Abstract:

Objective

The aim of this study is to observe the clinical efficacy of using sutureless intrascleral fixation of posterior chamber intraocular lens in eyes without capsular support and eyes with subluxation or complete luxation of lens.

Methods

The clinical data of 17 cases（17 eyes）without capsular support and 18 cases（18 eyes）with subluxation or complete luxation of lens treated with sutureless intrascleral fixation of intraocular lens，combined with anterior or complete vitrectomy，from November 2022 to November 2023 in Shandong Lunan Eye Hospital were analyzed retrospectively.The follow-up time was 3～12 months.The postoperative uncorrected visual acuity（UCVA），best corrected visual acuity（BCVA），intraocular pressure，stability of the intraocular lens，and surgical complications were observed.UCVA，BCVA，the intraocular pressure and astigmatism refractive error followed a normal distribution and were described using±s and used by paired t-tests for preoperative and postoperative comparisons.

Results

In this study，there were 17 cases（17 eyes）without capsular support，accounting for 48.57%，including 1 case（1 eye）requiring anterior vitrectomy，accounting for 5.88%；8 cases（8 eyes）of complete luxation of lens，accounting for 22.86%；and 10 cases（10 eyes）of subluxation of lens，accounting for 28.57%；with 8 cases（8 eyes）having elevated intraocular pressure，accounting for 22.86%.The preoperative and postoperative UCVA were（1.56±0.63）logMAR and（0.50±0.44）logMAR，respectively，with a statistically significant difference（t＝8.60，P＜0.05）.The preoperative and postoperative BCVA were（0.73±0.56）logMAR and（0.36±0.45）logMAR，respectively，with a statistically significant difference（t＝3.16，P＜0.05）.The preoperative and postoperative intraocular pressure were（20.6±10.7）mmHg（1 mmHg＝0.133 kPa）and（14.0±4.4）mmHg，respectively，with a statistically significant difference（t＝3.54，P＜0.05）.The position of intraocular lens in all eyes was centrally after surgery without apparent deviation or tilt.Postoperatively，two cases（2 eyes）had mild vitreous hemorrhage，accounting for 5.71%；1 case（1 eye）had transiently elevated intraocular pressure，accounting for 2.86%；and 1 case（1 eye）had subluxation of intraocular len，accounting for 2.86%.There were no serious complications such as subchoroidal expulsive hemorrhage，retinal detachment，or intraocular inflammation during surgery and postoperative follow-up.

Conclusions

osterior chamber intraocular lens of sutureless intrascleral fixation can be used for the treatment of eyes without capsular support or eyes with subluxation or complete luxation of lens.The procedure of operation is simple，with less surgery complications，and is safe and effective，demonstrating clinical value for promotion.

Key words: No capsule, Intraocular lens, Sclera, Fixation, Sutureless