ABSTRACT
AIM:To compare the clinical outcome of anterior chamber intraocular lens (IOL) at Ⅰ stage versus sclerafixed IOL at Ⅱ stage in complicated cataract surgeries with inadequate capsular support.METHODS:Complicated cataract surgeries with anterior chamber IOL (ACIOL) or scleral-fixated IOL implantation from January 2003 to December 2014 when capsular support was inadequate were included and analyzed.Postoperative best-corrected visual acuity (BCVA) were compared.Postoperative complications were recorded and analyzed.RESULTS:Totally 84 eyes and 79 eyes were included in the ACIOL group and in the scleral-fixated IOL group,respectively.The mean postoperative logarithm of minimal angle of resolution (LogMAR) BCVA at 1a was 0.30±0.64 and 0.33±0.34 in the ACIOL group and the scleral-fixated IOL group,respectively (t=0.407,P=0.712).The mean latest LogMAR BCVA was 0.67±0.55 and 0.62 ± 0.50 in the primary ACIOL group and the secondary scleral-fixated IOL group,respectively (t=0.225,P=0.545).There were more early postoperative complications in the ACIOL group (x2 =14.613.P＜0.001).No difference in late postoperative complications was found between the two groups (x2 =0.231,P=0.267).Regression analysis suggested that ACIOL and scleralfixated IOL implantation had similar latest postoperative LogMAR BCVA (t=0.397,P=0.957);however the existence of late complications were related with a worse final visual outcome (t=22.156,P＜0.001).CONCLUSION:The long-term differences in the visual outcomes and complication profiles after ACIOL at Ⅰ stage or scleral-fixated IOL implantation at Ⅱ stage in a complicated cataract operation are not found when capsular support is inadequate.
ABSTRACT
Background: A new emerging complication of trans‑scleral fixation of posterior chamber (PC) intraocular lens (IOL) with polypropylene suture is high rates of spontaneous dislocation of the IOL due to disintegration or breakage of suture. Materials: We report a new surgical technique of trans‑scleral fixation of posterior chamber intraocular lens (SF PCIOL) with steel suture to eliminate the complication of dislocation of IOL fixed with polypropylene suture in one adult and a child. Results: We successfully achieved stable fixation and good centration of IOL after SF PCIOL with steel suture in these patient having inadequate posterior capsular support. Both eyes achieved best corrected visual acuity 20/40 at 18 months follow‑up. Conclusions: Steel suture is a viable option for trans‑scleral fixation of posterior chamber intraocular lens.