A truly knotless technique for scleral fixation of intraocular lenses: Two-year results

Yadav, Naresh Kumar; Kemmanu, Vasudha; Bhargava, Mayuri; Shetty, Bhujanga

doi:10.4103/0301-4738.90493

Cited by 11 publications

(11 citation statements)

References 10 publications

(12 reference statements)

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“…No significant statistical differences were found when comparing the preoperative and postoperative BCVA values between the two groups of patients, indicating that the visual outcomes of the two groups were equal after surgery. In our study, all of the treated eyes (30/30) either maintained or improved their BCVAs, which is similar to Szurman’s original knotless suture fixation of the PCIOL method (21/22) [ 21 ], suggesting that the modified knotless method could be a potentially promising surgery technique for patients with CEL.…”

Section: Discussionsupporting

confidence: 82%

A Modified Knotless Transscleral Intraocular Lens Fixation Technology for Congenital Ectopia Lentis

Liu

Cao

et al. 2022

Ophthalmol Ther

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Introduction This study aimed to compare modified knotless transscleral suture fixation of intraocular lens (IOL) with traditional transscleral suture fixation for adolescents and young patients with congenital ectopia lentis (CEL). Methods This retrospective cohort study included 49 patients with CEL (60 eyes) who underwent surgery at the Zhongshan Ophthalmic Center. Improvements based on knotless Z-suture fixation technique were made to form a modified knotless method, in which thicker 8–0 polypropylene sutures were used, and double parallel scleral grooves were constructed behind the limbus instead of triangular lamellar scleral flaps to cover suture stitches. Modified knotless transscleral fixation of IOL was conducted on 30 eyes, and the other 30 eyes underwent traditional transscleral fixation surgery. Pre- and postoperative best-corrected visual acuity (BCVA), refractive error, astigmatism, other ocular parameters, and complications were statistically analyzed. Results For patients in the modified knotless group, the mean cylindrical refractive error and astigmatism at 1 month and 3 months postoperative were lower (all P < 0.05), and the mean IOL tilt degree was smaller at 3 months postoperative (3.21° ± 2.13° vs. 5.65° ± 3.66°, P = 0.032). The incidence of suture exposure in the modified knotless group was also lower than in the controls (0 vs. 16.7%, P = 0.026). No group differences were observed in mean BCVA, spherical equivalent, or other ocular biometric parameters between groups. Conclusion Modified knotless technique was a valid method to achieve optimal IOL position and reduce postoperative astigmatism for adolescents and young patients with CEL. It effectively reduced the incidence of knot-related complications, greatly improved the postoperative comfort, and achieved aesthetic benefits. Supplementary Information The online version contains supplementary material available at 10.1007/s40123-022-00586-9.

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Section: Discussionsupporting

confidence: 82%

A Modified Knotless Transscleral Intraocular Lens Fixation Technology for Congenital Ectopia Lentis

Liu

Cao

et al. 2022

Ophthalmol Ther

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“…[27] The SFIOL procedure has good visual outcomes but is known to be associated with long-term complications such as cystoid macular edema, retinal detachments, and suture-related complications. [389] Teng and Zhang compared anterior chamber implantation of iris claw lens with SFIOL and found that iris claw lens implantation can be performed less invasively, within a shorter surgical duration and is associated with faster visual recovery in comparison with SFIOL. [9] The safety and efficacy of aphakic rehabilitation with retropupillary iris claw fixation has been studied and it has been found to be a safe procedure for rehabilitation of aphakic eyes.…”

Section: Discussionmentioning

confidence: 99%

Retropupillary fixation of iris-claw lens in visual rehabilitation of aphakic eyes

