Matias Iglicki1, Dinah Zur2, Hermino Pablo Negri3, Joaquin Esteves3, Romina Arias3, Emanuel Holsman3, Anat Loewenstein2, Catharina Busch4. 1. Retina Private Office, University of Buenos Aires, 525 Aguirre St., 3rd Floor, Apt. A, Buenos Aires, 1414, Argentina. matiasiglicki@gmail.com. 2. Ophthalmology Division, Tel Aviv Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. 3. Diagnostic Ophthalmology Center, Buenos Aires, Argentina. 4. Ophthalmology Department, University of Leipzig, Leipzig, Germany.
Abstract
AIMS: Intraoperative complications in cataract surgery are more common in diabetic patients. Solving aphakia in these circumstances remains a challenge, as the scleral structure has been shown to be different in diabetes. This study aims to analyze the role of a secondary sutureless scleral intraocular lens (IOL) flanged fixation in diabetic patients without capsular support and to compare the anatomical and functional outcomes using a 30 gauge (G) ultrathin wall needle vs. a 27G needle. METHODS: Retrospective, observational cohort study. 105 eyes (105 patients) who underwent PPV with secondary IOL fixation using a sutureless 27G (n = 51) or a 30G ultrathin wall (UTW) needle technique (n = 54) and had a 24 months postoperative follow up. Consecutive patients' records were reviewed for lens stability and centration parameters, intra- and postoperative complications at 7 days, 1, 3, 6, 12, and 24 months after surgery. Correlations between outcome measures and needle size (27G vs. 30G UTW) were analyzed. RESULTS: IOL displacement occurred in 30 patients (41.2%) in the 27G group and did not occur in the 30G UTW needle group (p < 0.001). Mean time until IOL displacement was 10.5 ± 7.0 months (range: 7 days-24 months). IOL centricity was significantly better in the 30G ultrathin wall needle group compared to 27 G (p = 0.001). Additional surgical interventions were necessary only in the 27G group (n = 14). CONCLUSIONS: Sutureless IOL flanged technique using a 30G UTW needle is more predictable and has less complications in aphakic diabetic patients, compared to a 27G needle technique.
AIMS: Intraoperative complications in cataract surgery are more common in diabeticpatients. Solving aphakia in these circumstances remains a challenge, as the scleral structure has been shown to be different in diabetes. This study aims to analyze the role of a secondary sutureless scleral intraocular lens (IOL) flanged fixation in diabeticpatients without capsular support and to compare the anatomical and functional outcomes using a 30 gauge (G) ultrathin wall needle vs. a 27G needle. METHODS: Retrospective, observational cohort study. 105 eyes (105 patients) who underwent PPV with secondary IOL fixation using a sutureless 27G (n = 51) or a 30G ultrathin wall (UTW) needle technique (n = 54) and had a 24 months postoperative follow up. Consecutive patients' records were reviewed for lens stability and centration parameters, intra- and postoperative complications at 7 days, 1, 3, 6, 12, and 24 months after surgery. Correlations between outcome measures and needle size (27G vs. 30G UTW) were analyzed. RESULTS: IOL displacement occurred in 30 patients (41.2%) in the 27G group and did not occur in the 30G UTW needle group (p < 0.001). Mean time until IOL displacement was 10.5 ± 7.0 months (range: 7 days-24 months). IOL centricity was significantly better in the 30G ultrathin wall needle group compared to 27 G (p = 0.001). Additional surgical interventions were necessary only in the 27G group (n = 14). CONCLUSIONS: Sutureless IOL flanged technique using a 30G UTW needle is more predictable and has less complications in aphakic diabeticpatients, compared to a 27G needle technique.
Authors: M Ali Khan; Omesh P Gupta; Ryan G Smith; Brandon D Ayres; Irving M Raber; Robert S Bailey; Jason Hsu; Marc J Spirn Journal: Br J Ophthalmol Date: 2015-08-28 Impact factor: 4.638
Authors: Elena Martínez-Plaza; Pedro Ruiz-Fortes; Roberto Soto-Negro; Carlos J Hernández-Rodríguez; Ainhoa Molina-Martín; Alfonso Arias-Puente; David P Piñero Journal: Diagnostics (Basel) Date: 2022-05-07