Injector implantation of sutured intraocular lens in the absence of capsular support via small-incision surgery

Abstract:

AIM:To evaluate the safety and efficacy of a modified technique for transscleral fixation of a foldable posterior chamber intraocular lens(IOL)in the absence of capsule support.

METHODS: Scleral fixation of a foldable IOL was performed by using a new small incision technique with injector implantation system via 3.2mm clear corneal incisions in 52 eyes of 52 patients who can not be normally implanted posterior chamber IOL because of posterior capsule rupture or suspensory ligament fracture. Postoperative visual acuity, corneal astigmatism and complications were observed in 6 months follow-up.

RESULTS: Postoperative uncorrected visual acuity improved in all patients, of which more than 1.0 in 8 eyes, 0.6 to 0.8 in 18 eyes, 0.4 to 0.6 in 16 eyes, less 0.4 in 10 eyes. Postoperative uncorrected visual acuity was at least 0.5 in 33 eyes(63%), 39 eyes(75%), 41 eyes(79%)at postoperative 1 week, 1 month, 3 months respectively. There was no significant difference in corneal astigmatism guided by corneal topography between preoperative and postoperative(P>0.05). During follow-up, the IOL was correctly positioned in all cases. There were no major complications, such as endophthalmitis or suture erosion through the conjunctiva at the site of fixation. No patient required further surgical interventions.

CONCLUSION: This modified technique of transscleral fixation of foldable posterior chamber IOL offers the advantages of a small incision and rapid visual rehabilitation, and minimizes the risk of intraoperative and postoperative complications.

Key words:foldable posterior chamber intraocular lens; transscleral fixation; injector implantation system; clear corneal incisions; corneal astigmatism