Outcomes of scleral-sutured conventional and aniridia intraocular lens implantation performed in a university hospital setting

J Cataract Refract Surg. 2014 Apr;40(4):609-17. doi: 10.1016/j.jcrs.2013.09.014. Epub 2014 Feb 20.

Abstract

Purpose: To evaluate the outcomes of transscleral sutured posterior chamber intraocular lens (PC IOL) implantation.

Setting: Public university hospital, Auckland, New Zealand.

Design: Retrospective case series.

Methods: A modified no-touch transscleral sutured PC IOL implantation technique with a 1-piece monofocal IOL (Alcon CZ70BD) or an aniridia IOL (type 67G, Morcher) was assessed.

Results: Seventy-eight cases (80.8% men; 53.9% aphakic) were identified. The mean follow-up was 35.5 months and the mean age at surgery, 41 years±21 (SD). The preoperative corrected distance visual acuity (CDVA) was worse than 6/30 in 66.7%. Indications included ocular trauma (46.2%), nontraumatic crystalline lens subluxation (16.7%), post-complicated cataract surgery (10.3%), idiopathic IOL dislocation (10.3%), and congenital cataract/aphakia (10.3%). An aniridia IOL was required in 39.7% of eyes. There were no significant intraoperative complications in 74.4% of eyes. Postoperative complications included transient corneal edema (15.4%), wound leak requiring resuturing (7.7%), retinal detachment (7.7%), and cystoid macular edema (6.4%). One eye (1.3%) developed suture breakage-related late IOL dislocation. Overall, 91.3% of eyes had improved visual acuity or were within 1 line of the presenting CDVA. In eyes with a guarded prognosis, 34.8% achieved a CDVA of 6/12 or better and 43.5% a CDVA of 6/15 to 6/48. In the better prognosis group, 73.9% achieved a CDVA of better than 6/12 and all achieved better than 6/30.

Conclusions: Scleral-sutured IOLs achieved good visual outcomes in a public hospital setting. The rate of complications was moderate in this series with a high proportion of severe ocular trauma and a large percentage of aniridia IOLs.

Financial disclosure: No author has a financial or proprietary interest in any material or method mentioned.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aphakia, Postcataract / surgery
  • Biocompatible Materials
  • Cataract Extraction
  • Child
  • Child, Preschool
  • Female
  • Follow-Up Studies
  • Hospitals, University
  • Humans
  • Infant
  • Intraoperative Complications
  • Lens Implantation, Intraocular / methods*
  • Lenses, Intraocular*
  • Male
  • Middle Aged
  • Polymethyl Methacrylate
  • Postoperative Complications
  • Prosthesis Design
  • Refraction, Ocular / physiology
  • Retrospective Studies
  • Sclera / surgery*
  • Suture Techniques*
  • Treatment Outcome
  • Visual Acuity / physiology

Substances

  • Biocompatible Materials
  • Polymethyl Methacrylate