Simplified and safe method of sutureless intrascleral posterior chamber intraocular lens fixation: Y-fixation technique.
Identifieur interne : 000E40 ( Main/Exploration ); précédent : 000E39; suivant : 000E41Simplified and safe method of sutureless intrascleral posterior chamber intraocular lens fixation: Y-fixation technique.
Auteurs : Toshihiko Ohta [Japon] ; Hiroshi Toshida [Japon] ; Akira Murakami [Japon]Source :
- Journal of cataract and refractive surgery [ 1873-4502 ] ; 2014.
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Abstract
We report a new surgical technique that allows intrascleral fixation of a posterior chamber intraocular lens (IOL) without sutures. The Y-fixation technique does not involve complicated intraocular manipulation and achieves safe sutureless fixation. A Y-shaped incision is made in the sclera and a 24-gauge microvitreoretinal (MVR) knife is used to create the sclerotomy instead of a needle. The Y-shaped incision eliminates the need to raise a large lamellar scleral flap and to use fibrin glue because the haptic can be fixed both inside the tunnel and in the groove, and performing the sclerotomy with the 24-gauge MVR knife simplifies extraction of the haptic and improves wound closure. There is no risk of infection from exposure of the haptic on the sclera and no use of fibrin glue. There was significantly less IOL decentration and tilt than with suture fixation.
DOI: 10.1016/j.jcrs.2013.11.003
PubMed: 24355716
Affiliations:
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Electronic address: ohta803@mist.ocn.ne.jp.</nlm:affiliation><country xml:lang="fr">Japon</country><wicri:regionArea>From the Department of Ophthalmology (Ohta, Toshida), Juntendo University Shizuoka Hospital, Shizuoka and the Department of Ophthalmology (Murakami), Juntendo University School of Medicine, Tokyo</wicri:regionArea><placeName><settlement type="city">Tokyo</settlement></placeName></affiliation></author><author><name sortKey="Toshida, Hiroshi" sort="Toshida, Hiroshi" uniqKey="Toshida H" first="Hiroshi" last="Toshida">Hiroshi Toshida</name><affiliation wicri:level="3"><nlm:affiliation>From the Department of Ophthalmology (Ohta, Toshida), Juntendo University Shizuoka Hospital, Shizuoka and the Department of Ophthalmology (Murakami), Juntendo University School of Medicine, Tokyo, Japan.</nlm:affiliation><country xml:lang="fr">Japon</country><wicri:regionArea>From the Department of Ophthalmology (Ohta, Toshida), Juntendo University Shizuoka Hospital, Shizuoka and the Department of Ophthalmology (Murakami), Juntendo University School of Medicine, Tokyo</wicri:regionArea><placeName><settlement type="city">Tokyo</settlement></placeName></affiliation></author><author><name sortKey="Murakami, Akira" sort="Murakami, Akira" uniqKey="Murakami A" first="Akira" last="Murakami">Akira Murakami</name><affiliation wicri:level="3"><nlm:affiliation>From the Department of Ophthalmology (Ohta, Toshida), Juntendo University Shizuoka Hospital, Shizuoka and the Department of Ophthalmology (Murakami), Juntendo University School of Medicine, Tokyo, Japan.</nlm:affiliation><country xml:lang="fr">Japon</country><wicri:regionArea>From the Department of Ophthalmology (Ohta, Toshida), Juntendo University Shizuoka Hospital, Shizuoka and the Department of Ophthalmology (Murakami), Juntendo University School of Medicine, Tokyo</wicri:regionArea><placeName><settlement type="city">Tokyo</settlement></placeName></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2014">2014</date><idno type="doi">10.1016/j.jcrs.2013.11.003</idno><idno type="RBID">pubmed:24355716</idno><idno type="pmid">24355716</idno><idno type="wicri:Area/PubMed/Corpus">000787</idno><idno type="wicri:Area/PubMed/Curation">000787</idno><idno type="wicri:Area/PubMed/Checkpoint">000537</idno><idno type="wicri:Area/Ncbi/Merge">002B77</idno><idno type="wicri:Area/Ncbi/Curation">002B77</idno><idno type="wicri:Area/Ncbi/Checkpoint">002B77</idno><idno type="wicri:Area/Main/Merge">000E39</idno><idno type="wicri:Area/Main/Curation">000E40</idno><idno type="wicri:Area/Main/Exploration">000E40</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Simplified and safe method of sutureless intrascleral posterior chamber intraocular lens fixation: Y-fixation technique.