Abstract
BackgroundsHowever there have been numerous investigations of intrascleral intraocular lens (IOL) fixation techniques, there is room for improvement in terms of simplifying complicated techniques and reducing the high levels of skill required. This study aimed to report a novel technique for sutureless intrascleral fixation of the IOL using retinal forceps with a 27-gauge trocar.MethodsNineteen eyes of 18 patients underwent intrascleral fixation of the IOL from July 2018 to September 2019 were enrolled in this study. A 27-gauge trocar formed 3-mm scleral tunnels positioned at 4 and 10 o’clock, 2 mm from the corneal limbus. We used a 3-piece IOL haptic grasped by a 27-gauge retinal forceps and pulled from the 27-gauge trocar. The IOL was fixed by making a flange. Main outcome measures were visual acuity, corneal endothelial cell density, IOL tilt, decentration, predicted error of refraction and complications.ResultsThe 19 eyes were followed up for 1 month. The mean pre- and postoperative logMAR uncorrected visual acuity (UCVA) was 1.06 ± 0.63 and 0.40 ± 0.26, respectively (p < 0.01), while the mean pre- and postoperative logMAR best corrected visual acuity (BCVA) was 0.27 ± 0.51 and 0.06 ± 0.15, respectively (p = 0.09). The mean corneal endothelial cell density was 2406 ± 625 to 2004 ± 759 cells/mm2 at 1 month (p = 0.13). The mean IOL tilt was 3.52 ± 3.00°, and the mean IOL decentration was 0.39 ± 0.39 mm. There was no correlation among IOL tilt, decentration and BCVA (p > 0.05). The mean prediction error of the target refraction was − 0.03 ± 0.93 D. The complications were vitreous hemorrhage (3 eyes), hyphema (1 eye), IOP elevation (1 eye), iris capture of the IOL (1 eye) and hypotony (2 eyes). No IOL dislocation occurred.ConclusionsIOL intrascleral fixation with a flange achieved good IOL fixation and visual outcome in the scleral tunnels created with the 27-gauge trocar.
Highlights
The pseudophakic population has been growing very rapidly in recent years as a result of longer lifespans, new phacorefractive procedures and improvements in the quality and safety of phacoemulsification surgery [1]
We developed a novel sutureless scleral Intraocular lens (IOL) fixation technique using a 27-gauge trocar with a flange
Totan and Karadag described a technique for making scleral tunnels prepared by insertion of 25-gauge transconjunctival sutureless vitrectomy microcannulas using trocars, and this technique provided good IOL stabilization with a shorter surgical time [14]
Summary
The pseudophakic population has been growing very rapidly in recent years as a result of longer lifespans, new phacorefractive procedures and improvements in the quality and safety of phacoemulsification surgery [1]. Intraocular lens (IOL) dislocation is a late complication after cataract surgery. It was reported that 20 years after. IOL dislocation causes a variety of complications. Increased intraocular pressure, rhegmatogenous retinal detachment, and vitreous hemorrhage may occur and urgent surgery is required [3, 4]. There are two procedures to correct IOL dislocation. One is the use of ab externo suture techniques to guide the sutures through the sclera to fix the IOL, as first reported by (2021) 21:8
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