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Preferred surgical techniques for secondary intraocular lens implantation in adults with aphakia

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Abstract

Aim

To identify the current surgical management of aphakia and the outcomes and complications of each technique.

Methods

This cross-sectional study included ophthalmic surgeons with at least one-year experience in surgery for aphakia. A study questionnaire was formulated to collect data in Saudi Arabia and other regional countries. The questionnaire included 22 questions on demographics, preferred surgical techniques, complications and the factors related to surgeon decision and the choice for managing aphakia.

Results

The study included 145 participants (111; 76.6% were males) with mean age of 46.7 ± 11.5 years. The mean duration of cataract surgery experience was 17.6 ± 11.1 years. Most participants (86.2%) were trained in cataract surgery. Scleral fixation of intraocular lens (SFIOL) was the most commonly preferred technique, followed by iris fixation IOL, and anterior chamber IOL (75.2%, 9%, and 15.9%, respectively). The main determinants for selection of a surgical technique were simplicity (56.6%), surgical instrument availability (48.3%), and training on the technique (47.6%). The most frequent postoperative complications were pupil distortion, high intraocular pressure (IOP), pupillary capture of the IOL, and IOL decentration.

Conclusions

SFIOL is the preferred surgical technique for managing aphakia. The decision to choose one technique over another is complex and is based on several factors, including technical difficulty, previous training, anatomical variations, ocular comorbidities, and the potential complications. The most frequent complications after surgical correction of aphakia are pupil distortion, high IOP, pupillary capture of the IOL, and decentered IOLs.

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Funding

The authors declare that no funds, grants, or other support was received during the preparation of this manuscript.

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Authors and Affiliations

  1. Anterior Segment Division, King Khaled Eye Specialist Hospital, Uruba Road, 11462, Riyadh, Saudi Arabia

    Mohammed Alshehri, Halah Bin Helayel, Mohammed Almutlak & Rafah Fairaq

  2. Anterior Segment Division, King Faisal Medical City, Abha, Saudi Arabia

    Mohammed Alshehri

  3. Ophthalmology Division, King Abdullah Bin Abdulaziz University Hospital, Riyadh, Saudi Arabia

    José Manuel Vargas

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  1. Mohammed Alshehri
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  2. Halah Bin Helayel
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  4. Mohammed Almutlak
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Contributions

All authors contributed to the study conception, design, material preparation, and data collection. Data analysis was performed by MA MBBS and HBH MBBS. MA MBBS, HBH MBBS, and RF MBBS wrote the first draft of the manuscript. All authors commented on previous versions of the manuscript. Finally, all authors read and approved the final manuscript.

Corresponding author

Correspondence to Rafah Fairaq.

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Conflict of interest

All authors declare they have no financial interests.

Ethical approval

This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the King Khaled Eye Specialist Hospital Institutional Review Board.

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Informed consent was obtained from all subjects included in this study.

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Alshehri, M., Bin Helayel, H., Vargas, J.M. et al. Preferred surgical techniques for secondary intraocular lens implantation in adults with aphakia. Int Ophthalmol 43, 3539–3547 (2023). https://doi.org/10.1007/s10792-023-02761-8

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  • DOI: https://doi.org/10.1007/s10792-023-02761-8

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