Intraocular lens ciliary sulcus suspension in aphakic vitrectomized eyes under anterior chamber perfusion

Abstract

Objective To evaluate the clinical efficacy of suture fixation to ciliary sulcus of a foldable intraocular lens (IOL) with the 25 G anterior chamber perfusion in eyes that had pars plana vitrectomy combined with lensectomy. Methods This is a retrospective non-comparative study. The medical data of 31 eyes of 31 patients who had vitrectomy combined with lensectomy surgery for severe vitreoretin opathy from Jan, 2012 to Dec, 2013 were reviewed. The underlying vitreoretinal diseases were complicated ocular trauma(n=16), proliferative vitreoretinopathy (n = 8), proliferative diabetic retinopathy (n= 4), and lens dislocation in vitreous cavity (n=3). The uncorrected visual acuity (VA) of the 31 eyes was from LogMar 6.64 to LogMar 3.06 and the best corrected visual acuity (BCVA) was from LogMar 2.74 to LogMar 0.097. In addition, the preoperative aphakic period and stable posterior segment condition was maintained at least 6 months. All the surgical procedures were operated by one surgeon, and were that the foldable IOL was implanted and sutured to ciliary sulcus through 3 mm limbal incision under 25 G anterior chamber perfusion. The follow-up after the surgery was more than 3 months. The value of VA, BCVA, intraocular pressure (IOP), the number of corneal endothelium cells (NCEC), the condition of IOL location and complications in all patients were recorded. The statistical analysis was paired t test. Results The postoperative uncorrected VA reached from LogMar 3.32 to LogMar 0.097 that was better than the preoperative VA at 3 to 6 months after the surgery (P 0.01). The NCEC 3 months after the surgery was (1789±321)/ mm2 and compared with preoperative (1837±289)/mm2, the difference was not statistically significant (P>0.01). The IOL location was at the center in 29 eyes (93.54%), mildly eccentric in 1 eye (3.23%), and slightly tilt in 1 eye (3.23%). A transient vitreous hemorrhage occurred in 1 eye after the surgery. Conclusion Suture fixation to ciliary sulcus of a foldable intraocular lens (IOL) through 3.0 mm limbal incision with the 25 G anterior chamber perfusion for aphakic eye after vitrectomy combined with lensectomy is safe with stable IOP. Key words: Aphakic; Lens, artificial, foldable; Implantation; Anterior chamber perfusion, 25 G