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The implantation of a sutureless scleral fixation posterior chamber IOL: the Carlevale intraocular lens. Long-term visual outcomes and complications

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First Author: A.Greco ITALY

Co Author(s):    A. Vaiano   G. Savini   C. Carlevale   A. Greco   D. Giovanni   A. Greco     

Abstract Details

Purpose:

To evaluate BCVA and possible complications of a new IOL in patients undergoing a sutureless scleral intraocular fixation technique

Setting:

Prospective,single-center, non comparative, interventional case series Santa Croce e Carle Hospital, Cuneo, Italy

Methods:

59 eyes of 58 consecutive patients were enrolled, with either aphakia or lens/IOL dislocation due to capsular or zonula defects.A pre-operative complete clinical evaluation was performed and repeated during follow-up.After conjunctiva dissection, two anteriorly hinged scleral flaps were made. The IOL was placed in posterior chamber via a 2.2 mm corneal incision and once fully opened,gently grabbed by 25-gauge forceps bended 90° apart through the distal sclerotomy up to the scleral surface, blocking the two short arms into the scleral flap, avoiding suture.A combined pars plana vitrectomy was performed in the majority of cases

Results:

We included 59 eyes. Mean age was 66 ± 18.79 years. The mean preoperative best-corrected VA was 1.02 ± 0.59 logMAR; remarkably improved after the procedure to 0.32 ± 0.28 by the last follow-up (p < 0.001 Paired Sample T-test), resulting in statistically significant difference between the groups.The mean corneal endothelial cell density decreased from 1743 ± 508 cells/mm2 before surgery to 1619 ± 522 cells/mm2 at 12 month. We had 6 cases of intraoperative aptic rupture (11,11%) 4 anterior chamber hemorrhage (7,40%) one retinal detachment (1,85%), and two conjunctival aptic exposition (3,70%). There were no episode of postoperative endophthalmitis, or IOL dislocation.

Conclusions:

Endothelial cell count loss noticed is in line with other surgical procedures, and BCVA statistically improved postoperatively.After an initial learning curve the new technique became intuitive.Avoiding suture and large corneal incision may reduce surgery time and related complications such as suture erosion,IOL dislocation and risk infection. The SSF Carlevale IOL seems a surgical solution combining the advantages of an easy and minimally invasive implantation with a good functional recovery.

Financial Disclosure:

... receives consulting fees, retainer, or contract payments from a competing company