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. 2016 May 4;16(1):50.
doi: 10.1186/s12886-016-0228-y.

Visual outcomes of posterior chamber intraocular lens intrascleral fixation in the setting of postoperative and posttraumatic aphakia

Dariusz Haszcz  1 , Katarzyna Nowomiejska  2 , Agnieszka Oleszczuk  1 , Cesare Forlini  3 , Matteo Forlini  4 , Joanna Moneta-Wielgos  1 , Ryszard Maciejewski  5 , Katarzyna Michalska-Malecka  6 , Anselm G Jünemann  7 , Robert Rejdak  1   8
Affiliations

Visual outcomes of posterior chamber intraocular lens intrascleral fixation in the setting of postoperative and posttraumatic aphakia

Dariusz Haszcz et al. BMC Ophthalmol. .

Abstract

Background: Several techniques for fixation of the posterior chamber intraocular lens (IOL) have been developed. We evaluate long-term functional outcomes and safety of posterior chamber IOL implantation using Hoffman scleral haptic fixation and sutureless Sharioth technique in patients with posttraumatic and postoperative aphakia.

Methods: This retrospective case-series included 42 eyes operated by one surgeon. The data including demographic data, ocular history, preoperative, early postoperative and final best corrected visual acuity (BCVA), rate of complications as well as postoperative IOL position were collected. The mean follow-up was 14.5 months. Hoffman haptic scleral fixation was performed in 31 eyes, Sharioth technique-in 11 eyes. Aphakia was due to eye trauma (19) or complicated cataract surgery (23).

Results: Overall, the final BCVA improved in 26 eyes, did not change in 5 eyes, and worsened in 11 eyes. No significant differences in BCVA were found between groups operated with Hoffman scleral fixation and Sharioth technique. Postoperatively, we noticed two dislocations of IOL fixated using Sharioth technique and none after Hoffman technique. No severe complications were observed.

Conclusion: Both transscleral fixation techniques are feasible methods of secondary IOL implantation in posttraumatic and postoperative aphakia. with low incidence of complications, however visual outcomes are diverse.

Keywords: Aphakia; Scleral fixation; Secondary intraocular lens implantation.

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Figures

Fig. 1
Fig. 1
Hoffman technique-1) hollowing the tunnel in the sclera 2) a straight needle attached to a 10–0 polypropylene suture is passed through the conjuctiva and sclera in the pocket, posterior to the iris to the pupil, out through the opposite paracentes 3) the needle is passed back using hollow 26-G needle 4) after tying the haptic, the suture is tied into pocket
Fig. 2
Fig. 2
Scharioth technique-1) hollowing the intrascleral tunnel 2) inserting a 25-G needle at the end of the opposite intrascleral tunnel, insert the haptic of the PCIOL (posterior chamber intraocular lens) into the hollow needle (this maneuver can be performed using micropincet 25-G) 3) removal of the haptic out by withdrawing the needle, the other haptic is retrieved using tweezers 4) inserting the second haptic into opposite intrascleral tunnel via the barrel of the hollow needle
See this image and copyright information in PMC

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