Adjustable flanged technique for secondary implantation of four-point scleral‑fixated posterior chamber intraocular lenses using two parallel 6-0 polyglactin sutures.
Flanged technique
Four-point scleral‑fixated
Intraocular lenses
Secondary implantation
Journal
BMC ophthalmology
ISSN: 1471-2415
Titre abrégé: BMC Ophthalmol
Pays: England
ID NLM: 100967802
Informations de publication
Date de publication:
04 Sep 2024
04 Sep 2024
Historique:
received:
24
06
2024
accepted:
20
08
2024
medline:
5
9
2024
pubmed:
5
9
2024
entrez:
4
9
2024
Statut:
epublish
Résumé
To assess the efficacy and safety of using the adjustable flanged technique for secondary implantation of four-point scleral‑fixated posterior chamber intraocular lenses with two parallel 6-0 polyglactin sutures. Two parallel 6-0 polyglactin sutures were passed separately through the two haptics on the horizontal line of the 4-haptic IOL. The four externalized sutures were then trimmed and cauterized to form flanges. The best corrected visual acuity, intraocular pressure, and complications in all patients were observed and recorded. The flanged technique using two parallel 6-0 polyglactin sutures was applied to 14 aphakic eyes. The average preoperative best corrected visual acuity was 1.00 ± 0.88 LogMAR (Snellen 20/200), which improved to 0.42 ± 0.38 LogMAR (Snellen 20/48) at the final follow-up (P = 0.004). None of the patients experienced vitreous hemorrhage, low intraocular pressure, or issues with exposed or broken sutures. The simplicity of the technique, along with its ability to accommodate adjustments post-implantation, allows for optimal positioning and reduces risks like IOL tilt or dislocation. Overall, this is a promising approach to secondary IOL implantation, with potential benefits for both patient outcomes and surgical efficiency.
Identifiants
pubmed: 39232692
doi: 10.1186/s12886-024-03652-x
pii: 10.1186/s12886-024-03652-x
doi:
Substances chimiques
Polyglactin 910
34346-01-5
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
394Subventions
Organisme : the General scientific research project of Zhejiang Education Department
ID : Y202352078
Informations de copyright
© 2024. The Author(s).
Références
John T, Tighe S, Hashem O, et al. New use of 8 – 0 polypropylene suture for four-point scleral fixation of secondary intraocular lenses. J Cataract Refract Surg. 2018;44(12):1421–5.
doi: 10.1016/j.jcrs.2018.08.008
pubmed: 30314754
Sewelam A. Four-point fixation of posterior chamber intraocular lenses in children with unilateral aphakia. J Cataract Refract Surg. 2003;29:294–300.
doi: 10.1016/S0886-3350(02)01531-6
pubmed: 12648640
Snyder ME, Perez MA. Tiltless and centration adjustable scleral-sutured posterior chamber intraocular lens. J Cataract Refract Surg. 2014;40(10):1579–83.
doi: 10.1016/j.jcrs.2014.08.022
pubmed: 25263035
McGrath LA, Lee GA. Transscleral fixation of a supplementary toric intraocular lens to prevent rotation in a pseudophakic patient. J Cataract Refract Surg. 2013;39(1):134–8.
doi: 10.1016/j.jcrs.2012.07.042
pubmed: 23245366
Jürgens I, Rey A. Simple technique to treat pupillary capture after transscleral fixation of intraocular lens. J Cataract Refract Surg. 2015;41(1):14–7.
doi: 10.1016/j.jcrs.2014.11.012
pubmed: 25532631
Zhang J, Tian J, Sun X, et al. Closed continuous-Loop suture: a Novel Surgical technique for transscleral fixation of intraocular lenses. Retina. 2022;42(11):2221–4.
doi: 10.1097/IAE.0000000000002644
pubmed: 31498288
Lockington D, Ali NQ, Al-Taie R, et al. Outcomes of scleral-sutured conventional and aniridia intraocular lens implantation performed in a university hospital setting. J Cataract Refract Surg. 2014;40(4):609–17.
doi: 10.1016/j.jcrs.2013.09.014
pubmed: 24560552
Chen S, Yuan G, Zhu W et al. Four-Point Scleral Fixation Of An Akreos-Adapt AO Intraocular Lens Using Double-Strand 9 – 0 Polypropylene Suture. Retina. 2022;10.1097/IAE.0000000000003601.
Stem MS, Todorich B, Woodward MA, et al. Scleral-fixated intraocular lenses: past and Present. J Vitreoretin Dis. 2017;1(2):144–52.
doi: 10.1177/2474126417690650
pubmed: 29104957
Chen S, Yuan G, Zhu W, et al. 8 – 0 polypropylene suture looping and Overhand Knot: Transconjunctival Approach to four-point scleral fixation of an Akreos Adapt intraocular Lens. Retina. 2023;43(5):860–3.
doi: 10.1097/IAE.0000000000002873
pubmed: 32604345
Yamane S, Sato S, Maruyama-Inoue M, et al. Flanged intrascleral intraocular Lens fixation with Double-Needle Technique. Ophthalmology. 2017;124(8):1136–42.
doi: 10.1016/j.ophtha.2017.03.036
pubmed: 28457613
Kelkar AS, Fogla R, Kelkar J, et al. Sutureless 27-gauge needle-assisted transconjunctival intrascleral intraocular lens fixation: initial experience. Indian J Ophthalmol. 2017;65(12):1450–3.
doi: 10.4103/ijo.IJO_659_17
pubmed: 29208833
pmcid: 5742981
Assia EI, Wong JXH. Adjustable 6 – 0 polypropylene flanged technique for scleral fixation, part 1: primary fixation IOLs in aphakia, capsular stabilizing devices, and aniridia implants. J Cataract Refract Surg. 2020;46(10):1387–91.
doi: 10.1097/j.jcrs.0000000000000260
pubmed: 32773609
Malbran ES, Malbran E Jr, Negri I. Lens guide suture for transport and fixation in secondary IOL implantation after intracapsular extraction. Int Ophthalmol. 1986;9:151–60.
doi: 10.1007/BF00159844
pubmed: 3522455
Vounotrypidis E, Schuster I, Mackert MJ, et al. Secondary intraocular lens implantation: a large retrospective analysis. Graefes Arch Clin Exp Ophthalmol. 2019;257(1):125–34.
doi: 10.1007/s00417-018-4178-3
pubmed: 30413876
Ucar F. Intraocular lens implantation with flattened flanged intrascleral fixation technique in pediatric aphakia. J AAPOS. 2022;26(1):8.e1-8.e7.
doi: 10.1016/j.jaapos.2021.09.010