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Résultats à Moyen Terme de la Vitrectomie Pars Plana Combinée à Un Implant Intraoculaire à Fixation Sclérale Sans Suture Chez Les Patients Présentant un Mauvais Soutien Capsulaire: une Nouvelle Approche Chirurgicale

The objective of this thudy was to evaluate the outcomes of pars plana vitrectomy combined with sutureless scleral-fixated intraocular lens (IOL), using the newly developed FIL SSF Carlevale IOL (Soleko, Italy), in patients with poor capsular support.

Retrospective, multi-centric study. All consecutive eyes undergoing pars plana vitrectomy combined with secondary Carlevale IOL implantation at two tertiary retina centres between March 2019 and December 2019 were retrospectively enrolled. 

Out of 36 eyes enrolled, more than 3 months data were available for 24 eyes of 23 patients. Mean follow-up was 6.0 ± 2.6 months (range 3 to 12). Mean age was 70.9 ± 12.2 years (50% female). Most frequent diagnosis was IOL subluxation (50%). Following surgery, best corrected visual acuity (BCVA) significantly improved from 0.4 ± 0.3 at baseline to 0.7 ± 0.3 postoperatively (P = 0.013). There was no significant change in the mean intraocular pressure (P = 0.704), and no sight-threatening adverse events, such as iatrogenic breakage of the IOL haptic, IOL decentration, endophtalmitis or retinal detachment were observed. Minor adverse events were reported in 58.3% of eyes (transient corneal edema [33.3%]; cystoid macular edema [29.2 %]; vitreous hemorrhage [12.5%] and hyphema [8.3%]).

Primary outcome (safety) and secondary outcome (improvement of BCVA) were reached in all the cohort of patients studied. At the same time major adverse events were not observed. 

Pars plana vitrectomy combined with secondary Carlevale IOL implantation is a safe method to effectively improve BCVA in patients with poor capsular support, especially after IOL subluxation. A high proportion of patients experienced transient adverse events such as corneal edema or cystoid macular edema. Nevertheless, those complications are in part also due to the preoperative patients’ presentation, as subluxated IOL or previous complicated cataract surgery.