scholarly journals A Modified Intrascleral Intraocular Lens Fixation Technique Using 27-Gauge Blunted Needles with Fewer Intraocular Manipulations

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Kazuya Morino ◽  
Yuto Iida ◽  
Masayuki Akimoto
Keyword(s):  
Retrospective Study ◽  
Intraocular Lens ◽  
New Method ◽  
Fixation Technique ◽  
Scleral Flap ◽  
Operation Room ◽  
Scleral Tunnel ◽  
Iol Fixation ◽  
Sclerotomy Site

A new method for intraocular lens (IOL) fixation in the scleral tunnel using two common 27G blunted needles and an ultrathin 30G needle with fewer intraocular manipulations was developed. Half-depth scleral flaps were prepared, and vertically angled sclerotomies were performed under each scleral flap, 2 mm from the limbs with a 20G microblade or a 26G needle. Two bent 27G blunted needles connected the sclerotomy and corneoscleral incisions. One haptic was inserted into this bent 27G blunted needle extraocularly and extruded through the sclerotomy site. Each haptic was inserted into the lumen of the preplaced ultrathin 30G needle and buried into the scleral tunnel. In this retrospective study, we reviewed the outcomes of this new technique in patients with at least 3 months’ follow-up data. Iris capture of the IOL was not observed in any case, and IOL repositioning was not performed either. Astigmatism induced by intraocular aberration was almost as same as that with other methods. Our technique can be performed in any operation room without any extra instruments. This trial is registered with UMIN000044350.

scholarly journals A modified intrascleral intraocular lens fixation technique with fewer anterior segment manipulations: 27-gauge needle-guided procedure with built-in 8-0 absorbable sutures

2019 ◽  
Author(s):  
Yuan Yang ◽  
Tengteng Yao ◽  
Yali Zhou ◽  
Yixiao Wang ◽  
Zhaoyang Wang
Keyword(s):  
Visual Acuity ◽  
Intraocular Lens ◽  
Anterior Segment ◽  
Vitreous Hemorrhage ◽  
Fixation Technique ◽  
Absorbable Sutures ◽  
Corneal Endothelial Cell Density ◽  
Support Methods ◽  
Iol Fixation

Abstract Background: To report a modified surgical technique for intrascleral intraocular lens (IOL) fixation with fewer anterior segment manipulations in eyes lacking sufficient capsular support. Methods: Eyes from 14 patients who underwent 27-gauge needle-guided intrascleral IOL fixation with built-in 8-0 absorbable sutures were studied. The 8-0 absorbable sutures were inserted into 27-gauge round needles and used to create sclerotomies at the 4 o’clock and 10 o’clock positions under the scleral flap. The sutures were used to tie knots at the end of each haptic and guide haptic externalization through the sclerotomy. After externalization, a sufficient flange was created at the end of each haptic and fixed under the scleral flaps. The best corrected visual acuity (BCVA), corneal endothelial cell density (ECD), IOL tilt and decentration, previous surgery history, and complications were determined. Results: Fourteen cases were analyzed. The majority of eyes exhibited an improvement in the BCVA after surgery. When comparing the last follow-up to preoperative visual acuity, the mean change in BCVA was + 26.32 letters (p=0.011). Postoperative complications included postoperative hypotony in 3 eyes, ocular hypertension in 2 eyes. No cases of postoperative cystoid macular edema (CME), vitreous hemorrhage (VH), IOL dislocation, or endophthalmitis were observed. Conclusions: The 27-gauge needle-guided intrascleral IOL fixation technique with built-in 8-0 absorbable sutures is easy to perform with fewer anterior chamber manipulations and achieves both anatomical and optical stability.

scholarly journals A modified intrascleral intraocular lens fixation technique with fewer anterior segment manipulations: 27-gauge needle-guided procedure with built-in 8-0 absorbable sutures

2019 ◽  
Author(s):  
Yuan Yang ◽  
Tengteng Yao ◽  
Yali Zhou ◽  
Yixiao Wang ◽  
Zhaoyang Wang
Keyword(s):  
Visual Acuity ◽  
Intraocular Lens ◽  
Anterior Segment ◽  
Vitreous Hemorrhage ◽  
Fixation Technique ◽  
Absorbable Sutures ◽  
Support Methods ◽  
Iol Fixation ◽  
Iol Dislocation

