Long-term outcome of scleral-fixated intraocular lens implantation without conjunctival peritomies and sclerotomy in ocular trauma patients

BMC Ophthalmol. 2019 Jul 29;19(1):164. doi: 10.1186/s12886-019-1172-4.

Abstract

Background: To investigate the long-term outcomes and complications of scleral-fixated intraocular lens (SFIOL) implantation without conjunctival peritomies and sclerotomy in patients with a history of ocular trauma with inadequate capsular support during primary pars plana vitrectomy or silicone oil removal.

Methods: Records of ocular trauma patients who underwent implantation of SFIOL without conjunctival peritomies and sclerotomy during primary pars plana vitrectomy or silicone oil removal.

Results: Sixty-nine eyes of 69 patients were included in this study. The median follow-up period was 34 months (range, 6-99 months). The average patient age at the time of surgery was 44 years old (range, 4-80 years). At the end of follow-up, the preoperative mean of best corrected visual acuity (BCVA) was 0.79 ± 0.86 log of the minimum angle of resolution (logMAR), which improved 0.20 ± 0.26 logMAR postoperatively (P = 0.01). BCVA improved or remained unchanged in 64 eyes (92.8%), VA decreased two lines in five eyes (7.2%). Early postoperative complications included transient corneal edema in seven eyes (10.1%), minor vitreous hemorrhage in four eyes (5.8%), transient elevated intraocular pressure (IOP) in one eye (1.4%), and hypotony in three eyes (4.3%). Late postoperative complications included persistent elevated IOP in five eyes (7.2%), epiretinal membrane formation in three eyes (4.3%), and cystoid macular edema noted in one eye (1.4%).

Conclusions: Use of a scleral-fixated intraocular lens implantation without conjunctival peritomies and sclerotomy in ocular trauma patients during either primary pars plana vitrectomy or second silicone oil removal is a valuable approach for the management of traumatic aphakia in the absence of capsular support.

Keywords: Postoperative complications; Scleral fixated intraocular lens; Traumatic aphakic eyes; Vitrectomy.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Aphakia / diagnosis
  • Aphakia / etiology
  • Aphakia / surgery*
  • Child
  • Child, Preschool
  • Conjunctiva
  • Eye Injuries / complications*
  • Eye Injuries / diagnosis
  • Eye Injuries / surgery
  • Female
  • Follow-Up Studies
  • Humans
  • Lens Implantation, Intraocular / methods*
  • Male
  • Middle Aged
  • Sclera / surgery*
  • Suture Techniques*
  • Time Factors
  • Visual Acuity*
  • Vitrectomy
  • Young Adult