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A different surgical approach to cases with zonular weakness or dialysis: sutureless transscleral fixated intraocular lens implantation and stabilization of lens capsule

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Abstract

Purpose

To evaluate the effect of sutureless transscleral fixated intraocular lens (IOL) implantation and capsule stabilization of IOL optics on postoperative visual outcomes in cases with zonular dialysis in excess of 70°.

Methods

Fifteen eyes of thirteen patients with > 70° zonular dialysis and endothelial cell counts higher than 1500 cells/mm2 who had been followed for at least 6 months were included. A modified surgical approach was applied to these eyes with sutureless transscleral fixated IOL implantation and the IOL was secured to the capsulorhexis to stabilize the lens capsule (optic capture).

Results

The mean best-corrected visual acuity (BCVA) was 0.21 ± 0.2 on the first day, 0.45 ± 0.33 on the first week, 0.60 ± 0.32 on the first month, 0.80 ± 0.26 on the third month, and 0.82 ± 0.27 on the sixth month. When preoperative BCVA and postoperative BCVA were compared, a statistically significant increase was observed in postoperative BCVA beginning from the seventh postoperative day. There was a statistically significant (p = 0.038) decrease in endothelial cell count at postoperative third and sixth months (1895 ± 65, 1872 ± 376, respectively) compared to preoperative values.

Conclusions

The use of this new surgical modification that utilizes capsular tension rings combined with a procedure that secures the sutureless scleral IOL fixation to the capsulorhexis for the treatment of eyes with zonular dialysis in excess of 70° was found to be very successful in the 6 months of follow-up. More cases and longer follow-up periods are required to provide an idea as to whether different complications will develop in such patients.

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Funding

There is no funding for conducting to this study. We did not receive any funding source regarding the current study.

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Authors and Affiliations

  1. Private Niveye Center, Ophthalmology Clinic, Adana, Turkey

    Ibrahim Taskin & Deniz Altinbay

  2. Private Office, Adana, Turkey

    Veli Nusret Ozdemir

Authors
  1. Ibrahim Taskin
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  2. Deniz Altinbay
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  3. Veli Nusret Ozdemir
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Contributions

IT, DA, VNO: concept and design; DA: Data acquisition; IT, DA: data analysis/interpretation; DA: drafting manuscript; IT, VNO: critical revision of manuscript; DA: statistical analysis; IT, DA: admin, technical or material support; VNO: supervision; IT, DA, VNO: final approval.

Corresponding author

Correspondence to Deniz Altinbay.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of Adana City Hospital Health Training and Research Centre Clinical Research Ethics Committee (approval number: 2019/371) and with the 1964 Helsinki declaration. This article does not contain any studies with animals performed by any of the authors.

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Taskin, I., Altinbay, D. & Ozdemir, V.N. A different surgical approach to cases with zonular weakness or dialysis: sutureless transscleral fixated intraocular lens implantation and stabilization of lens capsule. Int Ophthalmol 40, 2315–2323 (2020). https://doi.org/10.1007/s10792-020-01416-2

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  • DOI: https://doi.org/10.1007/s10792-020-01416-2

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