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Long-term outcome of scleral-sutured posterior chamber intraocular lens: a case series
  1. Maria Montserrat Bausili Portabella1,2,3,
  2. Jeroni Nadal1,3,
  3. Juan Alvarez de Toledo1,3,
  4. María Fideliz de la Paz1,3,
  5. Rafael Ignacio Barraquer1,3,4
  1. 1Institut Universitari Barraquer, Universitat Autònoma de Barcelona, Barcelona, Spain
  2. 2Departament de Cirurgia, Universitat Autonoma de Barcelona, Barcelona, Catalunya, Spain
  3. 3Centro de Oftalmología Barraquer, Barcelona, Spain
  4. 4Universitat Internacional de Catalunya, Barcelona, Spain
  1. Correspondence to Maria Montserrat Bausili Portabella, Retina, Barraquer Institute Eye, Barcelona, Barcelona, Spain; montserrat.bausili{at}gmail.com

Abstract

Purpose Purpose: To evaluate the long-term stability of scleral-sutured intraocular lenses (IOLs) and analyse the possible causes of suture breakage.

Setting Barraquer Institute in Barcelona, Spain.

Design Retrospective study of consecutive cases.

Methods Study of patients with scleral-sutured IOL with aphakia, subluxated or luxated IOL were included. Follow-up was longer than 6 months and patients over 18 years of age. Preoperative data (best-corrected visual acuity testing (BCVA), intraocular pressure (IOP), axial length and slit-lamp examination), intraoperative data (characteristics of the scleral flaps, suture material (Prolene or Mersilene) and scleral-sutured IOL) and postoperative data (BCVA, IOP, slit-lamp examination and complications) through 10 years were collected for analysis.

Results 345 consecutive cases of scleral-sutured IOL were included. 25 eyes underwent a second operation after a prior sutured IOL due to suture breakage (mean 40.2±39.6 months after the first surgery) and three of them needed a third surgery. Younger adults (less than 40-year old), the use of a combination of Prolene and Mersilene sutures to perform the surgery and suturing only one flap were found to have higher risk of suture breakage after a follow-up of 10 years. The probability of surviving of the scleral-sutured IOL at 10 years after surgery was 0.79.

Conclusions Scleral-sutured posterior chamber IOL in eyes with a lack of capsular support is a safe and effective procedure with a low rate of complication and stable visual acuity. Further studies with special focus on young adults or myopic eyes are required to demonstrate long-term safety in those special cases.

  • scleral-sutured
  • intraocular lens
  • suture breakage
  • aphakia
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Footnotes

  • Contributors MMB has contributed to the content of this manuscript in the following areas: concept and design, data acquisition and interpretation, statistical analysis, and final approval. JN and JPAdT have contributed to the content of this manuscript in the following areas: concept and design, critical revision, supervision and final approval. MFdlP and RIB have contributed to the content of this manuscript in the following areas: supervision and final approval.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval Comité Ético de InvestigaciónClínica del Centro de Oftalmología Barraquer. ID number: 134_LOTOS.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available upon request.

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