Clinical Outcomes of Secondary Scleral-Sutured Foldable Hydrophilic Acrylic Intraocular Lens Placement by Trainees: A Single-Site Analysis

Yesha S Shah,1 Angela Y Zhu,1 Sidra I Zafar,1 Daniel Sarezky,1 Ximin Li,2 TY Alvin Liu,1 Mira M Sachdeva,1 Fasika A Woreta1 1Department of Ophthalmology, Wilmer Eye Institute, Johns Hopkins Medical Institutions, Baltimore, MD, USA; 2Department of Biostatistics, Johns Hopkins Bloomberg School of Publ...

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Autores principales:	Shah YS, Zhu AY, Zafar SI, Sarezky D, Li X, Liu TYA, Sachdeva MM, Woreta FA
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2021
Materias:	secondary iol scleral-fixated iol scleral-sutured iol akreos clinical outcomes Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/620e4a7c5370440da6060db56ecacedd
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spelling	oai:doaj.org-article:620e4a7c5370440da6060db56ecacedd2021-12-02T16:23:31ZClinical Outcomes of Secondary Scleral-Sutured Foldable Hydrophilic Acrylic Intraocular Lens Placement by Trainees: A Single-Site Analysis1177-5483https://doaj.org/article/620e4a7c5370440da6060db56ecacedd2021-02-01T00:00:00Zhttps://www.dovepress.com/clinical-outcomes-of-secondary-scleral-sutured-foldable-hydrophilic-ac-peer-reviewed-article-OPTHhttps://doaj.org/toc/1177-5483Yesha S Shah,1 Angela Y Zhu,1 Sidra I Zafar,1 Daniel Sarezky,1 Ximin Li,2 TY Alvin Liu,1 Mira M Sachdeva,1 Fasika A Woreta1 1Department of Ophthalmology, Wilmer Eye Institute, Johns Hopkins Medical Institutions, Baltimore, MD, USA; 2Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USACorrespondence: Fasika A WoretaDepartment of Ophthalmology, Wilmer Eye Institute, Johns Hopkins Medical Institutions, 600 N. Wolfe St., Wilmer B-29, Baltimore, MD, 21287, USATel +1 410 955-8265Fax +1 410 614-9632Email fworeta1@jhmi.eduPurpose: To evaluate the outcomes of a 4-point scleral-fixated foldable Akreos AO60 intraocular lens (IOL) insertion using Gore-Tex suture performed by trainees under supervision of a single attending surgeon.Methods: Retrospective chart review for 53 eyes of 50 patients whose surgery was performed by trainees under supervision of a single surgeon between 2015 and 2018 at a tertiary care hospital (Johns Hopkins Wilmer Eye Institute, Baltimore, MD). Indications for surgery, preoperative risk factors, and intraoperative techniques were analyzed. Outcome measures included final best-corrected visual acuity (BCVA), change in BCVA, difference between expected and final spherical equivalent (SE), and postoperative complications.Results: Mean patient age was 62.8 years (range 26.9 to 88.4). The most common indication for surgery was IOL dislocation (59.6%) due to trauma in 21 cases (40.4%) and pseudoexfoliation in 6 (11.5%). Combined pars plana vitrectomy was performed simultaneously in 46 cases (88.5%). Mean BCVA improved from 20/100 to 20/40 (p < 0.001). The difference between expected and final SE was within 1.0 D in 28 cases (53.8%). Postoperative hypotony occurred in 12 eyes (21.2%) on day 1; all were resolved at last follow-up. Postoperative cystoid macular edema (CME) occurred in 20 cases (38.5%); 11 (21.2%) persisted through last follow-up.Conclusion: Scleral-fixation of Akreos AO60 IOL in absence of capsular support can be performed by trainees under supervision and results in effective visual rehabilitation. Postoperative CME occurred at a higher rate than previously reported in the literature. Future studies should assess the rates of postoperative complications amongst different techniques of secondary IOL fixation performed by trainees to determine which is the safest.Keywords: secondary IOL, scleral-fixated IOL, scleral-sutured IOL, Akreos, clinical outcomesShah YSZhu AYZafar SISarezky DLi XLiu TYASachdeva MMWoreta FADove Medical Pressarticlesecondary iolscleral-fixated iolscleral-sutured iolakreosclinical outcomesOphthalmologyRE1-994ENClinical Ophthalmology, Vol Volume 15, Pp 783-790 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	secondary iol scleral-fixated iol scleral-sutured iol akreos clinical outcomes Ophthalmology RE1-994
