Long-term results of aphakia management by scleral fixation intraocular lens placement with knotless transscleral Z-suture method

• Published in: International ophthalmology Vol. 40; no. 6; pp. 1449 - 1454
• Main Authors: Kandemir Beşek, Nilay, Alagoz, Nese, Gumus, Gulsah, Kepez Yildiz, Burcin, Kirgiz, Ahmet, Yildirim, Yusuf, Agca, Alper
• Format: Journal Article
• Language: English
• Published: Dordrecht Springer Netherlands 01.06.2020; Springer Nature B.V
• Subjects: Acuity; Aphakia, Postcataract - physiopathology; Aphakia, Postcataract - surgery; Astigmatism; Cataracts; Complications; Edema; Evaluation; Eye (anatomy); Female; Fixation; Follow-Up Studies; Humans; Intraocular lenses; Intraocular pressure; Lens Implantation, Intraocular - methods; Lenses, Intraocular; Loosening; Male; Medical records; Medicine; Medicine & Public Health; Middle Aged; Ophthalmology; Original Paper; Patients; Placement; Retrospective Studies; Sclera - surgery; Surgery; Suture Techniques - instrumentation; Sutures; Time Factors; Trauma; Vector analysis; Visual Acuity; Aphakia; Scleral fixation; Z-suture technique
• ISSN: 0165-5701; 1573-2630
• DOI: 10.1007/s10792-020-01311-w

Purpose To evaluate the long-term refractive outcomes and complications of posterior chamber intraocular lens placement by scleral fixation surgery (SF-IOL) with the knotless Z-suture method. Methods The authors retrospectively reviewed the medical records of patients who underwent SF-IOL placement with the Z-suture method between January 2010 and December 2018 and who attended a follow-up after at least 1 year. Preoperative and postoperative best-corrected visual acuity (BCVA), anterior segment biomicroscopy, fundus examinations, and postoperative complications were evaluated. Lenticular astigmatism was calculated through the vector analysis method. Results One hundred thirty-six eyes of 136 patients (mean age 57.78 ± 22 years, 98 male/38 female) were included in the study. Of the 136 patients, 67 (49.3%) had a complicated cataract, 50 (36.8%) had pseudoexfoliation syndrome, and 19 (14%) had a trauma history. The mean follow-up period was 50.83 ± 27 months. The mean preoperative BCVA was 0.65 ± 0.24 LogMAR, and the postoperative BCVAs were: 0.40 ± 0.30 ( p  < 0.001) at 1 year; 0.40 ± 0.30 ( p  < 0.001) at 2 years; 0.41 ± 0.31 ( p  < 0.001) at 3 years; 0.43 ± 0.32 ( p  < 0.001) at 5 years; and 0.47 ± 0.24 ( p  = 0.03) at 8 years. Complications included retinal detachment in 2 patients (1.5%), cystoid macular edema in 4 patients (2.9%), increase in intraocular pressure in 5 patients (3.6%), suture loosening in 3 patients (2.2%), and IOL dislocation in 3 patients (2.2%). Conclusion Scleral fixation of IOL with knotless Z-suture technique is an effective method to correct aphakia, with reliable long-term results.