Sutureless Technique Research Articles

Iris Fixation for Intraocular Lens Dislocation: Relocation with Iris Suture Versus Exchange to Sutureless Iris Claw IOL.

Background/Objectives: To compare the clinical outcome of suture and sutureless iris fixation techniques for dislocated intraocular lenses (IOLs). Methods: Retrospective cohort study including patients who underwent surgery for late IOL dislocation over a 10-year period. IOL repositioning was achieved either by suturing the original IOL to the iris using the Siepser slipknot technique or by replacing it with a retropupillary sutureless iris claw IOL. Data collected during surgery included the type of dislocation, the need for anterior or posterior vitrectomy, duration of surgery, and intraoperative complications. Six months after surgery we assessed the eye and iris anatomy; refraction, astigmatism, and visual acuity; endothelial cell damage; and rate of postoperative complications. Results: Included in the study were 60 patients: 32 underwent IOL relocation and 28 underwent IOL exchange. Pseudoexfoliation (43.7% and 39.3%) and retinal surgery (34.4% and 28.6%) were identified as the main possible causes for IOL dislocation. The mean duration of the surgery was 62.9 ± 14.9 min for the Relocation group, and was 42.7 ± 11.4 min for the Exchange group (p < 0.001), with similar low intraoperative complication rates (6.25% and 7.14%, respectively). The studied parameters showed no differences between the two groups postoperatively, except for corneal astigmatism which was 1.31 ± 0.45 D in the Relocation group and was 1.89 ± 0.86 D in the Exchange group (p < 0.001). Conclusions: Both suture and sutureless iris fixation techniques for dislocated IOLs yielded similarly favorable outcomes in this study. IOL relocation resulted in less postoperative astigmatism, while IOL exchange offered the advantage of shorter surgical time.

Successful repair of infracardiac total anomalous pulmonary venous connection with nonconfluent bilateral pulmonary veins.

We report a rare case of an infracardiac-type total anomalous pulmonary venous connection with nonconfluent bilateral pulmonary veins in a patient diagnosed with heterotaxy syndrome with right atrial isomerism, mitral valve atresia, a single atrium, and double-outlet right ventricle. On the fourth day of life, the patient underwent successful repair using a sutureless technique. Two years after the surgery, the patient remained well without any signs of pulmonary venous obstruction.

Postoperative complication rates in intraocular lens placement and fixation methods for inadequate capsular bag support: a review and meta-analysis.

To evaluate the complication rates of different IOL placement methods in adults with inadequate capsular bag support. The surgical correction of inadequate capsular bag support for the intraocular lens (IOL) harbors several challenges, and there is a wide-range of surgical procedures. For the purpose of this meta-analysis, surgical methods were grouped based on the location of IOL placement: (i) AC placement, (ii) iris fixation, which included prepupillary or retropupillary placement of an iris-claw IOL, or iris suturing of an IOL (iii) scleral fixation, which included scleral sutured and sutureless techniques. Only studies comparing the results of two or more different placement methods were analyzed. The study protocol has been registered in the PROSPERO database (CRD42023458557). Fifteen studies were included in the final analysis, which reported results of 1,247 eyes. The overall complication rate was non-significantly lower in iris fixation (4.4%; 95%CI: 3.6-5.4%, P=0.150) than in AC placement (7.4%; 95%CI: 6.4-7.9%) and scleral fixation (7.4%; 95%CI: 6.5-8.4%). Transient corneal edema was the most common complication in AC placement (29.9%; 95%CI: 2.4-57.5%, P<0.001), compared to scleral fixation (11.9%; 95%CI: 2.6-21.2%) and iris fixation (4.1%; 95%CI: 0.8-7.3%;). Vitreous hemorrhages were more frequently reported following scleral fixation (8.5%; 95%CI: 6.3-11.2%, P=0.006) than in AC placement (5.4%; 95%CI 3.4-8.5%) and iris fixation, 1.4%; 95%CI 0.4-4.2%), and so was IOL decentration/dislocation (8.9%; 95%CI: 6.7-11.8%, P=0.047 compared to 1.1%; 95%CI: 0.4-3.4% and 4.0%; 95%CI: 2.2-7.3%, respectively). The risks associated with particular techniques should be taken into account in preoperative counseling and planning postoperative treatment.

