Evaluation of suturless scleral fixation with posterior chamber foldable intraocular lens implantation

Bedda, Ahmed M.

doi:10.18240/ijo.2019.08.08

Cited by 12 publications

(7 citation statements)

References 18 publications

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“…Additional postoperative complications such as vitreous haemorrhage (VH), iris capture, transient hypotony, and CME have been previously reported. [27][28][29] Whereas no cases of VH, iris capture and transient hypotony were observed, one case of postoperative CME was reported. Regarding the iris capture, we believe that further observations should be done.…”

Section: Discussionmentioning

confidence: 99%

A novel approach for scleral fixation using Carlevale lens

Fiore

Messina

Muzi

et al. 2021

European Journal of Ophthalmology

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Purpose: To evaluate the surgical outcomes and feasibility of a novel approach for scleral-fixation using a single-piece acrylic foldable Carlevale lens (Soleko). Methods: Eighteen eyes of 18 patients with aphakia, dislocated IOL, subluxated lens, anisometropia, perforated trauma, and retinal detachment who underwent IOL implantation with a Carlevale lens were evaluated. All the patients underwent a standard ophthalmologic examination. Anterior segment (AS)-OCT was used postoperatively to check plugs positioning and IOL tilt. Results: Mean patients age was 73 ± 19 years. Mean follow-up was 11.2 ± 4.1 months. Mean axial length was 23.7 ± 1.65 mm, white-to-white distance was 11.74 ± 0.40 mm, and axial length was 23.67 ± 1.65 mm. Refractive spherical equivalent prediction error was −0.31 ± 0.71D. Mean IOL tilt was 2.2° ± 1.6° and plugs were placed within the sclera. Five patients had aphakia, five in-the-bag IOL subluxation, three in-the-bag IOL luxation, one high residual myopia after previous verisyse implant, one Uveitis-Glaucoma-Hyphema syndrome, one perforating trauma with phacodonesis, one intraocular foreign body and retinal detachment, two lens subluxation. One eye developed cystoid macular edema which disappeared with topical steroids and FANS. No other complications were observed throughout the follow-up. Conclusion: Carlevale lens (Soleko) appears to be a viable option for both anterior and posterior segment surgeons in the management of complex cases providing less challenging maneuvers which lead to a good lens self-centration and minimal risk of haptic rupture and/or dislocation. The lens seems to offer a good compartmentalization between the anterior and posterior chamber reducing the risk of an inflammatory response.

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Section: Discussionmentioning

confidence: 99%

A novel approach for scleral fixation using Carlevale lens

Fiore

Messina

Muzi

et al. 2021

European Journal of Ophthalmology

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“…Moreover, it is a contact inspection method and the deformation of the eyeball extruded by water in bath cup may affect the measured results [ 27 ]. Given the above limitations and its ability to clearly depict ocular structure posterior to the pupillary plane, UBM has been more frequently used to assess the IOL stability in scleral fixated, [ 14 , 32 , 33 , 34 ] iris fixated [ 35 ] and sulcus IOLs [ 36 , 37 ] rather than a routine modality in evaluation of tilt and decentration via validated quantitative measurements. Marianelli et al [ 14 ] used this technique to compare the IOL tilt between two groups of sutureless and sutured scleral fixated IOL groups.…”

Section: Measurement Of Iol Tilt and Decentrationmentioning

confidence: 99%

Effect of Intraocular Lens Tilt and Decentration on Visual Acuity, Dysphotopsia and Wavefront Aberrations

Ashena

Maqsood

Ahmed

et al. 2020

Vision

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Tilt and decentration of intraocular lenses (IOL) may occur secondary to a complicated cataract surgery or following an uneventful phacoemulsification. Although up to 2–3° tilt and a 0.2–0.3 mm decentration are common and clinically unnoticed for any design of IOL, larger extent of tilt and decentration has a negative impact on the optical performance and subsequently, the patients’ satisfaction. This negative impact does not affect various types of IOLs equally. In this paper we review the methods of measuring IOL tilt and decentration and focus on the effect of IOL tilt and decentration on visual function, in particular visual acuity, dysphotopsia, and wavefront aberrations. Our review found that the methods to measure the IOL displacement have significantly evolved and the available studies have employed different methods in their measurement, while comparability of these methods is questionable. There has been no universal reference point and axis to measure the IOL displacement between different studies. A remarkably high variety and brands of IOLs are used in various studies and occasionally, opposite results are noticed when two different brands of a same design were compared against another IOL design in two studies. We conclude that <5° of inferotemporal tilt is common in both crystalline lenses and IOLs with a correlation between pre- and postoperative lens tilt. IOL tilt has been noticed more frequently with scleral fixated compared with in-the-bag IOLs. IOL decentration has a greater impact than tilt on reduction of visual acuity. There was no correlation between IOL tilt and decentration and dysphotopsia. The advantages of aspheric IOLs are lost when decentration is >0.5 mm. The effect of IOL displacement on visual function is more pronounced in aberration correcting IOLs compared to spherical and standard non-aberration correcting aspherical IOLs and in multifocal versus monofocal IOLs. Internal coma has been frequently associated with IOL tilt and decentration, and this increases with pupil size. There is no correlation between spherical aberration and IOL tilt or decentration. Although IOL tilt produces significant impact on visual outcome in toric IOLs, these lenses are more sensitive to rotation compared to tilt.

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“…Presently we describe a simple rescue technique for the management of extruded haptic after SFIOL. [ 7 8 9 10 ]…”

Section: Surgical Techniquementioning

confidence: 99%

Scleral tunnel with conjunctival autograft for rescue management of extruded haptic

Agarwal

Todi

Bafna

et al. 2021

Indian Journal of Ophthalmology

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Extrusion of haptic is a rare complication after intra-scleral haptic fixation of intraocular lens (SF-IOL). Various techniques described for its management such as autologous scleral patch, cauterization of exposed haptic, reattempting the glued IOL and IOL explant have their own limitations. Presently, we describe a simple rescue technique for management of such situations. In this method, after performing localized conjunctival peritomy, 2 mm long partial-thickness scleral tunnel is fashioned with an angled 20-guage microvitreoretinal blade 1.5 mm away from the limbus in line with pre-existing defective scleral flap underneath which the exposed haptic is tucked securely. Following this, conjunctival autograft (CAG) with fibrin glue application is undertaken to combat conjunctival fibrosis. In three patients, where this technique was performed, had well-tucked haptic and maintained visual acuity with no complications at 3-months follow-up. This technique is a useful method of tucking extruded haptic after SFIOL in eyes subjected to multiple previous surgeries.

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Evaluation of suturless scleral fixation with posterior chamber foldable intraocular lens implantation

Cited by 12 publications

References 18 publications

A novel approach for scleral fixation using Carlevale lens

A novel approach for scleral fixation using Carlevale lens

Effect of Intraocular Lens Tilt and Decentration on Visual Acuity, Dysphotopsia and Wavefront Aberrations

Scleral tunnel with conjunctival autograft for rescue management of extruded haptic

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