Abstract Background To report a modified surgical technique for intrascleral intraocular lens (IOL) fixation with fewer anterior segment manipulations in eyes lacking sufficient capsule support. Methods Eyes from 14 patients who underwent 27-gauge needle-guided intrascleral IOL fixation with built-in 8-0 absorbable sutures were studied. The 8-0 absorbable sutures were inserted into 27-gauge round needles and used to create angled sclerotomies at the 4 o’clock and 10 o’clock positions under the scleral flap. The sutures were used to tie knots at the ends of the haptics and guide haptic externalization through sclerotomy. After externalization, a sufficient flange was created at the end of the haptics and fixed under the scleral flaps. The best corrected visual acuity (BCVA), previous surgery history, and complications were determined. Results Fourteen cases were analyzed. The majority of eyes exhibited an improvement in BCVA after surgery. When comparing the last follow-up to preoperative visual acuity, the mean change in BCVA was + 26.32 letters (p=0.011). Postoperative complications included postoperative hypotony in 3 eyes, ocular hypertension in 2 eyes. No postoperative cystoid macular edema, vitreous hemorrhage, IOL dislocation, or endophthalmitis was observed. Conclusions The 27-gauge needle-guided intrascleral IOL fixation technique with built-in 8-0 absorbable sutures is easy to manipulate with fewer anterior chamber manipulations and achieves both anatomical and optical stability.

scholarly journals A modified intrascleral intraocular lens fixation technique with fewer anterior segment manipulations: 27-gauge needle-guided procedure with built-in 8-0 absorbable sutures

2019 ◽  
Author(s):  
Yuan Yang ◽  
Tengteng Yao ◽  
Yali Zhou ◽  
Yixiao Wang ◽  
Zhaoyang Wang
Keyword(s):  
Visual Acuity ◽  
Intraocular Lens ◽  
Anterior Segment ◽  
Vitreous Hemorrhage ◽  
Fixation Technique ◽  
Absorbable Sutures ◽  
Corneal Endothelial Cell Density ◽  
Support Methods ◽  
Iol Fixation

Abstract Background: To report a modified surgical technique for intrascleral intraocular lens (IOL) fixation with fewer anterior segment manipulations in eyes lacking sufficient capsular support. Methods: Eyes from 14 patients who underwent 27-gauge needle-guided intrascleral IOL fixation with built-in 8-0 absorbable sutures were studied. The 8-0 absorbable sutures were inserted into 27-gauge round needles and used to create sclerotomies at the 4 o’clock and 10 o’clock positions under the scleral flap. The sutures were used to tie knots at the end of each haptic and guide haptic externalization through the sclerotomy. After externalization, a sufficient flange was created at the end of each haptic and fixed under the scleral flaps. The best corrected visual acuity (BCVA), corneal endothelial cell density (ECD), IOL tilt and decentration, previous surgery history, and complications were determined. Results: Fourteen cases were analyzed. The majority of eyes exhibited an improvement in the BCVA after surgery. When comparing the last follow-up to preoperative visual acuity, the mean change in BCVA was + 26.32 letters (p=0.011). Postoperative complications included postoperative hypotony in 3 eyes, ocular hypertension in 2 eyes. No cases of postoperative cystoid macular edema (CME), vitreous hemorrhage (VH), IOL dislocation, or endophthalmitis were observed. Conclusions: The 27-gauge needle-guided intrascleral IOL fixation technique with built-in 8-0 absorbable sutures is easy to perform with fewer anterior chamber manipulations and achieves both anatomical and optical stability.

scholarly journals A modified intrascleral intraocular lens fixation technique with fewer anterior segment manipulations: 27-gauge needle-guided procedure with built-in 8–0 absorbable sutures

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Yuan Yang ◽  
Teng-teng Yao ◽  
Ya-li Zhou ◽  
Yi-xiao Wang ◽  
Zhao-yang Wang
Keyword(s):  
Visual Acuity ◽  
Intraocular Lens ◽  
Anterior Segment ◽  
Vitreous Hemorrhage ◽  
Fixation Technique ◽  
Absorbable Sutures ◽  
Corneal Endothelial Cell Density ◽  
Iol Fixation ◽  
Iol Dislocation