6/0 prolene double-flanged IOL sutureless scleral fixation with a 27-gauge needle for intraocular lens surgery.

To report our initial experience of a modified intraocular lens (IOL) scleral fixation technique using 6/0 prolene in a double-flanged sutureless technique with a 27-gauge needle. 29 consecutive patients with IOL surgery were retrospectively reviewed between December 2021 and October 2023. Early Treatment Diabetic Retinopathy Study (ETDRS) letters, spherical equivalent (SE), astigmatism axial degree and intraocular pressure (IOP) were evaluated at baseline, and 1, 2, 3, and 6 months postoperatively. Surgery-related complications were evaluated during follow-up. ETDRS letters or SE at 1, 2, 3, and 6 months postoperation was significantly improved compared to baseline levels. Patients with younger (estimate [SE] = 8.011 [2.485], p = 0.006), preoperative lens drop (estimate [SE] = 8.621 [2.906], p = 0.009), idiopathic cataract (estimate [SE] = 6.021 [2.099], p = 0.048), high baseline ETDRS letters (estimate [SE] = 15.449 [2.352], p < 0.001), or low baseline SE (estimate [SE] = 6.357 [2.406], p = 0.018) had the greatest improvement in ETDRS letters during follow-up. Patients with preoperative lens or IOL dislocation had a greater postoperative SE improvement than those with preoperative lens or IOL subluxation (dislocation vs. subluxation: estimate [SE] = -189.235 [70.692], p = 0.016). There were no cases of vitreous hemorrhage, cystoid macular edema, endophthalmitis, subluxation or dislocation were observed during the 6-month follow-up. Our modified IOL scleral fixation technique is a simple, safe, efficient method that avoids haptic manipulation and slippage, reduces postoperative complications, achieves completely sutureless surgery, and results in an achievement of surgical refractive goals.

Suture-Less and Glue-Less Amniotic Membrane Graft for Keratopathy and Early Keratinization in Drug Reaction With Eosinophilia and Systemic Symptoms Syndrome

Purpose: Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome can cause significant keratopathy and lead to lasting visual effects. The main objective of this study was to describe an ocular presentation of DRESS treated with a modified suture-less and glue-less amniotic membrane graft technique. This study also provides a literature review of ocular DRESS manifestations and ocular management of the other severe cutaneous adverse reactions. Methods: This is a case review about an 82-year-old man with sepsis due to recent Mycobacterium tuberculosis, who presented with DRESS based on clinical findings. Results: The patient was treated with a modified suture-less and glue-less amniotic membrane graft technique along with a Prokera corneal bandage placement. The patient had significant improvement of visual acuity and symptoms with this technique. Conclusions: Patients with significant corneal and conjunctival involvement associated with DRESS, similar to Stevens–Johnson syndrome/toxic epidermal necrolysis (SJS/TEN), may benefit from more aggressive treatment with amniotic membrane transplantation and Prokera corneal bandage placement to prevent scarring and subsequent vision loss. The modified technique described in this article can be used for patients who may be poor candidates for the operating room.

Pterygium Excision with Conjunctival Autograft: Sutures Vs Sutureless Technique

Pterygium Excision with Conjunctival Autograft: Sutures Vs Sutureless Technique

Clinical Outcomes, Predictors, and Surgical Management of Infracardiac Total Anomalous Pulmonary Venous Connection.

