Purpose:

To present my experience with Sutureless Scleral Fixated intraocular lens (SSF IOL) during 2 years of retinal surgery fellowship between November 2013 and November 2015).

Method:

Sutureless scleral fixation of IOL implants involves externalising the haptics of the 3-pieces IOL (MA 50 BM® Alcon, Fort Worth, US) for fixation either within limbal scleral tunnels and or underneath scleral flaps. Two ab-externo sclerotomies are performed at the ciliary sulcus in opposite clock-hour positions and 25-gauge forceps are introduced through the sclerotomies to grasp and externalise one haptic at a time. Once externalised, the haptic is securely threaded into a preformed scleral tunnel or beneath a scleral flap. Scleral flaps are then closed with 10-0 nylon or fibrin glue.

Results:

I performed 16 procedures over a 2-year period, 10 of them were males and the mean age was 71 years. Eleven patients had complicated cataract surgery and 5 had traumatic crystalline lens subluxation or dislocation. The mean preoperative visual acuity (VA) was 1.13 LogMAR and, after a mean follow-up of 6 months, postoperative VA was 0.35 LogMAR. Postoperative complications included increased intraocular pressure that resolved with medical treatment (n=2), Irvine-Gass cystoid macular oedema that resolved with the use of periocular steroid injection (n=1), haptic extrusion into the subconjunctival space that was treated with scleral autograft (n=1) and corneal graft rejection (n=1) in a patient that also had keratoplasty a the time of IOL surgery.

Conclusion:

The technique of Sutureless Scleral Fixation of IOL has a good outcome with a few complications and a short learning curve.

Contact Details:

Email: drimbea.andrei@gmail.com
Cell Phone: +33637612114