A novel approach for scleral fixation using Carlevale lens

Area of Science:

• Ophthalmology
• Surgical Innovation
• Intraocular Lens Technology

Background:

• Managing complex cases in ophthalmology, such as aphakia or dislocated intraocular lenses (IOLs), presents significant surgical challenges.
• Novel intraocular lens (IOL) fixation techniques are crucial for improving surgical outcomes and patient vision.
• Scleral fixation offers an alternative for eyes unsuitable for standard capsular bag implantation.

Purpose of the Study:

• To evaluate the surgical outcomes and feasibility of using the Carlevale lens for scleral-fixation in complex ophthalmic cases.
• To assess the effectiveness of a novel single-piece acrylic foldable lens for IOL implantation in challenging scenarios.

Main Methods:

• A study involving 18 eyes of 18 patients with various conditions including aphakia, dislocated IOLs, and trauma.
• Surgical implantation of the Carlevale lens using a scleral-fixation technique.
• Postoperative evaluation included standard ophthalmologic examinations and anterior segment optical coherence tomography (AS-OCT) to assess IOL tilt and plug positioning.

Main Results:

• The mean follow-up period was 11.2 months, with a mean refractive prediction error of -0.31 ± 0.71D.
• Mean IOL tilt was minimal (2.2° ± 1.6°), and plugs were correctly positioned within the sclera.
• One case of cystoid macular edema resolved with treatment; no other significant complications were reported across diverse complex cases.

Conclusions:

• The Carlevale lens (Soleko) is a viable option for both anterior and posterior segment surgeons in managing complex ophthalmic cases.
• This technique facilitates less challenging maneuvers, leading to good lens self-centration and reduced risk of haptic issues.
• The lens design appears to minimize inflammatory response by effectively compartmentalizing anterior and posterior chambers.