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Case series report for scleral fixated sutureless intraocular lens implantation sutureless intra-ocular lens for aphakia

Poster Details

First Author: D.Matos PORTUGAL

Co Author(s):    D. Bernardo-Matos   N. Pinto-Ferreira   R. Barão   M. Faria           

Abstract Details

Purpose:

Description of the implantation technique of a retropupillary foldable lens, without the need for corneal or scleral fixation suturing. Description of the functional and anatomical outcomes of the surgeries.

Setting:

All surgeries were conducted at Centro Hospitalar Universitário Lisboa Norte – Hospital Santa Maria (CHULN – HSM) with explicit informed consent and following the portuguese medical legis artis.

Methods:

A total of 3 patients underwent Carlevale® lens implantation. All the surgical procedures were performed by vitreo-retinal surgeons (MF and NPF) at CHULN-HSM, under local anaesthetic protocol. Bilateral periotomies were performed 180º apart and 2 scleral flaps were created, respectively at 3 and 9 o’clock with a crescent knife. Pars Plana Vitrectomy was performed with subsequent extraction of the subluxated lens and capsular remnants. A 2.65 mm clear corneal incision was made, through which the folded Carlevale® lens was introduced. The anchoring haptics were then exteriorized on both scleral sides with the assistance of two 23G vitrectomy forceps.

Results:

A total of 3 patients underwent the procedure. All patients experienced clinical improvement of best-corrected visual acuity (BCVA) on first post-operative follow-up appointment. The 2 myopic patients with sub-luxated lens achieved BCVA of 20/100 and 20/20 respectively. The third patient, which was left aphakic after a complicated cataract surgery also achieved a 20/20 BCVA post Carlevale® implantation. No complication was reported and the implanted lenses were stable and their optical segment was well centred, as confirmed by Ultrasound Biomicroscope (UBM) protocols.

Conclusions:

The implantation of a foldable retro-pupillary lens with scleral anchoring without suturing of other fixation means seems to present a promising solution over standard iris-fixed or scleral-sutured techniques, especially in aphakic or otherwise complicated patients. The Carlevale® lens does not imply corneal suturing and therefore induces little astigmatism. Since there is no need for iris fixation no pigmentary dispersion was observed. This seems to be a safe and easy technique to perform in the context of lens sub-luxation or aphakic patients. This option for aphakia has the advantage of a better 3-dimentional stability and long-term refractive predictability.

Financial Disclosure:

None

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