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Ultrasound biomicroscopic evaluation of stability of trans-scleral and intrascleral fixated intraocular lenses

Session Details

Session Title: Subluxed IOLs and Scleral Fixation

Session Date/Time: Wednesday 09/10/2013 | 08:00-10:30

Paper Time: 08:37

Venue: E102 (First Floor)

First Author: : R.Sinha INDIA

Co Author(s): :    M. Bansal   N. Sharma   R. Tandon   J. Titiyal     

Abstract Details

Purpose:

To evaluate and compare the stability of trans-scleral suture fixation and intrascleral glued haptic fixation of posterior chamber intraocular lens (IOL) using ultrasound biomicroscope (UBM).

Setting:

Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi.

Methods:

Scleral fixation of posterior chamber IOL was performed in 40 eyes of 40 patients. Of these, 20 eyes underwent intrascleral haptic fixation with fibrin glue and 20 eyes underwent trans-scleral suture fixation of IOL in the posterior chamber. Ultrasound biomicroscopy was performed at 3 months following surgery to look for the stability of IOLs. The visual outcome and presence of any intraoperative or postoperative complication in both the procedures were also compared.

Results:

The patients in both the groups were comparable preoperatively. The mean pre-operative uncorrected visual acuity (UCVA) in logMAR was 1.59 ±0.24 and 1.63 ±0.26 in the sutured and glued group respectively (Mann Whitney U test, p=0.45). The mean post-operative UCVA at 6 months was 0.33 ± 0.17 in sutured and 0.22 ±0.10 in the glued group. There was significant improvement in UCVA in both groups (Wilcoxon signed-rank test, p=0.001). Mean UCVA and BCVA at 6 months were more in the glued group which was statistically significant (p<0.05). UBM showed greater pseudophakodonesis in the sutured group in comparison to glued group (Chi-square test, p=0.046). The degree and range of movement of IOL in sutured group was higher. Mean central macular thickness (CMT) in micrometers was 250.95 ±23.98 in sutured and 225.85 ±21.13 in glued group (Mann Whitney U test, p=0.009). Vision and CMT were found to have inverse correlation [Pearson correlation -0.475 (p=0.01)].

Conclusions:

Intrascleral glued haptic fixation of a posterior chamber IOL provides greater stability of IOL with lesser pseudophacodonesis thereby possibly resulting in lesser chance of macular edema in comparison with sutured trans-scleral fixation of IOL.

Financial Interest:

NONE