A Long term Result of Transscleral Fixation of Intraocular Lens

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A Long term Result of Transscleral Fixation of
Intraocular Lens

• Eun Chul Kim, M.D. , Man Soo Kim,M.D.
• Department of Ophthalmology and Visual Science,
• College of Medicine,
• The Catholic University of Korea, Seoul, Korea

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IntroductionTransscleral fixation Technique

• Approach method
• ab interno approach
• ab externo approach
• Suture technique
• One suture technique
• Two suture technique
• IOL material
• PMMA IOL 6mm incision
• Foldable IOL 3mm incision using injector

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Introduction

• Optimal IOL transscleral fixation criteria
• IOL be stable without tilt 2-point fixation
  prevents IOL tilt
• Good IOL centration (precise placement of the
  scleral-fixated suture) ab interno approach
  cannot achieve as precise a penetrating site as
  an ab externo approach.
• Suture knots should be buried otherwise, they
  may erode the tissue, causing discomfort or
  inducing endophthalmitis in a worst-case scenario.

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Purpose

• To evaluate long term result of transscleral
  fixation of Intraocular lens(IOL)

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Methods

• We performed a retrospective review of the
  medical records of 50 patients who had undergone
  transscleral fixation of IOL from January 2002 to
  April 2004 in KangNam St. Marys Hospital.
• Mean follow up time 28.75 3.25 Months
• Over 2 year follow up
• Operated by one surgeon
• Surgical technique ab externo technique
• Divided by two group
• Primary group cataract surgery group(unplanned
  IOL fixation)
• Secondary groupsecondary intraocular lens
  fixation (planned IOL fixation)

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Preoperative Diagnosis
IOL Intraocular lens
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Methods(N50)
Primary group primary cataract surgery
group Secondary groupsecondary intraocular lens
fixation
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ResultsInitial characteristics
BCVA best corrected visual acuity.
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Surgical technique
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Preoperative BCVA Vs Postoperative BCVA
Postoperative BCVA
Preoperative BCVA
BCVA is increased after IOL transscleral
fixation in almost cases (Plt0.05).
BCVA best corrected visual acuity.
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BCVA Change
BCVA best corrected visual acuity
Secondary group increased BCVA more than primary
group , but no statistical difference.
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Comparison of BCVA at 2 years after operation
BCVA best corrected visual acuity
Secondary group has good BCVA than primary group,
but no statistical difference
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Comparison between target and postoperative
refraction
Secondary group is more myopic refractive change
than primary group, but that is not significant.
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Complications
intraocular pressure Early before 2weeks ,
Late 2 weeks later
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Conclusions

• Planned IOL transscleral fixation has generally
  good results than unplanned operation.(but,
  statistically not significant)
• Despite of complication, best corrected visual
  acuity is increased in most of cases.
• Transscleral fixation of IOL was good method to
  improved visual acuity after long term period in
  patients who have defective posterior capsule