This study sought to find the risk factors of postoperative pulmonary venous obstruction (PVO), PVO-related reintervention, and postoperative mortality, determine the relationship between pulmonary venous confluence (PVC) morphology and the clinical outcomes, and provide the basis for the selection of the optimal surgical strategy for infracardiac total anomalous pulmonary venous connection (TAPVC). From December 2009 to December 2023, 101 patients with infracardiac TAPVC undergoing surgical repair in our institution were included [Conventional surgery (CS) group, n = 73; Sutureless technique (ST) group, n = 28]. The Kaplan-Meier curve was used to demonstrate the survival estimates. The Cox proportional hazard model was used to identify risk factors for primary endpoints. There were 8 in-hospital deaths and 4 late deaths. The survival rates at 1, 5, and 10years were 88.8%, 87.6%, and 87.6%, respectively, in the whole cohort. Multivariable analysis showed that prolonged cardiopulmonary bypass (CBP) time was associated with overall mortality and Y-shaped PVC has a trend for a higher mortality rate. Postoperative PVO occurred in 27 patients. Freedom from postoperative PVO at 1, 5, and 10years were 81.8%, 69.9%, and 69.9%, respectively. Y-shaped PVC and preoperative PVO were incremental risk factors for PVO, but ST repair was a protective factor. Sixteen patients underwent PVO-related reintervention. Y-shaped PVC was the only independent risk factors for PVO-related reintervention while ST repair was a protective factor. Sutureless technique can achieve satisfactory outcomes for infracardiac TAPVC repair. Compared with CS repair, ST repair is significantly associated with decreased postoperative PVO and PVO-related reintervention. Y-shaped PVC is associated with a higher risk of PVO, PVO-related reintervention, and mortality, respectively. Patients with preoperative PVO are more likely to develop postoperative PVO.

CM T flex scleral fixated intraocular lens short-term outcomes in different clinical scenarios

Objective: The purpose is to report the visual outcomes of a “T”-shaped haptic scleral fixated intraocular lens (SFIOL) implanted using the sutureless technique in different clinical scenarios. Material and Methods: A retrospective case series, where patients implanted with “T”-shaped haptic SFIOL between September 2022 and February 2023, were included in the study. Subjects with missing data were excluded from the study. All surgeries were performed by a single surgeon. Pre- and post-surgery follow-up visual acuity and intraocular pressure were noted. Post-operative centration of intraocular lens (IOL), haptics condition, and occurrence of any complication were noted. Results: Overall, 20 eyes of 19 patients were implanted with “T”-shaped haptic SFIOL and had a mean age of 54.15 ± 15.99 years. None of the patients had any intraoperative IOL damage or any other intraoperative complication. There was a significant improvement in visual acuity post-SFIOL implantation (Paired t-test, P &lt; 0.001), which was noted. Corneal edema was noted in one patient. IOL was stable and well-centered in all patients. No haptic-related complications were encountered. Conclusions: SFIOL with “T”-shaped haptic is a viable option for aphakic cases with inadequate capsular support. IOL implantation with “T”-shaped haptic is sutureless, less damaging to ocular structures and has a shorter learning curve making it easier for implantation.

Resolving conjunctival prolapse following severe blepharoptosis correction: A simple sutureless direct excision technique and systematic review

BackgroundConjunctival prolapse (CP) is an uncommon but challenging condition following maximal levator resection (MLR) and other extensive periorbital procedures. MLR extending beyond the Whitnall’s ligament is frequently performed to address severe blepharoptosis with poor levator function (LF). Patients with CP may encounter symptoms such as ocular discomfort, tearing, vision impairment, persistent conjunctival chemosis, lagophthalmos, or exposure keratopathy. Typically, surgical intervention becomes necessary if conservative measures prove to be ineffective; nevertheless, there is no consensus regarding the optimal treatment approach. ObjectivesThis study aimed to propose a simple sutureless direct excision method and explore the surgical advancements in CP correction through a systematic review. MethodsPatients with recurrent CP after MLR who underwent sutureless direct excision of the conjunctiva using loupe magnifiers at a tertiary hospital were included in this study. The clinical evolution and surgical results were recorded. PubMed, MEDLINE, EMBASE, and Web of Science databases were queried following The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocol. ResultsThe comprehensive analysis of 1858 articles identified 88 patients from 24 studies, highlighting that blepharoptosis surgery is predominantly associated with CP (36.6%). Surgically treated CP showed a higher resolution rate compared to those managed conservatively (54.8% vs. 45.2%; p = 0.034). No relapse was observed in patients treated with sutureless direct excision of CP in long-term follow-up. ConclusionWe proposed a simple sutureless direct excision technique that offers a straightforward and efficient approach in treating CP, which is particularly suitable for cases requiring excision lengths >16 mm during MLR. Furthermore, stitch removal can be obviated after surgery.

