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Barbieri F, Maglionico MN, Casini G, Guidi G, Figus M, Posarelli C. Current Evidence for a New Surgical Technique for Scleral Fixation: The Implantation of a Carlevale Lens, a Systematic Review. J Clin Med 2024; 13:3287. [PMID: 38892997 PMCID: PMC11172714 DOI: 10.3390/jcm13113287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Revised: 05/23/2024] [Accepted: 05/29/2024] [Indexed: 06/21/2024] Open
Abstract
Background: The Carlevale lens (FIL SSF, Soleko IOL Division, Italy) is a new lens for suture-less scleral fixation. This paper aimed to systematically review articles on this lens, the surgical techniques used for its implantation, complications and outcomes. Methods: This systematic review was performed following the PRISMA guidelines. The search string used was "Carlevale" AND "scleral fixation" from inception until March 2024. For completeness, either case-control studies, case reports or case series written in English were included. The authors used the Newcastle-Ottawa scale for the case-control studies and the JBI Critical Appraisal Checklist for case reports and case series. Results: Twenty-nine articles were included. Scleral fixation with Carlevale lens can be performed by creating scleral flaps or, alternatively, by using scleral pockets. The two sclerotomies must be diametrically opposed, and are preferably created by 25-gauge trocars. A pars plana vitrectomy should be performed every time, and the design of the lens should be suitable for self-anchoring to the sclera; the most accredited strategy to achieve this is to avoid scleral sutures. There were only a few intraoperative and postoperative complications reported; vitreous hemorrhages were the most frequent intraoperative events, while the most relevant postoperative complications were vitreous hemorrhages, cystoid macular oedema and transient variations in the intraocular pressure. Excellent results have been obtained in terms of BCVA, IOL centration and stability, mean intraocular pressure, postoperative spherical equivalent, separation between anterior and posterior chamber and the distance of the IOL from anterior chamber structures. Conclusions: The foldable hydrophilic design of the Carlevale lens has shown good effectiveness, IOL stability and few intra and post-operative complications.
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Affiliation(s)
- Francesca Barbieri
- Department of Surgical, Medical, Molecular Pathology and Critical Care Medicine, University of Pisa, 56126 Pisa, Italy; (F.B.); (M.N.M.); (M.F.)
| | - Maria Novella Maglionico
- Department of Surgical, Medical, Molecular Pathology and Critical Care Medicine, University of Pisa, 56126 Pisa, Italy; (F.B.); (M.N.M.); (M.F.)
| | - Giamberto Casini
- Ophthalmology, Department of Medical and Surgical Specialties, Azienda Ospedaliero Universitaria Pisana, 56124 Pisa, Italy; (G.C.); (G.G.)
| | - Gianluca Guidi
- Ophthalmology, Department of Medical and Surgical Specialties, Azienda Ospedaliero Universitaria Pisana, 56124 Pisa, Italy; (G.C.); (G.G.)
| | - Michele Figus
- Department of Surgical, Medical, Molecular Pathology and Critical Care Medicine, University of Pisa, 56126 Pisa, Italy; (F.B.); (M.N.M.); (M.F.)
- Ophthalmology, Department of Medical and Surgical Specialties, Azienda Ospedaliero Universitaria Pisana, 56124 Pisa, Italy; (G.C.); (G.G.)
| | - Chiara Posarelli
- Department of Surgical, Medical, Molecular Pathology and Critical Care Medicine, University of Pisa, 56126 Pisa, Italy; (F.B.); (M.N.M.); (M.F.)
- Ophthalmology, Department of Medical and Surgical Specialties, Azienda Ospedaliero Universitaria Pisana, 56124 Pisa, Italy; (G.C.); (G.G.)
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Batsos G, Bouratzis N, Kontomichos L, Casas DR, Atzamoglou S, Peponis V, Karagiannis D, Paroikakis E. A Novel Modified Surgical Approach for FIL SSF Lens. Cureus 2023; 15:e49857. [PMID: 38169895 PMCID: PMC10758903 DOI: 10.7759/cureus.49857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/30/2023] [Indexed: 01/05/2024] Open
Abstract
This study aimed to describe a novel modified surgical technique for FIL SSF lens (Rome, Italy: Soleko) implantation. A retrospective study of FIL SSF lens implantation on six eyes of six patients with subluxated or dislocated intraocular lens (IOL). Standard pars plana vitrectomy (PPV) was performed in all patients. The subluxated or dislocated IOL was removed from a 2.4 corneal incision. From the same incision, the folded FIL SSF lens was inserted. Then lens plugs were extremized through a 23G scleral incision inside two 4 mm pockets that were created at the beginning of the operation. In two cases one pocket had to be converted into a triagonal-shaped scleral flap. All scleral pockets were sutured with 7.0 Vicryl suture and the conjunctiva with 7.0 Vicryl. In the follow-up period of six months, the lens is centered and not tilted. The refractive outcome is within the expectations. Visual acuity is improved in all patients. No haptic exposure and no other complications were noted in all cases. FIL SSF lens is a good option for treating aphakia. This modified implantation technique is safe, fast, and easy. It is also versatile, combining the advantages of both previously described techniques, as it gives the option of flap conversion if needed. Larger studies and prospective comparative studies can highlight the best and more appropriate technique.
