Secondary Sutureless Posterior Chamber Lens Implantation with Two Specifically Designed IOLs: Iris Claw Lens versus Sutureless Trans-Scleral Plugs Fixated Lens.

Daniel Seknazi,Francesca Amoroso,Eric H. Souied,Alexandra Miere,Rachid Tahiri,Donato Colantuono

doi:10.3390/jcm10102216

Daniel Seknazi, Francesca Amoroso + Show 4 more

Open Access

https://doi.org/10.3390/jcm10102216

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Abstract

Background. The management of patients with aphakia and/or lack of capsular support remains debated. The sutureless posterior chamber IOL (PCIOL) fixation is a very useful surgical option. The purpose of the study was to compare the early outcomes as well as post-operative best corrected visual acuity, refractive errors and complications of two different techniques of sutureless PCIOL secondary implantation. Methods. Patients who underwent secondary implantation from December 2019 to January 2021 in the Department of Ophthalmology of Creteil Hospital, and in the Granville Ophthalmology Center, were retrospectively included. Eyes implanted with the iris claw lens (Artisan Aphakia IOL model 205, Ophtec BV, Groningen, The Netherlands) were included in group 1, and eyes implanted with a newly developed sutureless trans-scleral plugs fixated lens (STSPFL, Carlevale lens, Soleko, Pontecorvo, Italy) were included in group 2. Results. Twenty-two eyes of 22 patients were enrolled in group 1, and twenty eyes of 20 patients in group 2. No difference was found in visual acuity between two groups (0.35 +/− 0.29 logmar for group 1 and 0.23 +/− 0.51 logmar for group 2) (p = 0.15) at mean post-operative follow up (6.19 +/− 3.44 months for group 1 and 6.42 +/− 3.96 months for group 2) (p = 0.13). Both the mean refractive error (MRE) and induced astigmatism (IA) were greater in group 1 compared to group 2, respectively: the MRE was 0.99 +/− 0.57 vs. 0.46 +/− 0.36 (p < 0.01), and IA was 1.72 +/− 0.96 vs. 0.72 +/− 0.52 (p < 0.01). Conclusions. No significant differences in terms of the recovery of visual acuity were found between the two groups. Group 2 (STPFL) gives better results in our sample due to less post-operative induced astigmatism and less refractive error.

Highlights

The surgical solution for patients with aphakia and/or lack of capsular support remains a debated topic
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The available options are the implantation of the intraocular lens (IOL) in the anterior chamber (ACIOL) or the fixation of the IOL to the iris or the sclera, in the posterior chamber (PCIOL) [1]

Summary

Introduction

The surgical solution for patients with aphakia and/or lack of capsular support remains a debated topic. According to the classic procedure, the designed IOL is injected through a 5.5 mm incision and anchored posterior to the iris by fine haptics, without sutures, with more stability and lower risk of iris injury [3]. This technique has very good visual outcomes and low complication rates, even though the large corneal incision induces significant postoperative astigmatism and the integrity of the iris diaphragm is an indispensable requirement for the surgery [1].

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