Abstract
The aim of this study is to compare complication rates in two different operative techniques applied for the secondary, posterior chamber intraocular lens (PCIOL) implantation with sulcus fixation. 179 eyes with partial or no posterior capsule support underwent surgery. Applied techniques were: transscleral fixation of the IOL by passing with the fixation needle through the sulcus from the inside (70 eyes) or from the outside (109 eyes) of the bulbus. The most frequent intraoperative complications were haemorrhages and vitreous prolaps with no significant difference between used techniques. In the ‘from the inside’ group, following late postoperative complications developed: astigmatism of >4D (24%), cystoid macular oedema (20%), pupil distortion (14%), partial posterior capsule opacification (10%), suture exposure (10%), IOL decentration (8%) and hemophthalmus (3%). In the ‘from the outside’ group same complications showed a decreased rate: 17%, 16%, 8%, 8%, 9%, 5% and 1%, respectively. Other late complications like high intraocular pressure, synechiae and uveitis were adequately represented in both techniques. After 24 months follow-up, best corrected visual acuity ≥0.8 was achieved in 48.5% of eyes when ‘from the inside’ and in 57.7% of eyes when ‘from the outside’ technique was used.
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Abbreviations
- PCIOL:
-
posterior chamber intraocular lenses
References
McGuinness R, Kennedy I. Implantation of sutured posterior chamber intraocular lenses. Cataract Refract Surg 1995; 21 (4): 373–5.
Mittelviefhaus H. A modified technique of transscleral suture fixation of posterior chamber lenses. Ophthalmic Surg 1992; 23 (7): 496–8.
Kora Y, Fukado Y, Yaguchi S. Sulcus fixation of posterior chamber lenses by transscleral sutures. J Cataract Refract Surg 1991; 17 (5): 636–9.
Smiddy WE, Avery R. Posterior chamber IOL implantation with suboptimal posterior capsular support. Ophthalmic Surg 1991; 22 (1): 16–9.
Lewis JS. Ab externo sulcus fixation. Ophthalmic Surg 1991; 22: 692–95.
Basti S, Tejaswi PC, Singh SK, Sekhar GC. Outside-in transcleral fixation for ciliary sulcus intraocular lens placement. J Cataract Refract Surg 1994; 20 (1): 89–92.
Vajpayee RB, Angra SK, Sandramouli S, Rewari R. Direct scleral fixation of posterior chamber intraocular lenses using a special needle-holder. Ophthalmic Surg 1992; 23 (6): 383–7.
McCluskey P, Harrisberg B. Long-term results using scleral-fixated posterior chamber intraocular lenses. J Cataract Refract Surg 1994; 20 (1): 34–9.
Small EA, Solomon JM, Prince AM. Hypotonus cyclodialysis cleft following suture fixation of a posterior chamber intraocular lens. Ophthalmic Surg 1994; 25 (2): 107–9.
Martin RG, Sanders DR, Souchek J, Raanan MG, DeLuca M. Effect of posterior chamber intraocular lens design and surgical placement on postoperative outcome. J Cataract Refract Surg 1992; 18 (4): 333–41.
Vilhjalmsson GA, Lucas BC. Incidence of secondary cataract in sulcus versus capsular bag fixation of posterior chamber lenses. Klin. Monatsbl Augenheilkd 1992; 200 (3): 167–70.
Tan DT, Chee SP. Early central posterior capsular fibrosis in sulcus-fixated biconvex intraocular lenses. J Cataract Refract Surg 1993; 19 (4): 471–80.
Althaus C, Sundmacher R. Transscleral suture fixation of posterior chamber intraocular lenses through the ciliary sulcus: endoscopic comparison of different suture techniques. Ger J Ophthalmol 1992; 1 (2): 117–21.
Althaus C, Sundmacher R. Intraoperative intraocular endoscopy in transscleral suture fixation of posterior chamber lenses: consequences for suture techniques, implantation procedure, and choice of PCL design. Refract Corneal Surg 1993; 9 (5): 333–9.
Pavlin CJ, Rootman D, Arshinoff S, Harasiewicz K, Foster FS. Determination of hapti position of transsclerally fixated posterior chamber intraocular lenses by ultrasound biomicroscopy. J cataract Refract Surg 1993; 19 (5): 573–7.
Horiguchi M, Hirose H, Koura T, Satou M. Identifying the ciliary sulcus for suturing a posterior chamber intraocular lens by transillumination. Arch Ophthalmol 1993; 111 (12): 1693–5.
Maden A, Gunenc U, Erkin E. Gonioscopic changes in eyes with posterior chamber intraocular lenses. Doc Ophthalmol 1992; 82 (3): 231–8.
Hansen TE, Naeser K, Nilsen NE. Intraocular pressure 2 1/2 years after extracapsular cataract extraction and sulcus implantation of posterior chamber intraocular lens. Acta Ophthalmol 1991; 69 (2): 225–8.
Lewis JS. Sulcus fixation without flaps. Ophthalmology 1993; 100: 1346–50.
Gabrić N, Henč-Petrinović Lj, Dekaris I, Petrinovic-Dorešič J, Bradetić T. Transscleral suture fixation of posterior chamber intraocular lenses through the ciliary sulcus: three years follow-up study. Book of abstracts, IX European Congress of Ophthalmology. Milano, Italy, 25th–29th June, 1995.
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Gabrić, N., Henč-Petrinović, L. & Dekaris, I. Complications following two methods of posterior chamber intraocular lens suturing. Doc Ophthalmol 92, 107–116 (1996). https://doi.org/10.1007/BF02583283
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DOI: https://doi.org/10.1007/BF02583283