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Outcomes of sutureless secondary intraocular lens fixation with haptic flanging in a cohort of surgically complex eyes

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Abstract

Purpose

To describe clinical outcomes of secondary intraocular lens (IOL) implantation using sutureless trans-scleral techniques in surgically complex eyes.

Methods

Retrospective surgical case series of 45 eyes that underwent secondary IOL implantation using a sutureless haptic flange technique. Demographic data of age, sex, primary diagnosis, best-corrected visual acuity (BCVA), refractive error, intraocular pressure, full ophthalmic exam findings, surgical approach, and any intraoperative complications were noted.

Results

The most common indication for secondary IOL implantation was aphakia, most commonly after ocular trauma. The primary outcome measures were pre-operative and post-operative BCVA, which revealed recovery of pre-operative vision levels by post-operative week 1 and improved vision by post-operative month 1 (p = 0.03). Secondary outcome measures of target refraction pre-operatively and post-operatively revealed significant reduction in post-operative spherical equivalent to achieve BCVA (p < 0.001). Targeting of the secondary IOLs using Barrett Universal II, Holladay 1, Holladay 2, and SRK/T all exhibited a hyperopic shift post-operatively in post-traumatic aphakic eyes and a myopic shift in the post complicated cataract extraction eyes. No intraoperative adverse events were noted. The most common post-operative complication was transient IOP elevation, with most patients completing 6 months of follow-up.

Conclusion

There is rapid visual rehabilitation and reduction of spherical equivalent correction to attain BCVA in eyes with a history of ocular trauma that undergo secondary IOL implantation using a trans-scleral flange technique. Moreover, this study highlights that a specific IOL power formula can be more predictive of the desired refractive outcome depending on the indication for secondary IOL implantation.

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Authors and Affiliations

  1. Department of Ophthalmology, University of Washington Eye Institute, Seattle, WA, USA

    Debarshi Mustafi, Elysse Tom, Wyatt B. Messenger, Michael R. Banitt & Kasra A. Rezaei

Authors
  1. Debarshi Mustafi
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  2. Elysse Tom
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  3. Wyatt B. Messenger
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  4. Michael R. Banitt
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  5. Kasra A. Rezaei
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Corresponding author

Correspondence to Kasra A. Rezaei.

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All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript. All procedures involving human participants were approved by the University of Washington Institutional Review Board and adhered to the tenants of the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This type of study does not require informed consent.

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Mustafi, D., Tom, E., Messenger, W.B. et al. Outcomes of sutureless secondary intraocular lens fixation with haptic flanging in a cohort of surgically complex eyes. Graefes Arch Clin Exp Ophthalmol 259, 1357–1363 (2021). https://doi.org/10.1007/s00417-020-04937-9

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  • DOI: https://doi.org/10.1007/s00417-020-04937-9

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