Abstract Background To report a modified surgical technique for intrascleral intraocular lens (IOL) fixation with fewer anterior segment manipulations in eyes lacking sufficient capsular support. Methods Eyes from 14 patients who underwent 27-gauge needle-guided intrascleral IOL fixation with built-in 8–0 absorbable sutures were studied. The 8–0 absorbable sutures were inserted into 27-gauge round needles and used to create sclerotomies at the 4 o’clock and 10 o’clock positions under the scleral flap. The sutures were used to tie knots at the end of each haptic and guide haptic externalization through the sclerotomy. After externalization, a sufficient flange was created at the end of each haptic and fixed under the scleral flaps. The best corrected visual acuity (BCVA), corneal endothelial cell density (ECD), IOL tilt and decentration, previous surgery history, and complications were determined. Results Fourteen cases were analyzed. The majority of eyes exhibited an improvement in the BCVA after surgery. When comparing the last follow-up to preoperative visual acuity, the mean change in BCVA was + 26.32 letters (p = 0.011). Postoperative complications included postoperative hypotony in 3 eyes, ocular hypertension in 2 eyes. No cases of postoperative cystoid macular edema (CME), vitreous hemorrhage (VH), IOL dislocation, or endophthalmitis were observed. Conclusions The 27-gauge needle-guided intrascleral IOL fixation technique with built-in 8–0 absorbable sutures is easy to perform with fewer anterior chamber manipulations and achieves both anatomical and optical stability.

scholarly journals A modified intrascleral intraocular lens fixation technique with fewer anterior segment manipulations: 27-gauge needle-guided procedure with built-in 8-0 absorbable sutures

2019 ◽  
Author(s):  
Yuan Yang ◽  
Tengteng Yao ◽  
Yali Zhou ◽  
Yixiao Wang ◽  
Zhaoyang Wang
Keyword(s):  
Visual Acuity ◽  
Intraocular Lens ◽  
Anterior Segment ◽  
Vitreous Hemorrhage ◽  
Fixation Technique ◽  
Absorbable Sutures ◽  
Corneal Endothelial Cell Density ◽  
Support Methods ◽  
Iol Fixation

Abstract Abstract Background : To report a modified surgical technique for intrascleral intraocular lens (IOL) fixation with fewer anterior segment manipulations in eyes lacking sufficient capsular support. Methods : Eyes from 14 patients who underwent 27-gauge needle-guided intrascleral IOL fixation with built-in 8-0 absorbable sutures were studied. The 8-0 absorbable sutures were inserted into 27-gauge round needles and used to create sclerotomies at the 4 o’clock and 10 o’clock positions under the scleral flap. The sutures were used to tie knots at the end of each haptic and guide haptic externalization through the sclerotomy. After externalization, a sufficient flange was created at the end of each haptic and fixed under the scleral flaps. The best corrected visual acuity (BCVA), corneal endothelial cell density (ECD), IOL tilt and decentration, previous surgery history, and complications were determined. Results: Fourteen cases were analyzed. The majority of eyes exhibited an improvement in the BCVA after surgery. When comparing the last follow-up to preoperative visual acuity, the mean change in BCVA was + 26.32 letters (p=0.011). Postoperative complications included postoperative hypotony in 3 eyes, ocular hypertension in 2 eyes. No cases of postoperative cystoid macular edema (CME), vitreous hemorrhage (VH), IOL dislocation, or endophthalmitis were observed. Conclusions : The 27-gauge needle-guided intrascleral IOL fixation technique with built-in 8-0 absorbable sutures is easy to perform with fewer anterior chamber manipulations and achieves both anatomical and optical stability.

Long-Term Stability of Sutured Scleral Fixation of a Posterior Chamber Intraocular Lens With 10-0 Polypropylene for More Than 30 Years

2021 ◽  
pp. 247412642097887
Author(s):  
Gregg T. Kokame ◽  
Tarin T. Tanji ◽  
Jase N. Omizo
Keyword(s):  
Intraocular Lens ◽  
Posterior Chamber ◽  
Scleral Flap ◽  
Scleral Fixation ◽  
Polypropylene Suture ◽  
Long Term Stability ◽  
Posterior Chamber Intraocular Lens ◽  
Polypropylene Sutures

