Outcomes and complications of iris-fixated intraocular lenses in cases with inadequate capsular support and complex ophthalmic history

Abstract

Background To report the indications, visual outcomes, and intra-operative and post-operative complications of iris-sutured posterior chamber intraocular lens (IOL) in eyes with inadequate capsular support and complex ocular history. Methods A chart review and data analysis of eyes that underwent iris fixation of posterior chamber (PC) IOL for correction of aphakia, dislocated and subluxed IOLs, ectopia lentis, and IOL exchange. Data included clinical risk factors, associated eye conditions, previous surgeries, and concomitant procedures. The pre-operative and post-operative vision, manifest refraction, endothelial cell density, intraocular pressure (IOP), as well as intra-operative and post-operative complications were also recorded. Results One hundred and seventeen eyes from 114 patients were examined with a mean follow-up of 22.4 months. The most common identifiable predisposing risk factor was high myopia in 23 eyes. A significant improvement in uncorrected and best corrected visual acuity compared with baseline was observed. The most common post-operative complications included recurrent IOL subluxation in 16 (13.7%) eyes, IOP spike in 7 (5.9%) eyes, cystoid macular oedema in 5 (4.3%) eyes, and epiretinal membrane formation in 4 (3.4%) eyes. There was one (0.85%) case of sterile endophthalmitis. Conclusions Iris suture fixation of PC IOLs is a good treatment option for eyes with inadequate capsular support and complex ocular history.

Megalocornea, anterior megalophthalmos, keratoglobus and associated anterior segment disorders: A review

“…49,114 In addition to the risk of on-going iris chafing, the most common complications with this technique include pupil ovalization, lens dislocation, glaucoma and retinal detachment. [124][125][126]…”

“…While posterior iris fixation of the IOL is a viable option in these patients, there are significant technical challenges in the use of the McCannel suture technique, given an enlarged anterior segment, poorly dilating pupil and sutures with needles of limited length 49,114 . In addition to the risk of on‐going iris chafing, the most common complications with this technique include pupil ovalization, lens dislocation, glaucoma and retinal detachment 124–126 …”

1 Year Surgical Outcomes and Safety of Combined Trans Pars Plana Vitrectomy with Iris Fixated Posterior Chamber Intraocular Lens for Subluxated Intraocular Lens and Cataracts

“…To date, most studies have reported small case series of short follow-up periods for combined TPPV and IF-PCIOL in the same sitting after removal of subluxated lenses or IOLs with lensectomy or IOL explant respectively. [6][7][8][9][10][11][12] Therefore, we aim to report a case series of the 1-year surgical outcomes and safety profile of TPPV and IF-PCIOL implantation for subluxated cataracts and IOLs.…”

Sutureless Intrascleral Fixation Of The Carlevale (Soleko) Intraocular Lens In The Correction Of Aphakia. Own Experience

“…Techniques of sutureless fixation of haptics in the transscleral tunnel are associated with the risk of complications associated mainly with damage of the haptics. Haptic kink, breakage, dislocation or slippage and less frequently IOL dislocation have been described in literature [8], [9]. Each of the complications lead to a decrease in quality and acuity of vision.…”

“…A more serious complication was corneal oedema, requiring DSAEK, which was observed in 7.5% of a group of 135 eyes. Other complications, observed in less than 10% of all cases were: vitreous haemorrhage, hyphema, macular oedema and retinal detachment [2]- [9].…”