Cataract Clinical Trial
Official title:
Evaluating Safety and Efficacy of a Modified Technique of Scleral Fixation Intraocular Lens Implantation
Cataract is the leading cause of blindness globally and cataract surgery with the
implantation of intraocular lens (IOL) is the most commonly performed operation worldwide.
After removal of the cataract, an IOL is usually implanted within the capsular bag. However,
endocapsular implantation of IOL is not always feasible due to inadequate zonular or capsular
support, intraoperative posterior capsule rupture, or in primary intracapsular cataract
extraction. Predisposing factors including prior ocular trauma, intravitreal injection or
intraocular surgery, co-existing ocular comorbidities like chronic uveitis, pseudoexfoliation
syndrome, may increase the risk of failure of in-the-bag implantation.
In such situation, the surgeons may consider implanting the IOL in the anterior chamber,
ciliary sulcus, or using fixation techniques. In Asian eyes, the anterior chambers are often
shallow and placement in anterior chamber may accelerate corneal endothelial cell loss
leading to corneal decompensation, or worsen pre-existing glaucoma. Placement in the ciliary
sulcus depends on the amount and integrity of the capsular remnant, and inadequate support
may result in dislocation of the IOL. In recent years, newer forms of scleral fixation of IOL
using glue or glue-less approach, although these procedure appeared to be simpler, the
long-term stability of these IOL have not been evaluated against conventional approach with
suture fixation. The main limitations of suture fixation technique are related to the sutures
either intraoperatively (e.g. entanglement, failure to rotate and bury the suture knot) or
postoperatively (breakage, dissolution of suture with time), and the learning curve required
for surgeons in training.
Our study aims to study the efficacy and safety of a modified technique of scleral fixation
of an intraocular lens in the posterior chamber.
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