| Autor: |
Marolo P; Department of Ophthalmology, University of Turin, 10126 Turin, Italy., Caselgrandi P; Department of Ophthalmology, University of Turin, 10126 Turin, Italy., Gaidano M; Department of Ophthalmology, University of Turin, 10126 Turin, Italy., Conte F; Department of Ophthalmology, University of Turin, 10126 Turin, Italy., Parisi G; Department of Ophthalmology, University of Turin, 10126 Turin, Italy., Borrelli E; Department of Ophthalmology, University of Turin, 10126 Turin, Italy., Fallico M; Department of Ophthalmology, University of Catania, 95123 Catania, Italy., Toro MD; Department of General Ophthalmology, Medical University of Lublin, 20079 Lublin, Poland.; Eye Clinic, Public Health Department, Federico II University, 80131 Naples, Italy., Ventre L; Department of Ophthalmology, Beauregard Hospital, 11100 Aosta, Italy., Vaiano AS; Institute of Ophthalmology, Santa Croce e Carle Hospital, 12100 Cuneo, Italy., Reibaldi M; Department of Ophthalmology, University of Turin, 10126 Turin, Italy. |
| Abstrakt: |
Objectives: This study compared long-term surgical outcomes of the scleral flap versus scleral pocket technique for sutureless intrascleral one-piece intraocular lens (IOL) fixation. Methods : A retrospective comparative study was conducted at a single center, involving consecutive patients undergoing sutureless intrascleral one-piece IOL implantation, between January 2020 and May 2022. Eyes were divided into two groups based on the surgical technique: group 1 underwent scleral flap (n = 64), and group 2 received scleral pocket technique ( n = 59). Visual acuity, refractive outcomes, and complications were assessed over a minimum 24-month follow-up period. Results : Both groups showed improvements in best-corrected visual acuity (BCVA), increasing from 0.84 ± 0.56 logMAR at baseline to 0.39 ± 0.23 logMAR ( p = 0.042) at 24 months in group 1 and from 0.91 ± 0.63 logMAR at baseline to 0.45 ± 0.38 logMAR ( p = 0.039) at 24 months in group 2. No significant differences in BCVA were observed between the groups at baseline ( p = 0.991), 12 ( p = 0.496) and 24 months ( p = 0.557). Mean spherical equivalent (-0.73 ± 1.32 D in group 1 and -0.92 ± 0.99 D in group 2, p = 0.447), refractive prediction error (-0.21 ± 1.1 D in group 1 and -0.35 ± 1.8 D in group 2, p = 0.377), and surgically induced astigmatism (0.74 ± 0.89 D in group 1 and 0.85 ± 0.76 in group 2, p = 0.651) were comparable between the two groups. An IOL tilt of 5.5 ± 1.8 and 5.8 ± 2.0 degrees ( p = 0.867) and an IOL decentration of 0.41 ± 0.21 mm and 0.29 ± 0.11 mm ( p = 0.955) were obtained, respectively, in group 1 and group 2 at 24 months. Mean endothelial cell density remained stable at 24 months in both groups ( p = 0.832 in group 1 and p = 0.443 in group 2), and it was 1747.20 ± 588.03 cells/mm 2 in group 1 and 1883.71 ± 621.29 cells/mm 2 in group 2 ( p = 0.327) at baseline, 1545.36 ± 442.3 cells/mm 2 in group 1 and 1417.44 ± 623.40 cells/mm 2 in group 2 ( p = 0.483) at 24 months. No cases of endophthalmitis were observed. Conclusions : The scleral pocket technique for sutureless intrascleral one-piece IOL fixation is comparable to the traditional scleral flap technique in terms of long-term visual outcomes and safety. The scleral pocket technique offers a simplified approach and a viable option even for less experienced surgeons. |
