Visual outcomes of posterior chamber intraocular lens intrascleral fixation in the setting of postoperative and posttraumatic aphakia.

Dariusz Haszcz,Agnieszka Oleszczuk,Cesare Forlini,Matteo Forlini,Joanna Moneta-Wielgos,Robert Rejdak,Anselm G Jünemann,Ryszard Maciejewski,Katarzyna Nowomiejska,Katarzyna Michalska-Malecka

doi:10.1186/s12886-016-0228-y

Abstract

BackgroundSeveral techniques for fixation of the posterior chamber intraocular lens (IOL) have been developed. We evaluate long-term functional outcomes and safety of posterior chamber IOL implantation using Hoffman scleral haptic fixation and sutureless Sharioth technique in patients with posttraumatic and postoperative aphakia.MethodsThis retrospective case-series included 42 eyes operated by one surgeon. The data including demographic data, ocular history, preoperative, early postoperative and final best corrected visual acuity (BCVA), rate of complications as well as postoperative IOL position were collected. The mean follow-up was 14.5 months. Hoffman haptic scleral fixation was performed in 31 eyes, Sharioth technique—in 11 eyes. Aphakia was due to eye trauma (19) or complicated cataract surgery (23).ResultsOverall, the final BCVA improved in 26 eyes, did not change in 5 eyes, and worsened in 11 eyes. No significant differences in BCVA were found between groups operated with Hoffman scleral fixation and Sharioth technique. Postoperatively, we noticed two dislocations of IOL fixated using Sharioth technique and none after Hoffman technique. No severe complications were observed.ConclusionBoth transscleral fixation techniques are feasible methods of secondary IOL implantation in posttraumatic and postoperative aphakia. with low incidence of complications, however visual outcomes are diverse.

Highlights

Several techniques for fixation of the posterior chamber intraocular lens (IOL) have been developed
Suturing the IOL to the iris may result in iris chafing, uveitis, and pupillary constriction [10]
Mean preoperative best corrected visual acuity (BCVA) was 0.291 in the group operated with Hoffman technique and 0.245 in the group managed with Sharioth technique

Summary

Introduction

Several techniques for fixation of the posterior chamber intraocular lens (IOL) have been developed. We evaluate long-term functional outcomes and safety of posterior chamber IOL implantation using Hoffman scleral haptic fixation and sutureless Sharioth technique in patients with posttraumatic and postoperative aphakia. Surgical secondary artificial intraocular lens (IOL) implantation is a standard procedure both in posttraumatic and postoperative aphakia. The technique of implantation of IOL may vary from putting the lens into the bag [1] to suturing of IOL to iris or implantation to the anterior or posterior chamber [2,3,4,5,6,7]. If the anterior capsule is not damaged, the lens may be implanted to the sulcus [1]. If the posterior capsule is not present and if there is lack of iris tissue, most of IOLs are placed into posterior chamber and sutured to the sclera through the ciliary sulcus or pars plana

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