Visual outcome and early complications of sutureless and glueless scleral fixated intraocular lens

Abstract

Introduction: In the absence of capsular support, anterior chamber intraocular lens (IOL), iris fixated IOL and sutured scleral fixated intraocular lens (SFIOL) implantation have been performed for many years. Recently sutureless glued SFIOL have been used as a primary or secondary procedure to correct aphakia. In this study we have used sutureless and glueless technique of SFIOL implantation. Methodology: An interventional case series was conducted. Aphakic patients without capsular support, sub-luxated lens (>180˚), dislocated lens and dislocated IOL were the inclusion criteria. The patients with hazy cornea, non-dilating pupil, macular scar and glaucoma were not enrolled in the study. Results: Of 62 eyes who completed 1 month followup, 48 were men and 14 women. There was a significant improvement in uncorrected distance visual acuity after surgery (p<0.001). One month postoperative best corrected distance visual acuity was 6/18 or better in 45 eyes (72.6%). The common early postoperative complications were hypotony, corneal edema. No serious complications such as endophthalmitis and retinal detachment were seen. Conclusion: Our technique of sutureless and glueless SFIOL implantation showed good visual outcome in the absence of serious complications. SFIOL will be the only choice in eyes that have anatomic contraindications like non constricting pupil, large sectoral iridectomy and peripheral anterior synechia in which other types of lens are not suitable.

27-gauge needle-assisted externalization and haptic securing technique for sutureless scleral fixation of the intraocular lens &ndash; moving toward simplicity

“…Most authors have reported a low IOP in their cases following surgery in the immediate postoperative period. 21 , 24 In our study, postoperative hypotony was not present in any of the cases. Instead, raised IOP was the most common immediate postoperative complication seen in 4 (4.5%) of the cases.…”

“…The results of our technique have been encouraging, with 94% of the cases attaining a stable BCVA of 6/12 or better at 6 weeks. Agarwal et al 21 have reported 72% of their patients undergoing SFIOL of having vision better than or equal to 6/18 in a similar setup but with a different technique. They have also reported that there was no drop in BCVA at 1-month follow-up.…”

Intraocular lens implantation in the absence of capsular support: scleral-fixated vs retropupillary iris-claw intraocular lenses

“…The incidence of corneal edema after SF IOL implantation has been reported to range from 1% to 41%, with most of the studies reporting this in the early postoperative period (∼1 month). 12,13,17–20,23,25,28,30,31,40,44,49 After RP-IC IOL implantation, Hazar et al and Shanida et al reported transient corneal edema as an early postoperative complication in 4.1% and 30% of eyes, respectively, which resolved after 1 week. 23,36 In addition, Faria et al reported corneal edema in 2.85% of eyes (3/105) over a mean follow-up of 23 months.…”

“…16–18,25,39,40,44,49,63–65,77 Among SF IOL studies, Leung et al and McKee et al reported broken haptic in 6.3% and 2% of cases after 1 and 3 months, respectively; Agarwal et al reported dislocated haptic in 1.6% of cases after a mean follow-up of 8.1 months. 28,88,89 Chan et al reported vitreous incarceration at the wound site in 1.4% of eyes after sutured SF IOL, and Sy Oh et al reported 8.3% after sutureless SF IOL implantation. Yalniz-Akkaya et al reported wound leakage in 3.4% of eyes, which required resuturing within 1 month.…”

Intrascleral Knotless Zigzag Suture Fixation of Four-Haptic Hydrophilic Acrylic Foldable IOL: Clinical Outcomes

“…Of note, this complication was more frequent than hypertension with haptic-fixation techniques. 9 , 39 Kam et al 38 reported early ocular hypertension and vitreous hemorrhage to be more frequent following SFIOL implantation without concurrent PPV. In our series, all patients were vitrectomized, which explains the lower rate of vitreous hemorrhage.…”