Indian journal of ophthalmology · 2025
Long term outcome of in situ scleral fixation of subluxated capsular bag - intraocular lens complex.
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Fathima Allapitchai, Sadasivan Samyukta K, Chandrasekharan Shivkumar, Khader Mohideen Abdul, Rengappa Ramakrishnan, Ravindran Meenakshi, Uduman Mohammed Sithiq
Аннотация
PURPOSE: To examine the long-term outcome in terms of visual performance and positional stability of a minimally invasive in situ fixation technique for repositioning of subluxated capsular bag-intraocular lens complex.
SETTING: Tertiary eye care and postgraduate training institute.
DESIGN: Single-center retrospective study.
METHODS: The medical records of 13 pseudophakic patients who presented with Subluxated capsular bag - intraocular lens complexes operated by a single surgeon with a minimally invasive in situ fixation technique from January 2014 to February 2020 were retrospectively reviewed. This technique employs creation of a scleral pocket and an opposing paracentesis to pass the nonabsorbable suture to engage the subluxated capsular bag-intraocular lens complex followed by centration and tying of suture ends and burying the knot. The uncorrected and best-corrected visual acuity and centration and stability of the repositioned complex were analyzed at baseline, 3 weeks, and final visit. The refractive status and ocular residual astigmatism were also analyzed.
RESULTS: On comparing the best corrected visual acuity at baseline with that at final visit mean follow-up 53 months, 92.3% had successful visual outcome as defined in this study. Centration was achieved in 12 patients on follow-up visits except in one patient who had inferior iris coloboma. The measured ocular residual astigmatism ranged between J0 -0.55 and J45 -0.17. Three patients had posterior capsule opacification as the only late complication that would occur even otherwise.
CONCLUSION: The minimized surgical manoeuvring and long term satisfactory visual outcomes suggest that this technique can be performed as a primary repositioning surgery for subluxated capsular bag - intraocular lens complex.
SETTING: Tertiary eye care and postgraduate training institute.
DESIGN: Single-center retrospective study.
METHODS: The medical records of 13 pseudophakic patients who presented with Subluxated capsular bag - intraocular lens complexes operated by a single surgeon with a minimally invasive in situ fixation technique from January 2014 to February 2020 were retrospectively reviewed. This technique employs creation of a scleral pocket and an opposing paracentesis to pass the nonabsorbable suture to engage the subluxated capsular bag-intraocular lens complex followed by centration and tying of suture ends and burying the knot. The uncorrected and best-corrected visual acuity and centration and stability of the repositioned complex were analyzed at baseline, 3 weeks, and final visit. The refractive status and ocular residual astigmatism were also analyzed.
RESULTS: On comparing the best corrected visual acuity at baseline with that at final visit mean follow-up 53 months, 92.3% had successful visual outcome as defined in this study. Centration was achieved in 12 patients on follow-up visits except in one patient who had inferior iris coloboma. The measured ocular residual astigmatism ranged between J0 -0.55 and J45 -0.17. Three patients had posterior capsule opacification as the only late complication that would occur even otherwise.
CONCLUSION: The minimized surgical manoeuvring and long term satisfactory visual outcomes suggest that this technique can be performed as a primary repositioning surgery for subluxated capsular bag - intraocular lens complex.