Transscleral knotless zigzag suture fixation of four-haptic hydrophilic acrylic foldable IOL in the management of aphakia: clinical outcomes

Session Details

Session Title: Cataract Surgery Complications: IOL Dislocation and Opacification

Session Date/Time: Tuesday 10/10/2017 | 14:00-16:00

Paper Time: 14:32

Venue: Room 3.6

First Author: : V.Lages PORTUGAL

Co Author(s): :    J. Coelho   N. Correia   B. Pessoa   M. Beirao   N. Ferreira   M. Angelina     

Abstract Details

Purpose:

There is no consensus on the optimal choice of intraocular lenses (IOL) or fixation methods in eyes without capsular support. The purpose of this study was to determine the refractive and visual outcomes and complications of combined vitrectomy and transscleral knotless zigzag suture fixation of Bausch & Lomb Akreos Adapt AO® four-haptic hydrophilic acrylic foldable IOL (AA-IOL) in the management of aphakia with inadequate capsular support.

Setting:

Department of Ophthalmology of a tertiary referral center in Porto, Portugal - Centro Hospitalar e Universitário do Porto.

Methods:

Retrospective case series analysis of 52 eyes, mean age of 73,3 ± 13,2 years, submitted to pars plana vitrectomy and transscleral knotless zigzag suture fixation of AA-IOL due to late-in-the-bag IOL dislocation (IOLD) (n=32, trauma n=1), cataract surgery complicated by vitreous loss (CSC) (n=9) , lens dislocation (n=7, trauma n=6), scleral fixated IOL with recurrent intraocular bleeding (n=3) and corneal endothelium loss due to anterior chamber IOL (n=1), between October 2011 and February 2017. The main outcome measures were baseline best corrected visual acuity (BCVA) improvement, postoperative refractive cylinder and postoperative complications.

Results:

Mean follow-up was 10,6 (1 to 62) months. In the IOLD group, 56,2% had AA-IOL repositioned with scleral fixation and 43,8% had IOL exchanged to a scleral-fixated AA-IOL. In the CSC group, 66,7% had AA-IOL secondary implantation and 33,3% had AA-IOL primary implantation. Mean BCVA improvement was 31,0 letters (-25 to 80) (p<0,001). Postoperative mean cylinder was 0,78 ± 0,92. The main postoperative complications were: elevated IOP controlled with topical medication (n=5), cystoid macular edema (n=2), endothelial decompensation (n=1), corneal wound leakage (n=1), recurrent intraocular bleeding (n=1) and endophthalmitis (n=1).

Conclusions:

This study reports the postoperative results of patients submitted to pars plana vitrectomy and transscleral knotless zigzag suture fixation of AA-IOL in our clinical department. It demonstrated an improvement in BCVA with acceptable refractive results and a low incidence of severe intraoperative and postoperative complications.

Financial Disclosure:

NONE