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Akiko Masai, MD, Tomoichiro Ogawa, MD Takuya Shiba, MD, Hiroshi Tsuneoka, MD Department of Ophthalmology The Jikei University School of Medicine Tokyo, Japan The authors have no financial interest in the subject matter of this e-poster.
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Akiko Masai, MD, Tomoichiro Ogawa, MD Takuya Shiba, MD, Hiroshi Tsuneoka, MD Department of Ophthalmology The Jikei University School of Medicine Tokyo, Japan The authors have no financial interest in the subject matter of this e-poster. Outcomes of Transscleral Sulcus Fixation of Intraocular Lenses through a 2.4-mm Incision with an Injector System: 1-Year Follow-Up
Objective • To evaluate postoperative outcomes of scleral-sutured ciliary sulcus fixation of foldable intraocular lens (IOL) through a 2.4-mm incision
Methods • Subjects: 9 eyes (9 patients) • Lens subluxation: 1 eye • Aphakia: 5 eyes • IOL dislocation 3 eyes • Variables examined • Best-corrected visual acuity (BCVA) • Before and after surgery (1 week; 1, 3, 6, 12 months) • Surgically induced astigmatism (SIA) (Cravy method) • After surgery (1 week; 1, 3, 6, 12 months) • Endothelial cell density • Before and after surgery
Surgical Technique 1. Preparation for IOL setting of PC-9 hooking • 10-0 double polypropylene thread (PC-9, Alcon) was inserted through the cartridge (E1, HOYA). • PC-9 was looped around the haptics of the IOL (VA70AD or VA65BB, HOYA) by using a cow hitch knot.
Surgical Technique • Scleral pockets created at the 2 and 8-o’clock positions • Anterior vitrectomy performed • 2.4-mm scleral corneal incision created at 12-o’clock position
IOL inserted through incision with injector (ISH-001, HOYA), leaving opposite haptics out of anterior chamber • PC-9 looped around haptics • IOL fixed to ciliary sulcus
Result 1 • Early improvement in BCVA maintained for 1year BCVA Surgically induced astigmatism was minimal SIA
Result 2 • Mean endothelial cell density reduced 9.80% • Complications • IOLiris capture and pupillary block in 1 case • Retinal detachment in 1 case • Cystoid macular edema in 1 case.
Treatments for Complications • IOLcapture • IOL repositioned • Peripheral iridectomy at 6 and 12 o’clock • Retinal detachment • Scleral buckling surgery • Retina reattached • Cystoid macular edema • Improvement without medication
Conclusion • With this technique, visual acuity improved early postoperatively and was maintained for 1 year