Daniel Su1, John D Stephens1, Anthony Obeid1, Durga Borkar1, Philip P Storey1, M Ali Khan2, Jason Hsu1, Sunir J Garg1, Omesh Gupta3. 1. Retina Service, Wills Eye Hospital, Philadelphia, Pennsylvania. 2. Retina Service, Wills Eye Hospital, Philadelphia, Pennsylvania; Retina Division, Doheny and Stein Eye Institutes, David Geffen School of Medicine at UCLA, Los Angeles, California. 3. Retina Service, Wills Eye Hospital, Philadelphia, Pennsylvania. Electronic address: ogupta@midatlanticretina.com.
Abstract
PURPOSE: To evaluate refractive outcomes after combined pars plana vitrectomy (PPV) and scleral fixation of an intraocular lens (IOL) using Gore-Tex suture. DESIGN: Retrospective cohort study. PARTICIPANTS: Fifty-five eyes from 53 patients who underwent PPV with a Gore-Tex sutured IOL from June 2013 through December 2017. METHODS: Patients who underwent combined PPV and scleral fixation of an IOL with Gore-Tex suture were identified. All eyes underwent scleral fixation of either an Akreos A060 or enVista MX60 IOL and were fixated either 2 mm or 3 mm posterior to the limbus. Postoperative manifest refractions were performed at least 3 months after surgery and were compared with preoperative predicted target refraction based on in-the-bag IOL calculations. Subgroup analyses based on sclerotomy placement and IOL models were performed. MAIN OUTCOME MEASURES: Postoperative manifest refraction and difference with sclerotomy placement and IOL model. RESULTS: The mean postoperative spherical equivalent (SEQ) was -0.99±1.00 diopters (D). The mean difference in SEQ (ΔSEQ) from preoperative predicted target was -0.64±1.00 D. The IOL was fixated 2 mm posterior to the limbus in 14 eyes and 3 mm in 41 eyes. Within these 2 subgroups, the mean postoperative SEQ was -1.53±1.35 D for fixation 2 mm posterior to the limbus and -0.82±0.83 D for fixation 3 mm posterior to the limbus (P = 0.09). The mean ΔSEQ was -0.43±0.71 D for fixation 3 mm posterior to the limbus and -1.35±1.32 D for fixation 2 mm posterior to the limbus (P = 0.03). The mean amount of surgically induced astigmatism in the overall cohort was 0.77±0.65 D. The mean ΔSEQ and induced astigmatism were similar between IOL models. CONCLUSIONS: After combined PPV and Gore-Tex-sutured IOL implantation, mean postoperative refractive outcomes were more myopic when the IOL was fixated 2 mm from the limbus compared with 3 mm from the limbus. No significant difference was found between IOL models. Based on these results, future implant power calculations may be adjusted to approximate preoperative target refraction more accurately.
PURPOSE: To evaluate refractive outcomes after combined pars plana vitrectomy (PPV) and scleral fixation of an intraocular lens (IOL) using Gore-Tex suture. DESIGN: Retrospective cohort study. PARTICIPANTS: Fifty-five eyes from 53 patients who underwent PPV with a Gore-Tex sutured IOL from June 2013 through December 2017. METHODS:Patients who underwent combined PPV and scleral fixation of an IOL with Gore-Tex suture were identified. All eyes underwent scleral fixation of either an Akreos A060 or enVista MX60 IOL and were fixated either 2 mm or 3 mm posterior to the limbus. Postoperative manifest refractions were performed at least 3 months after surgery and were compared with preoperative predicted target refraction based on in-the-bag IOL calculations. Subgroup analyses based on sclerotomy placement and IOL models were performed. MAIN OUTCOME MEASURES: Postoperative manifest refraction and difference with sclerotomy placement and IOL model. RESULTS: The mean postoperative spherical equivalent (SEQ) was -0.99±1.00 diopters (D). The mean difference in SEQ (ΔSEQ) from preoperative predicted target was -0.64±1.00 D. The IOL was fixated 2 mm posterior to the limbus in 14 eyes and 3 mm in 41 eyes. Within these 2 subgroups, the mean postoperative SEQ was -1.53±1.35 D for fixation 2 mm posterior to the limbus and -0.82±0.83 D for fixation 3 mm posterior to the limbus (P = 0.09). The mean ΔSEQ was -0.43±0.71 D for fixation 3 mm posterior to the limbus and -1.35±1.32 D for fixation 2 mm posterior to the limbus (P = 0.03). The mean amount of surgically induced astigmatism in the overall cohort was 0.77±0.65 D. The mean ΔSEQ and induced astigmatism were similar between IOL models. CONCLUSIONS: After combined PPV and Gore-Tex-sutured IOL implantation, mean postoperative refractive outcomes were more myopic when the IOL was fixated 2 mm from the limbus compared with 3 mm from the limbus. No significant difference was found between IOL models. Based on these results, future implant power calculations may be adjusted to approximate preoperative target refraction more accurately.
Authors: Yesha S Shah; Angela Y Zhu; Sidra I Zafar; Daniel Sarezky; Ximin Li; T Y Alvin Liu; Mira M Sachdeva; Fasika A Woreta Journal: Clin Ophthalmol Date: 2021-02-24
Authors: Nimesh A Patel; Kenneth C Fan; Nicolas A Yannuzzi; Jorge A Fortun; Luis J Haddock; Sonia H Yoo; Patrice J Persad; Elizabeth A Vanner; Sarah P Read; Basil K Williams; Jayanth Sridhar; Thomas A Albini; Harry W Flynn; Kendall Donaldson; Justin H Townsend Journal: Clin Ophthalmol Date: 2020-12-21