We performed a retrospective observational case-controlled study of vitrectomized aphakic eyes in patients who had undergone foldable intraocular lens implantation into the posterior chamber. Outcomes and complications were compared between the surgical methods. In the present study, we evaluated three separate groups of patients with vitrectomized aphakic eyes lacking capsular support in whom foldable IOL were implanted through a small corneal incision using either transscleral fixation, iris fixation, or intrascleral fixation. Alternatively, IOL implantation can be performed through a small incision to the posterior chamber with sutureless intrascleral fixation ( 12 - 22 ). In cases with no capsular support, the implantation of a foldable IOL can be performed through a small corneal incision into the posterior chamber with suture fixation to the sclera or iris ( 4 - 11 ). In these cases, a small corneal tunnel incision may be used to create a closed and more stable surgical space. However, the lack of the volume creation and supporting effect of the vitreous, and the fact that the surgery is generally performed under irrigation fluid, may complicate PCIOL fixation in vitrectomized eyes. Posterior chamber IOL implantation may be performed via posterior chamber transscleral fixation ( 1 - 7 ), iris fixation ( 8 - 11 ), intrascleral fixation ( 12 - 22 ), angle supported anterior chamber IOL ( 23, 24 ), or iris claw IOL implantation ( 25, 26 ).Īdvantages of PCIOL fixation include the distant position from anterior segment structures, such as the corneal endothelium, and proximity to the focal point of the eye where the lens is naturally situated. During PPV, the iatrogenic removal of the lens capsule may be required depending on the etiology and severity of the vitreoretinal disease. Eye trauma or iatrogenic damage during complicated cataract surgery, loss of position and zonule connections of the crystalline lens, and IOL via dislocation may cause loss of support tissue for lens capsule implantation prior to pars plana vitrectomy (PPV). The capsule of the crystalline lens, if sufficiently present, is used as a support tissue for intraocular lens (IOL) implantation surgery performed on vitrectomized eyes. Implante de lente intraocular/métodos Íris/cirurgia Técnicas de sutura Afacia Conclusões: Nenhuma das três técnicas cirúrgicas teve destaque em termos de resultados cirúrgicos comparativos. A acuidade visual melhorou em todos os grupos. Não houve diferença estatisticamente significativa do astigmatismo relacionado à PCIOL entre os grupos. Frequência de complicações pós-operatórias temporárias como hemorragia intraocular leve e edema macular cistóide foi maior no grupo ISF. Deslocamentos intraoperatórios da PCIOL ocorram em dois pacientes no grupo IF. Resultados: Subluxação ou luxação da PCIOL ocorreu em um caso no grupo TSF e em dois casos no grupo ISF. Foram utilizados as técnicas cirúrgicas de fixação transescleral (TSF), fixação iriana (IF) e túnel de fixação intraescleral (ISF). Todos os pacientes foram submetidos ao implante de PCIOL dobrável de três peças na câmara posterior, através de uma pequena incisão na córnea. Métodos: Um total de 60 olhos de 60 pacientes afácicos vitrectomizados, sem apoio capsular foram inscritos. Objetivo: Avaliar os resultados de três diferentes técnicas cirúrgicas para implantação da lente intraocular de câmara posterior (PCIOL) dobrável em olhos vitrectomizados sem apoio capsular. Lens implantation, intraocular/methods Iris/surgery Suture techniques Aphakia Conclusions: Postoperative outcomes were comparable between TSF, IF, and ISF for PCIOL in vitrectomized eyes without capsular support. No statistically significant difference in PCIOL-related astigmatism was observed between groups. The incidence of temporary postoperative complications, such as mild intraocular hemorrhage and cystoid macular edema, was higher in the ISF group. Intraoperative PCIOL dislocation occurred in two patients in the IF group. Results: Postoperative PCIOL subluxation or dislocation occurred in one case in the TSF group and two cases in the ISF group. Transscleral fixation (TSF), iris fixation (IF), and intrascleral tunnel fixation (ISF) surgical techniques were performed. All patients underwent three-piece foldable PCIOL implantation into the posterior chamber through a small corneal incision. Methods: A total of 60 patients with aphakic and vitrectomized eyes without capsular support were enrolled. Purpose: To evaluate the outcomes of three different surgical techniques for foldable posterior chamber intraocular lens (PCIOL) implantation in vitrectomized eyes without capsular support.
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