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Affiliation(s)
- Georgios Batsos
- First Department of Ophthalmology, Specialized Eye Hospital, Ophthalmiatreio Athinon, Athens, GRC
| | - Nikolaos Bouratzis
- First Department of Ophthalmology, Specialized Eye Hospital, Ophthalmiatreio Athinon, Athens, GRC
| | - Loukas Kontomichos
- First Department of Ophthalmology, Specialized Eye Hospital, Ophthalmiatreio Athinon, Athens, GRC
| | - Diego Ruiz Casas
- Department of Ophthalmology, Ramon y Cajal Hospital, Madrid, ESP
| | - Spyros Atzamoglou
- First Department of Ophthalmology, Specialized Eye Hospital, Ophthalmiatreio Athinon, Athens, GRC
| | - Vasileios Peponis
- First Department of Ophthalmology, Specialized Eye Hospital, Ophthalmiatreio Athinon, Athens, GRC
| | - Dimitris Karagiannis
- Second Department of Ophthalmology, Specialized Eye Hospital, Ophthalmiatreio Athinon, Athens, GRC
| | - Efstratios Paroikakis
- Second Department of Ophthalmology, Specialized Eye Hospital, Ophthalmiatreio Athinon, Athens, GRC
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Huang JJ, Waldner D, Huang JJ, Huang JM, Huang P, Teichman JC, Darvish-Zargar M, Gooi P. Face and Content Validity of an Artificial Eye Model for Secondary Intraocular Lens Fixation via Yamane Technique. Clin Ophthalmol 2023; 17:2063-2069. [PMID: 37496849 PMCID: PMC10368112 DOI: 10.2147/opth.s419464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Accepted: 07/10/2023] [Indexed: 07/28/2023] Open
Abstract
Purpose To assess the face and content validity of an artificial eye model for secondary intraocular lens (IOL) fixation via the Yamane technique. Methods Ophthalmologists and residents participated in a 90-minute simulation session on secondary IOL fixation via the Yamane technique. Hands-on practice of this technique was performed on an artificial eye, the Bioniko Okulo BR8. After, all ophthalmologists answered an 18-question survey assessing the face and content validity of the model. Survey responses were recorded on a 5-point double-headed Likert scale, ranging from strongly agree (1)-to-strongly disagree (5) (Figure 1). Results Twenty-three surveys were completed. Respondents rated the survey with a median response of 1 (strongly agree)-to-3 (neutral). Highest ratings for the model were received for "usefulness for training residents", and "easier to set up and clean-up compared to a cadaver". Lowest ratings were received for realism of the model compared to cadaveric eyes. Statistical analysis revealed no significant difference among identified groups. Ratings for face and content validity were viewed favorably, both with an overall median response of 2.00 (agree). Conclusion The Bioniko Okulo BR8 shows promise as a valid tool for practicing secondary IOL fixation via the Yamane technique. Considering recent guidelines in competency-based ophthalmology education programs, this model may be a valuable tool over traditional techniques for teaching and improving surgical skill amongst trainees.
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Affiliation(s)
- Jordan J Huang
- Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Derek Waldner
- Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Division of Ophthalmology, University of Calgary, Calgary, Alberta, Canada
| | - Jaxon J Huang
- John A. Burns School of Medicine, University of Hawaii, Honolulu, HI, USA
| | - Joshua M Huang
- Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Paul Huang
- Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Division of Ophthalmology, University of Calgary, Calgary, Alberta, Canada
| | - Joshua C Teichman
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada
- Division of Ophthalmology, Trillium Health Partners, Mississauga, Ontario, Canada
| | | | - Patrick Gooi
- Division of Ophthalmology, University of Calgary, Calgary, Alberta, Canada
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Carlà MM, Boselli F, Giannuzzi F, Caporossi T, Gambini G, Mosca L, Savastano A, Rizzo S. Sutureless scleral fixation Carlevale IOL: a review on the novel designed lens. Int Ophthalmol 2022; 43:2129-2138. [DOI: 10.1007/s10792-022-02579-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 11/12/2022] [Indexed: 11/27/2022]
Abstract
AbstractBackground: Complicated cataract surgery is the main cause of secondary lens implantation surgery. Several approaches have been introduced to face those circumstances. As it concerns scleral-fixated IOLs for the posterior chamber, many types of IOL can be implanted. The aim of article is to review the single piece sutureless scleral fixation Carlevale lens; Methods: Narrative review; Results: Several works described as safe the IOL implantation utilizing the handshake approach, without tactile manipulation, which allows for self-centration and lens firm fixation in uncomplicated surgery. This allows to reduce high order aberration such as astigmatism and coma, with a very good postoperative BCVA Conclusions: Carlevale lens is one of the best option to manage insufficient capsular support.
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