Sutureless technique for repositioning and scleral fixation of the capsular bag – intraocular lens complex with permanent use of iris retractors

Objective To present the surgical outcome of posterior chamber intraocular lens scleral fixation using a 27-gauge trocar-assisted transconjunctival sutureless technique in aphakic patients due to cataract surgery complications with inadequate capsular support. Methods Six consecutive patients with aphakia due to cataract surgery complications with inadequate capsular bag support were operated by two surgeons. Intraocular lens scleral fixation was performed with a 27-gauge trocar-assisted transconjunctival sutureless technique. Patients were followed-up for 12 months. Preoperative and postoperative best-corrected visual acuities were assessed with Early Treatment Diabetic Retinopathy Study charts and expressed in decimals. Results All patients showed statistically significant best-corrected visual acuity improvement and excellent anatomic results. Mean preoperative best-corrected visual acuity was 0.17 (range of 0.1–0.2). Mean postoperative best-corrected visual acuity was 0.84 (range of 0.63–1.00). Mean initial spherical equivalent refractive error was +11.85 (range of +9.00 to +15.00). Mean final spherical equivalent refractive error was –0.25 (range of –1.25 to +2.25). There were no postoperative complications during the whole follow-up. Conclusion Fixation of a posterior chamber intraocular lens using a 27-gauge trocar-assisted transconjunctival sutureless intrascleral technique is an excellent option for aphakic patients secondary to cataract surgery complications with inadequate capsular support.

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Scleral fixation of a subluxated intraocular lens–capsular bag complex through a fibrotic continuous curvilinear capsulorhexis

Journal of Cataract & Refractive Surgery ◽

10.1016/j.jcrs.2011.02.002 ◽

2011 ◽

Vol 37 (4) ◽

pp. 629-632 ◽

Cited By ~ 8

Author(s):

Howard V. Gimbel ◽

Matthew Brucks ◽

Albena A. Dardzhikova ◽

Gerardo D. Camoriano

Keyword(s):

Intraocular Lens ◽

Scleral Fixation ◽

Capsular Bag

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Modified Flapless and Sutureless Technique of Scleral Fixation of Intraocular Lens in the Management of Dislocation of Crystalline Lens Following Closed Globe Injury

10.21203/rs.3.rs-230197/v1 ◽

2021 ◽

Author(s):

Naresh Babu Kannan ◽

Sagnik Sen ◽

Gauri Khare ◽

Obuli Ramachandran ◽

Kim Ramasamy

Keyword(s):

Intraocular Lens ◽

Demographic Data ◽

Crystalline Lens ◽

Modified Technique ◽

Prospective Longitudinal Study ◽

Scleral Fixation ◽

Sutureless Technique ◽

Pars Plana ◽

Prospective Longitudinal

Abstract Purpose To evaluate the outcomes of management of subluxation of lens following closed globe injury with a modified technique of scleral fixation of intraocular lens (SFIOL). Methods This prospective longitudinal study evaluated eyes with subluxation of crystalline lens which underwent combined pars plana vitrectomy (PPV), lensectomy (PPL) along with a sutureless and flapless technique of SFIOL implantation. We documented clinico-demographic data of all eyes at baseline and final anatomical and visual outcomes at 6 months after the surgery. Results We evaluated 113 eyes of 113 subjects with a mean age of 51.5 +- 15.7 years. 48.7% of eyes had a partial subluxation of lens from patellar fossa, while 51.3% of eyes had complete subluxation. After 6 months, the baseline visual acuity of 1.40 +- 0.66 logMAR (Snellen equivalent = 6/180) increased to 0.23 +- 0.27 (Snellen equivalent = 6/9) (p < 0.001). Eyes having VA < 6/36 reduced from 79.6% at baseline to 4.4% at final follow-up (p < 0.001). Eyes having VA > = 6/12 increased from 8.8–85.8% (p < 0.001). The proportion of eyes having raised intraocular pressure reduced from 20.4–1.8% at final follow-up (p < 0.001). The most common cause of subnormal visual gain was macular degeneration secondary to commotio retinae. Conclusion Subluxation of lens is a common entity faced by ophthalmologists across the world. Lensectomy with PPV and SFIOL is an effective method of refractive rehabilitation for subluxation eyes following closed globe injury. Visual prognosis may still depend upon the initial insult on the retina.

