Sclerocorneal fixation of posterior chamber intraocular lenses using polytetrafluoroethylene suture
Abstract
Dislocation of the intraocular lens (IOL) is a serious complication in cataract surgery. Therefore, the search for an effective method of fixing IOLs for non-standard surgical situations is relevant.
The purpose of this study is to analyze the clinical results of the technique of flanged corneoscleral fixation of IOL using a polytetrafluoroethylene thread.
The results of surgical treatment of 34 patients (34 eyes) who underwent IOL suturing with threads made of polytetrafluoroethylene 6-0 (Ecoflon) through the sclera and fixation of flanges in the lumen of corneal paracentesis («Sclerocorneal IOL Fixation Technique») without incisions of the conjunctiva and sclera were analyzed [3].
The average index of maximally corrected visual acuity before surgery was 0,27± 0,11. A day after surgery, this indicator increased to 0,41±0,1. One week after surgery, the average index of maximally corrected visual acuity was 0,6S±0,1, while the improvement in visual acuity was statistically significantly different from the indicator before surgery and a day after surgery (p<0,0S).
The use of polytetrafluoroethylene suture material in the ab externo technique, with threads passing through the sclera and fixing the flanges in the lumen of the corneal paracentesis is safe and effective. On average, patients had positive results from visual acuity with a low frequency of adverse events.
About the Authors
T. G. Sazhin
ЧУЗ ДКБ «РЖД-Медицина»
Russian Federation
Russian Federation
M. O. Sokolova
ФГБВОУ ВО «Военно-медицинская академия им. С.М. Кирова» МО РФ
Russian Federation
Russian Federation
References
1. Belonozhenko Ya. V., Sorokin Е. L. Frequency of Spontaneous dislocation of Intraocular Lens — capsular bag complex in various terms of the postoperative period after phacoemulsification of age-related cataract with posterior intraocular lens implantation. Oftalmohirurgiya. 2020; 2: 6—11. doi:10.2S276/0235-4160-2020-2-6-11. [(in Russian.)]
2. Monestam Е. Frequency of intraocular lens dislocation and pseudophacodonesis, 20 years after cataract surgery — a prospective study. Am. J. Ophthalmol. 2019; 198: 21S—22. doi: 10.1016/j.ajo.2018.10.020.
3. Kozhukhov A. A., Unguryanov O. V., Rumiantsev A D. Classification and analysis of scleral IOL fixation methods. Sovremennye tekhnologii v oftal’mologii. 2019; S: 49—S4. [(in Russian)]
4. Malbran Е. S., Malbran Е., Negri I. Lens guide suture for transport and fixation in secondary IOL implantation after intracapsular extraction. Int. Ophthalmol 1986; 9: 1S1—60. doi: 10.1007/BF001S9844.
5. Fedorov S. N., Еgorova Е. V. ЕГЮ^ and complications in the implantation of an artificial lens. M.: MNTK «Mikrohirurgiya glaza», 1992. 243 s. [(in Russian)]
6. Batkov Е. N., Pashtayev N.P. Tactical approaches to surgical management of lens subluxation. Oftal’mokhirurgiya. 2018; 3: 80—7. [(in Russian)]
7. Patent RUS № №2446777 C1 / 10.04.2012. Byul. № 10. Kozhukhov A. A., Gorbunkova M. V. Method of intraocular lens fixation. Available at: https://rusneb.ru/catalog/000224_000128_0002446777_20120410_C1_RU/?ysclid=l8ctynbinn327802450. (accessed 22 September 2022). [(in Russian)]
8. Kojuhov A., Arbisser L., Anisimov S. et al. Intracorneal knot or flange depot fixation: new transscleral technique for intraocular lens fixation. J. Cataract & Refractive Surgery. 2022; 6 (48): 74S—9. doi: 10.1097/j.jcrs.0000000000000949.
9. Drews R. Polypropylene in the human eye. American Intra-Ocular Implant Society Journal. 1983; 9 (2): 137—42. doi: 10.1016/s0146-2776(83)80027-5.
10. Vote B. J., Tranos P., Bunce C. et al. Long-term outcome of combined pars plana vitrectomy and scleral fixated sutured posterior chamber intra-ocular lens implantation. Am. J. Ophthalmol. 2006; 141: 308—12. doi: 10.1016/j.ajo.2005.09.012.