Insight into the research history and trends of total anomalous pulmonary venous connection: a bibliometric analysis

BackgroundTotal anomalous pulmonary venous connection (TAPVC) is a rare congenital heart disease characterized by the inability of all pulmonary veins to connect to the left atrium. Our previous bibliometric article summarized the characteristics of only the 100 most cited papers in TAPVC research. The purpose of this study was to use comprehensive bibliometric analysis to examine the development history, current status, and future trends in the field of TAPVC.MethodsAll publications on TAPVC published between 2000 and 2023 were collected from the Web of Science Core Collection. The publication and citation data were quantitatively analyzed by publication year, country, institution, author, and journal. Co-authorship and co-occurrence analyses were performed using VOSviewer, and keyword and reference bursts were identified using CiteSpace. Pearson’s test was used to examine the correlations between two continuous variables.ResultsAs of July 20, 2023, we identified 368 publications with 3320 citations. These publications were published in 132 journals and authored by 1835 researchers from 457 institutions in 47 countries. For the number of publications, the top country, top institution, top author, and top journals were the United States (n = 82), Shanghai Jiao Tong University (n = 13), Huiwen Chen (n = 9), and Annals of Thoracic Surgery and Pediatric Cardiology (n = 29 each), respectively. For the number of citations, the top country, top affiliation, top author, and top journal were the United States (n = 1348), University of Toronto (n = 250), Christopher A. Caldarone (n = 315), and Annals of Thoracic Surgery (n = 746), respectively. The number of national publications significantly correlated with GDP (R = 0.887, P < 0.001), research & development (R&D) expenditure (R = 0.375, P = 0.013), population (R = 0.694, P < 0.001), and journals (R = 0.751, P < 0.001). The number of national citations significantly correlated with GDP (R = 0.881, P < 0.001), R&D expenditure (R = 0.446, P = 0.003), population (R = 0.305, P = 0.037), and journals (R = 0.917, P < 0.001). International collaboration in the field of TAPVC was not well developed. The most commonly cited publication discussed era changes in mortality and reoperation rate in TAPVC patients. The most common keywords were “total anomalous pulmonary venous connection” and “congenital heart disease”. The keyword “case report” appeared most recently, with an average occurrence year of 2021.8. The co-occurrence analysis grouped 26 keywords into six themes: surgical repair of TAPVC, postoperative pulmonary vein stenosis, surgical repair of TAPVC patients with heterotaxy, application of echocardiography in diagnosing TAPVC, application of echocardiography in the prenatal diagnosis of TAPVC, and application of the sutureless technique in the surgical repair of TAPVC patients with right atrial isomerism or a single ventricle. Citation burst detection identified 32 references with citation bursts, seven of which had ongoing citation bursts until 2023.ConclusionsThis study conducted a bibliometric analysis to provide a comprehensive overview of TAPVC research. We hope to offer new ideas for promoting development in the field of TAPVC.

Validation of Novel Microsurgical Vessel Anastomosis Techniques: A Systematic Review.

