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A novel device for safe exteriorization of haptic in scleral fixation intraocular lens surgery.

ABSTRACT: The aim of this study was to describe a novel device that has been designed to facilitate anterior segment and novice surgeons to perform extraocular needle-guided haptic insertion technique (X-NIT) for scleral fixation intraocular lens surgery (SFIOL). We performed SFIOL surgery using X-NIT device in 21 eyes of 21 patients. The mean preoperative best-corrected visual acuity (BCVA) was 0.5 ± 0.2 logarithm of minimum angle of resolution (log MAR), which improved by one or more lines postoperatively in all eyes. There were no intraoperative complications. Postoperatively, we noted minimal corneal edema in one patient and dispersed vitreous hemorrhage in one patient. The sharpness and angulation of the needle and the haptic holding ability of silicone stopper were found to be satisfactory. The X-NIT device may potentially improve the safety of SFIOL procedures by minimizing intraocular maneuvers.

SUBMITTER: Baskaran P

PROVIDER: S-EPMC7728004 | biostudies-literature | 2020 Oct

REPOSITORIES: biostudies-literature

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A novel device for safe exteriorization of haptic in scleral fixation intraocular lens surgery.

Baskaran Prabu P Venkatesh Rengaraj R Ramakrishnan Seema S Sriram Ravilla Duraisami RD Iyer Gautham G Ramnath R K RK

Indian journal of ophthalmology 20201001 10

The aim of this study was to describe a novel device that has been designed to facilitate anterior segment and novice surgeons to perform extraocular needle-guided haptic insertion technique (X-NIT) for scleral fixation intraocular lens surgery (SFIOL). We performed SFIOL surgery using X-NIT device in 21 eyes of 21 patients. The mean preoperative best-corrected visual acuity (BCVA) was 0.5 ± 0.2 logarithm of minimum angle of resolution (log MAR), which improved by one or more lines postoperative ...[more]

PMID: 32971642

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Project description:PurposeTo report two patients with a complication of Yamane intrascleral haptic fixation surgery (ISHF) with the Zeiss CT Lucia 602 lens: severely tilted intraocular lens (IOL) leading to significantly decreased vision in the early post-operative period.ObservationsWe report two patients presenting with severely tilted IOL implants one day and one month following Yamane ISHF. The first patient is a monocular 81-year-old woman referred for treatment of cornea edema. Initial surgery involved replacement of an anterior chamber lens with a CT Lucia 602 posterior chamber lens using Yamane technique and Descemet's stripping endothelial keratoplasty. The patient returned at one month follow-up with poor vision and IOL tilt observable at the slit lamp through a peripheral iridectomy site. Explanation of the Zeiss lens revealed haptic distortion at the optic-haptic insertion point such that each haptic was about 45° off axis to the plane of the optic in approximately equal and opposite directions. The second patient, a 75-year-old woman, was referred with a completely dislocated lens-bag complex in the right eye. The initial operative treatment for this patient included pars plana vitrectomy, retrieval and removal of the dislocated lens-bag complex, and placement of a Zeiss 602 lens via Yamane ISHF technique. On the first postoperative day, the patient was count fingers in the right eye with an intraocular pressure of 5 mm Hg and obvious IOL tilt on slit lamp examination. Explanation of the lens revealed severely distorted haptics relative to the optic by more than a 60-degree angle on both sides. In both cases, initial surgery was performed with an IOL inspected prior to implantation and found to have normal appearing haptics. At the end of each case, there was adequate centration and no tilt of the IOL. Management in both patients included removal of the defective lens and placement of a new, same power CT Lucia 602 lens via the Yamane technique. Visual acuity improved from CF to 20/30 best corrected after reoperation in both cases.Conclusions and importanceIn summary, we describe a complication of Yamane ISHF with the CT Lucia 602 lens in which there is lens tilting associated with distortion at the optic-haptic fastening zone in the early postoperative period. In the event of a titled lens following Yamane ISHF, awareness of this complication may help surgeons consider lens replacement, as the haptics may be permanently distorted or damaged.

Dataset Information

A novel device for safe exteriorization of haptic in scleral fixation intraocular lens surgery.

Publications

A novel device for safe exteriorization of haptic in scleral fixation intraocular lens surgery.

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