COMPARISON OF RESCUE APPROACH WITH GORE-TEX SUTURE SCLERAL FIXATION AND LENS EXPLANTATION COMBINED WITH STANDARDIZED FLANGED INTRASCLERAL FIXATION.

Purpose: To evaluate the safety and effectiveness of fixing dislocated intraocular lenses (IOLs) with Gore-TEX suture scleral fixation, compared to IOL explantation combined with a secondary implant using a standardized flanged intrascleral fixation (Yamane technique).

Setting: Department of Ophthalmology, "Vito Fazzi" Hospital, Lecce, Italy.

Study design: We conducted a single-center, retrospective, comparative study involving patients surgically managed for late in-the-bag single-piece IOL dislocation with either Gore-TEX suture scleral fixation and IOL explantation combined with a secondary implant using a standardized flanged intrascleral fixation (Yamane technique).

Methods: The study included patients that underwent rescue of a dislocated single-piece, four-eyelet acrylic IOL, fixated to the sclera with Gore-Tex sutures (Group A), or IOL explantation followed by three-piece IOL implant using the Yamane technique (Group B).

Primary outcomes: uncorrected and best-corrected distance visual acuity (UCDVA and BCDVA), refractive target, corneal cylinder (CC), endothelial cell loss (ECL), and post-operative complications.

Results: Thirty-four eyes (Group A, 16; Group B, 18) of 34 consecutive patients were included. Overall mean follow-up was 11.4±2.2 months. In both groups, UCDVA and BCDVA significantly improved (p<0.001) at last visit. Final refractive target and CC were not significantly different between the groups (p=0.62). ECL was significantly greater (p=0.001) in Group B (14.7%; -306±11 cells/mm2) than in A (5.1%; -105.6±12 cells/mm2).

Conclusions: The rescue approach with Gore-TEX suture scleral fixation was similar to IOL explantation combined with Yamane technique regarding functional and refractive outcomes. A lesser degree of ECL occurred after the rescue approach.