Transconjunctival Scleral Fixation of Posterior Chamber Intraocular Lens with Expanded Polytetrafluoroethylene by Microincision
DOI:
https://doi.org/10.48560/rspo.25939Keywords:
Anterior Chamber/surgery, Intraocular Pressure, Lens Capsule, Crystalline, Lens Implantation, Intraocular, Suture TechniquesAbstract
Introduction: This study presents a new minimally invasive transconjunctival surgical technique for fixation of a hydrophilic acrylic posterior chamber intraocular lens (IOL) at 4 different points, in the absence of capsular support, using expanded polytetrafluoroethylene (ePTFE, Gore) thread -Tex®).
Methods: The technique described was used in 26 eyes, without capsular support, of 26 patients with a minimum follow-up period of 6 months. The following variables were evaluated: age, sex, indication for surgery, intraocular pressure (IOP), distance corrected visual acuity (AVCC) before and after surgery, postoperative spherical equivalent (EE), centering and tilt of the IOL, surgically induced astigmatism (AIC), combined procedures, intraoperative and postoperative complications, and follow-up time after surgery.
Results: The mean age of patients was 77.62 ± 12.23 years; the mean follow-up was 20.2 ± 9.30 months. Stroke improved after surgery, from logMAR 0.43 ± 0.25 to 0.13 ± 0.08 (p = 0.010). No patient lost visual acuity lines on the Snellen chart. Mean postoperative EE was -0.28 ± 0.26 diopters; the mean AIC of 0.24 ± 0.16 diopters was obtained after a limbal incision of 2.0 or 2.2 mm. In five patients with prior uncontrolled glaucoma, simultaneous glaucoma surgery was performed. As postoperative complications, we observed two cases of ocular hypertension (both in patients with previous glaucoma) and one case (3.8%) of non-surgically resolved hemovitreous. In no case was observed pseudophacodonesis, decentering or “tilt” of the IOL, pupillary optical capture, pigment dispersion or other postoperative complications.
Conclusion: The results of this study demonstrate that this technique represents a minimally invasive procedure for scleral lens fixation, which significantly reduces the morbidity associated with scleral suspension techniques, increasing its safety and reproducibility.
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