Scleral-fixated posterior chamber intraocular lenses in nonvitrectomised eyes

Abstract

Objective To assess the long-term outcome of scleral-fixated sutured posterior chamber intraocular lens (SPCIOL) implantation in non pars plana vitrectomised eyes (1) to evaluate the long-term visual outcome, (2) to identify preoperative risk factors for poor visual outcomes, and (3) to identify the incidence of vitreoretinal complications. Method A retrospective review of 65 eyes, which had not undergone pars plana vitrectomy prior to scleral-fixated SPCIOL implantation. Results In all, 65 eyes of 61 patients were analysed. The median follow-up period was 16 months (range 1-68 months). At final follow-up, 43 (66%) eyes had unchanged or improved BCVA at final follow-up. A total of 20 (31%) eyes had at least a two line improvement and eight (12%) eyes had at least a two line deterioration in final BCVA. No significant preoperative risk factors for a poor visual outcome were identified. In all, 24 eyes (37%) had per-and postoperative adverse events. These eyes were significantly more likely to have a poor visual outcome. Three eyes (4.6%) had a retinal detachment in the postoperative period, all of which had no perception of light at final follow-up. Conclusions This study confirmed that while scleral-fixated SPCIOL intraocular lens implantation might be beneficial, there is a significant risk of per-and postoperative complications leading to loss of best-corrected vision in some eyes.

Primary and secondary implantation of scleral-fixated posterior chamber intraocular lenses in adult patients

“…Several reports concerning scleral-fixated posterior chamber intraocular lenses (PCIOL) have been reported with mostly favorable results 4891011. However, the surgical technique of scleral-fixated PCIOL insertion is more technically demanding 111213. Histological studies of the anterior segment showed that the best position in these eyes is sulcus fixation 1415.…”

Molecular pathogenesis and management strategies of ectopia lentis

“…Sutured posterior chamber lenses can provide excellent visual results. 68,69 We have documented that late suture breakage (using 10/0 proline) is an important problem using this technique 70 and have therefore moved away from suturing lenses as a technique of choice. Modern designs of anterior chamber lens implant generally have low levels of complications 71 and are suitable for this patient population.…”

Management of Elevated Intraocular Pressure Associated With Subluxated/Dislocated Lenses by Combining Trabeculectomy With Adjunctive Mitomycin C With Lensectomy, Vitrectomy, and Scleral Fixation of Intraocular Lens

“…12 The 4-point Ab externo SFIOL technique used in our study has been described in detail elsewhere. 13 The SFIOL implantation technique, although more advantageous, is associated with a unique set of sightthreatening complications such as retinal detachment, 14 choroidal hemorrhage, 15 endophthalmitis, 16 suture erosion, and SFIOL dislocation. 17 Complete pars plana vitrectomy before SFIOL reduces the rate of long-term risk of retinal detachment to 3% 8 when compared with the incidence reported with lensectomy and anterior vitrectomy, the earlier technique used in managing ectopia lentis.…”