Clinical Ophthalmology (Oct 2020)

Secondary Posterior Chamber Intraocular Lens Fixation Using Flanged Prolene Sutures as an Alternative to an Anterior Chamber Intraocular Lens Implantation

  • Hostovsky A,
  • Mandelcorn M,
  • Mandelcorn ED

Journal volume & issue
Vol. Volume 14
pp. 3481 – 3486

Abstract

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Avner Hostovsky,1,2 Mark Mandelcorn,1,2 Efrem D Mandelcorn1,2 1Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada; 2Department of Ophthalmology, Toronto Western Hospital, The University Health Network, Toronto, Ontario, CanadaCorrespondence: Avner HostovskyDepartment of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, CanadaEmail [email protected]: To describe and evaluate the clinical outcomes of the Flanged Prolene Suture intraocular lens fixation (PIF) technique and compare it to anterior chamber IOL (ACIOL) implantation.Design: A retrospective comparative review.Methods: A retrospective comparative review of consecutive patients undergoing secondary IOL implantation was performed. A comparison between patients that had ACIOL and PIF technique was conducted. The main outcome measures were changes in best-corrected visual acuity (VA), IOL position and complications.Results: In the study period, fourteen eyes had ACIOL implantation and ten eyes had PIF surgery. VA acuity for both groups combined improved from 1.27 ± 0.65 logMAR preoperatively to 0.84 ± 0.65 logMAR (P< 0.0001). Seventeen patients had VA measurements in the year before the IOL dislocation. In those seventeen patients, VA changed from a baseline of 0.90 ± 0.68 to 0.97 ± 0.61 logMAR in the PIF group (p=0.334) and from 0.54 ± 0.27 to 0.85 ± 0.65 logMAR in the ACIOL group (p=0.145). No intraoperative or early postoperative complications were documented in either group. Two (20%) patients in the PIF group developed CME and one patient developed corneal edema. In the ACIOL group, one patient developed significant CME and two patients developed visual significant corneal edema.Conclusion: The PIF technique seems to offer a simple, fast and safe way to fixate an IOL posteriorly. In our experience, the learning curve of the technique is short with a low complication rate and good visual outcomes.Keywords: four-point, flange, IOL fixation

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