A different surgical approach to cases with zonular weakness or dialysis: sutureless transscleral fixated intraocular lens implantation and stabilization of lens capsule

• Published in: International ophthalmology 2020-09, Vol.40 (9), p.2315-2323
• Main Authors: Taskin, Ibrahim, Altinbay, Deniz, Ozdemir, Veli Nusret
• Format: Article
• Language: English
• Subjects: Acuity; Complications; Dialysis; Endothelial cells; Eye; Eye (anatomy); Hemodialysis; Implantation; Intraocular lenses; Medicine; Medicine & Public Health; Ophthalmology; Optics; Original Paper; Stabilization; Statistical analysis; Statistical significance; Visual acuity
• ISSN: 0165-5701; 1573-2630
• DOI: 10.1007/s10792-020-01416-2

Purpose To evaluate the effect of sutureless transscleral fixated intraocular lens (IOL) implantation and capsule stabilization of IOL optics on postoperative visual outcomes in cases with zonular dialysis in excess of 70°. Methods Fifteen eyes of thirteen patients with > 70° zonular dialysis and endothelial cell counts higher than 1500 cells/mm 2 who had been followed for at least 6 months were included. A modified surgical approach was applied to these eyes with sutureless transscleral fixated IOL implantation and the IOL was secured to the capsulorhexis to stabilize the lens capsule (optic capture). Results The mean best-corrected visual acuity (BCVA) was 0.21 ± 0.2 on the first day, 0.45 ± 0.33 on the first week, 0.60 ± 0.32 on the first month, 0.80 ± 0.26 on the third month, and 0.82 ± 0.27 on the sixth month. When preoperative BCVA and postoperative BCVA were compared, a statistically significant increase was observed in postoperative BCVA beginning from the seventh postoperative day. There was a statistically significant ( p  = 0.038) decrease in endothelial cell count at postoperative third and sixth months (1895 ± 65, 1872 ± 376, respectively) compared to preoperative values. Conclusions The use of this new surgical modification that utilizes capsular tension rings combined with a procedure that secures the sutureless scleral IOL fixation to the capsulorhexis for the treatment of eyes with zonular dialysis in excess of 70° was found to be very successful in the 6 months of follow-up. More cases and longer follow-up periods are required to provide an idea as to whether different complications will develop in such patients.