International ophthalmology · 2025
Clinical outcomes of sutured scleral-fixated capsular tension segments in lens subluxation: a retrospective case series with short- and long-term follow-up.
СтатьяМногоцентровое исследованиеНазвание и аннотация: Перевод пока не подготовлен
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Chang-Sotomayor Meilin, de Rojas Silva Mª Victoria, Corretger Xavier, Guell Jose L, Bandeira Francisco, Mendez-Mourelle Andrea, Gómez Mercedes Rodríguez, Civera Alfredo Adán, Figueras-Roca Marc
Аннотация
PURPOSE: To report the short- and long-term outcomes of sutured scleral-fixated capsular tension segments (CTS) in patients with lens instability.
METHODS: This retrospective study included 21 eyes of 21 patients who underwent scleral fixation of a CTS, with or without capsular tension ring (CTR) ± intraocular lens (IOL) implantation, between 2015 and 2023 at two academic centers. The primary outcome was stability of the IOL-bag complex, defined as centration without tilt or reintervention. Secondary outcomes included corrected distance visual acuity (CDVA), refractive stability, and postoperative complications, classified as early (≤ 4 weeks) or late (> 4 weeks). Minimum follow-up was 6 months, with a subgroup of eyes ≥ 12 months. Outcomes were compared between polypropylene and Gore-Tex sutures.
RESULTS: Mean patient age was 59.1 ± 18.6 years, and mean follow-up 28.6 months (range 6-80). Mean zonular dialysis was 142° ± 41° (range 60°-210°), with two cases requiring two CTSs. At final follow-up, 85.7% of eyes achieved CDVA of 20/40 or better. Early complications occurred in 5 eyes (23.8%), including cystoid macular edema (14.3%), wound leak (4.8%), and posterior capsular rupture (4.8%). Late complications were limited to one haptic displacement and one polypropylene suture rupture; no late events occurred with Gore-Tex.
CONCLUSION: Scleral fixation of CTSs is a safe and effective strategy for lens subluxation, providing stable long-term centration of the IOL-bag complex with good visual outcomes and low complication rates. Gore-Tex demonstrated superior long-term durability, supporting its use when extended stability is required, particularly in cases with ≥ 120º degrees of zonular dialysis.
METHODS: This retrospective study included 21 eyes of 21 patients who underwent scleral fixation of a CTS, with or without capsular tension ring (CTR) ± intraocular lens (IOL) implantation, between 2015 and 2023 at two academic centers. The primary outcome was stability of the IOL-bag complex, defined as centration without tilt or reintervention. Secondary outcomes included corrected distance visual acuity (CDVA), refractive stability, and postoperative complications, classified as early (≤ 4 weeks) or late (> 4 weeks). Minimum follow-up was 6 months, with a subgroup of eyes ≥ 12 months. Outcomes were compared between polypropylene and Gore-Tex sutures.
RESULTS: Mean patient age was 59.1 ± 18.6 years, and mean follow-up 28.6 months (range 6-80). Mean zonular dialysis was 142° ± 41° (range 60°-210°), with two cases requiring two CTSs. At final follow-up, 85.7% of eyes achieved CDVA of 20/40 or better. Early complications occurred in 5 eyes (23.8%), including cystoid macular edema (14.3%), wound leak (4.8%), and posterior capsular rupture (4.8%). Late complications were limited to one haptic displacement and one polypropylene suture rupture; no late events occurred with Gore-Tex.
CONCLUSION: Scleral fixation of CTSs is a safe and effective strategy for lens subluxation, providing stable long-term centration of the IOL-bag complex with good visual outcomes and low complication rates. Gore-Tex demonstrated superior long-term durability, supporting its use when extended stability is required, particularly in cases with ≥ 120º degrees of zonular dialysis.