Microinvasive reposition technique of posterior chamber IOLs with suturing pars plana without the use of viscoelastic

TITLE
Microinvasive reposition technique of posterior chamber IOLs with suturing through pars plana of the ciliary body without the use of viscoelastic.

Purpose
To improve the technique for repositioning and for reliable intrascleral fixation of IOL without the use of viscoelastics.

Tasks:
1. To develop a technique for IOL repositioning and IOL fixation in various complicated clinical
situations.
2. To assess the results of the developed surgical intervention.

Methods:
67patients(72eyes),age from 52-89 y.o.,with dislocation of PCIOL were observed for 10 years.IOL dislocation with PCrupture-29 eyes;in-the-bag IOL dislocation-43 eyes.Patients underwent surgery according to micro-invasive technique developed by us without use of viscoelatic.5 eyes had combined pathology of posterior segment disease.Following types of IOLs were repositioned:Alcon Acrysof IQ Natural,Acrysof 3-part,Rayner aspheric,Akreos AO,Hanita lenses. For fixation of IOL after its reposition we used the sclerocorneal method, developed by us,which gives reliable fixation of almost any type of most frequently used IOL.VA before surgery:0.01-0.7cc (on average,0.28 ± 0.06).IOP:14-25 mmHg

Results:
In 69 cases central stable fixation of IOL was achieved. In 3 cases IOL decentration of 1.0 mm was observed, which did not affect the result of the operation. Re-fixation of IOL was not required in any case. The visual functions in patients corresponded to the initial situation before the dislocation of the IOL and the degree of preservation of the optic nerve and retinal layers.

VA ranged from 0.2 to 1.0 with correction (on average, 0.78 ± 0.08). IOP after surgery was from 11 to 23 mm Hg. in 68 cases. In 4 cases, transient ocular hypertension was observed up to 26 and 37 mm Hg, treated with drops for 1.5 months.

Conclusion
The Developed technique for repositioning PCIOLs is safe and allows to achieve reliable fixation.Sclerocorneal method of IOL-fixation without use of viscoelastic allows minimizing the risk of complications,in particular,reducing the likelihood of p/o hypertension. No scleral/conjunctival incisions were made,so no stitches neededed to be removed p/o.