11. Canabrava S., Andrade N., Rezende P. Scleral fixation of a 4-eyelet foldable intraocular lens in patients with aphakia using a 4-flanged technique. J. Cataract. Refract Surg. 2021; 47 (2): 26S—9. doi: 10.1097/j.jcrs.0000000000000310.
12. Khan M., Gupta O., Smith R. et al. Scleral fixation of intraocular lenses using Gore-Tex suture: clinical outcomes and safety profil. Br. J. Ophthalmol. 2016; 100: 638—43. doi: 10.1136/bjophthalmol-2015-306839.
13. Pozdeeva N. A. Scleral fixation using Hoffman pockets. Modern technologies of cataract, corneal and refractive surgery. 2019. Available at: https://oor.ru/learning/videolekciy/od/sklerafix. (accessed 22 Septemder 2022). [(in Russian)]
14. Malyugin B. Е. Suture fixation of the capsular bag. Modern technologies of cataract, corneal and refractive surgery. 2019. Available at: https://oor.ru/learning/videolekciy/od/sklerafix. (accessed 22 Septemder 2022). [(in Russian)]
15. Nikolaenko V. P. The use of polytetrafluoroethylene implants in ophthalmology [Dissertation]. 200S. [(in Russian)]
16. Shaldin P. I., Kovalkina A. A., Vorob’eva N. V., Anisimova N. S. Scleral fixation of posterior chamber intraocular lensesusing polytetrafluoroethylene (Gore-Tex) suture in the eyes with lack of capsular support: clinical outcomes. Sovremennye tekhnologii v oftal’mologii. 2019; S: 168—70. [(in Russian)]
17. Fayzrahmanov R. R., Shishkin M. M., Konovalova K. I., Karpov G. O. Transcleral IOL fixation: from simple to complex. Ufa: Bshk. ЕПЫМ. 2020. [(in Russian)]
18. Price M. O., Price F. W. Jr, Werner L. et al. Late dislocation of scleralsutured posterior chamber intraocular lenses. J. Cataract. Refract. Surg. 200S; 31 (7): 1320—6. doi: 10.1016/j.jcrs.2004.12.060.
19. Asadi R., Kheirkhah A. Long-term results of scleral fixation of posterior chamber intraocular lenses in children. Ophthalmology. 2008; 11S (1): 67—72. doi: 10.1016/j.ophtha.2007.02.018.
20. Bading G., Hillenkamp J., Sachs H. G. et al. Longterm safety and functional outcome of combined pars plana vitrectomy and scleral-fixated sutured posterior chamber lens implantation. Am. J. Ophthalmol. 2007; 144 (3): 371—7. doi: 10.1016/j.ajo.2007.0S.014.
21. McAllister A. S., Hirst L. W. Visual outcomes and complications of scleralfixate posterior chamber intraocular lenses. J. Cataract Refract. Surg. 2011; 37 (7): 1263—9. doi: 10.1016/j.jcrs.2011.02.023.
22. Mimura T., Amano S., Sugiura T et al. 10-year followup study of secondarytransscleral ciliary sulcus fixated posterior chamber intraocular lenses. Am. J. Ophthalmol. 2003; 136 (S): 931—3. doi: 10.1016/s0002-9394(03)00893-6.
23. Parekh P., Green W. R., Stark W. J., Akpek Е. Subluxation of suture-fixated posterior chamber intraocular lenses a clinicopathologic study. Ophthalmology. 2007; 114 (2): 232—7. doi: 10.1016/j.ophtha.2006.10.037.
24. Price M. O., Price F. W. Jr, Werner L. et al. Late dislocation of scleralsutured posterior chamber intraocular lenses. J. Cataract. Refract. Surg. 200S; 31 (7): 1320—6. doi: 10.1016/j.jcrs.2004.12.060.
Review
For citations:
Sazhin T.G., Sokolova M.O. Sclerocorneal fixation of posterior chamber intraocular lenses using polytetrafluoroethylene suture. Healthcare. 2024;(3):52-59. (In Russ.)
Views:
12
Email this article 