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Intrascleral fixation of capsular bag and intraocular lens in cases with large zonular dialysis

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Abstract

Purpose

To evaluate the clinical outcomes of sutureless capsular bag and intraocular lens (IOL) fixation with flattened, flanged intrascleral fixation technique in patients with large zonular dialysis.

Methods

Fifty-five eyes of 51 patients who underwent flattened flanged intrascleral capsular bag and IOL fixation and optic capture for traumatic cataract, subluxated cataract, and pseudoexfoliation syndrome (PEX) with zonular dialysis greater than 180° were included in the study. The main difference of this technique from the Yamane technique is that it has a flattened flange with sharp borders at the haptic tip. Uncorrected visual acuity, corrected distance visual acuity (CDVA), astigmatism, endothelial cell loss, IOL tilt, and intraoperative and postoperative complications were evaluated.

Results

The mean age of the patients was 57.4 ± 15.1 years (range 18–83). Of the patients, 28 (55%) were male and 23 (45%) were female. The mean duration of follow-up after surgery was 19.3 ± 6.5 months (range 12–36). The mean preoperative and postoperative CDVA were 0.71 ± 0.16 logMAR and 0.13 ± 0.20 logMAR, respectively (p < 0.001). The mean preoperative and postoperative astigmatism were 2.0 ± 1.4 D and 1.0 ± 0.7 D, respectively (p < 0.001). The mean IOL tilt was 5.7° ± 5.2°. The mean endothelial cell loss was 9% (range 0.9–19.5). Anterior capsular phimosis was developed in 2 eyes (4%).

Conclusion

The flattened flanged intrascleral technique of the capsular bag combined with optic capture provides good visual outcomes, robust capsular bag-IOL fixation, and minimal adverse events. However, further studies with more patients are needed for long-term results.

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Data availability

All data will be available upon request.

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Funding

The authors did not receive any financial support from any public or private sources.

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Authors and Affiliations

  1. Ophthalmology Department, Konyagoz Eye Hospital, Sancak Mah. Unluer Sok. No:13, Selcuklu, 4200, Konya, Turkey

    Fikret Ucar

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  1. Fikret Ucar
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Contributions

The study conception, design, material preparation, data collection, and analysis were performed by Fikret Ucar.

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Correspondence to Fikret Ucar.

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Conflict of interest

All authors declare that they have no conflict of interest.

Ethical approval

All procedures were performed in accordance with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The study protocol was approved by the local ethics committee (Necmettin Erbakan University, Faculty of Medicine Ethics Committee, Konya). The study was conducted in accordance with the tenets of the Declaration of Helsinki.

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Informed consent was obtained from all individual participants included in the study.

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Video 1 The combination technique of flattened flanged intrascleral IOL fixation and optic capture in cases with large zonular dialysis (MP4 41347 KB)

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Ucar, F. Intrascleral fixation of capsular bag and intraocular lens in cases with large zonular dialysis. Int Ophthalmol 43, 131–140 (2023). https://doi.org/10.1007/s10792-022-02395-2

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  • DOI: https://doi.org/10.1007/s10792-022-02395-2

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