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      Transscleral fixation of foldable intraocular lenses.

      Journal of Cataract and Refractive Surgery
      Acrylic Resins, Adolescent, Adult, Aged, Aged, 80 and over, Female, Humans, Lens Implantation, Intraocular, methods, Lenses, Intraocular, Male, Middle Aged, Phacoemulsification, Polypropylenes, Sclera, surgery, Suture Techniques, Sutures, Visual Acuity, Vitrectomy

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          Abstract

          To report the results of transscleral implantation of foldable intraocular lenses (IOLs). Department of Ophthalmology Dokuz Eylül University School of Medicine, Izmir, Turkey. Twenty eyes of 20 patients had transscleral fixation of a foldable IOL combined with conventional 3-port pars plana vitrectomy or anterior vitrectomy. Twelve eyes had lens luxation, 8 traumatic and 4 idiopathic. Six eyes were aphakic, 3 after extracapsular cataract extraction and 3 as a result of complicated phacoemulsification. One patient with a mature cataract and pseudoexfoliation had a wide zonular dialysis during phacoemulsification. One patient had an opacified hydrophilic acrylic IOL. The mean age of the patients was 52.9 years (range 17 to 80 years). The mean preoperative best corrected visual acuity (BCVA) was 20/63 (range counting fingers to 20/25). The mean preoperative refraction was +10.8 diopters (D) (range +10 to +13 D) and the mean preoperative astigmatism, 1.8 D (range 1.0 to 5.5 D). Sixteen IOLs were hydrophobic acrylic, 14 of which were 3-piece AcrySof MA60BM (Alcon) and 2 of which were Sensar AR40 (Allergan). Four IOLs, all VisaAcryl(Staar), were hydrophilic acrylic. The mean power of the IOLs was +22.0 D (range 19.0 to 26.0 D). The mean follow-up was 12 months (range 1 to 18 months). The postoperative BCVA ranged between 20/100 and 20/20, and the mean postoperative astigmatism was 1.1 D (range 0.5 to 4.0 D) at the last follow-up visit. The difference was statistically significant (P<.05). Suture exposure and cystoid macular edema were the only complications, each occurring in 2 eyes. Transscleral fixation of foldable IOLs takes less time and results in fewer complications and better visual outcomes.

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