Akreos Intraocular Lense Fixation Using Goretex Suture And Pupilloplasty In Aphakic Patients With Iris Damage.

The aim of this video is to describe surgical technique and clinical outcomes of a novel AkreosÒ intraocular lense (IOL) scleral fixation with 4 Goretex CV-7Ò  sutures and pupilloplasty in aphakic patients with iris damage after traumatic cataract surgery.

Akreos IOL was fixated to sulcus with 4 Goretex sutures under 25/27G 4-port esclerotomy in all cases.

In total, 3 eyes of 3 patients who underwent a new scleral suture fixation technique and pupilloplasty with Goretex CV-7 suture to Akreos were included.  All patients presented loss of capsular bag support and pupilar midriasis with sphincter atrophy due to complicated cataract surgery. Main outcome measures included visual acuity, endothelial cell density, and postoperative complications over 3-month follow-up. All surgeries were performed by the same surgeon, D. De casas (MD).

Mean best-corrected visual acuity (BCVA) logMAR improved from 0.7 (20/100 Snellen equivalent) to 0.3 (20/40 Snellen equivalent) at 3 months post-surgery. No pre or postoperative complications were observed.

Many times, iatrogenic aphakia due to complicated cataract surgery used to be followed by iris sphincter damage. Technique selection is often influenced by patient age, anatomical factors (e.g. Previous trauma loss of iris tissue), other ocular comorbidities (such as glaucoma), and surgeon preference. In the context of inadequate capsular or iris support, surgical options for IOL implantation include scleral fixation (with or without suture) of a posterior chamber intraocular lens (PCIOL).

These results support the safety and efficacy of Akreos lens fixation to sulcus with 4-port 25/27G pars plana esclerotomy and Goretex sutures in patients without iris nor capsular support.