Beyoglu Eye J. 2023; 8(4): 253-259 | DOI: 10.14744/bej.2023.30085

Visual Outcomes, Endothelial Loss, and Complications Following Iris-Claw Intraocular Lens Implantation and Trocar-Assisted Sutureless Scleral Fixation of Intraocular Lenses

Ebubekir Durmus¹, Veysel Aykut¹, Mustafa Hepokur², Fatma Sali¹, Huseyin Avni Sanisoglu³, Halit Oguz¹, Fehim Esen^1
1Department of Ophthalmology, Istanbul Medeniyet University, Ýstanbul, Türkiye
²Department of Ophthalmology, Goztepe Prof. Dr. Suleyman Yalçin City Hospital, Ýstanbul, Türkiye
³Department of Ophthalmology, Kadikoy Diabetes Hospital, Ýstanbul, Türkiye

OBJECTIVES: Iris-claw intraocular lens (IC-IOL) implantation and sutureless scleral fixation of intraocular lenses (SSF-IOL) are two commonly preferred surgical approaches for the management of aphakic patients without sufficient capsular support. The aim of this study was to compare the outcomes of IC-IOL implantation and trocar-assisted SSF-IOL implan-tation.
METHODS: The medical records of secondary IOL implantation patients were retrospectively reviewed. All patients had a detailed ophthalmological examination, including LogMAR best-corrected distance visual acuity (CDVA), intraocular pressure (IOP), and endothelial cell density (ECD) preoperatively and postoperatively. SPSS 21.0 software was used for the statistical analysis.
RESULTS: There were 15 patients in the IC-IOL group and 12 patients in the SSF-IOL group. Age and gender distributions were similar between the groups (p=0.456 and p=0.398, respectively). Similarly, patients in both groups had similar CDVA preoperatively and postoperatively (p=0.51, p=0.48, respectively). Both IC-IOL and SSF-IOL implantation significantly increased CDVA (p=0.001 and p=0.005, respectively). IOP remained unchanged in both groups. However, ECD reduced significantly following both IC-IOL and SSF-IOL implantation (p=0.001 and p=0.005, respectively) and trocar-assisted SSF-IOL implantation resulted in significantly more endothelial loss compared to IC-IOL implantation (439.5±89 vs. 164.4±53, p=0.013).
DISCUSSION AND CONCLUSION: Both surgical approaches increased CDVA significantly and at similar levels. However, trocar-assisted SSF-IOL implantation resulted in significantly more endothelial loss compared to IC-IOL implantation. None of the patients developed bullous keratopathy, but this difference should be kept in mind, especially in patients with critically low ECD.

Keywords: Endothelial loss, implantation, iris-claw intraocular lens, secondary intraocular lens, sutureless scleral fix-ation.

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