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Retina. 2018 Jul 16. doi: 10.1097/IAE.0000000000002268. [Epub ahead of print]

27-GAUGE SUTURELESS INTRASCLERAL FIXATION OF INTRAOCULAR LENSES WITH HAPTIC FLANGING: Short-Term Clinical Outcomes and a Disinsertion Force Study.

Author information

1
Associated Retinal Consultants, PC, William Beaumont School of Medicine, Oakland University, Royal Oak, Michigan.
2
Department of Ophthalmology and Vision Science, University of Arizona, Tucson, Arizona.
3
Pennsylvania Retina Specialists, Camp Hill, Pennsylvania.
4
W. K. Kellogg Eye Center, University of Michigan, Ann Arbor, Michigan.
5
Retina Associates, Tucson, Arizona.

Abstract

PURPOSE:

To determine whether haptic flanging during 27-gauge sutureless intrascleral fixation of intraocular lenses (IOLs) increases IOL stability and to report the short-term clinical outcomes of sutureless intrascleral surgery using 27-gauge trocar cannulas with haptic flanging.

METHODS:

Retrospective surgical case series using live and cadaveric human eyes.

RESULTS:

In the cadaveric experiment using five eyes, flanged haptics required more force to dislocate the IOL compared with unflanged haptics (14 ± 4 vs. 3 ± 1 g, P = 0.03). The clinical series included 52 eyes from 52 patients. The average age at the time of surgery was 73 ± 14 years, with a mean follow-up of 27 ± 19 weeks. The most common indication for surgery was IOL dislocation/subluxation (n = 43, 83%). Mean visual acuity improved from 20/140 preoperatively to 20/50 at postoperative Month 1 (P < 0.001). The most common postoperative issue was intraocular pressure elevation (n = 12, 23%). Two patients (4%) needed a reoperation for IOL dislocation.

CONCLUSION:

Haptic flanging during 27-gauge sutureless intrascleral surgery creates a more stable scleral-fixated IOL compared with the traditional unflanged technique based on a cadaveric human eye study. In addition, this variation of sutureless intrascleral surgery seems safe and effective for patients who require secondary IOLs.

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