Efficacy of different fixation methods of intraocular lenses in case of dislocation or in the absence of capsule support

Session Details

Session Title: Presented Poster Session: Cataract Complications & Special Cases

Venue: Poster Village: Pod 1

First Author: : S.Pinchuk UKRAINE

Co Author(s): :    M. Karliychuk   O. Baryska   V. Zamjatin   A. Lukijan              

Abstract Details

Purpose:

To demonstrate results of efficacy and safety of scleral and iris fixation of different IOLs in case of dislocation or after implantation into aphakic eye without capsule support by analysis of 127 medical records of patients which underwent surgery by one surgeon since 2008 till 2016.

Setting:

Center of Modern Ophthalmology “Vash Zir”, Chernivtsi, Ukraine.

Methods:

98 eyes had IOL dislocation as a result of: progressive pseudoexfoliation syndrome (71,4%), trauma (11,2%), capsule damage during extracapsular cataract extraction or phacoemulsification (17,4%). IOL types: 31,6% - “AcrySof” single-piece, 46,9% - hydrophilic acrylic IOL, 21,5% - PMMA IOL. 29 eyes were aphakic as a result of complicated cataract extraction. “AcrySof IQ” IOLs were implanted into these 29 eyes. IOLs were sutured with 10-0 polypropylene to sclera (56,7%) or to iris (43,3%). In 66,3 % cases partial anterior vitrectomy was performed. Stability of IOL position, complications and time of procedure were analysed. Time of observation was 1 - 8 years.

Results:

In all eyes with “AcrySof” stable centered IOL position, no cases of displacement were observed in long-term period. There were 2 cases (4,3%) of haptic breakage and 3 cases (6,5%) of significant decentration in eyes with sutured hydrophilic IOL. There were 2 cases (9,5%) of redislocation PMMA IOL. In all cases IOL were explanted and “AcrySof” were implanted and sutured. There were 1 case (1,8%) of hyphema after iris fixation and 5 cases (6,9%) of hemophthalmos after scleral fixation. Average time of procedure was in iris fixation – 21 ± 4 min, in scleral fixation – 37 ± 11 min.

Conclusions:

“AcrySof” IOLs demonstrate good stable follow-up after polypropylene suture fixation both to iris and to sclera with minimal complications in comparison with other types of IOL. Iris fixation is easier technically and faster. At the same time iris fixation of IOL causes myopic shift, that should be taken into account when calculating IOL power befor implantation into aphakic eye.

Financial Disclosure:

None