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The Effect of Scleral Sutured Intraocular Lens with Optic-haptic Junction Fixation in the Capsular Bag

Journal of the Korean Ophthalmological Society ◽

10.3341/jkos.2021.62.9.1172 ◽

2021 ◽

Vol 62 (9) ◽

pp. 1172-1180

Author(s):

Sun Young Lee ◽

Yang Kyung Cho

Keyword(s):

Anterior Chamber ◽

Intraocular Lens ◽

Anterior Chamber Depth ◽

Fixation Method ◽

Scleral Fixation ◽

Sulcus Fixation ◽

Refractive Change ◽

The Stability ◽

Target Refraction ◽

Capsular Bag

Purpose: To compare the stability of intraocular lens (IOL) insertion methods of sutured haptics in the bag with scleral fixation to those of in the bag insertion and scleral sulcus fixation. Methods: In group of only phacodonesis, two IOL insertion methods, in the bag insertion and sutured haptics in the bag with scleral fixation were compared. In group of phacodonesis with less than 90° zonulysis, two IOL insertion methods, sutured haptics in the bag with scleral fixation and scleral sulcus fixation were compared. Postoperative 2 months and 12 months refraction were compared with target refraction and the refractive change between postoperative 2 and 12 months were compared in each group. The change of anterior chamber depth (ACD) at postoperative 2 and 12 months were compared with preoperative ACD, and the change of ACD between postoperative 2 and 12 months were compared in each group. Results: In group of only phacodonesis, the typical in the bag insertion group showed significant ACD change between postoperative 2 and 12 months (p = 0.010), but the group of sutured haptics in the bag with scleral fixation didn’t show the significant ACD change (p = 0.515). In group of phacodonesis with less than 90° zonulysis, the sulcus scleral fixation method showed significant ACD change and significant refractive change (p = 0.015, p = 0.004), but the group of sutured haptics in the bag with scleral fixation method didn’t show the significant ACD nor refractive change (p = 0.713, p = 0.106) between postoperative 2 and 12 months. Conclusions: In eyes with zonular instability, sutured haptics in the bag with scleral fixation method can promote the postoperative stability of IOL.

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Visual Outcome After Sutureless Scleral Fixation of Intraocular Lens

Pakistan Journal of Ophthalmology ◽

10.36351/pjo.v37i1.1141 ◽

2020 ◽

Vol 37 (1) ◽

Author(s):

Muhammad Sajid Munir ◽

Muhammad Ramzan ◽

Muhammad Arshad ◽

Shahid Nazir ◽

Muhammad Rizwan Ullah

Keyword(s):

Intraocular Lens ◽

Case Series ◽

Visual Outcome ◽

Scleral Fixation ◽

Eye Trauma ◽

Complicated Cataract ◽

Safe Technique ◽

Male Patients ◽

Danlos Syndrome ◽

Capsular Bag

Purpose: To study the results of sutureless scleral fixation of intraocular lens (IOL) in cases of complicated cataract surgery. Study Design: Interventional case series. Place and Duration of Study: Niazi Medical and Dental College Sargodha from Jan 2018 to Dec 2019. Methods: Twenty-five eyes of 25 consecutive patients were selected for this study. Patients of traumatic cataract with zonular dehiscence, patients who had per-operative complications like PC rent with insufficient capsular bag, and children with subluxated lens of Marfan, Ehler Danlos syndrome were included in this study. After routine investigation all patients were operated under local anesthesia except children, who were operated under general anesthesia. Sclerotomies were made at 3 and 9 o’clock positions with MVR blade. Sutureless scleral fixation of intraocular lens was done. The haptics of lenses were buried in the scleral pockets which were already made at 3 and 9 o‘clock position. Post-operative antibiotics and steroids were given for 8 weeks and patients were followed up for two years. Results: Out of 25, 18 (72%) female patients and 7 (28%) male patients underwent surgery. Most of the patients had previous surgical complications of Posterior capsular rent 15 (60%). Four (16%) patients had eye trauma, three had lens subluxation for pseudo-exfoliation and 3 patients (children) were suffering from Marfan Syndrome. Seventy-two percent patients had visual acuity of more than 6/18, 16% had 6/18 to 6/24 and 12% had 6/24 to 6/60. Conclusion: Properly done suture-less scleral fixation is a safe technique with little chance of IOL dislocation. Key Words: Scleral fixation, Intraocular lens, Cataract.

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