Spyridon Dimopoulos1, Vasileios Dimopoulos2, Gunnar Blumenstock2, Hugo Trevino-Rodriguez2, Karl Ulrich Bartz-Schmidt2, Martin S Spitzer2, Bogomil Voykov2. 1. From the Centre for Ophthalmology (S. Dimopoulos, Trevino-Rodriguez, Bartz-Schmidt, Spitzer, Voykov), University Hospital Tübingen, and the Institute for Clinical Epidemiology and Applied Biometry (Blumenstock), Eberhard Karls University of Tübingen, Tübingen, and the Department of Ophthalmology (V. Dimopoulos, Spitzer), University Medical Center, Hamburg-Eppendorf, Germany. Electronic address: spyridon.dimopoulos@med.uni-tuebingen.de. 2. From the Centre for Ophthalmology (S. Dimopoulos, Trevino-Rodriguez, Bartz-Schmidt, Spitzer, Voykov), University Hospital Tübingen, and the Institute for Clinical Epidemiology and Applied Biometry (Blumenstock), Eberhard Karls University of Tübingen, Tübingen, and the Department of Ophthalmology (V. Dimopoulos, Spitzer), University Medical Center, Hamburg-Eppendorf, Germany.
Abstract
PURPOSE: To assess the long-term results and complications of scleral-fixated posterior chamber intraocular lenses (PC IOLs) with the knotless Z-suture technique. SETTING: University Eye Hospital, Tübingen, Germany. DESIGN: Retrospective case series. METHODS: Records of consecutive patients who had implantation of scleral-fixated PC IOLs with the knotless Z-suture technique with a minimum follow-up of 3 years were reviewed. RESULTS: Sixty-six eyes of 62 patients were included. The mean preoperative corrected distance visual acuity (CDVA) was 0.71 logarithm of the minimum angle of resolution (logMAR) ± 0.58 (SD). The mean CDVA was 0.67 ± 0.54 logMAR (P = .257; n = 66) after 3 years, 0.73 ± 0.55 logMAR (P = .399; n = 60) after 5 years, 0.8 ± 0.68 logMAR (P = .348; n = 30) after 8 years, and 1.09 ± 0.76 logMAR (P = .069; n = 13) after 10 years. Failure because of suture breakage was observed in 11 eyes (16.7%) after a mean of 7.5 years. Kaplan-Meier time-to-event analysis showed a 40% failure probability after 10 years. Traumatic aphakia was the only risk factor for failure (odds ratio 4.1; 95% confidence interval, 1.0-18.3; P = .049). Complications included retinal detachment (15%), cystoid macular edema (9%), increased intraocular pressure requiring surgical intervention (7.6%), corneal edema (4.5%), and posterior iris-chafing syndrome with microhyphema (3%). CONCLUSIONS: Implantation of scleral-fixated PC IOLs using the knotless Z-suture was a safe technique resulting in good visual outcomes. The long-term success of the procedure was dependent on the material properties of the suture.
PURPOSE: To assess the long-term results and complications of scleral-fixated posterior chamber intraocular lenses (PC IOLs) with the knotless Z-suture technique. SETTING: University Eye Hospital, Tübingen, Germany. DESIGN: Retrospective case series. METHODS: Records of consecutive patients who had implantation of scleral-fixated PC IOLs with the knotless Z-suture technique with a minimum follow-up of 3 years were reviewed. RESULTS: Sixty-six eyes of 62 patients were included. The mean preoperative corrected distance visual acuity (CDVA) was 0.71 logarithm of the minimum angle of resolution (logMAR) ± 0.58 (SD). The mean CDVA was 0.67 ± 0.54 logMAR (P = .257; n = 66) after 3 years, 0.73 ± 0.55 logMAR (P = .399; n = 60) after 5 years, 0.8 ± 0.68 logMAR (P = .348; n = 30) after 8 years, and 1.09 ± 0.76 logMAR (P = .069; n = 13) after 10 years. Failure because of suture breakage was observed in 11 eyes (16.7%) after a mean of 7.5 years. Kaplan-Meier time-to-event analysis showed a 40% failure probability after 10 years. Traumatic aphakia was the only risk factor for failure (odds ratio 4.1; 95% confidence interval, 1.0-18.3; P = .049). Complications included retinal detachment (15%), cystoid macular edema (9%), increased intraocular pressure requiring surgical intervention (7.6%), corneal edema (4.5%), and posterior iris-chafing syndrome with microhyphema (3%). CONCLUSIONS: Implantation of scleral-fixated PC IOLs using the knotless Z-suture was a safe technique resulting in good visual outcomes. The long-term success of the procedure was dependent on the material properties of the suture.
Authors: Lisa Brandt; Jörgen Petersen; Josep Callizo; Sebastian Bemme; Sebastian Pfeiffer; Hans Hoerauf; Nicolas Feltgen; Christian van Oterendorp Journal: Ophthalmologe Date: 2019-12 Impact factor: 1.059
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