Abstract

BackgroundTo investigate the long-term outcomes and complications of scleral-fixated intraocular lens (SFIOL) implantation without conjunctival peritomies and sclerotomy in patients with a history of ocular trauma with inadequate capsular support during primary pars plana vitrectomy or silicone oil removal.MethodsRecords of ocular trauma patients who underwent implantation of SFIOL without conjunctival peritomies and sclerotomy during primary pars plana vitrectomy or silicone oil removal.ResultsSixty-nine eyes of 69 patients were included in this study. The median follow-up period was 34 months (range, 6–99 months). The average patient age at the time of surgery was 44 years old (range, 4–80 years). At the end of follow-up, the preoperative mean of best corrected visual acuity (BCVA) was 0.79 ± 0.86 log of the minimum angle of resolution (logMAR), which improved 0.20 ± 0.26 logMAR postoperatively (P = 0.01). BCVA improved or remained unchanged in 64 eyes (92.8%), VA decreased two lines in five eyes (7.2%). Early postoperative complications included transient corneal edema in seven eyes (10.1%), minor vitreous hemorrhage in four eyes (5.8%), transient elevated intraocular pressure (IOP) in one eye (1.4%), and hypotony in three eyes (4.3%). Late postoperative complications included persistent elevated IOP in five eyes (7.2%), epiretinal membrane formation in three eyes (4.3%), and cystoid macular edema noted in one eye (1.4%).ConclusionsUse of a scleral-fixated intraocular lens implantation without conjunctival peritomies and sclerotomy in ocular trauma patients during either primary pars plana vitrectomy or second silicone oil removal is a valuable approach for the management of traumatic aphakia in the absence of capsular support.

Highlights

  • To investigate the long-term outcomes and complications of scleral-fixated intraocular lens (SFIOL) implantation without conjunctival peritomies and sclerotomy in patients with a history of ocular trauma with inadequate capsular support during primary pars plana vitrectomy or silicone oil removal

  • We have developed a new surgical procedure to reduce SFIOL-related complications in ocular trauma patients without sufficient capsule support during primary pars plana vitrectomy (PPV) or secondary silicone oil removal

  • The inclusion criteria were (1) primary PPV plus lensectomy and SFIOL implantation in ocular trauma patients with dislocation or loss of normal lens or IOL accompanied by vitreous hemorrhage

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Summary

Introduction

To investigate the long-term outcomes and complications of scleral-fixated intraocular lens (SFIOL) implantation without conjunctival peritomies and sclerotomy in patients with a history of ocular trauma with inadequate capsular support during primary pars plana vitrectomy or silicone oil removal. Ocular trauma is one of the main causes of severe visual impairment. Traumatic cataracts and lens dislocations or loss are the most common and significant sequela of ocular trauma [2]. For eyes with post-traumatic cataracts or abnormal lens positions, lens removal surgery should be performed. Ocular trauma patients often have deficient capsular support and preoperative zonular tear. Scleral fixated posterior chamber intraocular lens (SFIOL), anterior chamber intraocular lenses (ACIOL), iris-fixed IOL, are alternative options to intraocular lens (IOL) implantation in eyes with inadequate capsular or zonular

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