spellingShingle	secondary iol scleral-fixated iol scleral-sutured iol akreos clinical outcomes Ophthalmology RE1-994 Shah YS Zhu AY Zafar SI Sarezky D Li X Liu TYA Sachdeva MM Woreta FA Clinical Outcomes of Secondary Scleral-Sutured Foldable Hydrophilic Acrylic Intraocular Lens Placement by Trainees: A Single-Site Analysis
description	Yesha S Shah,1 Angela Y Zhu,1 Sidra I Zafar,1 Daniel Sarezky,1 Ximin Li,2 TY Alvin Liu,1 Mira M Sachdeva,1 Fasika A Woreta1 1Department of Ophthalmology, Wilmer Eye Institute, Johns Hopkins Medical Institutions, Baltimore, MD, USA; 2Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USACorrespondence: Fasika A WoretaDepartment of Ophthalmology, Wilmer Eye Institute, Johns Hopkins Medical Institutions, 600 N. Wolfe St., Wilmer B-29, Baltimore, MD, 21287, USATel +1 410 955-8265Fax +1 410 614-9632Email fworeta1@jhmi.eduPurpose: To evaluate the outcomes of a 4-point scleral-fixated foldable Akreos AO60 intraocular lens (IOL) insertion using Gore-Tex suture performed by trainees under supervision of a single attending surgeon.Methods: Retrospective chart review for 53 eyes of 50 patients whose surgery was performed by trainees under supervision of a single surgeon between 2015 and 2018 at a tertiary care hospital (Johns Hopkins Wilmer Eye Institute, Baltimore, MD). Indications for surgery, preoperative risk factors, and intraoperative techniques were analyzed. Outcome measures included final best-corrected visual acuity (BCVA), change in BCVA, difference between expected and final spherical equivalent (SE), and postoperative complications.Results: Mean patient age was 62.8 years (range 26.9 to 88.4). The most common indication for surgery was IOL dislocation (59.6%) due to trauma in 21 cases (40.4%) and pseudoexfoliation in 6 (11.5%). Combined pars plana vitrectomy was performed simultaneously in 46 cases (88.5%). Mean BCVA improved from 20/100 to 20/40 (p < 0.001). The difference between expected and final SE was within 1.0 D in 28 cases (53.8%). Postoperative hypotony occurred in 12 eyes (21.2%) on day 1; all were resolved at last follow-up. Postoperative cystoid macular edema (CME) occurred in 20 cases (38.5%); 11 (21.2%) persisted through last follow-up.Conclusion: Scleral-fixation of Akreos AO60 IOL in absence of capsular support can be performed by trainees under supervision and results in effective visual rehabilitation. Postoperative CME occurred at a higher rate than previously reported in the literature. Future studies should assess the rates of postoperative complications amongst different techniques of secondary IOL fixation performed by trainees to determine which is the safest.Keywords: secondary IOL, scleral-fixated IOL, scleral-sutured IOL, Akreos, clinical outcomes
format	article
author	Shah YS Zhu AY Zafar SI Sarezky D Li X Liu TYA Sachdeva MM Woreta FA
author_facet	Shah YS Zhu AY Zafar SI Sarezky D Li X Liu TYA Sachdeva MM Woreta FA
author_sort	Shah YS
title	Clinical Outcomes of Secondary Scleral-Sutured Foldable Hydrophilic Acrylic Intraocular Lens Placement by Trainees: A Single-Site Analysis
title_short	Clinical Outcomes of Secondary Scleral-Sutured Foldable Hydrophilic Acrylic Intraocular Lens Placement by Trainees: A Single-Site Analysis
title_full	Clinical Outcomes of Secondary Scleral-Sutured Foldable Hydrophilic Acrylic Intraocular Lens Placement by Trainees: A Single-Site Analysis
title_fullStr	Clinical Outcomes of Secondary Scleral-Sutured Foldable Hydrophilic Acrylic Intraocular Lens Placement by Trainees: A Single-Site Analysis
title_full_unstemmed	Clinical Outcomes of Secondary Scleral-Sutured Foldable Hydrophilic Acrylic Intraocular Lens Placement by Trainees: A Single-Site Analysis
title_sort	clinical outcomes of secondary scleral-sutured foldable hydrophilic acrylic intraocular lens placement by trainees: a single-site analysis
publisher	Dove Medical Press
publishDate	2021
url	https://doaj.org/article/620e4a7c5370440da6060db56ecacedd
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Clinical Outcomes of Secondary Scleral-Sutured Foldable Hydrophilic Acrylic Intraocular Lens Placement by Trainees: A Single-Site Analysis

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