Refractive outcomes for secondary sutureless posterior chamber lens implantation: sutureless scleral fixating lens Carlevale® versus retropupillary iris-claw lens Artisan®

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2024年11月11日

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Justine Bontemps,
Olivier Loria,
Lucas Sejournet,
Benoit Allignet,
Sandra Elbany,
Frédéric Matonti,
Carole Burillon,
Philippe Denis,
Laurent Kodjikian,
Thibaud Mathis

摘要

Purpose

To compare refractive outcomes of the foldable intraocular lens sutureless scleral fixated sutureless (Carlevale® FIL-SSF) with the iris-claw lens (Artisan®).

Methods

This retrospective study included consecutive patients who underwent a FIL-SSF implantation or an iris-claw implantation between January 2020 and November 2022 in the ophthalmology departments of Hospices Civils de Lyon (France).

Results

A total of 271 eyes from 265 patients were included: 96 eyes in the FIL-SSF group and 175 eyes in the iris-claw group. At 6 months, the mean (SD) surgically induced astigmatism (SIA) was significantly lower in the FIL-SSF group with 0.3 (1.8) diopters against 0.8 (2.1) diopters in the iris-claw group (p = 0.01). The mean (SD) refractive error was also lower for the FIL-SSF group with 0.1 (1.2) diopters versus 0.5 (1.6) diopters in the iris-claw group (p < 0.001). The mean best corrected visual acuity at 6 months was not significantly different between FIL-SSF and iris-claw lens with 0.47 (0.58) logMAR and 0.39 (0.55) logMAR, respectively (p = 0.12). However, the mean (SD) operative time was longer for FIL-SSF implantation in comparison to iris-claw implantation (59.8 (21.1) minutes versus 41.9 (24.4) minutes, respectively (p < 0.001)). The rate of postoperative complications was similar between the two techniques.

Conclusion

This study shows that FIL-SSF achieves better refractive results than iris-claw lens, with a similar rate of postoperative complications. As a relatively new implantation technique, there is a learning curve required to reduce operating time.

Key messages

What is known?

Multiple surgical options for correcting aphakia in the absence of capsular support can be used.

Currently, foldable intraocular lens sutureless scleral fixated sutureless (FIL-SSF, Carlevale®) and iris-claw (Artisan®) implants are the two preferred options, but there is no consensus on the best technique to adopt.

What is new?

We showed that FIL-SSF has a significantly lower surgically induced astigmatism compared to the iris-claw implant.

Similar rate of postoperative complications was found between these two techniques.

Future studies with a longer follow-up period are needed to ascertain its tolerance.