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22nd International Congress of German Ophthalmic Surgeons

18. to 21.06.2009, Nürnberg

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Sutureless in-the-bag fixation of a single-piece flexible IOL in congenital lens ectopia

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  • Oleg Fechin - S.Fyodorov Eye Microsurgery Federal State Institution, Ekaterinburg Branch, Ekaterinburg, Russia

22. Internationaler Kongress der Deutschen Ophthalmochirurgen. Nürnberg, 18.-21.06.2009. Düsseldorf: German Medical Science GMS Publishing House; 2009. Doc09docVI 1.2

doi: 10.3205/09doc067, urn:nbn:de:0183-09doc0677

Published: July 9, 2009

© 2009 Fechin.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

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Purpose: The existing methods of IOL fixation in congenital lens ectopia often result in secondary glaucoma, bleeding during sutures placement, and late tilt and decentration of the lens. That is why our purpose was to develop a technology of single-piece flexible IOL implantation with stable fixation in the capsular bag.

Methods: The technology includes capsulorhexis concentric to the optic axis, removal of lens substance, and implantation of a flexible S-shaped IOL into the capsular bag. An incision is made in the equator of the capsular bag in the zone of stretched zonulae, and one of the IOL loops is dialed into it counterclockwise. The second loop remains in the capsular bag. IOL centration is regulated by IOL rotation and length of the incision in the capsular bag. Optic part of the IOL is reliably fixed in the capsular bag and does not require suture fixation.

Results: We have operated 15 eyes of 12 patients aged from 6 to 38 years. Mean BCVA before surgery was 0.24. Central IOL position was achieved in all the cases. Mean BCVA at the second day post-op was 0.62. Incomplete correction was explained by refractive amblyopia. Intraoperative complications included one case of vitreous prolapse through a pre-existing zonulae defect. In remote period two cases of slight IOL decentration without significant influence on visual acuity were seen.

Conclusions: The developed technology allows implantation of existing flexible S-shaped IOLs with intracapsular fixation, exclusion of suture fixation, achievement of stable central IOL position in the posterior chamber, reduction of complications risk, and achievement of high functional results.