Outcomes and complications in scleral-fixated intraocular lens implantations
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ORIGINAL PAPER
Outcomes and complications in scleral-fixated intraocular lens implantations Ka Wai Kam . Yu Fung Anthony Chan . Marco Yu . Mary Ho . Alvin L. Young
Received: 15 April 2020 / Accepted: 20 June 2020 Springer Nature B.V. 2020
Abstract Purpose This study compares outcomes and complications of scleral-fixated intraocular lens implantation between 2 levels of surgeons. Methods A retrospective case series of patients undergoing scleral-fixated intraocular lens implantation at Prince of Wales Hospital, Hong Kong, between May 2012 and April 2017 were reviewed. Data collected included age, gender, affected eye, preoperative and postoperative visual acuities, refractive target and outcome, surgeon profile, operative details including method of scleral fixation, intraoperative and postoperative complications and length of followup. Results Ninety eyes of 90 patients were included for analyses. The mean LogMAR visual acuities were 1.17 ± 0.70 at postoperative week 1, 0.81 ± 0.56 at 1 month, 0.66 ± 0.55 at 3 months, 0.56 ± 0.59 at 6 months, and 0.51 ± 0.60 at 1 year, respectively. After adjusting for age at operation, operative time, axial length, subspecialty of the surgeon and preoperative LogMAR, surgeon seniority was not significantly associated with final visual outcomes. There was no K. W. Kam Y. F. A. Chan M. Ho A. L. Young (&) Department of Ophthalmology and Visual Sciences, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong e-mail: [email protected] M. Yu Singapore Eye Research Institute, Singapore, Singapore
statistically significant difference between the mean improvement in visual acuities between eyes operated by consultants and fellows under direct supervision of a senior surgeon. Conclusion Scleral-fixated intraocular lens implantation is safe and effective in improving visual acuity in aphakic adults without capsular support. Under good supervision, fellows were able to produce comparable results compared with experienced specialists. Keywords Intraocular lens Scleral fixation Aphakia Cataract Complications
Introduction Cataract is the leading cause of blindness globally, and cataract surgery with the implantation of intraocular lens (IOL) is the most commonly performed operation worldwide [1, 2]. After removal of the cataract, an IOL is usually implanted within the capsular bag [3]. However, endocapsular implantation of IOL is not always feasible due to inadequate zonular or capsular support, intraoperative posterior capsule rupture, or in primary intracapsular cataract extraction [4]. Predisposing factors including prior ocular trauma, intravitreal injection or intraocular surgery [5, 6], coexisting ocular comorbidities like chronic uveitis [7],
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pseudoexfoliation syndrome [8], may increase the risk of failure of in-the-bag implantation. In such situation, the surgeons may consider implanting the IOL in the anterior chamber, ciliary sulcus, or using fixation te
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