A case study of pars plana vitrectomy with scleral flaps covering a two-point sutured scleral-fixated intraocular lens in a tertiary care eye hospital.

Abstract

Purpose: To evaluate the functional outcomes and complications of pars plana vitrectomy with scleral flaps covered with a two-point sutured scleral-fixated intraocular lens (SFIOL).

Methods: A retrospective, single-center, single-surgeon case study, including 97 cases. About 25 G pars plana vitrectomy with a two-point sutured scleral-fixated IOL was used as a surgical modality.

Results: This study included 97 patients and eyes with scleral IOL fixation, with a mean follow-up of 6 months. The indications for SFIOL were divided into cases of surgical aphakia (63, 64.94%), hyper-mature cataract not suitable for routine procedure (5,5.15%), traumatic cataracts not suitable for routine procedures (18,18.5%), and other categories (11,64.94%). In this study, the median ± standard deviation of best-corrected visual acuity (BCVA) values in logarithm of the minimum angle of resolution (LogMAR) pre, post 1 month, 3 months, 6 months showed statistically significant improvement in VA with P value <0.001. The most common complications as number of cases seen in our study were cystoid macular edema (four cases), Descemet membrane folds (three cases), epiretinal membrane (five cases), exposed suture knots (one case), iatrogenic retinal break (two cases), iatrogenic retinal touch (two cases), IOL edge glare (one case), IOL tilt (one case), secondary glaucoma (three cases), post-op uveitis (one case), retinal detachment (one case), no complications 73 cases out of total cases.

Conclusion: The mean BCVA improved from preoperative to postoperative 1 day, 1 month, 3 months, and 6 months ( P < 0.001) using this technique. This technique, which is more time-consuming, offers advantages over other available options, including improved stability, reduced risk of complications, and enhanced visual outcome.