Una nueva técnica quirúrgica modificada sin colgajo para la fijación escleral sin suturas de la lente intraocular FIL...

To evaluate the anatomical and functional outcomes of sutureless scleral fixation of FIL SSF intraocular lens (FIL SSF IOL- Soleko S.P.A. Pontecorvo, Italy) using a novel modified flapless surgical technique.

In this prospective study, patients older than 18 years with IOL-bag complex subluxation and a minimum follow-up of 24 months were included. At 2.5 mm from the limbus, two circumferential partial-thickness scleral grooves, 4 mm in length, were sculpted at 3 and 9 o'clock with a 300 microns pre-calibrated knife. According to two different variants of the same technique - trocarless or trocar-assisted - 25-G needles or 25-G trocars were respectively used to perforate the deep scleral grooves at the center. The FIL SSF IOL was injected through a 2.4 mm-wide corneal tunnel, and the T-shaped harpoons were gently driven out of the eye through the scleral holes and grooves. No scleral sutures were placed.

A total of 54 eyes of 54 patients were included. The mean age was 74.0 ± 14.2 years (range 31-96), and 40.7% were female. The mean intra-operative time was 79.9 ± 23.2 min. After 24 months from surgery (mean follow-up 25 ± 1 months), BCVA significantly improved from 0.9 ± 0.9 to 0.4 ± 0.5 LogMAR (p < 0.001). The mean IOP showed a downward trend from 20.1 to 17.0 mmHg, although this difference did not reach statistical significance (p = 0.083). Overall, 87.3% of patients did not present any complications after 24 months from surgery.

This novel flapless technique for sutureless FIL SSF IOL implantation appears safe, and it may represent a valuable alternative to existing methods, offering reduced tissue manipulation, faster surgical time, and a potentially shorter learning curve. It combines the unique features of this IOL design with minimal tissue manipulation, low risk, a shorter learning curve, and reduced operative time.