Outcome of Sclera Fixated Intraocular Lens for Complicated Cataract Surgeries in an Eye Institute, Southwestern Nigeria

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Abstract

Background: Fixating an intraocular lens to the sclera is a technique for managing aphakia that results from complications of cataract surgery when there is difficulty in placing the intraocular lens in the bag or sulcus due to loss of capsular support for the posterior chamber intraocular lens. The procedure involves various techniques aimed at securing an intraocular lens to the sclera to restore sight in the aphakic eye. This is a report of the outcome of 19 cases performed at Eleta Eye Institute, Ibadan, Nigeria and St Mary’s Catholic Eye Hospital Ago Iwoye, Nigeria between April 2018 and February 2019, in which posterior chamber intraocular lenses were fixated to the sclera using polypropylene 10/0 sutures and subjects followed up for six months. Blindness and vision impairment was classified according to the international classification of diseases, ICD-10 for distance vision. Relevant data was retrieved from the medical records of the patients and analyzed using SPSS version 22. Results: The age range was 27-88 years. Posterior capsule rupture from initial surgery accounted for 68.42% of the cases while traumatic cataract accounted for 15.79%. Weak zonules and dislocated intraocular lens accounted for 10.53% and 5.26% respectively. At 24 weeks, there was 89.5% reduction in the number of blind eyes (VA less than 3/60), with 68.4% achieving VA of 6/6-6/12 with pin hole. All the eyes had intraocular pressure ranging between 10 and 22mmHg preoperatively. Postoperatively, temporary hypotony and transient corneal oedema occurred in 8(42.11%) and 6 (31.58%) of the cases respectively, while raised intraocular pressure occurred in 1 (5.2%) of cases. The patient with elevated intraocular pressure was further managed by a glaucoma specialist. Conclusion: The anchor suture technique in combination with the L-shaped scleral flap provides satisfactory visual outcome in managing aphakia or pseudoaphakia and ensures that sutures do not irritate the ocular surface thereby reducing postoperative inflammation. When a PCIOL is used, it eliminates the challenges of stocking of SFIOLs in low resource settings.

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APA

Egbu, E., Igwe, N., & Olatunji, P. (2020). Outcome of Sclera Fixated Intraocular Lens for Complicated Cataract Surgeries in an Eye Institute, Southwestern Nigeria. Journal of Ophthalmology Research Reviews & Reports, 1–4. https://doi.org/10.47363/jorrr/2020(1)107

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