A different surgical approach to cases with zonular weakness or dialysis: sutureless transscleral fixated intraocular le
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ORIGINAL PAPER
A different surgical approach to cases with zonular weakness or dialysis: sutureless transscleral fixated intraocular lens implantation and stabilization of lens capsule Ibrahim Taskin . Deniz Altinbay
. Veli Nusret Ozdemir
Received: 7 January 2020 / Accepted: 2 May 2020 Ó Springer Nature B.V. 2020
Abstract 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/mm2 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 Electronic supplementary material The online version of this article (https://doi.org/10.1007/s10792-020-01416-2) contains supplementary material, which is available to authorized users. I. Taskin D. Altinbay (&) Private Niveye Center, Ophthalmology Clinic, Adana, Turkey e-mail: [email protected] I. Taskin e-mail: [email protected] V. N. Ozdemir Private Office, Adana, Turkey e-mail: [email protected]
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. Keywords Optical capture Pseudoexfoliation Sutureless scleral fixated lens Zonular dialysis Zonular weakness
Introduction Lens subluxation due to zonular weakness or dialysis is a common clinical picture in pseudoexfoliation
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(PEX), high myopia, trauma and some connective tissue diseases (Marfan, Marchesani, Homocystinuria) [1–5]. Visual problems in these cases can be corrected by lens surgery with or without cataract coexistence, but the incidence of complications during and after surgery is very high [1–3, 5–9]. IOL dislocations can occur even after many years of cataract
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