Visual Outcomes, Endothelial Loss, and Complications Following Iris-Claw Intraocular Lens Implantation and Trocar-Assisted Sutureless Scleral Fixation of Intraocular Lenses.

Objectives: Iris-claw intraocular lens (IC-IOL) implantation and sutureless scleral fixation of intraocular lenses (SSF-IOL) are two commonly preferred surgical approaches for the management of aphakic patients without sufficient capsular support. The aim of this study was to compare the outcomes of IC-IOL implantation and trocar-assisted SSF-IOL implantation. Methods: The medical records of secondary IOL implantation patients were retrospectively reviewed. All patients had a detailed ophthalmological examination, including LogMAR best-corrected distance visual acuity (CDVA), intraocular pressure (IOP), and endothelial cell density (ECD) preoperatively and postoperatively. SPSS 21.0 software was used for the statistical analysis. Results: There were 15 patients in the IC-IOL group and 12 patients in the SSF-IOL group. Age and gender distributions were similar between the groups (p=0.456 and p=0.398, respectively). Similarly, patients in both groups had similar CDVA preoperatively and postoperatively (p=0.51, p=0.48, respectively). Both IC-IOL and SSF-IOL implantation significantly increased CDVA (p=0.001 and p=0.005, respectively). IOP remained unchanged in both groups. However, ECD reduced significantly following both IC-IOL and SSF-IOL implantation (p=0.001 and p=0.005, respectively) and trocar-assisted SSF-IOL implantation resulted in significantly more endothelial loss compared to IC-IOL implantation (439.5±89 vs. 164.4±53, p=0.013). Conclusion: Both surgical approaches increased CDVA significantly and at similar levels. However, trocar-assisted SSF-IOL implantation resulted in significantly more endothelial loss compared to IC-IOL implantation. None of the patients developed bullous keratopathy, but this difference should be kept in mind, especially in patients with critically low ECD.

Comparison of intra- and postoperative complications of phaco between sequential and combined procedures of 23-gauge vitrectomy and phaco.

PURPOSE: To evaluate the intra- and postoperative complications of phacoemulsification in sequential and combined procedures of 23-gauge vitrectomy and cataract surgery. METHODS: The medical records of 376 patients who underwent phacoemulsification in a vitrectomized eye (sequential group) and 458 patients who underwent combined vitrectomy and phacoemulsification (combined group) were retrospectively reviewed. Main outcome measures were intra- and postoperative complications of phacoemulsification surgery. Surgical indications were a progressed cataract with various retinal conditions. RESULTS: The most common intraoperative complication during phacoemulsification was posterior capsule rupture in both groups. The rate of this complication was higher in the sequential group (18 eyes, 4.8%) than in the combined group (7 eyes, 1.5%) (p = 0.006). The most common early postoperative complication was transient high intraocular pressure (68 eyes, 14.8%) and late postoperative complication was pupillary in the synechia combined group (82 eyes, 17.9%). The most common early postoperative complication was transient high intraocular pressure (29 eyes, 7.7%) and late postoperative complication was posterior capsule opacification (27 eyes, 7.2%) in the sequential group. Fibrinous exudation occurred more in the combined group (57 eyes, 12.4%) than in the sequential group (19 eyes, 5.1%) (p = 0.000). CONCLUSION: Both sequential and combined cataract surgeries seemed to be safe. Combined surgery could be preferred in harder cataracts and zonular dehiscence.