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Long-term outcome of scleral-sutured posterior chamber intraocular lens: a case series
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    Long Term Stability of Sutured Scleral-fixated Intraocular Lenses

    Dr. Portabella reviewed the stability of 345 consecutive cases of scleral-sutured posterior chamber IOLs retrospectively.1 In discussing sutured scleral-fixated IOLs several main points must be considered: 1) type of suture utilized; 2) length of follow-up; 3) multiple surgeons or single surgeon; 4) type of knot utilized; and 5) reoperation rate.

    This paper by Portabella et al.1 involved use of Prolene (polypropylene) or Mersilene sutures, follow-up with a maximum of 10 years, multiple surgeons, a knot with a single loop through the sclera and around the haptic, and a reoperation rate of 7.2%. The Vote et al study2 reviewed 61 eyes with Prolene sutures, follow-up with a maximum of 10.6 years, multiple surgeons, variable knots, and an extremely high rate of redislocation of 26.2%, which they postulated was due to suture breakage. This high rate of redislocation has not been confirmed in any other study.3,4

    A recent study by Kokame et al3 involved 118 eyes utilizing 10-0 Prolene sutures, a single surgeon, follow-up of up to 24.75 years, a knot with two sutures - one secured to the haptic by a cow-hitch and the other to the sclera with both sutures tied together in a single knot under a scleral flap, and a broken suture rate of 0.5% (1/214 fixation sutures). The maximum follow-up of 24.75 years with stable fixation strongly supports the stability of 10-0 Prolene. Higher rates of redislocations of sutured scleral-fixated IOLs can be due to multiple surgeo...

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    Conflict of Interest:
    None declared.