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Madhivanan N, Nivean PD, Singh V, Singh H, Arthi M, Madanagopalan VG. Long term surgical results and safety profile of the novel CM T Flex scleral fixated intraocular lens. Int Ophthalmol 2024; 44:327. [PMID: 38997613 DOI: 10.1007/s10792-024-03167-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2024] [Accepted: 06/15/2024] [Indexed: 07/14/2024]
Abstract
PURPOSE To report the long term visual outcomes and complications with use of the novel CM-T Flex scleral fixated intraocular lens (CMT-SFIOL). MATERIALS AND METHODS 116 eyes that underwent CMT-SFIOL were reviewed and 57 eyes with CMT-SFIOL that completed a 2-year follow-up were included. Main outcome measures noted were best-corrected visual acuity (BCVA) and complications. Postoperatively, follow-ups were done at 1 week (1w), 1 month (1 m), 1 year (1y) and 2-year (2y) intervals. RESULTS 40 (70.17%) of 57 eyes received CMT-SFIOL for surgical aphakia. Mean follow up was 39.77 ± 8.44 months. BCVA for distance & near improved from 1.26 ± 0.84 to 0.76 ± 0.77, 0.50 ± 0.72 and 0.51 ± 0.73 & 1.28 ± 0.58 to 0.98 ± 0.49, 0.92 ± 0.44 and 0.89 ± 0.40 at 1 m, 1y and 2y respectively (p < 0.001 for all). At 1w, 10 eyes (17.54%) had corneal edema (CE) and 8 eyes (14.03%) had anterior chamber (AC) reaction. Two eyes (3.50%) had IOP > 30 mm Hg and 1 eye (1.75%) had vitreous hemorrhage (VH). At 1 m, 3 eyes (5.26%) had CE and 5 eyes (8.77%) had AC reaction. Two eyes (3.50%) had IOP > 30 mm Hg and 1 eye (1.75%) had VH. Cystoid macular edema was noted in 3 eyes (5.26%). At 1y and 2y, 2 eyes (3.5%) and 1 eye (1.75%), had CE. No decentration, dislocation, haptic exposure or retinal detachment was noted. No eyes required resurgery. CONCLUSION CM-T Flex SFIOL is an effective method to correct aphakia, with reliable and safe long-term results.
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Affiliation(s)
- Nivean Madhivanan
- Cataract and Vitreoretinal Services, MN Eye Hospital, Chennai, India.
| | | | - Veer Singh
- Vitreoretinal Services, Sohan Singh Eye Hospital, Amritsar, India
| | - Harvinder Singh
- Vitreoretinal Services, Sohan Singh Eye Hospital, Amritsar, India
| | - M Arthi
- Cataract Services, JB Eye Hospital, Salem, India
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Drummond SC, Feist JE, Crosson JN, Haider AA, Fuerst JS, Hughes DA, Feist RM. Scleral Fixated Secondary IOLs: An Outcomes Comparison Between the Yamane and Gore-Tex-Sutured Techniques. Ophthalmic Surg Lasers Imaging Retina 2024; 55:384-390. [PMID: 38530983 DOI: 10.3928/23258160-20240226-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/28/2024]
Abstract
BACKGROUND AND OBJECTIVE Among secondary intraocular lens (IOL) techniques, scleral fixated IOLs (SFIOLs) offer advantages in cases without capsular support. In this article, we compare outcomes between two types of Gore-Tex scleral sutured IOLs with the Yamane technique. PATIENTS AND METHODS This study was a retrospective chart review of patients who underwent SFIOL implantation. RESULTS Analysis revealed a statistically significant improvement in final postoperative visual acuity (VA) for sutured SFIOLs (P < 0.001, Envista (n = 29) 95% CI 0.47 to 1.04, Akreos (n = 23) 95% CI 0.32 to 0.81) with no statistical improvement in the Yamane group (P = 0.44, n = 15, 95% CI -0.33 to 0.71). Outcomes analysis revealed greater incidences of cystoid macular edema (CME) in the Yamane cohort (P < 0.05) and a higher rate of reoperations in the Akreos cohort (P < 0.02). All complications related to suture material (n = 4) and IOL decentration (n = 2) occurred in the sutured SFIOL group. CONCLUSIONS The sutureless Yamane technique offered fewer subsequent surgeries and suture-specific complications while revealing diminished VA improvement in long-term follow-up compared to the sutured SFIOLs. [Ophthalmic Surg Lasers Imaging Retina 2024;55:384-390.].
