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Journals / Glokom Katarakt / 2006 / Cilt: 1 - Sayı: 1

Transscleral fixation of posterior chamber intraocular lenses: Safety and visual outcome with respect to etiology and timing of surgery

Skleral fiksasyonlu arka kamara lensi implantasyonu: Etioloji ve cerrahi zamanlama yönünden güvenilirlik ve görsel başarı

NESRİN BÜYÜKTORTOP GÖKÇINAR
MEHMET NUMAN ALP
Gülcan KURAL
Pages
47–52
DOI
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AI Summary & Key Takeaways

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⚡ TL;DR(Too Long; Didn't Read)

The goals of either achieving an increased visual outcome or preserving preoperative BCVA could be succeeded, if TF of PC-IOL implantation is performed as a primary or a secondary procedure, respectively.

📌 3 Key Takeaways

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Objective & Hypothesis:Purpose: To evaluate the safety and visual outcome of primary or secondary transscleral fixation (TF) of posterior chamber intraocular lenses (PC-IOLs) in eyes with inadequate capsular support as a result of various etiologies.
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Key Findings & Data:Materials and Methods: The records of 103 eyes of 98 patients (63 male, 35 female; mean age 49.4±22.0 years) who have undergone TF of PC-IOL implantation between January 1997 and January 2005 have been retrospectively reviewed.
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Conclusion & Impact:The goals of either achieving an increased visual outcome or preserving preoperative BCVA could be succeeded, if TF of PC-IOL implantation is performed as a primary or a secondary procedure, respectively.
🔬Design:Review & Systematic Survey
📍Scope:2005 Verileri
⚙️Variables:Lens implantasyonu · göz içi · Fiksasyon

Abstract

Purpose: To evaluate the safety and visual outcome of primary or secondary transscleral fixation (TF) of posterior chamber intraocular lenses (PC-IOLs) in eyes with inadequate capsular support as a result of various etiologies. Materials and Methods: The records of 103 eyes of 98 patients (63 male, 35 female; mean age 49.4±22.0 years) who have undergone TF of PC-IOL implantation between January 1997 and January 2005 have been retrospectively reviewed. Eyes were divided into 4 groups according to their clinical and surgical properties. There were 17 eyes that underwent primary TF of PC-IOL implantation for traumatic cataract extraction in Group 1, 32 eyes that underwent primary TF of PC-IOL implantation for (sub)luxated lens or IOL exchange in Group 2, 16 eyes that underwent secondary TF of PC-IOL implantation for complicated surgery in traumatic cataract in Group 3, and 38 eyes that underwent secondary TF of PC-IOL implantation for previously complicated cataract surgery with vitreous loss in Group 4. Results: Mean follow-up time was 11.6±11.5 (3-57) months. There was a statistically significant difference among groups in terms of preoperative best corrected visual acuity (BCVA) (p<0.001). Preoperative BCVA in Group 1 and Group 2 were statistically significantly lower than those in Group 3 and Group 4. There was no statistically significant difference among groups in terms of postoperative BCVA (p>0.05). As the difference between preoperative and postoperative BCVA in each group was investigated, postoperative BCVA in Group 1 and Group 2 was found to be significantly increased as compared to preoperative values (p=0.02 and p<0.001, respectively), while there was no significant difference for those of Group 3 and Group 4 (p>0.05). Of 103 eyes, final BCVA was found to be <0.1 in 11.6% of eyes, &#8805;0.1 in 88.4% of eyes, and &#8805;0.5 in 40.8% of eyes. BCVA was found to be decreased an amount of &#8805;1 Snellen line postoperatively in 16.5% of all eyes. Peripheral anterior synechia (28%), pupillary ectopia (25%), pigment precipitation at iridocorneal angle (20%), macular edema (17%), and suture erosion (13%) were the most common complications. Conclusion: TF of PC-IOL implantation is a safe procedure to provide sufficent visual results in eyes with inadequate capsular support. Expectancy of visual outcome should be outlined with respect to etiology. The goals of either achieving an increased visual outcome or preserving preoperative BCVA could be succeeded, if TF of PC-IOL implantation is performed as a primary or a secondary procedure, respectively.

Özet

Amaç: Farklı etiolojiler nedeniyle arka kapsül desteği yetersiz olan olgularda, primer veya sekonder olarak uygulanan skleral fiksasyonlu (SF) arka kamara lensi (AKL) implantasyonunun güvenilirliği ve görsel prognoza etkisinin incelenmesi. Gereç ve Yöntemler: Ocak 1997-Ocak 2005 tarihleri arasında kliniğimizde SF-AKL implantasyonu yapılan ardışık 98 hastanın (erkek/ kadın: 63/35; ortalama yaş 49.4±22.0 yıl) 103 gözüne ait kayıtlar geriye dönük olarak incelendi. Gözler klinik ve tedavi özelliklerine göre 4 gruba ayrıldı. Grup 1 (17 göz) travmatik kat arakt nedeniyle primer SF-AKL; Grup 2 (32 göz) lens (sub)luksasyonu veya göziçi lens değişimi nedeniyle primer SF-AKL; Grup 3 (16 göz) travmatik katarakt nedeniyle daha önceden ameliyat olup sekonder SF-AKL; Grup 4 (38 göz) ilk katarakt ameliyatında arka kapsül desteği bozulup sekonder SF-AKL implantasyonu uygulanan gözlerden oluşmaktaydı. Bulgular: Ortalama takip süresi 11.6±11.5 (3-57) aydı. Düzeltilmiş en iyi görme keskinliği (DEİGK) ortalamaları yönünden ameliyat öncesi (AÖ) dönemde gruplar arasında istatistiksel olarak anlamlı fark vardı (p 0.05). Her grup için, AÖ ve AS DEİGK ortalamalarının değişimleri incelendiğinde, AS DEİGK’nin Grup 1 ve 2’de AÖ’ne göre anlamlı olarak arttığı (sırasıyla p=0.02 ve p 0.05). Sonuç DEİGK tüm gözlerin %11.6’sında <0.1, %88.4’ünde ≥0.1, %40.8’inde ≥0.5 idi. AS DEİGK tüm gözlerin %16.5’inde ≥1 Snellen sırası azalmıştı. Periferik ön sineşi (%28), pupil çekintisi (%25), açıda pigmentasyon (%20), maküla ödemi (%17) ve sütür erozyonu (%13) en sık görülen komplikasyonlardı. Sonuç: Arka kapsül desteği yetersiz olgularda SF-AKL implantasyonu, görmenin rehabilitasyonunda güvenli bir yöntemdir. Görsel beklentiler etiolojiye göre şekillendirilmelidir. Primer uygulandığında ameliyat öncesine göre anlamlı görme artışı, sekonder uygulandığında ise ameliyat öncesi görme keskinliğinin korunması amaçlarına ulaşılabilir.

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Cite This Article

GÖKÇINAR, N. B., ALP, M. N., KURAL, G. (2006). Transscleral fixation of posterior chamber intraocular lenses: Safety and visual outcome with respect to etiology and timing of surgery. Glokom Katarakt, Cilt: 1 - Sayı: 1, 47–52. https://ajindex.com/articles/226740

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