Title : Safety and visual outcomes of scleral fixated physiol lens using gore-tex suture
Abstract:
Over the past two decades, surgical options for intraocular lens (IOL) implantation in the absence of capsular support have evolved. Surgical indications for secondary IOL implantation are mainly due to complicated cataract surgery, trauma, or inherited conditions such as Marfan syndrome. In the absence of capsular support, different techniques have evolved to implant intraocular lenses with variable outcomes. This study aimed to report visual outcomes and the complications rate of scleral fixated intraocular lens using Gore-Tex suture.
Subject and methods: This retrospective case series study reviewed 29 patients who underwent secondary intraocular lens implantation using a Gore-tex suture 4-point scleral fixation technique with the physiol lens at Prince Sultan Military Medical City, Ophthalmology Department – Riyadh, Saudi Arabia. Data collected include demographic data (i.e., age, gender), the primary cause of Aphakia, pre-op and post-op BCVA, post-op complications, pre-op comorbidity, and duration of follow-up.
Results: 69% of the patients were more than 10 years old during surgery. Male patients (62.1%) were predominantly higher than female patients (37.9%). Primary cause of aphakia was secondary to complicated cataract surgery (48.3%). There was a significant improvement between pre-OP BCVA logMAR from 0.85 ± 0.31 to postop BCVA logMAR 0.56 ± 0.4 (p<0.001). Significant improvement in post-OP BCVA was seen in female gender (p=0.047). 58.6% of the patients suffered postoperative complications, prevalent in patients who had short follow-up duration (≤15 months) (p=0.047). the most common postop complication was corneal decompensation (20.7%), followed by transient hypertension (10.3%) and iris capture (6.9%).
Conclusion: There was a significant visual improvement after scleral fixated physiol lens using Gore-Tex sutures. Female patients demonstrated better postoperative visual outcomes compared to male patients. The outcome of this study concludes that Gore-Tex scleral-fixated secondary IOLs are generally effective and safe, with modest complications that are mostly manageable. More investigations are warranted to establish its effectiveness in our region.