Purpose: We report the longest follow-up to our knowledge of stable scleral fixation of a posterior chamber intraocular lens (PC IOL) with 10-0 polypropylene sutures. Methods: A retrospective review is presented of a case with more than 30 years’ follow-up after performing sutured scleral fixation with 10-0 polypropylene suture using 2 sutures tied together under a scleral flap. One suture was a cow-hitch looped around the haptic, and the other suture was passed through the sclera to create the scleral fixation. Results: The scleral fixation with 10-0 polypropylene suture knots for both haptics of the PC IOL allowed central optic positioning with excellent vision for more than 30 years without suture breakage. Conclusions: Polypropylene sutures for scleral fixation of PC IOLs remained stable for more than 30 years with central positioning of the PC IOL, without exposure of the fixation suture knots through the conjunctiva, and without suture breakage.

scholarly journals Endophthalmitis Following Exposure of a Haptic After Sutureless Intrascleral Intraocular Lens Fixation

2018 ◽  
Vol 3 (1) ◽  
pp. 28-30 ◽  
Author(s):  
Shumpei Obata ◽  
Masashi Kakinoki ◽  
Yoshitsugu Saishin ◽  
Masahito Ohji
Keyword(s):  
Intraocular Lens ◽  
Ocular Pain ◽  
Conjunctival Hyperemia ◽  
Corrected Visual Acuity ◽  
Long Term Follow Up ◽  
White Substance ◽  
Iol Fixation ◽  
Best Corrected Visual Acuity

An 88-year-old woman who had undergone sutureless intrascleral fixation of the intraocular lens (IOL) 3 years previously was seen at an eye clinic because of ocular pain and loss of vision 2 days prior to this visit. She was diagnosed with endophthalmitis and referred to our hospital. At her first presentation here, the best-corrected visual acuity (BCVA) was 0.01 in the left eye, and conjunctival hyperemia and hypopyon were apparent. A haptic was exposed outside the conjunctiva at the nasal upper quadrant, with a white substance around the haptic. The fundus was not visible. We diagnosed endophthalmitis. That same day, we performed vitrectomy and IOL removal, immediately followed by intravitreal injection of antibiotic. The inflammation resolved gradually, and at the 1-year follow-up her BCVA had recovered to 0.6. Patients should receive careful, long-term follow-up after sutureless intrascleral IOL fixation.

Calcaneal Tuberosity Fracture (Beak Fracture) Fixation Using a Pre-contoured “L-form” Hook Plate: A Retrospective Study

2021 ◽  
Author(s):  
Qiang Zhang ◽  
Chan Zhu ◽  
Zongde Wu
Keyword(s):  
Retrospective Study ◽  
Internal Fixation ◽  
Plate Fixation ◽  
Hook Plate ◽  
Fixation Technique ◽  
Fixation Failure ◽  
Clinical Healing ◽  
Ankle Function ◽  
Calcaneal Tuberosity

Abstract Background: The treatment of calcaneal tuberosity fracture (beak fracture) is very tricky. Patients’ ankle function may be badly affected by skin flap necrosis and internal fixation failure. This study presented a simple, and safe internal fixation technique which is to fix the fracture fragment with a pre-contoured “L-form” hook plate.Methods: A retrospective study was done to analyze patients with calcaneal tuberosity fracture who were treated with pre-contoured “L-form” hook plate fixation from January 2015 to February 2020. When the patients could complete single-legged heel raise tests, and when they achieved clinical healing criteria were reviewed. Functional assessment was performed according to the American Orthopaedic Foot and Ankle Society Ankle-Hindfoot (AOFAS-AH) scores and the Visual Analogue Scale (VAS) was recommended for assessment of pain intensity (PI).Results: There were a total of 15 patients of calcaneal tuberosity fracture (beak fracture) treated with the pre-contoured “L-form” hook plate fixation technique, among which eight patients were female and the others were male, with the age ranging from 35 to 69 years (average of 55.3±9.0 years). And the mean duration of follow-up was 22.53±5.78 months (range: 12 to 36 months). 11 cases underwent emergency surgery. After the operation, there were no complications such as wound dehiscence, poor wound healing, infections, or plate exposure, no sural nerve injuries or venous thromboembolic events. Also, there was no loss of reduction or fixation failure in the follow-up. All 15 cases achieved clinical healing at 8-13 weeks (average 10.5±1.4 weeks) postoperatively. They were able to perform the test on their affected leg after 3.7±0.7 months (3-5 months) on average. The preoperative VAS and AOFAS-AH scores were 5.7±0.6 and 24.0±9.9 respectively, while the postoperative VAS and AOFAS-AH scores at the last follow-up were 1.3±0.5 and 93.8±5.2 (p<0.001).Conclusion: Emergency open reduction and internal fixation should be provided as soon as possible. For patients with Beavis type II beak fractures, the pre-contoured “L-form” hook plate fixation technique helps them restore normal ankle function. This simple, safe, and strong internal fixation technique can be one of the treatment options for avulsion fractures of the calcaneal tuberosity.

