Author: Matias Iglicki (Argentina)
Co-authors: Catharina Busch, Termino Pablo Negri, Emanuel Holsman, Joaquin Esteves, Dinah Zur, Prof Anat Loewenstein,
Purpose
Intraoperative complications in cataract surgery are more common in diabetic patients. Solving aphakia in these circumstances remains a challenge, as the scleral structure has been shown to be different in diabetes. This study aims to analyze the role of a secondary sutureless scleral intraocular lens (IOL) flanged fixation in diabetic patients without capsular support and to compare the anatomical and functional outcomes using a 30 gauge (G) ultrathin wall needle vs. a 27G needle.
Setting/Venue
Retina practice, University of Buenos Aires, Argentina Ophthalmology Department, University of Leipzig, Leipzig,Germany Diagnostic Ophthalmology Center, Buenos Aires, Argentina Ophthalmology Division, Tel Aviv Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
Methods
Multicenter International Study. We included 105 eyes (105 patients) who underwent PPV with secondary IOL fixation using a sutureless 27G (n = 51) or a 30G ultrathin wall (UTW) needle technique (n = 54) and had a 24 months postoperative follow up. Consecutive patients’ records were reviewed for lens stability and centration parameters, intra- and postoperative complications at 7 days, 1, 3, 6, 12, and 24 months after surgery. Correlations between outcome measures and needle size (27G vs. 30G UTW) were analyzed.
Results
IOL displacement occurred in 30 patients (41.2%) in the 27G group and did not occur in the 30G UTW needle group (p < 0.001). Mean time until IOL displacement was 10.5 ± 7.0 months (range: 7 days–24 months). IOL centricity was significantly better in the 30G ultrathin wall needle group compared to 27 G (p = 0.001). Additional surgical interventions were necessary only in the 27G group (n = 14).
Conlusions
Conclusions Sutureless IOL flanged technique using a 30G UTW needle is more predictable and has less complications in aphakic diabetic patients, compared to a 27G needle technique.
Financial Disclosure
'-Allergan – Consultant -Bayer - Consultant -Novartis- Consultant -Regeneron- PI -Genentech-PI -TSK Laboratory Europe B.V.
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