June 2023
Volume 64, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2023
Intraocular lens (IOL) implantation in the absence of zonular support
Author Affiliations & Notes
  • Hannah Phuong Uyen Ngo
    Ophthalmology, Mayo Clinic in Arizona, Scottsdale, Arizona, United States
  • Odette Houghton
    Ophthalmology, Mayo Clinic in Arizona, Scottsdale, Arizona, United States
  • Dharmendra (Dave) Patel
    Ophthalmology, Mayo Clinic in Arizona, Scottsdale, Arizona, United States
  • Eric Kawulok
    Ophthalmology, Mayo Clinic in Arizona, Scottsdale, Arizona, United States
  • Joanne F Shen
    Ophthalmology, Mayo Clinic in Arizona, Scottsdale, Arizona, United States
  • Footnotes
    Commercial Relationships   Hannah Ngo None; Odette Houghton None; Dharmendra (Dave) Patel None; Eric Kawulok None; Joanne Shen None
  • Footnotes
    Support  Mayo Clinic Department of Ophthalmology Research Funds
Investigative Ophthalmology & Visual Science June 2023, Vol.64, 3319. doi:
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    • Get Citation

      Hannah Phuong Uyen Ngo, Odette Houghton, Dharmendra (Dave) Patel, Eric Kawulok, Joanne F Shen; Intraocular lens (IOL) implantation in the absence of zonular support. Invest. Ophthalmol. Vis. Sci. 2023;64(8):3319.

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

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Abstract

Purpose : IOL fixation in patients without full capsular support is a surgical challenge. A retrospective chart review was performed to analyze the efficacy and safety of postoperative outcomes of IOL implantation techniques for these patients.

Methods : IRB-approved retrospective chart review for all 62 patients seen in the Mayo Clinic Arizona Department of Ophthalmology from 6/28/2017 to 6/28/2022 with an ICD-10 code for subluxation of lens, which resulted in 20 patients who received surgical treatment. Demographics, predisposing factors to complications, length of follow-up, type of surgery, visual acuity (VA), and complications were recorded.

Results : Four surgical techniques were evaluated: CV-8 polytetrafluoroethylene scleral-sutured PCIOL, intrascleral haptic fixation (ISHF), 10-0 polypropylene iris-sutured PCIOL, and anterior chamber IOL (ACIOL). Eleven received CV-8 scleral-sutured PCIOL, 5 received ISHF PCIOL, 2 received iris-sutured PCIOL, and 2 received ACIOL. For CV-8 scleral-sutured PCIOL, mean length of follow-up was 19 months, mean base VA was 20/90, and mean 6-month VA was 20/40. Complications included suture exposure in 2 patients associated with scleral lens wear requiring further surgery. For ISHF PCIOL, mean length of follow-up was 35 months, mean base VA was 20/4000, and mean 6-month VA was 20/80. Complications included haptic migration to subconjunctival space and IOL tilt. For iris-sutured PCIOL, mean length of follow-up was 34 months, mean base VA was 20/40, and mean 6-month VA was 20/30. Partial capsular sulcus support was present. No significant complications were noted. For ACIOL, mean length of follow-up was 25 months, mean base VA was 20/40, and mean 6-month VA was 20/65. No significant complications were noted. Lastly, no expulsive choroidal hemorrhage, endophthalmitis, or retinal detachment was noted in any of the 4 groups.

Conclusions : Non-ACIOL patients had improved VA. More invasive procedures CV-8 scleral-sutured PCIOL and ISHF PCIOL developed the most significant complications. Post-operative monitoring for suture and haptic exposure is critical. Iris fixation of a 3-piece PCIOL may be an option for patients with partial sulcus capsular support using existing PCIOL. Having multiple surgical methods available allows treatment to be tailored to individual patient factors.

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

 

Table: Outcomes, Complications, and Predisposing Factors

Table: Outcomes, Complications, and Predisposing Factors

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