</title><author><name sortKey="Ohta, Toshihiko" sort="Ohta, Toshihiko" uniqKey="Ohta T" first="Toshihiko" last="Ohta">Toshihiko Ohta</name><affiliation wicri:level="3"><nlm:affiliation>From the Department of Ophthalmology (Ohta, Toshida), Juntendo University Shizuoka Hospital, Shizuoka and the Department of Ophthalmology (Murakami), Juntendo University School of Medicine, Tokyo, Japan. Electronic address: ohta803@mist.ocn.ne.jp.</nlm:affiliation><country xml:lang="fr">Japon</country><wicri:regionArea>From the Department of Ophthalmology (Ohta, Toshida), Juntendo University Shizuoka Hospital, Shizuoka and the Department of Ophthalmology (Murakami), Juntendo University School of Medicine, Tokyo</wicri:regionArea><placeName><settlement type="city">Tokyo</settlement></placeName></affiliation></author><author><name sortKey="Toshida, Hiroshi" sort="Toshida, Hiroshi" uniqKey="Toshida H" first="Hiroshi" last="Toshida">Hiroshi Toshida</name><affiliation wicri:level="3"><nlm:affiliation>From the Department of Ophthalmology (Ohta, Toshida), Juntendo University Shizuoka Hospital, Shizuoka and the Department of Ophthalmology (Murakami), Juntendo University School of Medicine, Tokyo, Japan.</nlm:affiliation><country xml:lang="fr">Japon</country><wicri:regionArea>From the Department of Ophthalmology (Ohta, Toshida), Juntendo University Shizuoka Hospital, Shizuoka and the Department of Ophthalmology (Murakami), Juntendo University School of Medicine, Tokyo</wicri:regionArea><placeName><settlement type="city">Tokyo</settlement></placeName></affiliation></author><author><name sortKey="Murakami, Akira" sort="Murakami, Akira" uniqKey="Murakami A" first="Akira" last="Murakami">Akira Murakami</name><affiliation wicri:level="3"><nlm:affiliation>From the Department of Ophthalmology (Ohta, Toshida), Juntendo University Shizuoka Hospital, Shizuoka and the Department of Ophthalmology (Murakami), Juntendo University School of Medicine, Tokyo, Japan.</nlm:affiliation><country xml:lang="fr">Japon</country><wicri:regionArea>From the Department of Ophthalmology (Ohta, Toshida), Juntendo University Shizuoka Hospital, Shizuoka and the Department of Ophthalmology (Murakami), Juntendo University School of Medicine, Tokyo</wicri:regionArea><placeName><settlement type="city">Tokyo</settlement></placeName></affiliation></author></analytic><series><title level="j">Journal of cataract and refractive surgery</title><idno type="eISSN">1873-4502</idno><imprint><date when="2014" type="published">2014</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Humans</term><term>Intraoperative Complications</term><term>Lens Implantation, Intraocular (methods)</term><term>Lenses, Intraocular</term><term>Phacoemulsification</term><term>Postoperative Complications</term><term>Retrospective Studies</term><term>Sclera (surgery)</term><term>Sclerostomy</term><term>Suture Techniques</term></keywords><keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Lens Implantation, Intraocular</term></keywords><keywords scheme="MESH" qualifier="surgery" xml:lang="en"><term>Sclera</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Humans</term><term>Intraoperative Complications</term><term>Lenses, Intraocular</term><term>Phacoemulsification</term><term>Postoperative Complications</term><term>Retrospective Studies</term><term>Sclerostomy</term><term>Suture Techniques</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">We report a new surgical technique that allows intrascleral fixation of a posterior chamber intraocular lens (IOL) without sutures. The Y-fixation technique does not involve complicated intraocular manipulation and achieves safe sutureless fixation. A Y-shaped incision is made in the sclera and a 24-gauge microvitreoretinal (MVR) knife is used to create the sclerotomy instead of a needle. The Y-shaped incision eliminates the need to raise a large lamellar scleral flap and to use fibrin glue because the haptic can be fixed both inside the tunnel and in the groove, and performing the sclerotomy with the 24-gauge MVR knife simplifies extraction of the haptic and improves wound closure. There is no risk of infection from exposure of the haptic on the sclera and no use of fibrin glue. 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