Abstract

SA.22.04

Long-term results of sutureless intrascleral PC IOL fixation

Mitrofanis Pavlidis1, Calin Tataru2, Ilias Georgalas3, Gabor Scharioth1
1Augenzentrum Recklinghausen, Recklinghausen, 2Alcor Eyeclinic Bucarest, Bucarest, Romania, 3Vitreoretinal Department, Eyeclinic, University of Athens, Athen, Greece

Backround
There are different options for intraocular lens implantation in the absence of sufficient capsular support: AC IOL, irisfixated IOL and suturefixated PC IOL. We developed a technique for sutureless intrascleral fixation of the haptics of a standard three piece PCIOL. We report the 7 months (median) multicenter results of a technique for sutureless fixation of standard three-piece posterior chamber intraocular in the ciliary sulcus.
Methods
The study involved 60 eyes operated in 3 european ophtalmological centers. After standard three port pars plana vitrectomy and preparation of corneal incision for injector-assisted IOL implantation two straight sclerotomies are prepared with a 24G cannula 2.0 mm from the limbus exact 180° to each other. Then this cannula is used to create a 2.0-3.0 mm long limbusparallel tunnel starting from the sclerotomies. A standard three-piece intraocular lens is implanted with an injector and the tailing haptic is fixed in the corneal incision. The leading haptic is then grasp at its tip with an end gripping 25G forceps and pulled through the sclerotomy. Then this forceps is introduced in the distal end of the limbusparallel tunnel and while grasping the tip, the IOL haptic is pulled into the tunnel.
Results
Except difficulties in the intrascleral positioning of the forceps no intraoperative complications occured. Most IOLs were stable and centered 58. Two dislocated PC IOL have been recentered. Potential complications of transscleral fixation of PC IOLs include suture erosion, suture knot exposure and recurrent dislocation caused by a broken suture could be avoid by sutureless technique, used in our cases. There were no cases of endophthalmitis, vitreous hemorrhage, retinal detachment, or glaucoma.
Conclusions
This technique simplifies scleral fixation of PC IOLs and allows successful repositioning of dislocated and subluxated PC IOLs. It also minimizes intraoperative maneuvers that could reduce the risc of intraoperative trauma. Furthermore this technique can be performed with a standard three piece PC IOL without need of special haptic architecture or preparation or the need for storage or ordering special IOLs for rare indications.

Copyright: 2009 Porstmann Kongresse GmbH. All rights reserved. Impressum, Disclaimer.