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Scleral flaps can then be closed with nylon or fibrin glue. Some authors recommend using larger IOLs for these techniques in order to prevent torsion of the haptics and subsequent scleral erosion or IOL dislocation . The Yamane technique for intrascleral IOL fixation has become increasingly popular, avoiding the need for a conjunctival peritomy or scleral flaps . This technique of suture knot coverage was described in by Hoffman et al  and avoids the need for conjunctival dissection, scleral cauterization, or scleral wound closure.
A scleral pocket is created by initiating a scleral tunnel from a clear corneal incision. A double-armed suture can then be passed full thickness through the conjunctiva and scleral pocket, and the suture ends can be retrieved subsequently through the external corneal incision. The knots can then be buried within the pockets. Polypropylene Prolene is a monofilament polymer composed of propene used to be the most commonly used suture material for scleral-fixated IOLs.
Rates of suture breakage have been reported from 0 to For this reason, polypropylene has been increasingly used in order to reduce the rate of breakage. Gore-Tex W. Gore-Tex has greater tensile strength and has been reported to have lower suture breakage rates when used in the eye .
Gore-Tex is also commonly used for heart valve and vascular procedures. In the technique described in this report, four separate sclerotomies were made, each 2 to 3 mm from the limbus. The suture is passed through an eyelet of the IOL, into the anterior chamber through a main incision, and then externalized through one of the 4 sclerotomy sites.
In cases using the AO60, the other end of the suture is then passed through the adjacent eyelet. The second suture end is then passed into the anterior chamber and out through the adjacent sclerotomy. The same is done with the opposite eyelets and sclerotomies using a second piece of Gore-Tex suture.
The IOL is then inserted into the anterior chamber through the main incision. The suture knots are trimmed and rotated within one of the sclerotomies. Visual outcomes of scleral fixated IOLs are good, with poor outcomes typically related to comorbid ocular conditions. Few retrospective studies directly compare techniques.
A recent ophthalmic technology assessment by the American Academy of Ophthalmology  showed no superiority of a single IOL implantation technique in the absence of zonular support, although the 45 studies included had insufficient statistical power to compare the techniques conclusively. Complications of scleral-fixated IOLs include corneal edema, retinal detachment, intraocular hemorrhage due to the passage of suture through uveal tissue , suture erosion and infection due to externalized or exposed sutures , and IOL dislocation or tilt.
Caution is necessary in patients with a history of high myopia, hypertension, scleritis, or scleromalacia as well as those on anticoagulant medication. The risk of complications may correlate with increased surgical time and manipulation. Hypotony, which occurs when IOL implantation is performed with penetrating keratoplasty, also increases the risk of suprachoroidal hemorrhage, ranging from 0 to 2. Create account Log in. Main Page. Getting Started. Recent changes. View form.
View source. Redirected from Scleral fixated intraocular lens. Jump to: navigation , search. Article initiated by :. Brandon D. All authors and contributors:. Alpa S. Patel, M. Woreta, MD. Assigned editor:. Fasika A. Ninetyone Transmission of the ocular media. Girard, L. Complications of the Simcoe Flexible Loop Phacoprosthesis in the anterior chamber. Ophthalmic Surg. Willis, D. Pupillary block associated with 16 2 , Body diameter Optic diameter Overall diameter Your most recent searches Delete.
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Product Brand: Alcon. Why Shop With Us? Customer satisfaction is our top priority, we are not happy until you are happy. Patients who experience surgical complications associated with the cataract extraction procedure This information is being requested from all surgeons in order to document potential long-term effects of intraocular lens implantation.
Surgeons should use the following address and telephone number for reporting adverse events involving these lenses: Alcon Laboratories, Inc. Call Collect: Outside the United States, contact local Alcon ofces or distributors regarding reports of adverse events. However, these complications occurred early in the postoperative time frame and appear to be associated with the cataract extraction. Ten patients 2.
Ninetyone Transmission of the ocular media. Girard, L. Complications of the Simcoe Flexible Loop Phacoprosthesis in the anterior chamber. Ophthalmic Surg. Willis, D. Pupillary block associated with 16 2 , Body diameter Optic diameter Overall diameter Your most recent searches Delete. Frequent searches. Other sections. Catalog excerpts.