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

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.

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

10.21203/rs.2.11405/v3 ◽

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.

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

10.21203/rs.2.11405/v4 ◽

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

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

BMC Ophthalmology ◽

10.1186/s12886-019-1239-2 ◽

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.

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

10.21203/rs.2.11405/v2 ◽

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.

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27-gauge trocar-assisted sutureless intraocular lens fixation

BMC Ophthalmology ◽

10.1186/s12886-020-01758-6 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Tatsuya Jujo ◽

Jiro Kogo ◽

Hiroki Sasaki ◽

Reio Sekine ◽

Keiji Sato ◽

...

Keyword(s):

Visual Acuity ◽

Endothelial Cell ◽

Cell Density ◽

Intraocular Lens ◽

Vitreous Hemorrhage ◽

Corneal Endothelial Cell ◽

Endothelial Cell Density ◽

Corneal Endothelial Cell Density ◽

The Mean ◽

Iol Fixation

Abstract Backgrounds However there have been numerous investigations of intrascleral intraocular lens (IOL) fixation techniques, there is room for improvement in terms of simplifying complicated techniques and reducing the high levels of skill required. This study aimed to report a novel technique for sutureless intrascleral fixation of the IOL using retinal forceps with a 27-gauge trocar. Methods Nineteen eyes of 18 patients underwent intrascleral fixation of the IOL from July 2018 to September 2019 were enrolled in this study. A 27-gauge trocar formed 3-mm scleral tunnels positioned at 4 and 10 o’clock, 2 mm from the corneal limbus. We used a 3-piece IOL haptic grasped by a 27-gauge retinal forceps and pulled from the 27-gauge trocar. The IOL was fixed by making a flange. Main outcome measures were visual acuity, corneal endothelial cell density, IOL tilt, decentration, predicted error of refraction and complications. Results The 19 eyes were followed up for 1 month. The mean pre- and postoperative logMAR uncorrected visual acuity (UCVA) was 1.06 ± 0.63 and 0.40 ± 0.26, respectively (p < 0.01), while the mean pre- and postoperative logMAR best corrected visual acuity (BCVA) was 0.27 ± 0.51 and 0.06 ± 0.15, respectively (p = 0.09). The mean corneal endothelial cell density was 2406 ± 625 to 2004 ± 759 cells/mm2 at 1 month (p = 0.13). The mean IOL tilt was 3.52 ± 3.00°, and the mean IOL decentration was 0.39 ± 0.39 mm. There was no correlation among IOL tilt, decentration and BCVA (p > 0.05). The mean prediction error of the target refraction was − 0.03 ± 0.93 D. The complications were vitreous hemorrhage (3 eyes), hyphema (1 eye), IOP elevation (1 eye), iris capture of the IOL (1 eye) and hypotony (2 eyes). No IOL dislocation occurred. Conclusions IOL intrascleral fixation with a flange achieved good IOL fixation and visual outcome in the scleral tunnels created with the 27-gauge trocar.

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Comparison of safety and number of post-operative visits of patients in convenient day versus conventional first day follow-up after phacoemulsification

Pakistan Journal of Medical Sciences ◽

10.12669/pjms.37.5.4121 ◽

2021 ◽

Vol 37 (5) ◽

Author(s):

Zahid Kamal ◽

Ahmad Zeeshan Jamil ◽

Hira Shuja Khokhar ◽

Farah Huma

Keyword(s):

Visual Acuity ◽

Intraocular Lens ◽

Anterior Segment ◽

Care Facility ◽

Health Care Facility ◽

Creative Commons ◽

Group I ◽

Department Of Ophthalmology ◽

Group Ii

Objectives: To compare safety and number of post-operative visits of patients in convenient day versus conventional first day follow-up after phacoemulsification Methods: This observational cohort study was conducted in Department of ophthalmology, Sahiwal Medical College, Sahiwal from November 2019 to August 2020. There were 600 patients who underwent uncomplicated phacoemulsification with intraocular lens implantation. Patients were allocated into two groups. Group-I comprised of patients with convenient day follow-up during the first post-operative week. Group-II comprised of the patients with conventional first day follow-up. Rate of complications, number of visits during the first month and final visual acuity were recorded. Results: In Group-I post-operative complications were noted in 12.67% cases on first follow up visit and in 2.67% cases on first month follow up visit. In Group-II post-operative complication were noted in 22 % cases on first follow up visit and in 4% cases on first month follow up visit. Common postoperative complications were corneal oedema, anterior segment intraocular inflammation, residual lens matter in anterior chamber and intraocular lens subluxation. There was no difference in presenting and postoperative visual acuity between the two groups. Mean follow-up visits were 2.23 ± 0.42 in Group-I and 3.55 ± 0.50 in Group-II. Conclusion: Convenient day follow-up is as safe as conventional first day follow-up. Convenient day follow-up significantly reduces the number of post-operative visits. This would translate into cost reduction both for the patients and the health care facility. doi: https://doi.org/10.12669/pjms.37.5.4121 How to cite this:Kamal Z, Jamil AZ, Khokhar HS, Huma F. Comparison of safety and number of post-operative visits of patients in convenient day versus conventional first day follow-up after phacoemulsification. Pak J Med Sci. 2021;37(5):---------. doi: https://doi.org/10.12669/pjms.37.5.4121 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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27-Gauge trocar-assisted sutureless intraocular lens fixation.

