Up to recent times anterior chamber IOL and iris or scleral fixated IOL have been the techniques of choice in patients without capsular support, aphakic or with a dislocated intraocular lens. These techniques however, are well known for possible complications such as corneal decompensation, late dislocation or suture extrusion through the conjunctiva. In our presentation we illustrate a novel surgical technique of scleral fixation per formed transconjunctivally using trocar cannulas to create the scleral tunnels for the haptics of a lens specifically designed for sutureless scleral fixation. An eighty five years old pseudofakic man experienced progressive loss of visual acuity to the level of 20/100 beacause of clouding of the IOL. It was decided to substitute the cloudy IOL with a Carlevale lens. The Carlevale lens has an innovative designe that assures the anchoring to the sclera by means of special harpoons without the need of suture stitches. A standard 25-G PPV was performed using valved cannulas, the superonasal and the infero temporal cannulas were positioned at 180 degrees apart and 1.5 mm to the limbus to create the scleral tunnels for the Carlevale lens harpoons. On the first postoperative day the patient had no pain, irritation or foreign body sensation with an optimal vision result of 20/20 without correction. There was no tilting of the lens, no postoperative astigmatism, no corneal decompensation, or pupillary deformation. The harpoons were well positioned under the conjunctiva, there was no redness of the eye.

In conclusion, sutureless tranconjunctival intrascleral intraocular Carlevale lens fixation appears to decrease the risk of complications of suture fixated or anterior chamber IOLs, such as corneal decompensation, dislocation or suture extrusion. This lens specifically designed for sutureless fixation demonstrates stability, without induced astigmatism. Further experience is needed before use can be widely reccomended although our result is encouraging.


University of Bologna, Policlinico Sant’Orsola Malpighi
Bologna, Italy
Email : livia.dellamora@gmail.com
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