This article is more than 5 years old. Information may no longer be current.
Glued intrascleral haptic fixation yields fewer complications than transscleral suturing
Click Here to Manage Email Alerts
Intrascleral haptic fixation with fibrin glue provides less traumatic and more stable IOL positioning that sutured scleral fixation, leading to better visual outcomes and fewer complications, according to a study.
The comparison was made in a tertiary care center in New Delhi, India, between two groups of 20 patients each with aphakia and absence of capsular support in which sutured transscleral fixation (group 1) or glued intrascleral haptic fixation (group 2) techniques were used.
At the end of the 6-month follow-up, visual acuity was better in group 2, probably due to the lesser increase of central macular thickness as seen by ultrasound biomicroscopy. Mean refractive astigmatism, corneal astigmatism and IOL tilt were more frequent in group 1, although the difference was not statistically significant. The sutured group also experienced more pseudophakodonesis. Macular edema developed in eight cases in group 1 and one case in group 2.
The authors hypothesized that the single-point fixation of the haptic used with the sutured fixation technique might lead to more pseudophakodonesis. This causes, in turn, trauma to the iris and ciliary body, triggering eicosanoid and cytokine synthesis, eventually leading to increased macular thickness and macular edema. This may be avoided by glued fixation, in which a segment of the haptics is fixated within the sclera, making the IOL more stable.
They also noted that the glue technique “makes it possible to perform the entire procedure through a small self-sealing incision,” with “the intraoperative advantage of having a well-formed globe throughout the surgery” and “the postoperative advantages of having fewer complications associated with larger wounds.” – by Michela Cimberle
Disclosures: The authors report no relevant financial disclosures.
Click Here to Manage Email Alerts