Scleral Fixation of Intraocular Lenses with Gore-Tex Suture: Refractive Outcomes and Comparison of Lens Power Formulas

Ophthalmol Retina. 2019 Jun;3(6):468-472. doi: 10.1016/j.oret.2019.02.005. Epub 2019 Feb 19.

Abstract

Purpose: To report refractive outcomes of scleral-fixated intraocular lens (IOL) implantation with Gore-Tex (W.L. Gore & Associates, Newark, DE) suture and combined pars plana vitrectomy and compare predicted refractive outcomes among 5 IOL power calculation formulas.

Design: Retrospective case series.

Participants: Patients undergoing scleral-fixated IOL implantation with Gore-Tex suture at our institution between January 2015 and June 2018.

Methods: Comparison of preoperative biometrics with postoperative refraction and calculation of predicted refractive outcome with 5 different IOL formulas.

Main outcome measures: Prediction error and absolute error to compare postoperative refraction with refraction predicted by lens power calculation formulas.

Results: Thirty-one eyes of 31 patients were included. All power calculations assumed in-the-bag position of the IOL. The Akreos A060 (Bausch & Lomb, Rochester, NY) was implanted in 23 eyes and the CZ70BD (Alcon, Fort Worth, TX) in 8 eyes, and all lenses were sutured 3 mm behind the limbus. Average postoperative spherical equivalent (SE) was -0.79±0.95 diopters (D). Average prediction error (postoperative SE refraction minus target refraction) was -0.19±0.72 D. Postoperative SE was within 1.0 D of target in 25 of 31 patients (81%) and 2.0 D of target in 31 of 31 patients (100%). The repeated-measures analysis of variance of absolute error by lens power formula was significant (P = 0.012), with Haigis demonstrating greater error. There was no significant difference among Barrett II, Sanders-Retzlaff-Kraff theoretical (SRK/T), Holladay 2, or Hoffer Q.

Conclusions: For eyes undergoing pars plana vitrectomy with scleral-sutured IOL implantation, assumption of in-the-bag IOL position when calculating lens power leads to acceptable refractive outcomes. Barrett II, SRK/T, Holladay 2, and Hoffer Q formulas were noninferior to each other.

Publication types

  • Comparative Study
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Anterior Chamber / surgery
  • Biometry
  • Eye Diseases / physiopathology
  • Eye Diseases / surgery*
  • Female
  • Follow-Up Studies
  • Humans
  • Lens Implantation, Intraocular / methods*
  • Lenses, Intraocular*
  • Male
  • Middle Aged
  • Optics and Photonics*
  • Polytetrafluoroethylene
  • Prosthesis Design
  • Refraction, Ocular / physiology*
  • Retrospective Studies
  • Sclera / surgery*
  • Suture Techniques / instrumentation*
  • Sutures
  • Treatment Outcome
  • Visual Acuity
  • Vitrectomy / methods

Substances

  • Polytetrafluoroethylene