scholarly journals Comparison of Different IOL Types in the Flanged IOL Fixation Technique

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Yusaku Miura ◽  
Yosuke Harada ◽  
Yoshiaki Kiuchi
Keyword(s):  
Postoperative Complications ◽  
Case Series ◽  
Operation Time ◽  
University Hospital ◽  
Fixation Technique ◽  
The Mean ◽  
Group 2 ◽  
Iol Fixation ◽  
Group 1

Purpose. To compare short-term clinical outcomes between two different intraocular lens (IOL) types in the flanged IOL fixation technique. Methods. This study was a retrospective case series and included the patients who underwent flanged IOL fixation between June 2017 and July 2018 at the Hiroshima University Hospital. Two different 3-piece IOLs (NX-70 and PN6A) were used. Recipients of NX-70 and PN6A IOLs were classed into groups 1 (15 eyes) and 2 (25 eyes), respectively. Patient characteristics, surgical results, and postoperative complications were analyzed. We excluded patients with a postoperative follow-up of <1 month. Results. The mean follow-up period was 13.3 ± 11.7 weeks. The postoperative best corrected visual acuity, in logarithm of the minimum angle of resolution (logMAR), was 0.10 ± 0.33 in group 1 and 0.26 ± 0.42 in group 2. The mean operation times for groups 1 and 2 were 11.2 ± 4.54 minutes and 7.00 ± 2.20 minutes, respectively (p=0.0024). Detachment of the IOL haptic from the optic during surgery occurred in four eyes in group 2 (16%), but did not occur in group 1. Iris capture of the optic was observed in 3 of the 13 eyes (23%) without a peripheral iridotomy in group 2. No peripheral iridotomies were performed on group-1 eyes, but iris capture did not occur in that group. Conclusions. There was a trend to fewer intraoperative and postoperative complications when using NX-70 IOLs. On the other hand, PN6A IOLs was easy to maneuver within the anterior chamber, and the operation time was shorter when using PN6A IOLs. Selection of optimal IOLs for flanged IOL fixation necessitates an understanding of their characteristics in terms of intraoperative and postoperative complications.

scholarly journals Malik`s Technique of Single Loop Fixation of Posterior Chamber Intraocular Lens in Presence of Partial Capsular Support

2015 ◽  
Vol 9 (1) ◽  
pp. 169-171
Author(s):  
Krishan Pal Singh Malik ◽  
Ruchi Goel ◽  
Divya Kishore ◽  
Smriti Nagpal
Keyword(s):  
Intraocular Lens ◽  
Posterior Chamber ◽  
Scleral Flap ◽  
Single Loop ◽  
External Communication ◽  
Reproducible Technique ◽  
Scleral Tunnel ◽  
Posterior Chamber Intraocular Lens ◽  
Capsular Support

Single loop fixation of posterior chamber intraocular lens in the presence of partial capsular support is usually performed by creation of additional scleral flap or tunnel. This extra port may expose the suture holding the intraocular lens or the tucked-in lens haptics to the outside environment thereby increasing the risk of endophthalmitis. We describe a technique of single loop fixation where the scleral tunnel is created adjacent to the site with the absent capsule, the leading haptic is placed on the capsular scaffold, the trailing haptic is tied to 9-0 polypropylene, and the suture is then secured to the inner edge of the scleral lip with enough tension to center the optics and the wound is then closed. The suture knot gets buried within the scleral tunnel with no external communication and does not require a separate port. It is an easy, safe, fast and reproducible technique with a lens tilt of less than 2°.

Sign in / Sign up

Export Citation Format

Share Document