Supporting IOL'S in a Deficient Capsular Environment: The Tale of No "Tails"

Domenico Boccuzzi; Date Purva; Vincenzo Orfeo; Pasquale Napolitano; Alessandro Mularoni; Aurelio Imburgia; Matteo Forlini

doi:10.1155/2021/9933486

Supporting IOL'S in a Deficient Capsular Environment: The Tale of No "Tails"

J Ophthalmol. 2021 Sep 13:2021:9933486. doi: 10.1155/2021/9933486. eCollection 2021.

Authors

Domenico Boccuzzi¹, Date Purva², Vincenzo Orfeo¹, Pasquale Napolitano³, Alessandro Mularoni⁴, Aurelio Imburgia⁴, Matteo Forlini⁴

Affiliations

¹ Ophthalmology Unit "Clinica Mediterranea", Naples, Italy.
² Valvekar Medical & Research Centre, Solapur, India.
³ Department of Medicine and Health Sciences "V. Tiberio", University of Molise, Campobasso, Italy.
⁴ Department of Ophthalmology, San Marino State Hospital, San Marino, Italy.

Abstract

Purpose: To evaluate the efficacy and safety of the following three distinct surgical procedures for secondary IOL implantation without capsular support: Iris-claw lens, flanged transscleral fixated IOLs (Yamane technique), and sutureless transscleral hook IOL fixation (Carlevale IOL).

Materials and methods: In this retrospective comparative study, three different sutureless IOL implantation techniques were compared in patients without any capsular support. Visual acuity and outcomes were analyzed in 24 eyes of 23 patients (14 male and 9 female). Study included 13 iris-claw lenses (Artisan Ophtec), 6 flanged transscleral fixated IOLs (Yamane technique using a MA60MA Alcon Inc IOL), and 5 transscleral Carlevale IOLS (Carlevale IOL, Soleko, Italy).

Results: logMAR mean best-corrected visual acuity (BCVA) improved from 0.49 ± 0.19 to 0.19 ± 0.10 at three months after surgery (p < 0.05). Postoperative BCVA was similar in all three groups, and no intergroup difference was noted. Three eyes (12.5%) had a raised IOP >25 mmHg, 2 eyes (8%) presented a subluxated/dislocated IOL, 4 eyes (16%) had corneal edema longer than 7 days, 3 eyes (12.5%) had irregular pupil profile, 2 eyes (8%) had vitreous hemorrhage, 7 eyes had (29%) corneal astigmatism over 3 diopters, and one patient (4%) developed cystoid macular edema (CME).

Conclusions: All three surgical procedures can be considered adequate to correct aphakia in patients without capsular support with significant improvement in visual acuity and low complication.