Clinical Ophthalmology (Jan 2021)
Sutureless Scleral Fixated IOL: The “Catcher Pole” Technique
Abstract
Ciro Tamburrelli,1 Anna Clara Tamburrelli2 1Oftalmico Hospital of Rome, Rome, Italy; 2La Sapienza University of Rome, Clinica Oculistica Ospedale Umberto I, Rome, ItalyCorrespondence: Ciro TamburrelliOftalmico Hospital of Rome, Via Filippo Nicolai 91, Rome 00136, ItalyEmail [email protected]: To describe a new surgical technique for sutureless intrascleral intraocular lens (IOL) fixation with an adapted retinal scraper used as an instrument “the Catcher Pole” to retrieve the IOL haptic through a scleral tunnel.Setting: Public Eye Hospital, Roma, Italy.Design: Retrospective case series.Methods: Twenty-one eyes from 19 patients who underwent sutureless intrascleral IOL fixation were studied. A standard three-piece posterior chamber IOL (PCIOL) was implanted in aphakia or rescued and fixated in cases of dislocated PCIOL. A 23 to 25 G retinal loop scraper (the “Catcher Pole“) was inserted through a 1.5 mm long tunneled sclerotomy performed on the horizontal meridian, to capture, hold and externalize the tip of the haptic of the IOL. A flange created with an handheld cautery on the externalized haptic tip prevents IOL slippage. The best-corrected visual acuity (BCVA), central corneal pachymetry (CCP), IOL tilt and complications were assessed.Results: In twenty-one eyes of 19 patients, the mean preoperative BCVA was 0.61 logMAR units ± 0.05 SD, and the mean postoperative BCVA improved significantly to 0.18 logMAR units at three months ± 0.05 SD (P=0.002). The mean preoperative CCP was 610 μ ± 17 SD and the mean postoperative CCP 623 μ ± 16 SD, (P=0.73). In the subgroup that underwent IOL tilt evaluation, mean IOL tilt was 3.19± 2.01. The postoperative complications included iris capture of the IOL in one eye (4,7%) and transient ocular hypertension in two eyes (9,4%).Conclusions: The “Catcher Pole” sutureless intrascleral IOL fixation technique is easy to perform with reduced anterior chamber manipulations and achieves both anatomical and optical stability.Keywords: intrascleral intraocular lens fixation, Catcher Pole technique, capsular loss