10.21203/rs.3.rs-34867/v1 ◽

2020 ◽

Author(s):

Tatsuya Jujo ◽

Jiro Kogo ◽

Hiroki Sasaki ◽

Reio Sekine ◽

Keiji Sato ◽

...

Keyword(s):

Visual Acuity ◽

Endothelial Cell ◽

Cell Density ◽

Intraocular Lens ◽

Vitreous Hemorrhage ◽

Corneal Endothelial Cell ◽

Endothelial Cell Density ◽

Corneal Endothelial Cell Density ◽

The Mean ◽

Iol Fixation

Abstract Backgrounds: However there have been numerous investigations of intrascleral intraocular lens (IOL) fixation techniques, there is room for improvement in terms of simplifying complicated techniques and reducing the high levels of skill required. This study aimed to report a novel technique for sutureless intrascleral fixation of the IOL using retinal forceps with a 27-gauge trocar. Methods Nineteen eyes of 18 patients underwent intrascleral fixation of the IOL from July 2018 to September 2019 were enrolled in this study. A 27-gauge trocar formed 3-mm scleral tunnels positioned at 4 and 10 o’clock, 2 mm from the corneal limbus. We used a 3-piece IOL haptic grasped by a 27-gauge retinal forceps and pulled from the 27-gauge trocar. The IOL was fixed by making a flange. Main outcome measures were visual acuity, corneal endothelial cell density, IOL tilt, decentration, predicted error of refraction and complications. Results The 19 eyes were followed up for 1 month. The mean pre- and postoperative logMAR uncorrected visual acuity (UCVA) was 1.06 ± 0.63 and 0.40 ± 0.26, respectively (p < 0.01), while the mean pre- and postoperative logMAR best corrected visual acuity (BCVA) was 0.27 ± 0.51 and 0.06 ± 0.15, respectively (p = 0.09). The mean corneal endothelial cell density was 2406 ± 625 to 2004 ± 759 cells/mm2 at 1 month (p = 0.13). The mean IOL tilt was 3.52 ± 3.00°, and the mean IOL decentration was 0.39 ± 0.39 mm. There was no correlation among IOL tilt, decentration and BCVA (p > 0.05). The mean prediction error of the target refraction was − 0.03 ± 0.93 D. The complications were vitreous hemorrhage (3 eyes), hyphema (1 eye), IOP elevation (1 eye), iris capture of the IOL (1 eye) and hypotony (2 eyes). No IOL dislocation occurred. Conclusions IOL intrascleral fixation with a flange achieved good IOL fixation and visual outcome in the scleral tunnels created with the 27-gauge trocar.

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One Year Outcomes and Stability of a Novel Scleral Anchored Intraocular Lens

Journal of Ophthalmology ◽

10.1155/2021/3838456 ◽

2021 ◽

Vol 2021 ◽

pp. 1-6

Author(s):

Edoardo Abed ◽

Matteo Forlini ◽

Edlira Bendo ◽

Aurelio Imburgia ◽

Alessandro Mularoni ◽

...

Keyword(s):

Visual Acuity ◽

Intraocular Pressure ◽

Intraocular Lens ◽

Anterior Segment ◽

Case Series ◽

Specular Microscopy ◽

Iop Measurement ◽

Prospective Case Series ◽

One Year

Purpose. To assess one year results and stability of the implantation of a scleral anchored intraocular lens (IOL). Design. Interventional prospective case series. Methods. Sixty eyes of 60 patients affected by either aphakia or IOL dislocation were included in this study. Patients underwent vitrectomy, scleral fixation of the IOL, and, if present, dislocated IOL removal. Patients were evaluated preoperatively and at 1, 3, 6, and 12 months after surgery by best-corrected distance visual acuity (BCVA) assessment, intraocular pressure (IOP) measurement, corneal specular microscopy, and optical coherence tomography (OCT) of both the macula and anterior segment. Results. At twelve months, mean BCVA significantly improved ( p < 0.0001 ), and none of the patients experienced a decrease of visual acuity. A 10% decrease of endothelial cell count occurred after surgery. Cystoid macular edema occurred in three patients (5%). A transient increase of intraocular pressure was noted in 7 cases (12%). At one month, horizontal and vertical IOL tilt was 1.04 ± 0.87 and 0.74 ± 0.71 degrees, respectively, and did not significantly change in the follow-up ( p > 0.05 ). None of the patients had decentration or dislocation of scleral-fixated IOL during the follow-up. Conclusion. Implantations of scleral plug fixated IOL provide good visual results, low complication rate, and excellent stability of the lens until one-year follow-up.

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27-Gauge trocar-assisted sutureless intraocular lens fixation.

10.21203/rs.3.rs-34867/v2 ◽

2020 ◽

Author(s):

Tatsuya Jujo ◽

Jiro Kogo ◽

Hiroki Sasaki ◽

Reio Sekine ◽

Keiji Sato ◽

...

