User:Partha.Barai

Name
Dr. Partha S. Barai MBBS, MS

Location
Bangladesh

Affiliation
Netraloy Eye Care Center

Public E-mail or Contact
parthobarai@gmail.com

Subspecialty
Cataract, Glaucoma

Degree type
MS (Ophthalmology)

Clinical Study of Intraocular Lens Implantation by Scleral Suture Fixation after Lensectomy and Vitrectomy. Dr. Partha S. Barai

ABSTRACT

Objective: To investigate the surgical techniques and clinical significance of intraocular lens implantation by scleral suture fixation after lensectomy and vitrectomy.

Methods: According to the inclusion and exclusion criteria, 19 cases (20 eyes) were selected for IOL implantation by scleral suture fixation after lensectomy and vitrectomy. The uncorrected visual acuity (VA), best-corrected visual acuity (BCVA), intraocular pressure (IOP), preoperative IOL position and surface clarity, and complications were recorded, analyzed and compared. Results: In 20 eyes of 19 patients who underwent IOL implantation by scleral suture fixation in this study, both VA and BCVA after surgeries were significantly improved compared with those before surgeries (P<0.05). 11 eyes of 10 patients had IOP ≥ 21mmHg before surgeries. Three months after surgeries, IOP of all these affected eyes were within 21 mmHg, and no affected eyes required the application of ocular hypotensive drugs. Three months after surgeries, 17 eyes of 16 patients (85%) had centered IOL position and 3 eyes of 3 patients (15%) had slightly tilted IOL, all of these tilted IOLs were in patients with ocular trauma and all of them were found to be caused by scar adhesion in the peripheral part. In two eyes, the IOL optical edge was completely blocked by the pupil, which was only found after dilating the pupil. The pupil of one eye was traumatic and irregularly dilated, and the edge of the optical part of IOL was exposed. In two eyes of two patients who underwent silicone oil removal and IOL fixation during the same surgery, a small number of silicone oil droplets were found on the surface of IOL in the early stage after surgeries, and in the later stage, small flakes of pigment granules were observed. During the 3-month postoperative follow-up period, no patient had complications such as IOL dislocation, exposure of fixation suture, retinal detachment and corneal endothelial decompensation.

Conclusion: For patients with traumatic cataracts or primary subluxation or total dislocation of their own lens or intraocular lens, if the capsular support is inadequate or absent, IOL implantation after lensectomy with total capsulectomy and vitrectomy by scleral suture fixation technique can effectively correct aphakia and improve vision with relatively low complications.

Key words: Intraocular lens implantation, Scleral sutured fixation, The absence of posterior capsule, Clinical study