Two techniques for sutureless intrascleral posterior chamber IOL fixation

Area of Science:

• Ophthalmology
• Surgical Techniques
• Intraocular Lens Implantation

Background:

• Insufficient capsule support presents challenges for posterior chamber intraocular lens (IOL) fixation.
• Sutureless scleral fixation techniques aim to improve IOL stability and reduce surgical complications.

Purpose of the Study:

• To compare the outcomes of two distinct sutureless scleral fixation techniques for posterior chamber IOLs.
• Evaluate the efficacy and safety of needle versus trocar techniques in patients with inadequate capsular support.

Main Methods:

• A comparative study involving 29 patients undergoing sutureless scleral fixation of posterior chamber IOLs.
• Seventeen patients received the needle technique (24-gauge needle), and 12 received the novel trocar technique (25-gauge transconjunctival sutureless vitrectomy trocar).
• Postoperative assessment included visual acuity, intraocular pressure, complications, and IOL stability.

Main Results:

• Both techniques resulted in significant improvements in postoperative visual acuity (P = .028 and .012).
• No significant changes in postoperative intraocular pressure were observed with either method.
• All patients achieved sufficient IOL stability, with similar complication rates between the two techniques, none impacting vision.

Conclusions:

• Sutureless scleral fixation using either the needle or trocar technique provides comparable visual acuity improvement.
• Both methods demonstrate similar safety profiles regarding intraocular pressure and complications in patients with insufficient capsule support.