27-gauge needle-assisted externalization and haptic securing technique for sutureless scleral fixation of the intraocular lens – moving toward simplicity

Anadi Khatri,1 Sweta Singh,1 Roshija Rijal,1 Bal Kumar Khatri,2 Muna Kharel3 1Lumbini Eye Institute, Lumbini, Nepal; 2Birat Eye Hospital, 3Nepalese Army Insitute of Medical Sciences, Kathmandu, Nepal Purpose: To report a modified technique of sutureless intrascleral fixation of a posterior chamber...

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Autores principales: Khatri A, Singh S, Rijal R, Khatri BK, Kharel M
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Publicado: Dove Medical Press 2018
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spelling oai:doaj.org-article:3a321fdce871402d907f506ae8d60aca2021-12-02T06:19:48Z27-gauge needle-assisted externalization and haptic securing technique for sutureless scleral fixation of the intraocular lens – moving toward simplicity1177-5483https://doaj.org/article/3a321fdce871402d907f506ae8d60aca2018-08-01T00:00:00Zhttps://www.dovepress.com/27-gauge-needle-assisted-externalization-and-haptic-securing-technique-peer-reviewed-article-OPTHhttps://doaj.org/toc/1177-5483Anadi Khatri,1 Sweta Singh,1 Roshija Rijal,1 Bal Kumar Khatri,2 Muna Kharel3 1Lumbini Eye Institute, Lumbini, Nepal; 2Birat Eye Hospital, 3Nepalese Army Insitute of Medical Sciences, Kathmandu, Nepal Purpose: To report a modified technique of sutureless intrascleral fixation of a posterior chamber intraocular lens with use of instruments of anterior segment surgery and its outcomes. Design: Prospective, noncomparative, interventional case series. Participants: Ninety-two eyes of 92 patients with aphakia and subluxated lens who underwent surgery were evaluated. Materials and methods: 27-gauge needles were introduced transclerally and guided by the viscocanula to externalize via the main wound. The haptics were loaded into the lumen and externalized from entry points. The haptics were then fixed in a scleral tunnel made by a 27-gauge needle. The best-corrected visual acuity (BCVA) and complications were determined. Results: Ninety two eyes which were operated and completed follow-up of 6 weeks were included in the study. The most common indications for scleral-fixated intraocular lens (SFIOL) were subluxated lens – 55 eyes (59%), and surgical aphakia – 31 eyes (34%). Sixty-nine eyes (75.7%) had a postoperative vision of uncorrected visual acuity of 6/18 on day 1. There was an improvement in mean logMAR BCVA (0.086±0.18) at 6 weeks as compared to preoperative visual acuity (p<0.05). BCVA of 6/12 or better was attained in 94% of the cases at 6 weeks. Special mentions need to be made for 6 (7%) of our cases. Three of the patients were cases of fully treated postoperative endophthalmitis who lacked capsular support. Two of the other cases had undergone pars plana vitrectomy for retinal detachment. Both had silicon oil removal done 1 month before the SFIOL procedure. One of the patients had Marfan’s syndrome. Conclusion: Our procedure is safe, easy, less traumatic, and less resource-demanding with good visual outcomes and can be performed even in low-resource settings of developing countries. It may also be considered in patients who have had posterior segment surgeries previously. Keywords: scleral fixation, 27-gauge needle-assisted, aphakiaKhatri ASingh SRijal RKhatri BKKharel MDove Medical PressarticleScleral fixation27 gauge needle assistedaphakia.OphthalmologyRE1-994ENClinical Ophthalmology, Vol Volume 12, Pp 1441-1447 (2018)
institution DOAJ
collection DOAJ
language EN
topic Scleral fixation
27 gauge needle assisted
aphakia.
Ophthalmology
RE1-994
spellingShingle Scleral fixation
27 gauge needle assisted
aphakia.
Ophthalmology
RE1-994
Khatri A
Singh S
Rijal R
Khatri BK
Kharel M
27-gauge needle-assisted externalization and haptic securing technique for sutureless scleral fixation of the intraocular lens – moving toward simplicity
description Anadi Khatri,1 Sweta Singh,1 Roshija Rijal,1 Bal Kumar Khatri,2 Muna Kharel3 1Lumbini Eye Institute, Lumbini, Nepal; 2Birat Eye Hospital, 3Nepalese Army Insitute of Medical Sciences, Kathmandu, Nepal Purpose: To report a modified technique of sutureless intrascleral fixation of a posterior chamber intraocular lens with use of instruments of anterior segment surgery and its outcomes. Design: Prospective, noncomparative, interventional case series. Participants: Ninety-two eyes of 92 patients with aphakia and subluxated lens who underwent surgery were evaluated. Materials and methods: 27-gauge needles were introduced transclerally and guided by the viscocanula to externalize via the main wound. The haptics were loaded into the lumen and externalized from entry points. The haptics were then fixed in a scleral tunnel made by a 27-gauge needle. The best-corrected visual acuity (BCVA) and complications were determined. Results: Ninety two eyes which were operated and completed follow-up of 6 weeks were included in the study. The most common indications for scleral-fixated intraocular lens (SFIOL) were subluxated lens – 55 eyes (59%), and surgical aphakia – 31 eyes (34%). Sixty-nine eyes (75.7%) had a postoperative vision of uncorrected visual acuity of 6/18 on day 1. There was an improvement in mean logMAR BCVA (0.086±0.18) at 6 weeks as compared to preoperative visual acuity (p<0.05). BCVA of 6/12 or better was attained in 94% of the cases at 6 weeks. Special mentions need to be made for 6 (7%) of our cases. Three of the patients were cases of fully treated postoperative endophthalmitis who lacked capsular support. Two of the other cases had undergone pars plana vitrectomy for retinal detachment. Both had silicon oil removal done 1 month before the SFIOL procedure. One of the patients had Marfan’s syndrome. Conclusion: Our procedure is safe, easy, less traumatic, and less resource-demanding with good visual outcomes and can be performed even in low-resource settings of developing countries. It may also be considered in patients who have had posterior segment surgeries previously. Keywords: scleral fixation, 27-gauge needle-assisted, aphakia
format article
author Khatri A
Singh S
Rijal R
Khatri BK
Kharel M
author_facet Khatri A
Singh S
Rijal R
Khatri BK
Kharel M
author_sort Khatri A
title 27-gauge needle-assisted externalization and haptic securing technique for sutureless scleral fixation of the intraocular lens – moving toward simplicity
title_short 27-gauge needle-assisted externalization and haptic securing technique for sutureless scleral fixation of the intraocular lens – moving toward simplicity
title_full 27-gauge needle-assisted externalization and haptic securing technique for sutureless scleral fixation of the intraocular lens – moving toward simplicity
title_fullStr 27-gauge needle-assisted externalization and haptic securing technique for sutureless scleral fixation of the intraocular lens – moving toward simplicity
title_full_unstemmed 27-gauge needle-assisted externalization and haptic securing technique for sutureless scleral fixation of the intraocular lens – moving toward simplicity
title_sort 27-gauge needle-assisted externalization and haptic securing technique for sutureless scleral fixation of the intraocular lens – moving toward simplicity
publisher Dove Medical Press
publishDate 2018
url https://doaj.org/article/3a321fdce871402d907f506ae8d60aca
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