Long-Term Outcome of Combined Pars Plana Vitrectomy and Scleral Fixated Sutured Posterior Chamber Intraocular Lens Implantation

• Published in: American journal of ophthalmology 2006-02, Vol.141 (2), p.308-312.e1
• Main Authors: Vote, Brendan J., Tranos, Paris, Bunce, Catey, Charteris, David G., Da Cruz, Lyndon
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Biological and medical sciences; Cataracts; Child; Eye surgery; Female; Follow-Up Studies; Hemorrhage; Humans; Lens Implantation, Intraocular - methods; Male; Marfan syndrome; Medical research; Medical sciences; Middle Aged; Miscellaneous; Ophthalmology; Patients; Postoperative Complications; Postoperative period; Reoperation; Retrospective Studies; Sclera - surgery; Studies; Surgery; Surgical techniques; Suture Techniques; Treatment Outcome; Visual Acuity; Vitrectomy - methods
• ISSN: 0002-9394; 1879-1891
• DOI: 10.1016/j.ajo.2005.09.012

To investigate the long-term visual outcome and the complication rate following transscleral suture fixation of posterior chamber intraocular lenses (sutured PC-IOLs). A retrospective case-series descriptive study. Records of patients who underwent combined pars plana vitrectomy and sutured PC-IOLs at Moorfields Eye Hospital and who had at least 12 months of follow-up were examined for recorded complications. Sixty-one eyes of 48 patients (33 males and 15 females) were identified and included in the analysis, with mean follow-up of 6 years. The mean final best-corrected visual acuity remained at preoperative levels ( P = .211) and was largely determined by the underlying ocular pathology before sutured PC-IOL. Overall 30 of 61 (49%) eyes, two or more procedures were performed to reverse a significant peri- or postoperative complication. Breakage of polypropylene sutures was the main indication accounting for 17 of 30 (57%) of those reoperations. Subgroup analysis showed that younger patients were more likely to suffer the above complication ( P = .009). The multivariate analysis also showed that longer follow-up was significantly associated with suture breakage ( P = .014), with the mean time to breakage approximately 4 years after surgery. Long-term follow-up of patients undergoing sutured PC-IOLs appears to be associated with a high rate of postoperative complications and significant need for further surgery, which should be discussed during their informed consent process.