Needle versus VacuFix enclavation of iris fixated intraocular lenses

• Autores: Omar A. Barrada, Marizol Gonzales, Celso D. Ponce, José Luis Güell Villanueva
• Localización: Journal of Emmetropia: Journal of Cataract, Refractive and Corneal Surgery, ISSN-e 2171-4703, Vol. 7, Nº. 1, 2016, págs. 23-31
• Idioma: inglés
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• Resumen

  • PURPOSE: To compare needle enclavation to the newer VacuFix enclavation of iris fi xated intraocular lenses in terms of visual/refractive outcomes, ease of positioning, postoperative pigment dispersion onto the lens surface, amount of horizontal iris capture and lens/iris distance.

    SETTING: Instituto de Microcirugía Ocular (IMO), Barcelona, Spain.

    METHODS: Prospective, interventional, comparative study. Patients were assigned to have intraocular lens (IOL) transplant using the enclavation needle in one eye and the VacuFix system in the other. Th e number of attempts needed to enclavate the haptics during the procedure was noted. Postoperatively, all eyes were followed up at one day, one week and three months. At follow-up, refraction, uncorrected/best-corrected visual acuities, anterior chamber fl are and cells, and cells present on the surface of the IOL were noted. Th ree months postoperatively, anterior segment optical coherence tomography was performed to assess both the amount of tissue included in the enclavation (iris bridge), and the distance of the posterior surface of the IOL from the anterior surface of the iris (lens/iris distance).

    RESULTS: Forty eyes of twenty patients were included. Postoperative mean uncorrected distance visual acuity (UDVA) was 0.11 ± 0.23 logMAR and 0.12 ± 0.20 logMAR (p = 0.99), and postoperative spherical equivalent (SE) was −0.06 ± 0.71 and +0.10 ± 1.28 (p = 0.72) with 100% and 88.9% of eyes within ±1 dioptre (D) of the intended postoperative refraction in the needle and VacuFix groups, respectively. Both enclavation techniques were equal in terms of pigment deposition on the IOL, postoperative infl ammation, lens/ iris distance and ease of enclavation. Iris-bridge was statistically greater (267.2 ± 63.4 μm;

    p < 0.01) but more inconsistent (range 224 - 332 μm) in the needle group than in the VacuFix group (232.4 ± 17.8 μm; range 222 - 241μm).

    CONCLUSION: VacuFix enclavation of iris-fi xated IOLs is as safe and effi cient as the needle fi xation technique. Iris-bridge was statistically greater and less consistent in the needle than in the VacuFix group.