Two techniques of posterior chamber intraocular lens (IOL) implantation by a 4-point ciliary sulcus suture fixation technique combined with vitrectomy

Abstract

To observe the results of two techniques of posterior chamber intraocular lens (IOL) implantation by a 4-point ciliary sulcus suture fixation combined with vitrectomy. Lensectomy and vitrectomy combined with posterior chamber IOL implantation by a 4-point scleral fixation was performed in 23 cases with complicated ocular trauma, including 9 eyes had eyeball rupture, vitreous hemorrhage, retinal contusion and traumatic cataract; 6 eyes having eyeball rupture, vitreous hemorrhage, retinal contusion, intraocular foreign body and traumatic cataract; 8 eyes having ocular blunt trauma, vitreous hemorrhage, traumatic cataract and lens dislocation. Two techniques of IOL were randomly assigned: Alcon CZ70BD PMMA suspensory IOL was performed in 12 cases (Group I); Bausch & Lomb Akreos Adapt four-haptic hydrophilic acrylic foldable IOL was performed in 11 cases (Group II). After completed vitrectomy, removed intraocular foreign body and (or) cataract extracted, one-stage IOL implantation by 4-point scleral fixation was performed and the knots of fixation sutures were rotated and buried under the sclera for all patients. The IOL position was adjusted by suture for the best centration. The mean follow-up time was (12.4 +/-1.7) months. The postoperative best-corrected visual acuity (BCVA) was improved in 11 cases (91.7%) of Group I; and BCVA was > or =0.5 in 3 patients(25.0 %). The postoperative BCVA was improved in 11 cases (100 %) of Group II; and BCVA was > or =0.5 in 4 eyes (36.4%). There was no IOL decentration or tilting in two groups. Lensectomy and vitrectomy combined with posterior chamber IOL implantation by a 4-point scleral fixation technique is a good method to treat complicated ocular trauma. Two techniques of posterior chamber IOL have both advantages and disadvantages, and can be used accordingly.