This retrospective case study series evaluated the outcome of a secondary intraocular lens (IOL) implantation technique of a Carlevale IOL (Soleko IOL Division, Italy) with either a conventional 23- or a modified 27-gauge (-g) vitrectomy port used as anchor fixation. Two-hundred-and-eighty-two eyes of 282 patients (123w / 158 m), after sutureless scleral technique and IOL fixation with implantation of a Carlevale IOL, were included in the study. Patients were divided into two groups: conventional 23-g technique (n=153) and modified 27-g technique (n=129). The mean age was 71 ±15 years (range 27–92) for group 23-g and 68 ±17 years (range 25–95) for group 27-g. Mean follow-up was 5.6 ±2.7 months (range: 1–24 months).Transient postoperative ocular hypotonia (intraocular pressure ≤5 mmHg) was observed less in the 27-g group (13 vs. four patients, p=0.057) – three requiring additional tunnel sutures (two cases for 23-g; one case 27-g). Postoperative vitreous haemorrhage was recorded more often in the 23-g group (eight vs. one patient, p=0.034), but all cases in both groups resolved without intervention. During the follow-up period of 5.6 ±2.7 months (range: 1–24 months), neither haptic exposure nor scleral or conjunctival erosion was noticed. No complications such as IOL decentration, pupillary capture, pseudo phacodonesis, IOL-tilt, clinical transillumination defect suggestive of chaffing, retinal detachment or endophthalmitis were observed. Visual acuity improved postoperatively in both groups. The mean BCVA increased in the 23-g group from 0.84 ±0.27 LogMAR baseline to 0.4 ±0.28 at the last follow-up (p<0.01). In the 27-g group, the mean BCVA increased from 0.85 ±0.24 LogMAR baseline to 0.3 ±0.31 at the last follow-up (p<0.01). The refractive spherical equivalent at the last follow-up was comparable in the two groups (-0.85 ±0.92D for 23-g and -0.94 ±0.87D for 27-g; p=0.12) The study concluded that the 27-g modified technique for sutureless intrascleral implantation is simple and effective and causes less postoperative hypotony. Limitations: retrospective approach, limited number of patients, short follow-up time, and the bias in the results that may have been caused by the differences in preoperative indications.
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- Outcome of secondary intraocular lens implantation-conventional 23- vs. modified 27-gauge vitrectomy port anchor fixation
Outcome of secondary intraocular lens implantation-conventional 23- vs. modified 27-gauge vitrectomy port anchor fixation
Reviewed by Sofia Rokerya
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Sofia Rokerya
MBBS MRCOphth FRCSI, King's College University Hospital, UK.
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