Anterior Chamber Intraocular Lens Implantation Versus Four-Flanged Scleral Fixation Technique for Patients With Loss of Capsular Support During Routine Cataract Surgery.
Biana Dubinsky-Pertzov, Ori Mahler, Asaf Shemer, Idan Hecht, Francis Simaan, Avner Belkin, Eran Pras, Adi Einan-Lifshitz
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引用次数: 0
Abstract
Purpose: To compare the outcomes of anterior chamber intraocular lens (AC-IOL) implantation versus the four-flanged scleral fixation technique in eyes with loss of capsular support during routine cataract surgery.
Methods: This was a retrospective cohort study of all patients in whom an IOL was implanted either during or after short-term aphakia due to loss of capsular and sulcus support in a routine cataract surgery with at least 6 months of follow-up time between 2015 and 2023 in a tertiary medical center in Israel. Two different IOL implantation techniques were compared: the implantation of an angle-supported ACIOL and four-flanged scleral fixation. Main outcome measures included postoperative complications such as pseudophakic bullous keratopathy, loss of intraocular pressure control and glaucoma, IOL subluxation, and retinal detachment.
Results: Sixty-five eyes of 65 patients were included in the study, 33 eyes in the AC-IOL group and 32 eyes in the flange group. Follow-up time was 29.92 ± 20.02 months in the AC-IOL group and 20.17 ± 15.56 months in the flange group (P = .087). Pseudophakic bullous keratopathy was observed in 10 (30.3%) patients in the AC-IOL group and in 1 (3.1%) patient in the flange group (P = .04). This association remained significant using survival analysis (P = .006). In 4 (12.1%) patients in the AC-IOL group, a glaucoma filtering procedure was performed to control the intraocular pressure compared with none in the flange group (P = .042).
Conclusions: In the setting of loss of capsular support during routine cataract surgery, four-flanged scleral fixation showed an overall lower rate of complications and significantly reduced rate of subsequent surgical interventions. [J Refract Surg. 2024;40(8):e520-e526.].
期刊介绍：
The Journal of Refractive Surgery, the official journal of the International Society of Refractive Surgery, a partner of the American Academy of Ophthalmology, has been a monthly peer-reviewed forum for original research, review, and evaluation of refractive and lens-based surgical procedures for more than 30 years. Practical, clinically valuable articles provide readers with the most up-to-date information regarding advances in the field of refractive surgery. Begin to explore the Journal and all of its great benefits such as:
• Columns including “Translational Science,” “Surgical Techniques,” and “Biomechanics”
• Supplemental videos and materials available for many articles
• Access to current articles, as well as several years of archived content
• Articles posted online just 2 months after acceptance.
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