Short-term outcomes of a modified technique for small-incision scleral-fixated intraocular lens implantation using Gore-Tex sutures

Huang, Ching-Wen; Tsai, Chia‐Ying; Lai, Tso‐Ting

doi:10.1007/s00417-021-05201-4

Cited by 4 publications

(3 citation statements)

References 33 publications

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“…The Gore-Tex suture (W.L. Gore & Associates, Elkton, Maryland, USA), which is a nonabsorbable, polytetrafluoroethylene monofilament suture with greater tensile strength, minimal inflammatory response, and easy manipulation [ 17 ], has demonstrated favorable outcomes used for scleral fixation of IOLs [ 10 , 11 , 18 ]. For example, the one-year follow-up data of a novel surgical technique for the scleral fixation of a CZ70BDIOL (Alcon Laboratories, Inc, Fort Worth, TX) with Gore-Tex suture suggested that this technique is a reasonable surgical option for secondary IOL placement [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

A novel surgical approach for fixation of a posterior chamber intraocular lens of Rayner 620 H with Gore-Tex suture

Wang

Chen

et al. 2023

BMC Ophthalmol

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Purpose To report a novel surgical approach for the scleral fixation of the Rayner 620 H intraocular lens (IOL) with Gore-Tex suture and its outcomes at 6 months postoperatively. Methods 19 consecutive patients who underwent novel surgical approach for the scleral fixation of Rayner 620 H IOL with Gore-Tex suture at Peking Union Medical College Hospital between June 2020 and June 2021 were included. Data on best-corrected visual acuity (BCVA), spherical equivalent, total astigmatism/axis, short-term and long-term complications, and corresponding management with a follow-up of 6 months were collected. Results Nineteen patients (11 men and 8 women) with a mean age of 62.7 ± 10.6 years were included. The median BCVA improved significantly from 0.90 ± 0.90 (Snellen 20/160) preoperatively to 0.20 ± 0.30 (Snellen 20/32) at postoperative 6 months follow-up (P < 0.001). The stratification of the accuracy of refractive outcomes was 53% of patients within ± 0.5 D and 84% of patients within ± 1.0 D of the refractive target. Corneal edema (n = 3, 16%) and increased intraocular pressure (IOP) (n = 4, 11%) were short-term complications. Long-term complications included increased IOP (n = 1, 5%), and macular edema (n = 1, 5%). Conclusion The novel surgical approach for scleral fixation of the Rayner 620 H IOL with Gore-Tex suture is a reasonable option for patients who need secondary IOL placement without adequate capsular support.

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Section: Introductionmentioning

confidence: 99%

A novel surgical approach for fixation of a posterior chamber intraocular lens of Rayner 620 H with Gore-Tex suture

Wang

Chen

et al. 2023

BMC Ophthalmol

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“…in their retrospective, interventional, consecutive case series compared the classic technique required a relatively large corneal wound or scleral tunnel incision that ranges from 3.5 to 7 mm depending on the IOL model and their novel technique with 2.3mm corneal incision. They concluded that the modified small-incision technique for implantation of scleral-fixated IOLs using Gore-Tex sutures was well tolerated in all patients, with favorable postoperative visual outcomes and minimal surgically induced astigmatism (SIA) and IOL-induced astigmatism ( 12 ).…”

Section: Discussionmentioning

confidence: 99%

Scleral flaps, pars plana vitrectomy and gore-tex sutured posterior chamber intraocular lens placement: a case series and review of literature

Napolitano¹,

Filippelli²,

Carosielli³

et al. 2023

Front. Ophthalmol.

