Surgical outcomes of iris-sutured intraocular lenses with the McCannel suture technique
Quoi:
Paper Presentation | Présentation d'article
Quand:
4:18 PM, Samedi 2 Juin 2018
(3 minutes)
Où:
Metro Toronto Convention Centre (Édifice Sud)
- Salle 801
Comment:
Authors: Rami Abo-Shasha, Phil Hooper, John Gonder
Author Disclosure Block: R. Abo-Shasha: None. P. Hooper: None. J. Gonder: None.
Abstract Body:
Purpose: To determine surgical outcomes of Iris-Sutured Intraocular Lenses with the McCannel Suture Technique.
Study Design: Three year retrospective chart review of all patients with discloated intraocular lenses that underwent repair with McCannel suture technique by Dr. Gonder and Dr. Hooper.
Methods: Three year(2014-2017) retrospective chart review of all patients with intraocular lens dislocation that underwent repair by the McCannel suture technique by Dr. Gonder and Dr. Hooper at the Ivey Eye Institute - St. Joseph’s Hospital.Visual acuity was converted to logMAR equivalents. P-Value was analyzed with the Wilcox Signed Rank Test. Inclusion Criteria included 1.) dislocated 3 piece IOLs or dislocated single piece-in the bag-IOLs. 2.) Follow up period of at least four months. Exclusion Criteria included 1.) baseline anterior chamber inflammation, 2.) dislocated-out of the bag- one piece IOL, 3.) co-morbid, advanced ocular disease prior to surgery or the development of advanced ocular disease after surgery (ie: AMD) Pre-operative variables included age, gender, visual acuity, intraocular pressure, refraction, risk factors for dislocation, iknterval time between cataract surgery and IOL-repositioning surgery, and type of IOL. Post-operative variables included post-operative visual acuity, post-operative intraocular pressure,post-operative complications, post-operative refraction.
Results: 67 participants were enrolled in the study. Average age was 77, and 51% were male. Baseline visual acuity was 1.17 logmar. Baseline intraocular pressure was 18.4, with a range of 0-40. Leading risk factors for discloation included pseudoexfolation (29%), trauma (11%), and cataract surgery related complications (3%). Interval time between cataract surgery and time of dislocation was 11 years. Follow up data ranged from 4 months to 3 years, with average follow up period of 11 months. Final visual acuity was 0.41 logmar (P-value < 0.00005). Final IOP was 14.29(P Value <0.02). There was limited pre-operative refractions prior to dislocation and post-operative refractions post-operative to investigate induced astigmatism. Data available to make this comparison was only available for 12 patients, and there was no induced astigmatism in this small sub-population. Complications were observed and included retinal detachment (1.5%), hemorrhagic choroidal detachment (1.5%), persistent anterior uveitis (3%), lens dislocation (6%), cystoid macular edema (3%), pupillary block (4.5%), and iridodialysis (1.5%). The rate of endophthalmitis was 0%.
Conclusions: This study demonstrates statistically significant improvement in visual acuity and IOP with the McCannel suture technique for dislocated IOLs. Surgically induced astigmatism was not observed in this study and consistent with findings in the literature. Re-dislocation of the intraocular lens was the #1 complication associated with this procedure, followed by pupillary block. Head-to-head studies comparing the McCannel suture with alternative IOL-repositioning surgery is key.
Author Disclosure Block: R. Abo-Shasha: None. P. Hooper: None. J. Gonder: None.
Abstract Body:
Purpose: To determine surgical outcomes of Iris-Sutured Intraocular Lenses with the McCannel Suture Technique.
Study Design: Three year retrospective chart review of all patients with discloated intraocular lenses that underwent repair with McCannel suture technique by Dr. Gonder and Dr. Hooper.
Methods: Three year(2014-2017) retrospective chart review of all patients with intraocular lens dislocation that underwent repair by the McCannel suture technique by Dr. Gonder and Dr. Hooper at the Ivey Eye Institute - St. Joseph’s Hospital.Visual acuity was converted to logMAR equivalents. P-Value was analyzed with the Wilcox Signed Rank Test. Inclusion Criteria included 1.) dislocated 3 piece IOLs or dislocated single piece-in the bag-IOLs. 2.) Follow up period of at least four months. Exclusion Criteria included 1.) baseline anterior chamber inflammation, 2.) dislocated-out of the bag- one piece IOL, 3.) co-morbid, advanced ocular disease prior to surgery or the development of advanced ocular disease after surgery (ie: AMD) Pre-operative variables included age, gender, visual acuity, intraocular pressure, refraction, risk factors for dislocation, iknterval time between cataract surgery and IOL-repositioning surgery, and type of IOL. Post-operative variables included post-operative visual acuity, post-operative intraocular pressure,post-operative complications, post-operative refraction.
Results: 67 participants were enrolled in the study. Average age was 77, and 51% were male. Baseline visual acuity was 1.17 logmar. Baseline intraocular pressure was 18.4, with a range of 0-40. Leading risk factors for discloation included pseudoexfolation (29%), trauma (11%), and cataract surgery related complications (3%). Interval time between cataract surgery and time of dislocation was 11 years. Follow up data ranged from 4 months to 3 years, with average follow up period of 11 months. Final visual acuity was 0.41 logmar (P-value < 0.00005). Final IOP was 14.29(P Value <0.02). There was limited pre-operative refractions prior to dislocation and post-operative refractions post-operative to investigate induced astigmatism. Data available to make this comparison was only available for 12 patients, and there was no induced astigmatism in this small sub-population. Complications were observed and included retinal detachment (1.5%), hemorrhagic choroidal detachment (1.5%), persistent anterior uveitis (3%), lens dislocation (6%), cystoid macular edema (3%), pupillary block (4.5%), and iridodialysis (1.5%). The rate of endophthalmitis was 0%.
Conclusions: This study demonstrates statistically significant improvement in visual acuity and IOP with the McCannel suture technique for dislocated IOLs. Surgically induced astigmatism was not observed in this study and consistent with findings in the literature. Re-dislocation of the intraocular lens was the #1 complication associated with this procedure, followed by pupillary block. Head-to-head studies comparing the McCannel suture with alternative IOL-repositioning surgery is key.
