Título

FOUR-POINT SCLERAL FIXATION USING GORE-TEX SUTURE

Introdução / Purpose

To evaluate the visual results and the rate of intra and postoperative (PO) complications in a short-term cohort of eyes that had the scleral fixation of an Akreos AO60 fixed at four points on the sclera using Gore-Tex suture, in the absence of capsular support.

Material e Método / Methods

The patient underwent a complete ophthalmologic evaluation to estimate whether he would be a good candidate, such as specular microscopy.
Conjunctival limbal peritomies were performed. A 23-gauge sclerotomy for the infusion, two temporal and two nasal, keeping distance of 5mm between the ipsilateral, and all at a distance of 3 mm from the limbus. If indicated, a pars plana vitrectomy was performed.
Corneal incision was performed. The 8-0 Gore-Tex suture was passed through the eyelet of the lens that was folded and inserted into the anterior chamber.
The ends of the suture were externalized through the sclerotomies using intraocular forceps; the sutures were tied ensuring that the IOL's optics were well centered. The knots were trimmed and buried into the sclerotomies to minimize the chance of leakage from the wall.

Resultados / Results

To date, 8 surgeries have been performed; two with endophacoemulsification, two with IOL explantation and one with associated epiretinal membrane peeling.
One patient presented hypotony and seidel by corneal incision until the 3rd week of PO because of the enlargement of the incision to explant the IOL and three with corneal edema that resolved until 14º PO. Two patients had erosion of the suture, which was resolved after cutting the exposed extremity.
Visual improvement was significant in all patients.

Discussão e Conclusões / Discussion

Although any of the strategies for IOL implantation can be employed in the absence of capsular support, we have shown that the scleral fixation of an Akreos AO60 with Gore-Tex has many advantages, such as the relative ease of insertion and fixation through small corneal incisions, the decrease in IOL inclination, the prevention of iris contact and a lower risk of lens displacement.

Palavras Chave

FOUR-POINT SCLERAL FIXATION; Gore-Tex