New surgical approach for sutureless scleral fixation

Veronese, Chiara; Maiolo, Chiara; Armstrong, Grayson W.; Primavera, Laura; Torrazza, Carlo; Mora, L. Della; Ciardella, Antonio P.

doi:10.1177/1120672120902020

Cited by 69 publications

(97 citation statements)

References 18 publications

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“…So far, there is insufficient evidence to recommend any strategy over any other for patients suitable for all three options. 15 Scleral fixation of an IOL allows for a more physiological retroiris positioning and avoids damage to the endothelial cells and angle structures. [19][20][21] In this study, we report our experience with a new technique of scleral fixation of an IOL, consisting of a zigzag suture fixation of the four-haptic hydrophilic acrylic foldable Akreos AO60.…”

Section: Discussionmentioning

confidence: 99%

Intrascleral Knotless Zigzag Suture Fixation of Four-Haptic Hydrophilic Acrylic Foldable IOL: Clinical Outcomes

Silva¹,

Ferreira²,

Ferreira³

et al. 2022

OPTH

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Background:The main options for intraocular lens (IOL) placement without capsular bag support and/or zonular weakness are iris-fixated IOL and scleral-fixated IOL (SFIOL). Purpose: To describe the surgical technique and the outcomes of intrascleral knotless zigzag suture fixation of Akreos AO60 foldable IOL. Methods: Retrospective cohort study of consecutive cases. Results: Ninety-nine eyes of 92 patients were retrospectively studied. The mean age was 72.1±15.2 years (range 18-94), and the median follow-up duration was 19.5 months (range 3-81). The best-corrected visual acuity improved from a mean±SD of 1.34±0.70 logarithm of the minimum angle of resolution (logMAR) units at baseline to 0.49±0.56 logMAR at the end of follow-up (p<0.001). The mean±SD final SE was −1.24±1.82 diopters. The mean±SD prediction error was −0.51±1.16 diopters. The overall perioperative complications rate was 44.4% (n=44). The rate of complications requiring invasive treatment was 19.2% (n=19). The most common perioperative complications were ocular hypertension (OHT, 20.2%, n=20), and cystoid macular edema (CME, 15.2%, n=15). The rate of IOL dislocation was 7% (n=7). Conclusion: This knotless technique avoids the risks of haptics fixation but is more prone to IOL dislocation in cases of suture deterioration. Past ophthalmic history needs to be carefully considered in candidates who underwent SFIOL implantation.

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Section: Discussionmentioning

confidence: 99%

Intrascleral Knotless Zigzag Suture Fixation of Four-Haptic Hydrophilic Acrylic Foldable IOL: Clinical Outcomes

Silva¹,

Ferreira²,

Ferreira³

et al. 2022

OPTH

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“…Another disadvantage is associated with the properties of the lens, as type 311 lenses can only be implanted through relatively large incisions (approximately 9 mm), which may potentially induce astigmatism [ 18 ]. These problems can be overcome by using a Carlevale scleral fixated IOL (Soleko) [ 33 ], which is foldable, along with an artificial iris [ 34 ]. However, there may be disadvantages when using 2 different implants, as the integrity and symmetry of the eyeball may be compromised.…”

Section: Discussionmentioning

confidence: 99%

Traumatic Aniridia and Aphakia Management with Iris Reconstruction Lens Using Gore-Tex Sutures, an Ab-Externo Approach

et al. 2020

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Patient: Male, 55-year-old Final Diagnosis: Aphakia Symptoms: Decreased visual acuity • photophobia Medication:— Clinical Procedure: Lens implantation • vitrectomy Specialty: Ophthalmology Objective: Management of emergency care Background: A safer and more delicate approach is required for the management of a post-traumatic aphakia and subtotal aniridia. Case Report: A 55-year-old man was referred to our clinic with symptoms of decreased vision (hand motion) and photophobia in his right eye. This patient had previously undergone pars plana vitrectomy (PPV) for the management of blunt ocular trauma in the same eye. He was being treated with topical antihypertensives, due to silicone oil-induced glaucoma. On presentation, the best corrected visual acuity (BCVA) in his right eye was 20/40 and the intraocular pressure (IOP) in the same eye was 20 mmHg. Slit lamp examination of his right eye showed aphakia, aniridia, and some silicone oil droplets (fish eggs) following silicone oil extraction. His corneal endothelium and thickness were within normal limits. Dilated fundoscopic examination of the right eye revealed that the retina was attached with no signs of proliferative vitreoretinopathy (PVR). An artificial iris intraocular lens (IOL) was implanted, along with 4-point scleral fixation in conjunction with Gore-Tex sutures. After 6 months, the BCVA in his right eye was 20/40 and he had no symptoms of photophobia. The IOP in that eye was 15 mmHg while on treatment with dorzolamide-timolol eye drops. No suture-related or other serious complications were observed. The patient expressed satisfaction with the functional and cosmetic results. Conclusions: Modern vitrectomy combined with an artificial iris IOL and scleral fixation with Gore-Tex sutures in eyes lacking an iris and lens can provide long-term anatomic and functional restoration. Intraoperative IOP fluctuations and extra corneal damage can be avoided by lens preparation with the sutures using a small incision ab-externo approach.

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“…The use of a sutureless intrascleral fixation IOL is becoming more frequent [33], and the different surgical techniques are gaining in popularity. Such increase in interest on the matter is closely monitored by the lenses' manufacturers that aim to propose new solutions [34] in order to ease and ensure the lens' stability by improving the ergonomics and the haptics of three-dimensional structure. The development of new techniques and the manufacturing of more practical lens allow a wider spread of this surgical procedure [32].…”

Section: Sutureless Scleral-fixated Intraocular Lens Implantation (Sfmentioning

confidence: 99%

Diagnostic imaging versus surgical procedure: intra- and postoperative OCT evaluation of sutureless scleral-fixated intraocular lens implantation and possible related complications

Nuzzi

Rossi

2021

Graefes Arch Clin Exp Ophthalmol

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Because the popularity of corneal refractive surgery has been increasing throughout the last 25 years, many authors have thought to apply optical coherence tomography (OCT) to the anterior segment (AS-OCT); by revising the instrumentation needed and slightly improve the technique, it has become an element of vital importance in order to ensure a complete and exhaustive pre- and postsurgical evaluation. Many applications of OCT have been recently developed—mostly in cataract surgery due to the increasing numbers—such as chamber biometry, which is used in a preoperative stage to determine the details of IOL implantation, and lens evaluation. The aim of this review is to assess the applications of anterior segment OCT in dislocated IOL and/or capsular bag exchange surgery with scleral sutureless fixated intraocular lens and monitoring of possible postoperative complications.

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New surgical approach for sutureless scleral fixation

Cited by 69 publications

References 18 publications

Intrascleral Knotless Zigzag Suture Fixation of Four-Haptic Hydrophilic Acrylic Foldable IOL: Clinical Outcomes

Intrascleral Knotless Zigzag Suture Fixation of Four-Haptic Hydrophilic Acrylic Foldable IOL: Clinical Outcomes

Traumatic Aniridia and Aphakia Management with Iris Reconstruction Lens Using Gore-Tex Sutures, an Ab-Externo Approach

Diagnostic imaging versus surgical procedure: intra- and postoperative OCT evaluation of sutureless scleral-fixated intraocular lens implantation and possible related complications

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