N=1). Among the cases that required re-operation, 12 lenses were explanted and replaced with a new Zeiss CT Lucia 602 (N=4), a different 3-piece IOL (N=4), an Akreos lens using Goretex sutures (N=3), or an anterior chamber lens (N=1). During the follow-up period (93.0 ± 84.7 days, range 8 – 375 days), mean preoperative best-corrected logMAR visual acuity for all patients improved from 1.40 ± 0.82 to 0.57 ± 0.69 at the most recent follow-up visit (P<0.05).

Conclusions : The Zeiss CT Lucia 602 IOL can be associated with significant intraoperative or postoperative tilt with ISHF. Further studies are needed to understand the mechanisms and risk factors contributing to this complication.

This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.

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