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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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Ahmet S, Kemer Atik B, Kandemir Beşek N, Kırgız A, Gümüş Kasapoğlu G, Yayla Akıncılar G. Comparison of three techniques for simultaneous intraocular lens implantation in subluxated cataract surgery: Transconjunctival intrascleral, Z-suture knotless transscleral, and Cionni capsular tension ring assisted. Int Ophthalmol 2024; 44:152. [PMID: 38509438 DOI: 10.1007/s10792-024-03085-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 02/23/2024] [Indexed: 03/22/2024]
Abstract
PURPOSE To evaluate and compare the clinical outcomes of three different methods of intraocular lens (IOL) implantation in the surgery of subluxated cataracts. METHODS In this retrospective, comparative, clinical interventional study, the medical records of patients who underwent IOL implantation with sutureless 27-gauge needle-assisted transconjunctival intrascleral (Group 1), Z-suture knotless transscleral (Group 2), and Cionni capsular tension ring (Cionni-CTR) assisted (Group 3) simultaneously with subluxated cataract extraction between June 2010 and June 2022 were evaluated. Demographic characteristics, follow-up times, uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), spherical and cylindrical refractive values, and spherical equivalent (SE) values of three groups were compared. Intraoperative and postoperative complications were recorded. RESULTS There were 20 eyes in Group 1, 35 eyes in Group 2, and 40 eyes in Group 3. In all groups, statistically significant improvement was observed in postoperative UDVA and CDVA compared to preoperative values (each p < 0.05). There was no statistical difference between the groups in postoperative UDVA and CDVA values. (p = 0.130, p = 0.167 respectively). No significant difference was observed between the groups in terms of postoperative spherical, cylindrical, and SE values (each p > 0.05). CONCLUSION The study suggests that three different IOL implantation techniques for simultaneous IOL implantation in subluxated cataract surgery have similar effects on visual and refractive outcomes.
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Affiliation(s)
- Sibel Ahmet
- Department of Ophthalmology, University of Health Sciences Turkey, Beyoglu Eye Training and Research Hospital, Istanbul, Turkey.
| | - Burcu Kemer Atik
- Department of Ophthalmology, University of Health Sciences Turkey, Beyoglu Eye Training and Research Hospital, Istanbul, Turkey
| | - Nilay Kandemir Beşek
- Department of Ophthalmology, University of Health Sciences Turkey, Beyoglu Eye Training and Research Hospital, Istanbul, Turkey
| | - Ahmet Kırgız
- Department of Ophthalmology, University of Health Sciences Turkey, Beyoglu Eye Training and Research Hospital, Istanbul, Turkey
| | - Güneş Gümüş Kasapoğlu
- Department of Ophthalmology, University of Health Sciences Turkey, Beyoglu Eye Training and Research Hospital, Istanbul, Turkey
| | - Gizem Yayla Akıncılar
- Department of Ophthalmology, University of Health Sciences Turkey, Beyoglu Eye Training and Research Hospital, Istanbul, Turkey
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Ripa M, Angunawela R, Motta L. SCLERAL FIXATION OF CARLEVALE INTRAOCULAR LENS: A Systematic Review and Meta-Analysis. Retina 2023; 43:1750-1762. [PMID: 37399540 DOI: 10.1097/iae.0000000000003873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/05/2023]
Abstract
PURPOSE The mean change in best-corrected visual acuity (BCVA), intraocular pressure, and endothelial cell counts after intraocular lens (IOL) implantation and the incidence rate of postoperative complications were estimated by systematic review and meta-analysis to assess the surgical and refractive outcomes of the sutureless scleral fixation Carlevale IOL. METHODS A literature search was conducted using PubMed, Embase, and Scopus. The weighted mean difference (WMD) was used to present the mean change in BCVA, intraocular pressure, and endothelial cell count after IOL implantation, whereas a proportional meta-analysis was used to estimate the pooled incidence rate of postoperative complications. RESULTS In the meta-analysis of 13 studies involving 550 eyes, the pooled WMD of the mean change in BCVA showed a significant improvement in BCVA in patients who underwent Carlevale IOL implantation (WMD = 0.38, 95% confidence interval: 0.30-0.46, P < 0.001; heterogeneity [I 2 ] = 52.02%). The subgroup analyses indicated that the mean change in BCVA was not significantly higher according to the last follow-up visit, with no statistically significant subgroup effect ( P = 0.21) (WMD up to 6 months: 0.34, 95% confidence interval: 0.23-0.45, I 2 = 58.32%, WMD up to 24 months: 0.42, 95% confidence interval: 0.34-0.51, I 2 = 38.08%). In the meta-analysis of 16 studies involving 608 eyes, the pooled incidence rate of postoperative complications was equal to 0.22 (95% confidence interval: 0.13-0.32, I 2 = 84.87, P ≤ 0.001). CONCLUSION Carlevale IOL implantation represents a reliable method of restoring vision in eyes with missing capsular or zonular support.
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Affiliation(s)
- Matteo Ripa
- Department of Ophthalmology, William Harvey Hospital, East Kent Hospitals University NHS Foundation Trust, Ashford, United Kingdom; and
| | | | - Lorenzo Motta
- Department of Ophthalmology, William Harvey Hospital, East Kent Hospitals University NHS Foundation Trust, Ashford, United Kingdom; and
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Advances in the Management of Aphakia. J Ophthalmol 2022; 2022:9841758. [PMID: 35388354 PMCID: PMC8977344 DOI: 10.1155/2022/9841758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 03/08/2022] [Indexed: 11/18/2022] Open
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