OUTCOMES OF TRANSSCLERAL SULCUS FIXATION OF INTRAOCULAR LENSES

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OUTCOMES OF TRANSSCLERAL SULCUS FIXATION OF INTRAOCULAR LENSES THROUGH A 2. 4 -MM INCISION

OUTCOMES OF TRANSSCLERAL SULCUS FIXATION OF INTRAOCULAR LENSES THROUGH A 2. 4 -MM INCISION WITH AN INJECTOR SYSTEM: 1 -YEAR FOLLOW Akiko Masai, MD, Tomoichiro Ogawa, MD Takuya Shiba, MD, Hiroshi Tsuneoka, MD -UP Department of Ophthalmology The Jikei University School of Medicine Tokyo, Japan The authors have no financial interest in the subject matter of this e-poster.

Objective • To evaluate postoperative outcomes of scleral -sutured ciliary sulcus fixation of foldable

Objective • To evaluate postoperative outcomes of scleral -sutured ciliary sulcus fixation of foldable intraocular lens (IOL) through a 2. 4 -mm incision

Methods • Subjects: 9 eyes (9 patients) – Lens subluxation: 1 eye – Aphakia:

Methods • Subjects: 9 eyes (9 patients) – Lens subluxation: 1 eye – Aphakia: 5 eyes – IOL dislocation 3 eyes • Variables examined – Best-corrected visual acuity (BCVA) • Before and after surgery (1 week; 1, 3, 6, 12 months) – Surgically induced astigmatism (SIA) (Cravy method) • After surgery (1 week; 1, 3, 6, 12 months) – Endothelial cell density • Before and after surgery

Surgical Technique 1. Preparation for IOL setting of PC-9 hooking • 10 -0 double

Surgical Technique 1. Preparation for IOL setting of PC-9 hooking • 10 -0 double polypropylene thread (PC-9, Alcon) was inserted through the cartridge (E 1, HOYA). • PC-9 was looped around the haptics of the IOL (VA 70 AD or VA 65 BB, HOYA) by using a cow hitch knot.

Surgical Technique 2. Scleral pockets created at the 2 and 8 -o’clock positions 3.

Surgical Technique 2. Scleral pockets created at the 2 and 8 -o’clock positions 3. Anterior vitrectomy performed 4. 2. 4 -mm scleral corneal incision created at 12 -o’clock position

5. IOL setting: IOL and hooked PC-9 loaded into cartridge

5. IOL setting: IOL and hooked PC-9 loaded into cartridge

6. IOL inserted through incision with injector (ISH-001, HOYA), leaving opposite haptics out of

6. IOL inserted through incision with injector (ISH-001, HOYA), leaving opposite haptics out of anterior chamber 7. PC-9 looped around haptics 8. IOL fixed to ciliary sulcus

Result 1 BCVA SIA Early improvement in BCVA maintained for 1 year Surgically induced

Result 1 BCVA SIA Early improvement in BCVA maintained for 1 year Surgically induced astigmatism was minimal

Result 2 • Mean endothelial cell density reduced 9. 80% • Complications – IOL

Result 2 • Mean endothelial cell density reduced 9. 80% • Complications – IOL iris capture and pupillary block in 1 case – Retinal detachment in 1 case – Cystoid macular edema in 1 case.

Treatments for Complications • IOL capture – IOL repositioned – Peripheral iridectomy at 6

Treatments for Complications • IOL capture – IOL repositioned – Peripheral iridectomy at 6 and 12 o’clock • Retinal detachment – Scleral buckling surgery – Retina reattached • Cystoid macular edema – Improvement without medication

Conclusion • With this technique, visual acuity improved early postoperatively and was maintained for

Conclusion • With this technique, visual acuity improved early postoperatively and was maintained for 1 year

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