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Scleral fixation of subluxated or dislocated multifocal and multifocal toric intraocular lenses

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Abstract

Purpose

To evaluate the feasibility of scleral fixation of subluxated or dislocated multifocal/multifocal toric intraocular lenses (IOLs) to rescue the IOL and restore both near and far vision.

Method

A total of 18 eyes of 17 patients who underwent transscleral or intrascleral fixation of subluxated or dislocated multifocal or multifocal toric IOLs at 2.5 mm posterior to the limbus were enrolled. Preoperative uncorrected distance visual acuity (UDVA) and postoperative UDVA values were compared in this retrospective cross-sectional study. The postoperative corrected distance visual acuity (CDVA), uncorrected near visual acuity (UNVA) at 40 cm, residual sphere, cylinder, spherical equivalent, and IOL centration were evaluated.

Results

The mean follow-up period was 4.0 ± 5.0 months. The mean preoperative UDVA was 0.73 ± 0.71 logMAR and the postoperative UDVA was 0.05 ± 0.10 logMAR, which was significantly improved relative to the preoperative UDVA. The mean postoperative CDVA was 0.00 ± 0.00 logMAR and the mean postoperative UNVA at 40 cm was 0.05 ± 0.07 logMAR. The mean postoperative residual sphere, cylinder, and spherical equivalent values were − 0.21 ± 0.41 D, − 0.29 ± 0.26 CD, and − 0.33 ± 0.39 D, respectively. Postoperative anterior segment photographs showed good centration of optics in all cases of single-piece foldable multifocal IOLs but a slight inferior decentration in one case of a three-piece multifocal IOL.

Conclusion

Scleral fixation of subluxated or dislocated multifocal and multifocal toric IOLs could be one of the treatment options to rescue subluxated or dislocated multifocal IOLs and restore both near and far vision.

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Funding

This research was supported by a TRC Research Grant of the Korea University Medicine and Korea Institute of Science and Technology; by Korea University Ansan Hospital grant; by Korea University grants (K1625491, K1722121, K1811051, K1913161, and K2010921); by the Korea Medical Device Development Fund grant funded by the Korea government (the Ministry of Science and ICT, the Ministry of Trade, Industry and Energy, the Ministry of Health & Welfare, the Ministry of Food and Drug Safety) (Project Number: 9991007583, KMDF_PR_20200901_0296); by Korea Environment Industry & Technology Institute(KEITI) through Technology Development Project for Safety Management of Household Chemical Products, funded by Korea Ministry of Environment (MOE) (2020002960007, NTIS-1485017544); by the Technology development Program(S3127902) funded by the Ministry of SMEs and Startups(MSS, Korea); and by the National Research Foundation of Korea (NRF) grant funded by the Korea government (MSIT) (NRF-2021R1F1A1062017).

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Authors and Affiliations

  1. Department of Ophthalmology, Korea University Ansan Hospital, Gyeonggi-do, Republic of Korea

    Seo Yeon Park, Youngsub Eom, Young Joo Lee & Young Choi

  2. Department of Ophthalmology, Korea University College of Medicine, Seoul, Republic of Korea

    Youngsub Eom, Jong Suk Song & Hyo Myung Kim

  3. Department of Ophthalmology, Gyeongsang National University Hospital and Gyeongsang National University College of Medicine, Jinju, Republic of Korea

    Seong-Jae Kim

  4. Institute of Health Science, Gyeongsang National University, Jinju, Republic of Korea

    Seong-Jae Kim

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  1. Seo Yeon Park
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Correspondence to Youngsub Eom.

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Ethical approval

All procedures performed in studies involving human participants were in accordance with the Institutional Review Board of Korea University Ansan Hospital (IRB no. 2021AS0231) and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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According to the IRB standard operating procedures on retrospective clinical study, the Ethics Committee ruled that subject consent was not required for this study.

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Supplementary Information

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Supplementary file1 (WMV 93170 KB) Video 1. Surgery video of case 7. 9-0 polypropylene was passed through the CTR and suture fixation was performed 2.5 mm posterior to the limbus.

Supplementary file2 (WMV 118374 KB) Video 2. Surgery video of case 9. 9-0 polypropylene was tied to the optic–haptic junction.

Supplementary file3 (WMV 141530 KB) Video 3. Surgery video of case 15. IOL was fixed using an Eom’s double loop fixation method using one 9-0 polypropylene suture

Supplementary file4 (WMV 93381 KB) Video 4. Surgery video of case 12. Flanged intrascleral IOL fixation with modified double-needle technique was performed.

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Park, S.Y., Eom, Y., Lee, Y.J. et al. Scleral fixation of subluxated or dislocated multifocal and multifocal toric intraocular lenses. Graefes Arch Clin Exp Ophthalmol 260, 1195–1203 (2022). https://doi.org/10.1007/s00417-021-05498-1

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