Long-Term Analysis of IOL Stability of the Lewis Technique for Scleral Fixation

Cavallini, Gian Maria; Volante, Veronica; Maria, Michele De; Torlai, Giulio; Forlini, Matteo; Chiesi, Laura; Campi, L.; Cagini, Carlo

doi:10.5301/ejo.5000652

Cited by 20 publications

(13 citation statements)

References 11 publications

(18 reference statements)

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“…This technique is still being used today with relatively good success rates; a recent 2015 study of 13 eyes with long-term follow-up ranging from 5 to 10 years found only 2 eyes with minimal lens decentration; the decentration in these 2 eyes did not affect visual acuity. 50 Since Lewis's 1991 paper, surgeons have experimented with techniques such as transillumination 51 and endoscopic placement of ab interno sutures 52 to facilitate placement of the sutures in the ciliary sulcus and avoid injury to nearby ocular structures. Although some have advocated for positioning of IOLs in the pars plana, 53 this requires suture placement closer to the retina and choroid and theoretically increases the risk of devastating complications such as retinal detachment and suprachoroidal hemorrhage.…”

Section: Scleral-sutured Iols: Pastmentioning

confidence: 99%

Scleral-Fixated Intraocular Lenses

Stem

Todorich

Woodward

et al. 2017

Journal of VitreoRetinal Diseases

104

102

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Intraocular lenses (IOLs) can have inadequate support for placement in the capsular bag as a result of ocular trauma, metabolic or inherited conditions such as Marfan’s syndrome or pseudoexfoliation, or complicated cataract surgery. Surgical options for patients with inadequate capsular support include alternative placement in the anterior chamber (ACIOLs), fixation to the iris, or fixation to the sclera. The surgical techniques for each of these approaches have improved considerably over the last several decades resulting in improved visual and ocular outcomes. If no capsular or iris support exists, the surgeon can fixate an IOL to the sclera or the patient can remain aphakic. IOLs can be fixated to the sclera using sutures or by tunneling the IOL haptics into the sclera without sutures. This review summarizes the pre-operative considerations, surgical techniques, outcomes, and unique complications associated with implantation of scleral-fixated IOLs.

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Section: Scleral-sutured Iols: Pastmentioning

confidence: 99%

Scleral-Fixated Intraocular Lenses

Stem

Todorich

Woodward

et al. 2017

Journal of VitreoRetinal Diseases

104

102

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“…The external sutures were then tied down to the adjacent sclera. Ten-year follow-up of thirteen eyes showed only two eyes had minimal decentration although it did not affect final visual acuity [22].…”

Section: Scleral-fixated Intraocular Lensmentioning

confidence: 82%

Secondary Intraocular Lens

Manoharan¹,

Prasad²

2020

Intraocular Lens

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Secondary intraocular lens (IOL) implantation has evolved over the past few decades. Several new techniques, lens options, and materials now exist. Careful patient selection is important to determine the optimal secondary IOL technique. Intraocular lens placement in the capsular bag is the most ideal followed by sulcus placement. However, the best option when no capsular support exists in an aphakic patient remains unclear. Surgeons should be aware of contraindications for each technique; however, there are several situations where anterior chamber intraocular lens (ACIOL), scleral-fixated intraocular lens (SFIOL), and iris fixation can all be used. In those cases, surgeon familiarity and comfort with the secondary IOL technique can determine the type of surgery performed.

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“…This avoids slippage of the suture and easy placement of the needle. Other techniques described in literature for sclera fixation of IOLs are the Lewis technique [12], Kaluzny modification of scleral fixation of IOL [13] and the technique introduced by Seki et al [14].…”

Section: Discussionmentioning

confidence: 99%

Scleral Fixation of Sinking Bag-IOL Complex: A New Surgical Technique

Ram¹,

Singh²,

Hemanth³

et al. 2017

J Clin Exp Ophthalmol

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Treatment options for symptomatic subluxated or dislocated IOLs include observation; and repositioning, removal, or exchange of the IOL. We describe a surgical technique of trans-scleral suture fixation for subluxated bag-IOL complex. A 29 year old male; known case of bilateral recurrent tubercular panuveitis underwent left eye phacoemulsification with three piece hydrophobic acrylic IOL implantation a decade ago. He presented with decreased vision and monocular diplopia since one week. A diagnosis of subluxated bag-IOL complex was made. A 9-0 polypropylene suture was passed beneath the opposite scleral flaps and was taken out through superior stab incision. After exteriorizing both the haptics, they were sutured with prolene. Bag-IOL complex was centered and was fixated trans-sclerally under the scleral flaps. The bag-IOL complex remained stable and well centered 12 months following trans-scleral suture fixation with good visual outcome. This technique can be used in any case of postoperative bag-IOL complex subluxation or dislocation to achieve stabilization.

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Long-Term Analysis of IOL Stability of the Lewis Technique for Scleral Fixation

Cited by 20 publications

References 11 publications

Scleral-Fixated Intraocular Lenses

Scleral-Fixated Intraocular Lenses

Secondary Intraocular Lens

Scleral Fixation of Sinking Bag-IOL Complex: A New Surgical Technique

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