Scleral Fixation of Intraocular Lenses with Gore-Tex Suture

Abstract

Objective: To report refractive outcomes of scleral-fixated intraocular lenses (IOLs) with Gore-Tex suture and combined pars plana vitrectomy, and to compare predicted refractive outcomes between five IOL power calculation formulas. Design: Retrospective case series. Subjects: Patients undergoing scleral-fixated of intraocular lenses with Gore-Tex suture at our institution between January 2015 and June 2018. Methods: Comparison of preoperative biometrics with postoperative refraction, calculation of predicted refractive outcome with 5 different IOL formulas. Main Outcome Measures: Prediction error and absolute error to compare postoperative refraction with refraction predicted by lens power calculation formulas.Results: Thirty-one eyes of 31 patients were included. All power calculations assumed "in-thebag" position of the IOL. Akreos AO60 was implanted in 23 and CZ70BD in 8, and all lenses were sutured 3 millimeters behind the limbus. Average postoperative spherical equivalent was −0.79 ± 0.95 diopters (D). Average prediction error (postoperative spherical equivalent refraction minus target refraction) was −0.19 ± 0.72D. Postoperative spherical equivalent was within 1.0D of target in 25/31 (81%) of patients and within 2.0D of target in 31/31 (100%). The repeatedmeasures analysis of variance of absolute error by lens power formula was significant (p=0.012), with Haigis demonstrating greater error. There was no significant difference between Barrett II, SRKT, Holladay 2, or Hoffer Q.

Outcomes and Complications of Concurrent Pars Plana Vitrectomy and Scleral-Fixated Intraocular Lens Placement Using Gore-Tex Suture

“…Additionally, refractive outcomes in this setting have only recently been described in small case series involving a variety of IOLs and surgical techniques. 11,12 Our study is the first to our knowledge to report the postoperative refraction among eyes exclusively receiving an Akreos A060 IOL fixated 2 mm posterior to the limbus with Gore-Tex suture.…”

“…Only 18.8% of patients in our study had a final refraction that was 2.0 D or more off target of the predicted refraction, a slightly higher rate compared with a previous study. 12 All these cases were myopic shifts, likely due to anterior placement of the IOL.…”

“…To the best of our knowledge, only 1 institution has previously documented the refractive outcomes of these patients in the postoperative period, an important marker of postsurgical success. 11,12 The aim of this study is to characterize the postsurgical refractive outcomes and complications of scleral-fixated IOLs using Gore-Tex suture at a single center.…”

Refractive Outcomes of Four-Point Scleral Fixation of Akreos AO60 Intraocular Lens Using Gore-Tex Suture

“…There is a growing body of techniques for secondary intraocular lens (IOL) placement in the absence of capsular support, including the 4-point fixation of the Akreos AO60 lens using Gore-Tex suture. [1][2][3][4][5] Although there are multiple studies reporting short-term data with a favorable safety profile, there are few studies examining the refractive outcomes. 3,5 A challenge in accurately assessing this has been the multiple ocular comorbidities that often exist in these cases, including history of open globe injury, retinal detachment, or ocular trauma, which may preclude an accurate refraction or affect the uncorrected visual acuity.…”

“…[1][2][3][4][5] Although there are multiple studies reporting short-term data with a favorable safety profile, there are few studies examining the refractive outcomes. 3,5 A challenge in accurately assessing this has been the multiple ocular comorbidities that often exist in these cases, including history of open globe injury, retinal detachment, or ocular trauma, which may preclude an accurate refraction or affect the uncorrected visual acuity. 2,4,6,7 In this study, we aim to study the refractive outcomes in eyes with good visual potential post-secondary IOL implantation.…”