Open AccessImplantation of posterior chamber foldable intraocular lens in the absence of adequate capsular support: iris fixation versus scleral fixation
Author(s) -
Tamer Gamal Elsayed,
Kamal A. M. Solaiman,
Medhat Shawky,
Ayman M Elmasry
Publication year - 2015
Publication title -
journal of egyptian ophthalmological society
Language(s) - English
Resource type - Journals
eISSN - 2314-6648
pISSN - 2090-0686
DOI - 10.4103/2090-0686.168681
Subject(s) - medicine , fixation (population genetics) , ophthalmology , intraocular lens , visual acuity , intraocular pressure , surgery , intraocular lenses , fibrous joint , macular edema , aphakia , sclera , iris (biosensor) , population , environmental health , computer security , computer science , biometrics
PurposeThe aim of the study was to evaluate and compare the advantages and disadvantages of iris fixation with scleral fixation of posterior chamber foldable intraocular lenses (IOLs) in eyes without adequate capsular support.Patients and methodsAphakic eyes without adequate capsular support and planned to be corrected with posterior chamber foldable IOL implantation were randomly distributed between two groups. Group A included eyes treated with the scleral fixation technique and group B included eyes treated with the iris suture fixation technique. Preoperative, intraoperative, and postoperative data included uncorrected and best-corrected visual acuity, refraction, intraocular pressure, signs of anterior segment inflammation, areas of capsular remnants, vitreous prolapse, surgical time, intraoperative difficulties, IOL malposition, and postoperative complications. Patients were followed up for at least 6 months.ResultsEighty eyes were randomly distributed between two groups; each included 40 eyes. The mean duration of surgery was 48.3 ± 12.6 min in group A and 38.9 ± 7.8 min in group B (P < 0.05). The grades of anterior chamber cells and flare were higher in group B than in group A, and the differences were statistically significant (P < 0.05) until the first week only. IOL tilt was found in seven (17.5%) eyes in group A and in two (5%) eyes in group B (P < 0.05). After 6 months, the mean best-corrected visual acuity was 0.82 ± 0.28 in group A and 0.77 ± 0.22 in group B (P > 0.05). Macular edema was found in two (5%) eyes in group A and in five (12.5%) eyes in group B (P < 0.05). Except for two eyes in group B, none of the eyes in either group required antiglaucoma treatment.ConclusionIn the absence of adequate capsular support, fixation of posterior chamber foldable IOL by iris suturing is associated with significantly less IOL malposition and consumes a shorter operative time compared with scleral fixation. However, iris suture fixation is associated with a higher incidence of postoperative iridocyclitis in the early postoperative period