Scleral-Fixated Posterior Chamber Intraocular Lens Implantation in Pediatric and Adult Patients

Burcu, Ayşe; Yalnız-Akkaya, Züleyha; Abay, Iskan; Acar, Mehmet Akif; Örnek, Firdevs

doi:10.3109/08820538.2013.835834

Cited by 14 publications

(19 citation statements)

References 30 publications

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“…The third study subtype was of 10-0 polypropylene scleral-sutured PCIOLs that compared primary or secondary IOL implantation 7 or concomitant penetrating keratoplasty (PKP) versus non-PKP 8 or concomitant pars plana vitrectomy (PPV) versus concomitant anterior vitrectomy (AV). 9 Tables 1A, 1B, 1C, 1D, and 1E summarize the single surgical technique studies of 10-0 polypropylene scleralsutured PCIOL [10][11][12][13][14][15][16][17][18] (Table 1A), CV-8 polytetrafluoroethylene scleral-sutured PCIOL 19 (Table 1B), ISHF PCIOL in Table 1C, [3][4][5][20][21][22][23][24][25][26] 10-0 polypropylene irissutured PCIOL [27][28][29][30] (Table 1D), and iris-claw IOL [31][32][33][34][35][36][37][38][39][40] (Table 1E). The tables include months of follow-up and visual acuity outcomes for the studies.…”

Section: Published Resultsmentioning

confidence: 99%

“…However, a minority of studies was not consistent in BCVA reporting. Some studies contained only median BCVA, 14,43 a few did not include preoperative BCVA, 4,31,41,42,45,47 and others included only the percentage of eyes with 20/40 vision or better. 31,46 The 8-0 polypropylene scleral-sutured PCIOL authors 41 did not publish mean preoperative and postoperative BCVA.…”

Section: Visual Outcomesmentioning

confidence: 99%

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Intraocular Lens Implantation in the Absence of Zonular Support: An Outcomes and Safety Update

et al. 2020

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Purpose: To review the published literature on the visual acuity results and complications of different surgical techniques for intraocular lens (IOL) implantation in the absence of zonular support.Methods: Peer-reviewed literature searches were conducted last in PubMed and the Cochrane Library in July 2019. The searches yielded 734 citations of articles published in English. The panel reviewed the abstracts of these mostly retrospective case series studies, and 45 were determined to be relevant to the assessment objectives. Three articles were rated as level II evidence, and 42 articles were rated as level III evidence.Results: Eight different types of IOL fixation techniques with at least 6-month follow-up were evaluated: anterior chamber IOL (ACIOL), iris-claw IOL, retropupillary iris-claw IOL, 10-0 polypropylene iris-sutured posterior chamber IOL (PCIOL), 10-0 polypropylene scleral-sutured PCIOL, 8-0 polypropylene scleral-sutured PCIOL, CV-8 polytetrafluoroethylene, and intrascleral haptic fixation (ISHF). Eight articles reported data comparing 2 techniques. The 45 studies had insufficient statistical power to compare the techniques conclusively. A qualitative analysis of similar types showed that trends in visual acuity outcomes were not inferior to those of ACIOL implantation, but the severity of preoperative pathologic features was not controlled for. Compared with ACIOL, complications of cystoid macular edema were higher in 10-0 polypropylene iris-sutured PCIOL and 8-0 polypropylene scleral-sutured PCIOL. Noneanterior chamber IOL techniques were less likely to report chronic uveitis. Chronic glaucoma was highest in the 8-0 polypropylene scleral-sutured PCIOL group. Although retinal detachment was infrequent overall, it was twice as common in both iris-and scleral-sutured PCIOLs (except CV-8 polytetrafluoroethylene suture) compared with nonsutured methods: ACIOL, iris-clipped IOL, and ISHF PCIOL.Conclusions: The evidence reviewed shows no superiority of any single IOL implantation technique in the absence of zonular support. The various techniques seem to have equivalent visual acuity outcomes and safety profiles. Each technique has its own profile of inherent risk of postoperative complications. Surgeons must educate patients on the importance of close, long-term follow-up as a result of the uncertain nature of these techniques. Large prospective studies are needed to confirm the long-term complication profiles of these various IOL implantation techniques.

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Section: Published Resultsmentioning

confidence: 99%

Section: Visual Outcomesmentioning

confidence: 99%

Intraocular Lens Implantation in the Absence of Zonular Support: An Outcomes and Safety Update

et al. 2020

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“…22 There are no prospective randomized studies comparing outcomes between SFIOLs, ACIOLs, and IFIOLs in children, so decisions are based largely on surgeon preference and patient circumstance. Retrospective and longitudinal case series of children implanted with mainly sutured SFIOLs 2,27 –38 have yielded promising short-term results at follow-ups ranging from 1 year to approximately 6 years, but concerns regarding glaucoma, endophthalmitis, lens decentration/dislocation, and need for additional surgery have steered some clinicians toward the use of aphakic spectacles or contact lenses as a first-line treatment in children. 39,40 Recently, IOL implantation via sutureless intrascleral (SIS) fixation has been performed in children with no lens dislocations after 6 months of follow-up, but long-term data are needed to more completely assess the efficacy and safety of this technique.…”

Section: Preoperative Considerationsmentioning

confidence: 99%

Scleral-Fixated Intraocular Lenses

Stem

Todorich

Woodward

et al. 2017

Journal of VitreoRetinal Diseases

113

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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“…Anterior chamber or scleral fixated IOLs (SFIOLs) are most commonly used in IOL exchange. Serif et al and Burcu et al exchanged the majority of IOLs with SFIOLs (18,19) . Sturmer exchanged dislocated IOLs with ACIOLs and reported that postoperative intraocular pressure decompensation and vascular problems as major complications (20) .…”

Section: Discussionmentioning

confidence: 99%

Surgical management of intraocular lens dislocations

Gül¹,

Duran²,

Can³

et al. 2015

Arquivos Brasileiros De Oftalmologia

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Purpose: To report and compare the surgical, visual, and anatomical outcomes following treatment of dislocated intraocular lenses (IOLs). Methods: The medical records of 28 eyes of 28 patients were evaluated. Age, gender, pre-and postoperative best-corrected visual acuity (BCVA), surgical methods, and complications were recorded. Results: Pre-and postoperative BCVA ranged from counting fingers to 20/32 and from counting fingers to 20/25, respectively. Late-onset dislocations were the most frequently observed complication. The most frequent surgical method was IOL repositioning in 15 of 28 patients, followed by IOL exchange in 11 patients, and IOL removal in 2 patients. Only 1 patient required surgical re-intervention with IOL capture. Conclusions: Visual acuity improved following the use of either IOL repositioning or IOL exchange. No superiority of one method over the other was observed.In the present retrospective case series, management of dislocated IOLs with repositioning or exchange of the primary implant conferred comparable surgical and visual outcomes. Keywords

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Scleral-Fixated Posterior Chamber Intraocular Lens Implantation in Pediatric and Adult Patients

Abstract: In both pediatric and adult patients, SFIOL implantation ends with favorable outcomes over the short term.

Cited by 14 publications

References 30 publications

Intraocular Lens Implantation in the Absence of Zonular Support: An Outcomes and Safety Update

Intraocular Lens Implantation in the Absence of Zonular Support: An Outcomes and Safety Update

Scleral-Fixated Intraocular Lenses

Surgical management of intraocular lens dislocations

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