27-Gauge Sutureless Intrascleral Fixation of Intraocular Lenses with Haptic Flanging: Short-Term Clinical Outcomes and a Disinsertion Force Study
Retina (Philadelphia, Pa.)
PURPOSE: To determine whether haptic flanging during 27-gauge sutureless intrascleral fixation of intraocular lenses (IOLs) increases IOL stability and to report the short-term clinical outcomes of sutureless intrascleral surgery using 27-gauge trocar cannulas with haptic flanging.
METHODS: Retrospective surgical case series using live and cadaveric human eyes.
RESULTS: In the cadaveric experiment using five eyes, flanged haptics required more force to dislocate the IOL compared with unflanged haptics (14 ± 4 vs. 3 ± 1 g, P = 0.03). The clinical series included 52 eyes from 52 patients. The average age at the time of surgery was 73 ± 14 years, with a mean follow-up of 27 ± 19 weeks. The most common indication for surgery was IOL dislocation/subluxation (n = 43, 83%). Mean visual acuity improved from 20/140 preoperatively to 20/50 at postoperative Month 1 (P < 0.001). The most common postoperative issue was intraocular pressure elevation (n = 12, 23%). Two patients (4%) needed a reoperation for IOL dislocation.
CONCLUSION: Haptic flanging during 27-gauge sutureless intrascleral surgery creates a more stable scleral-fixated IOL compared with the traditional unflanged technique based on a cadaveric human eye study. In addition, this variation of sutureless intrascleral surgery seems safe and effective for patients who require secondary IOLs.
Stem MS, Wa CA, Todorich B, Woodward MA, Walsh MK, Wolfe JD. 27-Gauge Sutureless Intrascleral Fixation of Intraocular Lenses with Haptic Flanging: Short-Term Clinical Outcomes and a Disinsertion Force Study. Retina. 2019 Nov;39(11):2149-2154. doi: 10.1097/IAE.0000000000002268. PMID: 30024575; PMCID: PMC6335197.