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27-GAUGE SUTURELESS INTRASCLERAL FIXATION OF INTRAOCULAR LENSES WITH HAPTIC FLANGING

Short-Term Clinical Outcomes and a Disinsertion Force Study

Stem, Maxwell S., MD*; Wa, Christianne A., MD; Todorich, Bozho, MD, PhD*,‡; Woodward, Maria A., MD, MS§; Walsh, Mark K., MD, PhD; Wolfe, Jeremy D., MD, MS*

doi: 10.1097/IAE.0000000000002268
Original Study: PDF Only

Purpose: To determine whether haptic flanging during 27-gauge sutureless intrascleral fixation of intraocular lenses (IOLs) increases IOL stability and to report the short-term clinical outcomes of sutureless intrascleral surgery using 27-gauge trocar cannulas with haptic flanging.

Methods: Retrospective surgical case series using live and cadaveric human eyes.

Results: In the cadaveric experiment using five eyes, flanged haptics required more force to dislocate the IOL compared with unflanged haptics (14 ± 4 vs. 3 ± 1 g, P = 0.03). The clinical series included 52 eyes from 52 patients. The average age at the time of surgery was 73 ± 14 years, with a mean follow-up of 27 ± 19 weeks. The most common indication for surgery was IOL dislocation/subluxation (n = 43, 83%). Mean visual acuity improved from 20/140 preoperatively to 20/50 at postoperative Month 1 (P < 0.001). The most common postoperative issue was intraocular pressure elevation (n = 12, 23%). Two patients (4%) needed a reoperation for IOL dislocation.

Conclusion: Haptic flanging during 27-gauge sutureless intrascleral surgery creates a more stable scleral-fixated IOL compared with the traditional unflanged technique based on a cadaveric human eye study. In addition, this variation of sutureless intrascleral surgery seems safe and effective for patients who require secondary IOLs.

Using cadaveric eyes, we demonstrate that flanging the haptics of a sutureless intrascleral intraocular lens creates a more stable scleral-fixated intraocular lens compared with the traditional unflanged technique. In addition, this variation of sutureless intrascleral surgery seems safe and effective for patients who require secondary intraocular lenses.

*Associated Retinal Consultants, PC, William Beaumont School of Medicine, Oakland University, Royal Oak, Michigan;

Department of Ophthalmology and Vision Science, University of Arizona, Tucson, Arizona;

Pennsylvania Retina Specialists, Camp Hill, Pennsylvania;

§W. K. Kellogg Eye Center, University of Michigan, Ann Arbor, Michigan; and

Retina Associates, Tucson, Arizona.

Reprint requests: Jeremy D. Wolfe, MD, MS, Associated Retinal Consultants, PC, William Beaumont Hospital, 3555 W Thirteen Mile Road, Suite LL-20, Royal Oak, MI 48073; e-mail: jwolfe@arcpc.net

M. A. Woodward receives grant funding from the National Eye Institute (NEI, K23EY023596).

None of the authors has any conflicting interests to disclose.

© 2018 by Ophthalmic Communications Society, Inc.