Thorough validation of novel microsurgical techniques is deemed essential before their integration into clinical practice. To achieve proper validation, the design of randomized controlled trials (RCTs) should be undertaken, accompanied by the execution of comprehensive statistical analyses, including confounder adjustment and power analysis. This systematic review aims to provide an encompassing overview of the validation methodologies employed in microsurgical studies, with a specific focus on innovative vessel anastomosis techniques. A literature search was conducted in PubMed for articles describing the validation of novel microsurgical vessel anastomosis techniques in animal or human subjects. The literature search yielded 6,658 articles. A total of 6,564 articles were excluded based on title and abstract. Ninety-four articles were assessed for full-text eligibility. Forty-eight articles were included in this systematic review. Out of 30 comparative studies, 9 studies validated novel modified interrupted suture techniques, 6 studies modified continuous techniques, 6 studies modified sleeve anastomosis techniques, 1 study a modified vesselotomy technique, 7 studies sutureless techniques, and 1 study a modified lymphaticovenular anastomosis technique. Twenty-eight studies contained animals (n = 1,998). Fifteen animal studies were RCTs. Two studies contained human/cadaveric subjects (n = 29). Statistical power analysis and confounder adjustment were performed in one animal study. Out of 18 noncomparative studies, 5 studies validated novel modified interrupted suture techniques, 1 study a modified continuous technique, 2 studies modified sleeve anastomosis techniques, 4 studies modified vesselotomy techniques, 4 studies sutureless techniques, and 2 studies modified lymphaticovenular anastomosis techniques. Ten studies contained animal subjects (n = 320), with two RCTs. Eight studies contained human subjects (n = 173). Statistical power analysis and confounder adjustment were performed in none of the animal or human studies. The current methods of microsurgical technique validation should be reconsidered due to poor study design. Statistical analysis including confounder adjustment and power analysis should be performed as a standard method of novel technique validation.

Efficacy and safety analysis of scleral fixation intraocular lens implantation using the Yamane technique

Introduction: Cataract surgery technologies continue to manage complications. Current surgical methods for secondary Intra Ocular Lens (IOL) include Anterior Chamber IOL, Iris Claw IOL, and sutured and sutureless techniques of Scleral Fixation IOL (SFIOL). The Yamane technique of SFIOL is a novel, relatively safe, and easy method of sutureless SFIOL. This study aims to describe and analyze the surgical outcomes and complications of the Yamane IOL implantation technique. Methods: A retrospective study of 21 eyes of 21 patients that underwent scleral fixation of IOL by the Yamane technique was observed. Demographic data, primary indications for surgery, best corrected visual acuity (BCVA), intraocular pressure (IOP) pre-operative and post-operative during follow-up, and complications were also analyzed. Results: Twenty-one patients were included, with an average age of 52.57±23.41 years old. Eleven eyes with lens subluxation (52.4%), 9 eyes with aphakia (42.9%), and 1 eye with phacodonesis (4.8%) were indicated for the Yamane technique of SFIOL in this study. The preoperative mean BCVA was 2.2±0.9 LogMAR, while the 1-month postoperative BCVA was 1.1±0.9 LogMAR. The mean preoperative IOP was 15.81±6.7 mmHg, and the 1-month postoperative IOP was 16.00±7.7 mmHg. This study found that there was a significant improvement in BCVA with p=0.00 (p&lt;0.05), and there was no significant postoperative IOP spike with p=0.88 (p&lt;0.05). The main complications observed in this study were corneal edema (23.8%) and postoperative IOP spike (14,3%). Conclusion: The Yamane SFIOL technique is a relatively safe approach for the surgical management of patients who need secondary IOL implantation with significantly improved visual function without significant complications.

Customised Corneal Endotamponade - A Sutureless Technique to Treat Sterile Perforating Corneal Ulcers.

Customised Corneal Endotamponade - A Sutureless Technique to Treat Sterile Perforating Corneal Ulcers.

Fusion-Flanged Intrascleral Intraocular Lens Fixation Technique: Simple, Safe, Efficient.

To develop a new, sutureless intrascleral intraocular lens (IOL) fixation technique based on the Yamane double-needle and Canabrava 4-flanged techniques. The Fusion-Flanged technique involves using a 7-0 polypropylene suture loop threaded through the eyelets of the IOL. Afterward, both ends of the suture are passed outside the eye through a 27-gauge needle. This technique creates a single flange by joining the 2 suture ends through handheld cautery, and this flange is then embedded into the scleral tunnel to securely fix the IOL in place. This technique was performed on a total of 7 aphakic patients. Four of them had encountered complications following manual small incision cataract surgery, while the remaining 3 experienced complications after phacoemulsification. The results indicated a significant improvement in visual acuity, with mean preoperative and postoperative corrected distance visual acuities of 0.77 ± 0.11 and 0.27 ± 0.08 (logarithm of the minimum angle of resolution [logMAR] units), respectively. The Fusion-Flanged intrascleral IOL fixation technique offers improvements in simplicity, safety, and the overall efficiency when compared to existing sutureless intrascleral fixation techniques. Notably, this technique is versatile and can be applied to both non-foldable and foldable IOLs.

