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Clinical science
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. 1 Institut Universitari Barraquer, Universitat Autònoma de Barcelona, Barcelona, Spain
  2. 2 Departament de Cirurgia, Universitat Autonoma de Barcelona, Barcelona, Catalunya, Spain
  3. 3 Centro de Oftalmología Barraquer, Barcelona, Spain
  4. 4 Universitat 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

https://doi.org/10.1136/bjophthalmol-2019-314054

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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.