Jayamadhury¹,

Potti²,

Kumar³

et al. 2016

Indian J Ophthalmol

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Context:Surgical outcome of retropupillary fixation of iris claw lens.Aims:To evaluate the various indications, intra and post-operative complications, and visual outcome of retropupillary fixation of iris claw lens in aphakic eyes.Settings and Design:The study design is a retrospective study at a tertiary eye care center.Methods:Review of medical records of 61 aphakic eyes of 61 patients, who were rehabilitated with retropupillary fixation of an iris claw lens, with a follow-up duration of at least 1 year.Statistical Analysis Used:Data analysis was performed using paired t-test and Chi-square test.Results:Mean preoperative uncorrected visual acuity was 1.66 ± 0.3 LogMAR and postoperative acuity at 1 year was 0.53 ± 0.5 LogMAR (P = 0.00001). Preoperative distant best-corrected visual acuity was 0.30 ± 0.48 LogMAR and postoperative acuity at 1 year was 0.27 ± 0.46 LogMAR (P = 0.07). Mean preoperative astigmatism was 1.43 ± 1.94 D and postoperatively was 1.85 ± 2.16 D (P = 0.0127). Mean endothelial cell count was 2353.52 ± 614 cells/mm2 preoperatively which decreased to 2200 ± 728 cells/mm2 at 1 year follow-up (P = 0.006). There was no significant difference in central macular thickness and intraocular pressure pre and post-surgery. Complications included ovalization of pupil in 9.83%, hypotony in 1.63%, toxic anterior segment syndrome in 1.63%, cystoid macular edema in 11.47%, epiretinal membrane in 3.27%, and iris atrophy in 6.55%.Conclusion:Iris claw is a safe and an effective method of rehabilitating aphakic eyes.

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“…This has been linked to various complications including bullous keratopathy, increase of intra ocular pressure (IOP), and endothelial cell loss or even visual loss. Several techniques including posterior chamber sclera fixed lens,3,4 and anterior chamber iris claw lens5 have been reported to result in good visual outcome in the management of unilateral aphakic eyes without capsular support. Technological advances in lens design (angular support) and in lens material (Acrysoft) has permitted the safe use of lens in the anterior chamber for refractive error correction 6,7.…”

Section: Introductionmentioning

confidence: 99%

Aphakia Correction by Injection of Foldable Intra Ocular Lens in the Anterior Chamber

et al. 2013

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We assessed the outcomes of the use of anterior chamber foldable lens for unilateral aphakia correction at the University Teaching Hospital of Yaounde. In this retrospective, non-comparative, consecutive case series study, we reviewed the records of patients who underwent an operation for aphakia correction by the means of injection of an angular supported foldable lens between January 2009 and December 2011 in the University Teaching Hospital Yaounde. Student’s paired t-test was carried out to compare pre-operative and post-operative visual acuity (VA) and intraocular pressure (IOP). P-values less than 0.05 were considered statistically significant. Twenty-one patients were included in the study; twelve were male (57.1%) and nine were female (42.9%). The mean age was 55.38 ± 17.67 years (range 9–75 years). The mean follow-up duration was 5.95 ± 3.14 months (range 2–12 months). The mean log-MAR visual acuity was 1.26 ± 0.46 pre-operatively and 0.78 ± 0.57 post-operatively (P = 0.003). The change in intraocular pressure was not statistically significant. Complications included intraocular hypertension (over 21 mmHg) in 3 patients (14.3%) and macular edema, pupillar ovalization, and retinal detachment in one patient each. The results indicate that injection of an angular support foldable lens in the anterior chamber is a useful technique for the correction of aphakia in eyes without capsular support. More extended follow-up, however, and a larger series of patients are needed to ascertain the effectiveness and safety of this procedure.

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A truly knotless technique for scleral fixation of intraocular lenses: Two-year results

Cited by 11 publications

References 10 publications

A Modified Knotless Transscleral Intraocular Lens Fixation Technology for Congenital Ectopia Lentis

A Modified Knotless Transscleral Intraocular Lens Fixation Technology for Congenital Ectopia Lentis

Retropupillary fixation of iris-claw lens in visual rehabilitation of aphakic eyes

Aphakia Correction by Injection of Foldable Intra Ocular Lens in the Anterior Chamber

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