Scleral Fixation of a One-Piece Toric Intraocular Lens

Emanuel, Matthew E.; Randleman, J. Bradley; Masket, Samuel

doi:10.3928/1081597x-20130117-10

Cited by 22 publications

(14 citation statements)

References 16 publications

(12 reference statements)

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“…In contrast to earlier reports on scleral fixation of a modern one-piece IOL (Emanuel et al 2013;Rho et al 2015;Leung et al 2016), we found a high incidence of new UGHS in patients with scleral fixated one-piece IOL (24.2%). In the multivariate Cox regression analysis, scleral fixation of a one-piece IOL was a strong independent risk factor for developing UGHS.…”

Section: Discussioncontrasting

confidence: 99%

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Outcomes of intraocular lens scleral fixation with the friction knot technique

Aaltonen

Oskala

Immonen

2018

Acta Ophthalmologica

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Purpose To examine the clinical outcomes of intraocular lens (IOL) scleral fixation with the friction knot technique. Methods Retrospective case series of 152 eyes of 152 patients with inadequate capsular bag support operated with the friction knot IOL scleral fixation technique by a single surgeon. The fixated IOLs were one‐piece or three‐piece models all with open loop haptics. Main outcome measures were change in corrected distance visual acuity (CDVA) and postoperative complications. Results The mean follow‐up time was 11.7 months (median 4.9, range 0.7–64.8). The mean logarithm of the minimum angle of resolution CDVA improved from preoperative 0.77 ± 0.73 (Snellen 20/118 ± 7.3 lines) to 0.44 ± 0.56 (Snellen 20/55 ± 5.6 lines) at the final visit (p < 0.001). The main postoperative complications were ocular hypertension (30.3%), uveitis–glaucoma–hyphaema syndrome (12.5%; UGHS), vitreous haemorrhage (11.2%) and retinal detachment (8.6%). Two (1.3%) cases of suture breakage were seen. In multivariate Cox regression analysis, age under 60 years [hazard ratio (HR) = 5.41; 95% confidence interval (CI) 1.95–15.01] and scleral fixated one‐piece IOL (HR = 4.23; 95% CI 1.44–12.44) were found as significant independent risk factors for developing new UGHS. Conclusion The friction knot technique provides a firm scleral fixation. Scleral fixation may successfully be utilized in dislocated three‐piece IOLs with loop haptics. We recommend avoiding scleral fixation of one‐piece IOLs in young patients due to a high risk of UGHS.

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Section: Discussioncontrasting

confidence: 99%

“…In contrast to earlier reports on scleral fixation of a modern one‐piece IOL (Emanuel et al. ; Rho et al. ; Leung et al.…”

Section: Discussioncontrasting

confidence: 62%

Outcomes of intraocular lens scleral fixation with the friction knot technique

Aaltonen

Oskala

Immonen

2018

Acta Ophthalmologica

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“…20 8 report in-the-bag suture fixation of a toric IOL with open-loop haptics in settings of a dislocated IOL due to compromised zonular support. Our technique is novel in that this was not an aphakic eye nor was the IOL sutured because of a dislocated capsular bag.…”

Section: Discussionmentioning

confidence: 99%

“…5,7,8 We describe a through-the-bag transscleral suture fixation technique to manage recurrent rotation of a hydrophilic acrylic toric IOL with a double-loop haptic design.…”

Section: Online Videomentioning

confidence: 99%

Transscleral suture fixation following recurrent toric intraocular lens rotation

Arjmand

Chan

Ahmed

2015

Journal of Cataract and Refractive Surgery

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We describe a surgical technique of transscleral suture fixation for recurrent rotation of a double-loop hydrophilic acrylic toric intraocular lens (IOL) in the capsular bag. Two 9-0 polypropylene sutures are placed in the proximal and distal angulations of 1 of the IOL haptics through the capsular bag. The clockwise and counterclockwise traction provided by these sutures prevents rotation of the IOL in either direction. This technique can be used in cases of spontaneous postoperative IOL rotation to achieve stabilization. In the case we describe, the IOL remained stable 11 months following transscleral suture fixation at the desired axis.

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“… 1 , 2 , 3 A large corneal incision changes the corneal shape significantly, and the two-point fixation raises the risk of IOL tilt. Although there have been several reports of scleral fixation of multifocal or toric IOLs, 4 , 5 , 6 , 7 , 8 , 9 the inherent limitations of conventional scleral fixation techniques have hindered the wide use of premium IOLs in patients without sufficient zonular support.…”

Section: Introductionmentioning

confidence: 99%

Application of a four-flanged intrascleral fixation technique for toric and multifocal intraocular lenses

Whang

Kwon

2020

American Journal of Ophthalmology Case Reports

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Purpose To report clinical outcomes of a four-flanged intrascleral fixation technique using toric and multifocal intraocular lens. Observations We describe two cases of premium intraocular lens (IOL) implantation after which the patients fully recovered their visual function following a four-point sutureless scleral fixation technique via a 2.8-mm corneal incision. In the first case, a monofocal toric hydrophobic lens consisting of two haptic plates with four holes for suturing was fixated with 5–0 polypropylene monofilament. In the second case, a bifocal hydrophobic lens with the same haptic design was fixated. No conjunctival or scleral sutures, glue, or flap formation was required during the surgery. There were no complications related to the surgical process. Conclusions and Importance A four-flanged intrascleral fixation technique may benefit patients with poor zonular support who have high expectations for postoperative visual quality.

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Scleral Fixation of a One-Piece Toric Intraocular Lens

Cited by 22 publications

References 16 publications

Outcomes of intraocular lens scleral fixation with the friction knot technique

Outcomes of intraocular lens scleral fixation with the friction knot technique

Transscleral suture fixation following recurrent toric intraocular lens rotation

Application of a four-flanged intrascleral fixation technique for toric and multifocal intraocular lenses

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