[Complications in sutured scleral fixation of artificial lens implantation].
Komplikationen bei skleranahtfixierter Kunstlinsenimplantation.
Cataract
Complication
Intraocular lens
Scleral fixation
Surgery
Journal
Der Ophthalmologe : Zeitschrift der Deutschen Ophthalmologischen Gesellschaft
ISSN: 1433-0423
Titre abrégé: Ophthalmologe
Pays: Germany
ID NLM: 9206148
Informations de publication
Date de publication:
Dec 2019
Dec 2019
Historique:
pubmed:
19
4
2019
medline:
18
12
2019
entrez:
19
4
2019
Statut:
ppublish
Résumé
Sutured scleral fixation of an artificial posterior chamber lens is a frequently used method for the treatment of eyes with poor or absent capsular support; however, the complication profile is often considered unfavorable. To analyze the postoperative complication profile. In this monocentric and retrospective analysis of a consecutive case series of patients with standardized sutured scleral fixation of a posterior chamber lens between 2007 and 2017, the documented complications were categorized as a permanent threat to visual acuity, such as endophthalmitis, choroidal hemorrhage, retinal detachment and clinically relevant but without a permanent threat to visual acuity, such as hemorrhage and hypotension. Additionally, the time point when complications first occurred was categorized into the 3 periods 0-3, 4-30 and ≥31 days. This is the largest patient collective of a study with scleral fixation of a posterior chamber lens published so far. A total of 338 eyes from 338 patients were included in the study (women 47%) and the median postoperative follow-up period was 60 days (range 1-5833 days). In 68% of the patients at least 1 complication was documented. Complications with a permanent threat to visual acuity occurred in 3% (n = 10) of the patients. The most frequent clinically relevant complications were intraocular hypotension ≤10 mm Hg (35%; n = 119), pupil decentration (28%; n = 93), hyphema, iris or vitreous hemorrhage (10%; n = 34), secondary glaucoma (9%; n = 32) and iris capture (5%; n = 17). Of the complications 41% occurred within the first 3 days and 70% within the first 30 days. Revision surgery was carried out in 4.5% (n = 15) of the patients. Although complications occurred in two thirds of the interventions, the number of permanent complications with a permanent threat to visual acuity was low. Scleral fixation of an artificial posterior chamber lens is still a justifiable intervention.
Sections du résumé
BACKGROUND
BACKGROUND
Sutured scleral fixation of an artificial posterior chamber lens is a frequently used method for the treatment of eyes with poor or absent capsular support; however, the complication profile is often considered unfavorable.
OBJECTIVE
OBJECTIVE
To analyze the postoperative complication profile.
METHODS
METHODS
In this monocentric and retrospective analysis of a consecutive case series of patients with standardized sutured scleral fixation of a posterior chamber lens between 2007 and 2017, the documented complications were categorized as a permanent threat to visual acuity, such as endophthalmitis, choroidal hemorrhage, retinal detachment and clinically relevant but without a permanent threat to visual acuity, such as hemorrhage and hypotension. Additionally, the time point when complications first occurred was categorized into the 3 periods 0-3, 4-30 and ≥31 days.
RESULTS
RESULTS
This is the largest patient collective of a study with scleral fixation of a posterior chamber lens published so far. A total of 338 eyes from 338 patients were included in the study (women 47%) and the median postoperative follow-up period was 60 days (range 1-5833 days). In 68% of the patients at least 1 complication was documented. Complications with a permanent threat to visual acuity occurred in 3% (n = 10) of the patients. The most frequent clinically relevant complications were intraocular hypotension ≤10 mm Hg (35%; n = 119), pupil decentration (28%; n = 93), hyphema, iris or vitreous hemorrhage (10%; n = 34), secondary glaucoma (9%; n = 32) and iris capture (5%; n = 17). Of the complications 41% occurred within the first 3 days and 70% within the first 30 days. Revision surgery was carried out in 4.5% (n = 15) of the patients.
CONCLUSION
CONCLUSIONS
Although complications occurred in two thirds of the interventions, the number of permanent complications with a permanent threat to visual acuity was low. Scleral fixation of an artificial posterior chamber lens is still a justifiable intervention.
Identifiants
pubmed: 30997528
doi: 10.1007/s00347-019-0896-0
pii: 10.1007/s00347-019-0896-0
doi:
Types de publication
Journal Article
Langues
ger
Sous-ensembles de citation
IM
Pagination
1200-1206Références
J Cataract Refract Surg. 2014 Dec;40(12):2099-105
pubmed: 25457381
J Cataract Refract Surg. 2016 Jan;42(1):27-34
pubmed: 26948775
J Cataract Refract Surg. 2016 Jul;42(7):955-60
pubmed: 27492091
J Cataract Refract Surg. 2003 Feb;29(2):301-8
pubmed: 12648641
J Clin Diagn Res. 2017 Mar;11(3):NC09-NC13
pubmed: 28511422
Retina. 2018 Sep;38 Suppl 1:S31-S40
pubmed: 29232333
J Cataract Refract Surg. 2005 May;31(5):903-9
pubmed: 15975454
Ophthalmology. 2014 Jan;121(1):61-66
pubmed: 24148655
J Cataract Refract Surg. 2015 Sep;41(9):1804-9
pubmed: 26471050
J Cataract Refract Surg. 2018 Feb;44(2):182-185
pubmed: 29502860
J Cataract Refract Surg. 2017 Mar;43(3):369-376
pubmed: 28410720