Long-term outcomes of glued (sutureless) amniotic membrane transplantation in acute Stevens-Johnson syndrome/toxic epidermal necrolysis: a comparative study

PurposeTo compare the effectiveness and efficiency of a glued (sutureless) technique for amniotic membrane transplantation (AMT) with a traditional sutured one in the setting of acute Stevens-Johnson syndrome/toxic epidermal necrolysis...

Scleral Fixated Secondary IOLs: An Outcomes Comparison Between the Yamane and Gore-Tex-Sutured Techniques.

Among secondary intraocular lens (IOL) techniques, scleral fixated IOLs (SFIOLs) offer advantages in cases without capsular support. In this article, we compare outcomes between two types of Gore-Tex scleral sutured IOLs with the Yamane technique. This study was a retrospective chart review of patients who underwent SFIOL implantation. Analysis revealed a statistically significant improvement in final postoperative visual acuity (VA) for sutured SFIOLs (P < 0.001, Envista (n = 29) 95% CI 0.47 to 1.04, Akreos (n = 23) 95% CI 0.32 to 0.81) with no statistical improvement in the Yamane group (P = 0.44, n = 15, 95% CI -0.33 to 0.71). Outcomes analysis revealed greater incidences of cystoid macular edema (CME) in the Yamane cohort (P < 0.05) and a higher rate of reoperations in the Akreos cohort (P < 0.02). All complications related to suture material (n = 4) and IOL decentration (n = 2) occurred in the sutured SFIOL group. The sutureless Yamane technique offered fewer subsequent surgeries and suture-specific complications while revealing diminished VA improvement in long-term follow-up compared to the sutured SFIOLs. [Ophthalmic Surg Lasers Imaging Retina 2024;55:384-390.].

Surgical Outcome of Postinfarction Left Ventricular Free Wall Rupture.

Left ventricular free wall rupture (LVFWR) is a rare and fatal complication after acute myocardial infarction. Early recognition and aggressive treatment are recommended. Between August 1999 and February 2023, 11 patients aged between 64 and 79 years developed LVFWR after acute myocardial infarction (mean interval, 3.5 days). Three patients had active bleeding (blowout-type LVFWR), and the other 8 patients experienced the oozing or sealed state. Eight patients were treated using a sutureless technique with Teflon felt and glue, 2 patients were treated using the primary suture closure technique, and 1 was treated using both the primary suture and the sutureless technique with Teflon felt and glue. One patient died in the operating room as a result of bleeding. Cardiovascular stability and hemostasis were achieved in the other 10 patients. There were 3 early deaths (all 3 cases as a result of area bleeding; 1 was treated with primary suture, 2 with sutureless glue). Three patients received percutaneous coronary intervention before discharge. All 8 remaining patients survived and were discharged. Three patients were lost to follow-up. The follow-up period ranged from 2 to 97 months, with 4 patients exhibiting New York Heart Association class I symptoms and 1 exhibiting New York Heart Association class II symptoms. Optimal surgical treatment for postinfarction LVFWR remains controversial. The sutureless technique may be a promising strategy for treating postinfarction LVFWR.

Comparison of suture and sutureless techniques on postoperative complications after third molar surgery: a systematic review.

