Endoscope-assisted transscleral suture fixation to reduce the incidence of intraocular lens dislocation.
OBJECTIVE
To examine the surgical complications of transscleral sulcus suture of posterior chamber intraocular lenses (IOLs) and to compare the rates of surgical complications between patients in the nonendoscope-assisted and endoscope-assisted groups.


METHODS
Kyoto University Hospital, Kyoto, Japan.


METHODS
This retrospective nonrandomized study comprised 121 eyes of 115 patients who had transscleral sulcus suture fixation of an IOL by the ab externo method. Typical 3-port vitrectomy was performed in 26 eyes in which the needle entry site and the haptic location were controlled using an endoscope.


RESULTS
During follow-up of at least 3 months, surgical complications in the nonendoscope-assisted group (95 eyes) included IOL dislocation in 22 eyes (23%), high astigmatism in 12 eyes (13%), transient ocular hypertension in 10 eyes (11%), vitreous hemorrhage in 5 eyes (5.3%), retinal detachment in 4 eyes (4.2%), and cystoid macular edema in 2 eyes (2.0%). In the endoscope-assisted group (26 eyes), the same complications were markedly decreased: there were no cases of IOL dislocation, high astigmatism, vitreous hemorrhage, retinal detachment, or cystoid macular edema; transient ocular hypertension occurred in 1 eye (3.8%). There was a statistically significant difference in the incidence of IOL dislocation between the 2 groups (P<.01).


CONCLUSIONS
Using an endoscope for transscleral sulcus suturing of an IOL can be an effective technique to reduce surgical complications, especially postoperative IOL dislocation.
Sasahara
Manabu
M
Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan.
Kiryu
Junichi
J
Yoshimura
Nagahisa
N
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004724:Endoscopy / Q000379:methods*; D005260:Female; D005548:Foreign-Body Migration / Q000517:prevention & control*; D006801:Humans; D015994:Incidence; D007431:Intraoperative Complications / Q000517:prevention & control; D019654:Lens Implantation, Intraocular / Q000379:methods*; D007910:Lenses, Intraocular; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000517:prevention & control; D012189:Retrospective Studies; D012590:Sclera / Q000601:surgery*; D013536:Suture Techniques; D014792:Visual Acuity; D014821:Vitrectomy