Long-term outcome of combined pars plana vitrectomy and scleral fixated sutured posterior chamber intraocular lens implantation.

PURPOSE To investigate the long-term visual outcome and the complication rate following transscleral suture fixation of posterior chamber intraocular lenses (sutured PC-IOLs). DESIGN A retrospective case-series descriptive study. METHODS Records of patients who underwent combined pars plana vitrectomy and sutured PC-IOLs at Moorfields Eye Hospital and who had at least 12 months of follow-up were examined for recorded complications. RESULTS Sixty-one eyes of 48 patients (33 males and 15 females) were identified and included in the analysis, with mean follow-up of 6 years. The mean final best-corrected visual acuity remained at preoperative levels (P=.211) and was largely determined by the underlying ocular pathology before sutured PC-IOL. Overall 30 of 61 (49%) eyes, two or more procedures were performed to reverse a significant peri- or postoperative complication. Breakage of polypropylene sutures was the main indication accounting for 17 of 30 (57%) of those reoperations. Subgroup analysis showed that younger patients were more likely to suffer the above complication (P=.009). The multivariate analysis also showed that longer follow-up was significantly associated with suture breakage (P=.014), with the mean time to breakage approximately 4 years after surgery. CONCLUSIONS Long-term follow-up of patients undergoing sutured PC-IOLs appears to be associated with a high rate of postoperative complications and significant need for further surgery, which should be discussed during their informed consent process.

[1]  D. Charteris,et al.  Combined pars plana vitrectomy and sutured posterior chamber implant. , 2000, Archives of ophthalmology.

[2]  K. Solomon,et al.  Incidence and management of complications of transsclerally sutured posterior chamber lenses , 1993, Journal of cataract and refractive surgery.

[3]  E. Holland,et al.  Histologic study of eyes with transsclerally sutured posterior chamber intraocular lenses. , 1990, American journal of ophthalmology.

[4]  P. McCluskey,et al.  Long‐term results using scleral‐fixated posterior chamber intraocular lenses , 1994, Journal of cataract and refractive surgery.

[5]  J. Güell,et al.  A review of suturing techniques for posterior chamber lenses , 2004, Current opinion in ophthalmology.

[6]  L. D. Del Priore,et al.  A new technique for suture fixation of posterior chamber intraocular lenses that eliminates intraocular knots. , 2003, Ophthalmology.

[7]  T. Cox,et al.  Intraocular lens implantation in the absence of capsular support: a report by the American Academy of Ophthalmology. , 2003, Ophthalmology.

[8]  M. Trese,et al.  A comparison of visual results and complications in eyes with posterior chamber intraocular lens dislocation treated with pars plana vitrectomy and lens repositioning or lens exchange. , 2001, Ophthalmology.

[9]  R. Steinert,et al.  Sutured posterior chamber intraocular lenses. , 1994, International ophthalmology clinics.

[10]  S. Hannush.  Sutured posterior chamber intraocular lenses: indications and procedure. , 2000, Current opinion in ophthalmology.

[11]  D. Charteris,et al.  Pars plana vitrectomy and sutured posterior chamber lens implantation , 2001, Current opinion in ophthalmology.

[12]  H. Er,et al.  Comparison of secondary implantation of flexible open‐loop anterior chamber and scleral‐fixated posterior chamber intraocular lenses , 2003, Journal of cataract and refractive surgery.