Outcomes of Transscleral Sulcus Fixation of Intraocular Lenses through a 2.4-mm Incision with an Injector System: 1-Year Follow-Up

Akiko Masai, MD, Tomoichiro Ogawa, MD Takuya Shiba, MD, Hiroshi Tsuneoka, MD

Department of OphthalmologyThe Jikei University School of Medicine

Tokyo, Japan

The authors have no financial interest in the subject matter of this e-poster.

Objective

• To evaluate postoperative outcomes of scleral-sutured ciliary sulcus fixation of foldable intraocular lens (IOL) through a 2.4-mm incision

Methods

• Subjects: 9 eyes (9 patients)– Lens subluxation: 1 eye– Aphakia: 5 eyes– IOL dislocation 3 eyes

• Variables examined– Best-corrected visual acuity (BCVA)

• Before and after surgery (1 week; 1, 3, 6, 12 months)– Surgically induced astigmatism (SIA) (Cravy method)

• After surgery (1 week; 1, 3, 6, 12 months)– Endothelial cell density

• Before and after surgery

Surgical Technique

1. Preparation for IOL setting of PC-9 hooking• 10-0 double polypropylene thread (PC-9, Alcon) was

inserted through the cartridge (E1, HOYA).• PC-9 was looped around the haptics of the IOL

(VA70AD or VA65BB, HOYA) by using a cow hitch knot.

Surgical Technique

2. Scleral pockets created at the 2 and 8-o’clock positions

3. Anterior vitrectomy performed4. 2.4-mm scleral corneal incision created at

12-o’clock position

5. IOL setting: IOL and hooked PC-9 loaded into cartridge

6. IOL inserted through incision with injector (ISH-001, HOYA), leaving opposite haptics out of anterior chamber

7. PC-9 looped around haptics8. IOL fixed to ciliary sulcus

BCVA

Surgically induced astigmatism was minimal

Early improvement in BCVA maintained for 1 year

SIA

Result 1

Result 2

• Mean endothelial cell density reduced 9.80%• Complications

– IOL iris capture and pupillary block in 1 case– Retinal detachment in 1 case– Cystoid macular edema in 1 case.

Treatments for Complications

• IOL capture– IOL repositioned– Peripheral iridectomy at 6 and 12 o’clock

• Retinal detachment– Scleral buckling surgery– Retina reattached

• Cystoid macular edema – Improvement without medication

Conclusion

• With this technique, visual acuity improved early postoperatively and was maintained for 1 year