Scleral fixation of intraocular lenses using Gore-Tex suture: clinical outcomes and safety profile

• Published in: British journal of ophthalmology Vol. 100; no. 5; pp. 638 - 643
• Main Authors: Khan, M Ali, Gupta, Omesh P, Smith, Ryan G, Ayres, Brandon D, Raber, Irving M, Bailey, Robert S, Hsu, Jason, Spirn, Marc J
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group LTD 01.05.2016
• Subjects: Adult; Age; Aged; Aged, 80 and over; Biometrics; Clinical outcomes; Female; Follow-Up Studies; Hospitals; Humans; Intraoperative Complications; Lens Implantation, Intraocular - methods; Lenses, Intraocular; Male; Middle Aged; Optics; Phacoemulsification; Polytetrafluoroethylene; Postoperative Complications; Postoperative period; Prostheses; Pseudophakia - physiopathology; Retrospective Studies; Sclera - surgery; Short term; Surgery; Surgical techniques; Sutures; Tomography; Visual Acuity - physiology; Young Adult; New Jersey; Lens and zonules; Posterior Chamber; Sclera and Episclera; Treatment Surgery
• ISSN: 0007-1161; 1468-2079
• DOI: 10.1136/bjophthalmol-2015-306839

Background/aimsTo report the short-term safety profile and clinical outcomes of scleral fixation of intraocular lenses (IOLs) using Gore-Tex suture.MethodsRetrospective, interventional case series. 85 eyes of 84 patients undergoing ab externo scleral fixation of a Bausch and Lomb Akreos AO60 or Alcon CZ70BD IOL using Gore-Tex suture. Primary outcome measures were change in visual acuity and occurrence of intraoperative and postoperative complications with minimum follow-up of 90 days.Results85 eyes of 84 patients were identified. Mean logarithm of the minimum angle of resolution visual acuity improved from 1.43±0.72 (20/538 Snellen equivalent) preoperatively to 0.64±0.61 (20/87 Snellen equivalent) postoperatively (p<0.001). Mean follow-up was 325 days (median 264 days, range 90–996 days). There were no intraoperative complications noted. Postoperative complications included hypotony in eight patients (9.4%), ocular hypertension in six eyes (7%), vitreous haemorrhage in six eyes (7%), hyphema in two eyes (2%), serous choroidal detachment in two eyes (2%), cystoid macular oedema in two eyes (2%) and corneal oedema in one eye (1%). There were no cases of postoperative endophthalmitis, suture erosion/breakage, retinal detachment, suprachoroidal haemorrhage, uveitis–glaucoma–hyphema syndrome or persistent postoperative inflammation in the follow-up period.ConclusionsAb externo scleral fixation of IOLs with Gore-Tex suture was well tolerated in all cases. No suture-related complications were encountered. This procedure led to improvement in visual acuity and was not associated with significant intraoperative or postoperative complications.