Gregg T Kokame1, Ryan T Yanagihara2, Jessica G Shantha3, Kyle N Kaneko3. 1. Division of Ophthalmology, Department of Surgery, University of Hawaii School of Medicine, Honolulu, Hawaii; The Retina Center at Pali Momi, Aiea, Hawaii; Retina Consultants of Hawaii, Aiea, Hawaii; Hawaii Macula and Retina Institute, Aiea, Hawaii. Electronic address: retinahi@aol.com. 2. The Retina Center at Pali Momi, Aiea, Hawaii; Retina Consultants of Hawaii, Aiea, Hawaii; Hawaii Macula and Retina Institute, Aiea, Hawaii; University of Hawaii John A. Burns School of Medicine, Honolulu, Hawaii. 3. The Retina Center at Pali Momi, Aiea, Hawaii; Retina Consultants of Hawaii, Aiea, Hawaii; Hawaii Macula and Retina Institute, Aiea, Hawaii.
Abstract
PURPOSE: To assess the long-term stability of sutured scleral-fixated posterior chamber intraocular lenses (PCIOLs) performed in combination with pars plana vitrectomy. DESIGN: Retrospective, consecutive, interventional case series. METHODS: Retrospective single-surgeon study of 118 eyes of 111 patients seen at Retina Consultants of Hawaii, who underwent sutured scleral fixation of at least 1 haptic of a posterior chamber intraocular lens with 10-0 polypropylene combined with a pars plana vitrectomy. The fixation knot-tying technique required 2 separate 10-0 polypropylene sutures tied into 1 combined knot-1 suture closed the fixation sclerotomy and created the scleral fixation, and 1 suture looped together around the haptic of the PCIOL, securing the haptic to the scleral fixation site. The primary outcomes were position of the PCIOL at last follow-up, dislocation of either 1 or both haptics of the PCIOL, and breakage of the 10-0 polypropylene fixation suture. RESULTS: PCIOLs remained well stabilized and positioned at last follow-up in 116 of 118 eyes (98.3%), with a mean follow-up of 6.0 years. The maximum stable follow-up with 2 intact fixation sutures was 24.75 years. There were 4 cases of redislocation (3.4%), but 2 cases were owing to unstable residual capsular support. There was 1 case of suture breakage in 214 fixation sutures (0.47%) and 1 case of haptic breakage. CONCLUSIONS: Scleral fixation sutures with 10-0 polypropylene provide excellent long-term fixation of PCIOLs, with a less than 0.5% incidence of suture breakage and documented suture stability for up to 24+ years.
PURPOSE: To assess the long-term stability of sutured scleral-fixated posterior chamber intraocular lenses (PCIOLs) performed in combination with pars plana vitrectomy. DESIGN: Retrospective, consecutive, interventional case series. METHODS: Retrospective single-surgeon study of 118 eyes of 111 patients seen at Retina Consultants of Hawaii, who underwent sutured scleral fixation of at least 1 haptic of a posterior chamber intraocular lens with 10-0 polypropylene combined with a pars plana vitrectomy. The fixation knot-tying technique required 2 separate 10-0 polypropylene sutures tied into 1 combined knot-1 suture closed the fixation sclerotomy and created the scleral fixation, and 1 suture looped together around the haptic of the PCIOL, securing the haptic to the scleral fixation site. The primary outcomes were position of the PCIOL at last follow-up, dislocation of either 1 or both haptics of the PCIOL, and breakage of the 10-0 polypropylene fixation suture. RESULTS:PCIOLs remained well stabilized and positioned at last follow-up in 116 of 118 eyes (98.3%), with a mean follow-up of 6.0 years. The maximum stable follow-up with 2 intact fixation sutures was 24.75 years. There were 4 cases of redislocation (3.4%), but 2 cases were owing to unstable residual capsular support. There was 1 case of suture breakage in 214 fixation sutures (0.47%) and 1 case of haptic breakage. CONCLUSIONS: Scleral fixation sutures with 10-0 polypropylene provide excellent long-term fixation of PCIOLs, with a less than 0.5% incidence of suture breakage and documented suture stability for up to 24+ years.
Authors: Natalia S Anisimova; Lisa B Arbisser; Natalya F Shilova; Roman V Kirtaev; Daria A Dibina; Boris E Malyugin Journal: Digit J Ophthalmol Date: 2020-06-26