First Author: A. Gorbunov RUSSIA
Co Author(s): V. Kanyukov
Purpose:
Development and insertion of new fixation way of soft intraocular lens to the iris at solution of capsular bag continuity and lens ligamentous failure at surgical incision 2.2 mm in clinical practice.
Setting:
Orenburg Branch of Federal State Institution " The Acad. S.N.Fyodorov Intersectoral Research & Technology Complex " Eye Microsurgery" of the Minzdravsocrazvitiya of the Russian Federation, Orenburg, Russia.
Methods:
Sub-tenon anesthesia was carried out in eyeball inferior internal part. Intraocular lens was implanted in the presence of capsular bag part, in it, or on it, after there had been performed preliminary anterior vitrectomy using 1.8mm injector. One haptic was infringed in surgical wound with size of 2.2mm. and tied by polypropylene suture 10,0. The ligatured haptic was moved in capsular bag and needle was output through left paracentesis forward end with pressed-in thread. Then the iris was needled in the incision projection and the needle was output through the incision. The next stitch was applied along the pupillary ring of iris in its central part through the operating incision; the needle was output with its point forward through the left paracentesis. Using the surgical instrument " iris microhook" we hooked the suture going the needle and there were formed two ends of a thread which were linked together in a knot. Intraocular lens was centered. If it was necessary, anterior vitrectomy was performed. After the carried out procedures viscoelastic was taken out of the anterior chamber, the wound edges and paracentesis were hydrated. At the end-stage of operation hormone with antibiotic and 0.5ml deprospan was inserted parabulbarly under conjunctiva.
Results:
5 patients with solution of capsular bag continuity during surgery and 10 patients with solution of lens ligamentous apparatus were operated according to the given method. In postoperative period the position of intraocular lens was correct and stable during all follow-up period. Acuity of vision was from 0.3 to 1.0 depending on the state of macular area.
In late postoperative period macular edema (Irvine-Gass syndrome) was observed in 2 cases. Complications were cut off medicamentally. Values of intraocular pressure were compensated in all cases. Long-term results were followed up to 1 year.
Conclusions:
Outcome analysis of the given method of soft intraocular lens fixation to the iris shows simplicity and safety of performing the procedure, providing stability of intraocular lens position and the absence of severe intra- and postoperative complications, and also few complications in late postoperative period that affords ground for considering this method rather effective and less traumatic. FINANCIAL DISCLOSURE?: No
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