Pars Plana Intrascleral Haptic Fixation of Posterior Chamber IOL
Narrative Responses:
Purpose
Intrascleral haptic fixation of posterior chamber intraocular lense (IOL) was recently reported as a new secondary IOL implantation technique. However, it has the potential to cause complications such as pupillary capture, vitreous hemorrhage and refractive errors. In the present study, the outcome of pars plana intrascleral fixation was assessed.
Methods
The subjects were 18 patients who received pars plana intrascleral haptic fixation of IOL at Juntendo University Shizuoka Hospital. After a T-incision was made in the sclera at 3 mm from the limbus, sclerotomy was done and scleral tunnel was made with a 24-G MVR knife. Next, an IOL was inserted into the anterior chamber, the IOL haptic was pulled out of the eye with forceps, and its tip was inserted into the scleral tunnel. The outcome of this technique was evaluated by assessing preoperative and postoperative visual acuity, anterior segment optical coherence tomography (OCT) findings, refractive errors and complications.
Results
Postoperatively, the corrected visual acuity was unchanged or improved compared with the preoperative acuity in all patients. After pars plana intrascleral haptic fixation, the IOL was positioned more deeply than in eyes treated by trans-sulcus intrascleral fixation and there was no IOL tilting or dislocation. Pupillary capture was not observed. Vitreous hemorrhage was detected in 1 eye, and was considered to be secondary to damage to the iris during lens removal. At 3 months after surgery, the mean refractive error was 0.43D in the pars plana group. It was almost equal to that in the bag group (0.34D).
Conclusion
Pars plana intrascleral fixation is considered to be a promising surgical technique for secondary IOL implantation.