Abstract
Purpose
To report a series of patients who developed neurotrophic keratopathy following scleral fixation of intraocular lenses.
Methods
Retrospective case series of patients undergoing implantation of scleral fixated IOLs with various techniques.
Results
Three patients developed NK in the immediate post-operative period following scleral fixation of IOLs. Scleral fixation of IOL was performed using three different techniques (4-point fixation, “Yamane” flanged intrascleral and tunneled intrascleral haptic fixation). None of the patient had any prior risk factors for the development of NK. In all patients, intrascleral haptics or scleral sutures were positioned on the horizontal meridian. All patients also underwent light peripheral retinal endolaser.
Conclusions
NK can rarely occur following scleral fixation of IOLs. The combination of suturing or intrascleral fixation of the IOL on the horizontal meridian and peripheral retinal endolaser may synergistically damage to the long ciliary nerves with a “two-hit” mechanism and cause NK.
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All authors contributed to the study conception and design. Data collection and analysis were performed by all authors. The first draft of the manuscript was written by Alfonso Iovieno and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.
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The University of British Columbia Research Ethics Committee has confirmed that no ethical approval is required.
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Iovieno, A., Mammo, Z.N. & Yeung, S.N. Neurotrophic keratopathy as a complication of scleral fixated intraocular lens implantation. Int Ophthalmol 42, 1259–1262 (2022). https://doi.org/10.1007/s10792-021-02112-5
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DOI: https://doi.org/10.1007/s10792-021-02112-5