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Observational Study
. 2024 Feb;262(2):487-494.
doi: 10.1007/s00417-023-06217-8. Epub 2023 Aug 30.

A mini-invasive surgical technique for Carlevale IOL implantation: case series study and description of concomitant surgery

Carla Danese  1   2 , Francesco Di Bin  1 , Paolo Lanzetta  3   4
Affiliations
Observational Study

A mini-invasive surgical technique for Carlevale IOL implantation: case series study and description of concomitant surgery

Carla Danese et al. Graefes Arch Clin Exp Ophthalmol. 2024 Feb.

Abstract

Purpose: To examine the feasibility and outcomes of a modified technique for the implantation of scleral fixated Carlevale intraocular lens (IOL) (I71 FIL SSF. Soleko IOL Division, Pontecorvo, Italy), and to analyze the occurrence of adverse events.

Methods: This is a retrospective observational study conducted revising patients charts from 2018 to 2023. Thirty-five eyes of 33 patients were included. Patients requiring IOL explantation had either IOL dislocation or opacification. The implantation of the Carlevale IOL was performed with the subconjunctival positioning of the anchors without any scleral flap. All maneuvers were performed transconjunctivally. The anatomical outcomes considered were IOL positioning, and the absence of postoperative complications. The functional outcomes analyzed were best correctedvisual acuity (BCVA) and refraction.

Results: In all the cases, the IOL was well positioned and centered postoperatively. No cases of conjunctival erosion were recorded. The best corrected visual acuity (BCVA) was 0.9±0.6 logMar (mean±standard deviation) preoperatively and 0.5±0.5 logMar (mean±standard deviation) postoperatively. The mean preoperative spherical equivalent was +6.8±7.7 dioptres, while postoperatively it was -1.1±1.6 dioptres. The most frequent procedure associated to secondary IOL implantation was posterior vitrectomy (25 eyes, 71.4%), which was performed with 25-gauge transconjunctival cannulas in the ciliary sulcus. The follow-up period was 24.5±16.9 months (mean±standard deviation).

Conclusion: The described mini-invasive technique for Carlevale IOL implantation is safe and effective. It can be recommended either as a stand-alone operation or associated to concurrent surgical procedures.

Keywords: Carlevale IOL; IOL luxation; IOL opacification; Scleral fixation; Secondary IOL implantation.

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Conflict of interest statement

Carla Danese is consultant for Bayer, outside the submitted work. Francesco Di Bin declares no conflicts of interest. Paolo Lanzetta is consultant for Aerie, Allergan, Apellis, Bausch&Lomb, Bayer, Biogen, Boerhinger, Centervue, Genentech, Novartis, Ocular Therapeutix, Outlook Therapeutics, Roche, outside the submitted work.

Figures

Fig. 1
Fig. 1
A Position of the cannulas in a case requiring associated vitrectomy and dislocated IOL removal. This is a left eye seen from surgeon position. The infero-temporal and supero-nasal cannulas are in the ciliary sulcus, while the supero-temporal cannula is in the pars plana. B Position of the cannulas in a case requiring IOL removal and Carlevale IOL implantation. This is also a left eye seen from surgeon position. The infero-temporal and supero-nasal cannulas are positioned in the ciliary sulcus
Fig. 2
Fig. 2
The Carlevale lens is injected through the corneal incision, while one of the anchors is grasped with a jaw forceps
Fig. 3
Fig. 3
The first anchor is externalized and the cannula is simultaneously removed
Fig. 4
Fig. 4
The second anchor is grasped with the handshake technique, using two jaw forceps
Fig. 5
Fig. 5
Immediate postoperative result. The lens is centered and the anchors are well positioned beneath the conjunctiva
See this image and copyright information in PMC

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