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IntroductionCataract surgery is one of the most common surgical procedures performed worldwide. Intraocular lens (IOL) implants are placed routinely in the capsular bag after successful cataract extraction. However, in the absence of adequate capsular support, IOL may be placed in the anterior chamber, fixated to the iris or fixated to the sclera. The purpose of this study is to report the clinical outcomes and safety profile of a trans-scleral sutured intraocular lens (IOL) technique using scleral flaps, vitrectomy, and Gore-Tex suture to place posterior chamber IOL.MethodsRetrospective, interventional case series of eyes undergoing scleral fixation of an IOL using Gore-Tex suture with concurrent vitrectomy. Ocular examination with the logarithm of the minimum angle of resolution visual acuity (logMAR BCVA), tonometry, and slit-lamp biomicroscopy was performed on all patients at 1, 3, 6, and 12 months after the operation. All post-operative complications were recorded.ResultsTwenty-five eyes of 25 patients were included. Mean logMAR BCVA improved from 0.43 ± 0.36 (20\40 Snellen equivalent) preoperatively to 0.13 ± 0.18 (20\25 Snellen equivalent) postoperatively at 12 months (p<0.01). Indications included surgical aphakia (16) and dislocated lens implant (9). No cases of IOL opacification, suprachoroidal haemorrhage, post-operative endophthalmitis, IOL dislocation, Gore-Tex exposure, or retinal detachment were observed during the follow-up period.ConclusionAb externo scleral fixation of IOLs with Gore-Tex suture plus scleral flap is well tolerated and associated with a very low rate of suture exposition. Moreover, our study confirms excellent refractive outcomes after surgery.

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“…In addition to the Carlevale IOL, 5 an on-label 1-piece lens for scleral IOL fixation, there are special fixation techniques using 1-piece open-loop haptic IOLs combined with polypropylene sutures such as the four-flange technique 6 or the combination of these IOLs with 8.0 GoreTex © sutures. 7,8 The majority of these publications focus on the surgical procedure, [9][10][11][12] refractive outcomes [13][14][15] and major complications such as retinal detachment, endophthalmitis and the sustainability of the haptic flanges, threads or anchor haptics. 16 Very little has been published on the postoperative anatomy of the anterior chamber, and even less is published on a finding called reverse pupillary block (RPB).…”

Section: Introductionmentioning

confidence: 99%

Reverse pupillary block, in contemporary scleral intraocular lens procedures

Schranz,

Schartmüller,

Lisy

et al. 2024

Clinical Exper Ophthalmology

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BackgroundTo evaluate the frequency and anterior segment optical coherence tomography parameters of patients with scleral fixated intraocular lenses (IOL) and reverse pupillary block (RPB).MethodsRetrospective analysis at a tertiary care centre (Department for Ophthalmology and Optometry, Medical University of Vienna, Austria).We researched our records for patients who underwent scleral fixated IOL implantation from January 2018 till February 2023.Patients were included only if there was at least one adequate post‐operative scan of anterior segment optical coherence tomography (AS‐OCT) available.Initially, AS‐OCT scans were assessed for IOL tilt and decentration employing a 3D scan and then later for anterior chamber angle (ACA), aqueous anterior chamber depth (AQD), pupil diameter and iris‐IOL distance using the 2D scan at a 0° angle. Both an iris‐IOL distance of 0 or less and an ACA of more than 70° were required to define an RPB.ResultsA total of 110 patients met the inclusion criteria, 41 were treated using the Carlevale, 33 the four flanged, 24 the Yamane and 12 the Scharioth technique, respectively. RPB was found in 32 patients (29%). Twenty patients with RPB were treated using YAG peripheral iridotomy, mean ACA decreased from 91.91° ± 13.77 to 61.02° ± 8.52, (p < 0.001), mean AQD decreased from 4.67 mm ± 0.47 to 4.31 ± 0.36 mm (p < 0.001) and mean iris‐IOL distance increased from −0.09 ± 0.04 to 0.33 ± 0.30 (p < 0.001).ConclusionsRPB is found in a third of eyes who have undergone scleral fixated IOL implantation without iridectomy. YAG peripheral iridotomy is a potent option to treat RPB, and subsequently reduce the risk of iris chafing and secondary inflammation or glaucoma.

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Short-term outcomes of a modified technique for small-incision scleral-fixated intraocular lens implantation using Gore-Tex sutures

Cited by 4 publications

References 33 publications

A novel surgical approach for fixation of a posterior chamber intraocular lens of Rayner 620 H with Gore-Tex suture

A novel surgical approach for fixation of a posterior chamber intraocular lens of Rayner 620 H with Gore-Tex suture

Scleral flaps, pars plana vitrectomy and gore-tex sutured posterior chamber intraocular lens placement: a case series and review of literature

Reverse pupillary block, in contemporary scleral intraocular lens procedures

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