To compare, among patients undergoing third molar surgeries, whether the use or omission of sutures improves postoperative clinical parameters. A systematic literature review was conducted to identify randomized clinical trials in humans. The steps of this review were conducted following the PRISMA protocol. The risk of bias assessment was performed using the revised Cochrane tool (RoB 2). The RevMan software was employed for meta-analyses, and the quality of evidence was evaluated using GRADE. A total of seven articles were included in the systematic review; however, only one article quantitatively measured bleeding, rendering meta-analysis for this outcome unfeasible. The group of patients in whom sutures were not used presented lower pain and edema on the first day (respectively: MD - 1.08; 95% CI - 1.35 to - 0.81; MD - 1.23; 95% CI - 2.34 to - 0.11) and second day (respectively: MD - 0.50; 95% CI - 0.83 to - 0.17; MD - 10.66; 95% CI - 1.16 to - 0.16) postoperatively, compared to the group where sutures were employed. The group of patients who received sutures exhibited increased trismus on the first day postoperatively (MD 1.04; 95% CI 0.67 to 1.41). The omission of postoperative sutures in third molar surgeries appears to favor pain and edema outcomes within the first 24h after the procedure, as well as trismus within the same timeframe. Despite the suture being the standard conduct in tooth extractions. The omission of sutures in third molar extractions may favor inflammatory outcomes of pain, edema, and trismus in the immediate postoperative period.

COMPARISION OF SUTURED VERSUS SUTURELESS SCLERAL FIXATED INTRAOCUALR LENS AT A TERTIARY EYE HOSPITAL, NEPAL

Background: One of the best options for correction of aphakia is scleral fixated intraocular lens. It can be implanted either using suture or without the use of suture. Each technique has its own pros and cons. The aim of this study was to compare the visual outcome and complications between the suture and sutureless technique of scleral fixation intra ocular lens. Methods: It was a retrospective study done at a tertiary eye hospital in Koshi Province, Nepal where data of patients who underwent scleral fixated intraocular lens implantation from March 2017 to June 2017 were analyzed. Aphakic patients with absence of capsular support, subluxated lens (&gt;180˚) and patients with posteriorly dislocated IOL with minimum follow up of 6 months were included in the study. All the data were entered into the SPSS version 20, descriptive analysis was done and independent t-test was applied to test the statistical significance. Results: Sixty-six eyes of 66 patients were included in the study. Out of which 51.5% underwent sutured and 48.5% underwent sutureless scleral fixated intraocular lens implantation. Male: female ratio was 1.6:1. Most common indication for scleral fixated intraocular lens was traumatic dislocation of lens. Mean postoperative vision of sutured and sutureless SFIOL when compared, sutured SFIOL was found to have statistically significant improvement. Most common complication was corneal edema in both the groups. Conclusions: Both techniques of scleral fixated intraocular lens showed satisfactory improvement in vision, but sutured SFIOL showed better vision postoperatively.

#128 : Is Non-Closure Suitable as a Skin Closure Technique for 5 mm Laparoscopic Port-Site? - A Randomised Controlled Trial of Non-Closure Versus Transcutaneous Suture

Background and Aims: Laparoscopy has become the access of choice even in complex abdomino-pelvic surgery cases and more abdominal access ports have been used to assist with the surgery. Systematic review done on skin closure of 5 mm laparoscopic port-site showed comparable outcome between sutured and sutureless technique. Transcutaneous suture is better than subcuticular suture in the sutured group sub-analysis. No RCT were found comparing skin closure versus non-closure technique using simple dressing only. Method: Randomised controlled trial – non superiority in Gynaecology Department, University Malaya Medical Centre in 2019. Based on power calculation, 40 subjects are needed. Each patient act as their own control – each will receive NC and TS for comparison. 40 patients (n=80) were included for final analysis. The 5 mm port site will be assigned with skin closure using NC versus TS where the surgical incision wound is covered with routine dressing after the operation. The primary outcome is the scar appearance at day 90 from the patient and blinded surgeons’ point of view. Secondary outcomes are patient satisfaction and pain at day 14, and wound complications. Results: Cosmetic outcome in terms of scar appearance at day 90 showed no difference between NC and TS rated by the patient (MD 5.25 [0.07, 10.57], p 0.053) and the surgeon (MD 0.88 [0.08, 1.83], p 0.07). Pain is better perceived in NC group (MD 3.6 [0.19, 6.96], p 0.039) and patient satisfaction at day 14 is also better in NC group (MD 11.8 [4.18, 19.33], p 0.03). There was no significant difference in terms of wound complications and no surgical site infection were observed in both groups. Conclusion: NC and TS techniques have comparable cosmetic outcome and wound complications. Pain perception is better in NC than TS.