Keyword(s):

Visual Acuity ◽

Endothelial Cell ◽

Cell Density ◽

Intraocular Lens ◽

Vitreous Hemorrhage ◽

Corneal Endothelial Cell ◽

Endothelial Cell Density ◽

Corneal Endothelial Cell Density ◽

The Mean ◽

Iol Fixation

Abstract Backgrounds: However there have been numerous investigations of intrascleral intraocular lens (IOL) fixation techniques, there is room for improvement in terms of simplifying complicated techniques and reducing the high levels of skill required. This study aimed to report a novel technique for sutureless intrascleral fixation of the IOL using retinal forceps with a 27-gauge trocar. Methods: Nineteen eyes of 18 patients underwent intrascleral fixation of the IOL from July 2018 to September 2019 were enrolled in this study. A 27-gauge trocar formed 3-mm scleral tunnels positioned at 4 and 10 o’clock, 2 mm from the corneal limbus. We used a 3-piece IOL haptic grasped by a 27-gauge retinal forceps and pulled from the 27-gauge trocar. The IOL was fixed by making a flange. Main outcome measures were visual acuity, corneal endothelial cell density, IOL tilt, decentration, predicted error of refraction and complications. Results: The 19 eyes were followed up for 1 month. The mean pre- and postoperative logMAR uncorrected visual acuity (UCVA) was 1.06 ± 0.63 and 0.40 ± 0.26, respectively (p<0.01), while the mean pre- and postoperative logMAR best corrected visual acuity (BCVA) was 0.27 ± 0.51 and 0.06 ± 0.15, respectively (p=0.09). The mean corneal endothelial cell density was 2406 ± 625 to 2004 ± 759 cells/mm 2 at 1 month (p=0.13). The mean IOL tilt was 3.52 ± 3.00°, and the mean IOL decentration was 0.39 ± 0.39 mm. There was no correlation among IOL tilt, decentration and BCVA (p>0.05). The mean prediction error of the target refraction was –0.03 ± 0.93 D. The complications were vitreous hemorrhage (3 eyes), hyphema (1 eye), IOP elevation (1 eye), iris capture of the IOL (1 eye) and hypotony (2 eyes). No IOL dislocation occurred.Conclusions: IOL intrascleral fixation with a flange achieved good IOL fixation and visual outcome in the scleral tunnels created with the 27-gauge trocar.

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27-Gauge trocar-assisted sutureless intraocular lens fixation.

10.21203/rs.3.rs-34867/v4 ◽

2020 ◽

Author(s):

Tatsuya Jujo ◽

Jiro Kogo ◽

Hiroki Sasaki ◽

Reio Sekine ◽

Keiji Sato ◽

...

Keyword(s):

Visual Acuity ◽

Endothelial Cell ◽

Cell Density ◽

Intraocular Lens ◽

Vitreous Hemorrhage ◽

Corneal Endothelial Cell ◽

Endothelial Cell Density ◽

Corneal Endothelial Cell Density ◽

The Mean ◽

Iol Fixation

Abstract Backgrounds: However there have been numerous investigations of intrascleral intraocular lens (IOL) fixation techniques, there is room for improvement in terms of simplifying complicated techniques and reducing the high levels of skill required. This study aimed to report a novel technique for sutureless intrascleral fixation of the IOL using retinal forceps with a 27-gauge trocar.Methods: Nineteen eyes of 18 patients underwent intrascleral fixation of the IOL from July 2018 to September 2019 were enrolled in this study. A 27-gauge trocar formed 3-mm scleral tunnels positioned at 4 and 10 o’clock, 2 mm from the corneal limbus. We used a 3-piece IOL haptic grasped by a 27-gauge retinal forceps and pulled from the 27-gauge trocar. The IOL was fixed by making a flange. Main outcome measures were visual acuity, corneal endothelial cell density, IOL tilt, decentration, predicted error of refraction and complications.Results: The 19 eyes were followed up for 1 month. The mean pre- and postoperative logMAR uncorrected visual acuity (UCVA) was 1.06 ± 0.63 and 0.40 ± 0.26, respectively (p<0.01), while the mean pre- and postoperative logMAR best corrected visual acuity (BCVA) was 0.27 ± 0.51 and 0.06 ± 0.15, respectively (p=0.09). The mean corneal endothelial cell density was 2406 ± 625 to 2004 ± 759 cells/mm2 at 1 month (p=0.13). The mean IOL tilt was 3.52 ± 3.00°, and the mean IOL decentration was 0.39 ± 0.39 mm. There was no correlation among IOL tilt, decentration and BCVA (p>0.05). The mean prediction error of the target refraction was –0.03 ± 0.93 D. The complications were vitreous hemorrhage (3 eyes), hyphema (1 eye), IOP elevation (1 eye), iris capture of the IOL (1 eye) and hypotony (2 eyes). No IOL dislocation occurred.Conclusions: IOL intrascleral fixation with a flange achieved good IOL fixation and visual outcome in the scleral tunnels created with the 27-gauge trocar.

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