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Purpose <p>To report the short- and long-term outcomes of sutured scleral-fixated capsular tension segments (CTS) in patients with lens instability.</p> Methods <p>This retrospective study included 21 eyes of 21 patients who underwent scleral fixation of a CTS, with or without capsular tension ring (CTR) ± intraocular lens (IOL) implantation, between 2015 and 2023 at two academic centers. The primary outcome was stability of the IOL–bag complex, defined as centration without tilt or reintervention. Secondary outcomes included corrected distance visual acuity (CDVA), refractive stability, and postoperative complications, classified as early (≤ 4&#xa0;weeks) or late (&gt; 4&#xa0;weeks). Minimum follow-up was 6&#xa0;months, with a subgroup of eyes ≥ 12&#xa0;months. Outcomes were compared between polypropylene and Gore-Tex sutures.</p> Results <p>Mean patient age was 59.1 ± 18.6&#xa0;years, and mean follow-up 28.6&#xa0;months (range 6–80). Mean zonular dialysis was 142° ± 41° (range 60°–210°), with two cases requiring two CTSs. At final follow-up, 85.7% of eyes achieved CDVA of 20/40 or better. Early complications occurred in 5 eyes (23.8%), including cystoid macular edema (14.3%), wound leak (4.8%), and posterior capsular rupture (4.8%). Late complications were limited to one haptic displacement and one polypropylene suture rupture; no late events occurred with Gore-Tex.</p> Conclusion <p>Scleral fixation of CTSs is a safe and effective strategy for lens subluxation, providing stable long-term centration of the IOL–bag complex with good visual outcomes and low complication rates. Gore-Tex demonstrated superior long-term durability, supporting its use when extended stability is required, particularly in cases with ≥ 120º degrees of zonular dialysis.</p>

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Clinical outcomes of sutured scleral-fixated capsular tension segments in lens subluxation: a retrospective case series with short- and long-term follow-up

  • 期刊论文

  • 发表日期：

    2025年10月30日

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  • Meilin Chang-Sotomayor,
  • Mª Victoria de Rojas Silva,
  • Xavier Corretger,
  • Jose L. Guell,
  • Francisco Bandeira,
  • Andrea Mendez-Mourelle,
  • Mercedes Rodríguez Gómez,
  • Alfredo Adán Civera,
  • Marc Figueras-Roca

摘要

Purpose

To report the short- and long-term outcomes of sutured scleral-fixated capsular tension segments (CTS) in patients with lens instability.

Methods

This retrospective study included 21 eyes of 21 patients who underwent scleral fixation of a CTS, with or without capsular tension ring (CTR) ± intraocular lens (IOL) implantation, between 2015 and 2023 at two academic centers. The primary outcome was stability of the IOL–bag complex, defined as centration without tilt or reintervention. Secondary outcomes included corrected distance visual acuity (CDVA), refractive stability, and postoperative complications, classified as early (≤ 4 weeks) or late (> 4 weeks). Minimum follow-up was 6 months, with a subgroup of eyes ≥ 12 months. Outcomes were compared between polypropylene and Gore-Tex sutures.

Results

Mean patient age was 59.1 ± 18.6 years, and mean follow-up 28.6 months (range 6–80). Mean zonular dialysis was 142° ± 41° (range 60°–210°), with two cases requiring two CTSs. At final follow-up, 85.7% of eyes achieved CDVA of 20/40 or better. Early complications occurred in 5 eyes (23.8%), including cystoid macular edema (14.3%), wound leak (4.8%), and posterior capsular rupture (4.8%). Late complications were limited to one haptic displacement and one polypropylene suture rupture; no late events occurred with Gore-Tex.

Conclusion

Scleral fixation of CTSs is a safe and effective strategy for lens subluxation, providing stable long-term centration of the IOL–bag complex with good visual outcomes and low complication rates. Gore-Tex demonstrated superior long-term durability, supporting its use when extended stability is required, particularly in cases with ≥ 120º degrees of zonular dialysis.