DOI: 10.36347/sasjm.2023.v09i10.018

Pages: 1125-1131

Implantation of an intraocular lens (IOL) in the capsular bag is considered the gold standard in cataract surgery. However, ophthalmologists often face patients with aphakia or insufficient capsular support following complicated cataract surgery, trauma or various zonulopathies. In such cases, the implantation of an IOL in the capsular bag is risky or impossible. Managing this type of patients remains a real challenge for surgeons, despite the considerable progress made in secondary implantation techniques. Lately, the new Carlevale Sutureless scleral fixation implant has enlarged this therapeutic arsenal, establishing itself as an attractive alternative for secondary implantation, offering good functional results with a low complication rate. We conducted a prospective interventional study including 15 eyes diagnosed with aphakia, subluxation or dislocation of an intraocular implant. All our patients consulted in the ophthalmology department of Jacques Coeur hospital in Bourges between November 2020 and November 2021. Our patients underwent secondary implantation surgery by Sutureless scleral fixation technique (SSF) with a Carlevale-type lens (Soleko, Italy). The post-operative follow-up was adjusted to the evolution of each case, with a minimum of 12 months' follow-up. It included at each visit the assessment of the best corrected visual acuity (BCVA), refraction, Intra-ocular pressure, clinical ophthalmic examination and endothelial cellularity count. The mean age of our patients was 76 ± 13.5 years, with a slight male predominance (53%). The indication for the secondary implantation surgery was the presence of aphakia in 60% of cases. IOL subluxation was noted in 33% of cases, while the remaining 6% concerned intraocular implants dislocated in the vitreous cavity. Mean best corrected visual acuity (BCVA) was 0.7 ± 0.25 log MAR preoperatively and 0.15 ± 0.33 log MAR at one year postoperatively, representing a mean gain of 5 lines on the Snellen scale. ........