Outcomes of Transscleral Sulcus Fixation of Intraocular Lenses through a 2.4-mm Incision with an Injector System: 1-Year Follow-Up

1
Outcomes of Transscleral Sulcus Fixation of
Intraocular Lenses through a 2.4-mm Incision with
an Injector System 1-Year Follow-Up

• Akiko Masai, MD, Tomoichiro Ogawa, MD
• Takuya Shiba, MD, Hiroshi Tsuneoka, MD
• Department of Ophthalmology
• The Jikei University School of Medicine
• Tokyo, Japan
• No financial interest

2
Objective

• To evaluate postoperative outcomes of
  scleral-sutured ciliary sulcus fixation of
  foldable intraocular lens (IOL) through a 2.4-mm
  incision

3
Methods

• Subjects 9 eyes (9 patients)
• Lens subluxation 1 eye
• Aphakia 5 eyes
• IOL dislocation 3 eyes
• ?the lenses were divided in the eye
• and extracted through 2.4mm incision.
• Variables examined
• Best-corrected visual acuity (BCVA)
• Before and after surgery (1 week 1, 3, 6, 12
  months)
• Surgically induced astigmatism (SIA) (Cravy
  method)
• After surgery (1 week 1, 3, 6, 12 months)
• Endothelial cell density
• Before and after surgery

4
Surgical Technique

• Preparation for IOL setting of PC-9 hooking
• 10-0 double polypropylene thread (PC-9, Alcon)
  inserted through cartridge (E1, HOYA)
• PC-9 looped around haptics of IOL (VA70AD or
  VA65BB, HOYA) with cow-hitch knot

5
Surgical Technique

• Scleral pockets created at the 2 and 8-oclock
  positions
• Anterior vitrectomy performed
• 2.4-mm scleral corneal incision created at
  12-oclock position
• IOL setting IOL and hooked PC-9 loaded into
  cartridge
• IOL inserted through incision with injector
  (ISH-001, HOYA), leaving opposite haptics out of
  the eye
• PC-9 looped around haptics
• IOL fixed to ciliary sulcus

6
Result 1

• Early improvement in BCVA maintained for 1 year

BCVA (LogMAR)
7
Result 2

• Surgically induced astigmatism was minimal

SIA (D)
8
Result 3

• Mean endothelial cell density reduced 9.80

9
Conclusion

• Sulcus fixation of an IOL by the injector
• reduced the number of intraocular actions
  because of the preoperative preparation for IOL
  setting of PC-9 hooking.
• allowed IOL insertion through a small incision.
• With this technique, visual acuity improved early
  postoperatively and was maintained for 1 year