title: Long-term analysis of IOL stability of the Lewis technique for scleral fixation.
abstract: OBJECTIVE
  To demonstrate that in case of absence of capsular support intraocular lens (IOL) scleral fixation is both effective and stable over years.
  
  
  METHODS
  A total of 13 eyes from 13 patients who underwent an IOL scleral fixation according to Lewis suturing technique between January 2001 and December 2008 were studied. Patients underwent a complete ophthalmologic evaluation. The IOL stability was assessed using slit-lamp and anterior segment optical coherence tomography (AS-OCT) examination. The IOL stability was evaluated in terms of centration and tilting. All the knots were photographed and their integrity assessed.
  
  
  RESULTS
  Follow-up was 60-129 months. Eleven knots appeared evident and undamaged, 6 knots were eroded, and 9 knots were not detectable. All IOLs were stable in the sulcus. Two patients presented a slight decentration of the IOL at the slit-lamp examination, while the AS-OCT demonstrated slight tilting of the lenses in 4 patients.
  
  
  CONCLUSIONS
  The Lewis technique for IOL scleral fixation is an optimal surgical technique in case of absence of capsular support. No IOL luxation in the vitreous chamber has been reported; only 2 of the 10 patients with at least one eroded knot presented a minimal decentration of the lens with no influence on visual acuity. Although knot erosion is not an uncommon occurrence, IOL remains stable in the long term, probably due to a fibrotic process around the suture, and the IOL haptics, which prevent IOL dislocation.
authors.affiliation: Institute of Ophthalmology, University of Modena, Modena - Italy.
authors.forename: Gian Maria
authors.initials: GM
authors.lastname: Cavallini
authors.affiliation: Institute of Ophthalmology, University of Modena, Modena - Italy.
authors.forename: Veronica
authors.initials: V
authors.lastname: Volante
authors.affiliation: Institute of Ophthalmology, University of Modena, Modena - Italy.
authors.forename: Michele
authors.initials: M
authors.lastname: De Maria
authors.affiliation: Institute of Ophthalmology, University of Modena, Modena - Italy.
authors.forename: Giulio
authors.initials: G
authors.lastname: Torlai
authors.affiliation: Institute of Ophthalmology, University of Modena, Modena - Italy.
authors.forename: Matteo
authors.initials: M
authors.lastname: Forlini
authors.affiliation: Institute of Ophthalmology, University of Modena, Modena - Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Chiesi
authors.affiliation: Institute of Ophthalmology, University of Modena, Modena - Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Campi
authors.affiliation: Department of Surgical and Biomedical Sciences, University of Perugia, Ospedale S. Maria della Misericordia, Sant'Andrea delle Fratte, Perugia - Italy.
authors.forename: Carlo
authors.initials: C
authors.lastname: Cagini
mesh_terms: D000328:Adult; D000368:Aged; D000869:Anterior Eye Segment / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D019654:Lens Implantation, Intraocular / Q000379:methods*; D007906:Lens Subluxation / Q000601:surgery; D007910:Lenses, Intraocular; D008297:Male; D008875:Middle Aged; D019591:Pseudophakia / Q000503:physiopathology; D012189:Retrospective Studies; D012590:Sclera / Q000601:surgery*; D066167:Slit Lamp; D013536:Suture Techniques; D041623:Tomography, Optical Coherence; D014792:Visual Acuity / Q000502:physiology