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Results in comparison between 30 gauge ultrathin wall and 27 gauge needle in sutureless intraocular lens flanged technique in diabetic patients: 24-month follow-up study

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Abstract

Aims

Intraoperative complications in cataract surgery are more common in diabetic patients. Solving aphakia in these circumstances remains a challenge, as the scleral structure has been shown to be different in diabetes. This study aims to analyze the role of a secondary sutureless scleral intraocular lens (IOL) flanged fixation in diabetic patients without capsular support and to compare the anatomical and functional outcomes using a 30 gauge (G) ultrathin wall needle vs. a 27G needle.

Methods

Retrospective, observational cohort study.

105 eyes (105 patients) who underwent PPV with secondary IOL fixation using a sutureless 27G (n = 51) or a 30G ultrathin wall (UTW) needle technique (n = 54) and had a 24 months postoperative follow up. Consecutive patients’ records were reviewed for lens stability and centration parameters, intra- and postoperative complications at 7 days, 1, 3, 6, 12, and 24 months after surgery. Correlations between outcome measures and needle size (27G vs. 30G UTW) were analyzed.

Results

IOL displacement occurred in 30 patients (41.2%) in the 27G group and did not occur in the 30G UTW needle group (p < 0.001). Mean time until IOL displacement was 10.5 ± 7.0 months (range: 7 days–24 months). IOL centricity was significantly better in the 30G ultrathin wall needle group compared to 27 G (p = 0.001). Additional surgical interventions were necessary only in the 27G group (n = 14).

Conclusions

Sutureless IOL flanged technique using a 30G UTW needle is more predictable and has less complications in aphakic diabetic patients, compared to a 27G needle technique.

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Author notes

  1. Matias Iglicki and Dinah Zur have contributed equally to this work.

Authors and Affiliations

  1. Retina Private Office, University of Buenos Aires, 525 Aguirre St., 3rd Floor, Apt. A, Buenos Aires, 1414, Argentina

    Matias Iglicki

  2. Ophthalmology Division, Tel Aviv Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel

    Dinah Zur & Anat Loewenstein

  3. Diagnostic Ophthalmology Center, Buenos Aires, Argentina

    Hermino Pablo Negri, Joaquin Esteves, Romina Arias & Emanuel Holsman

  4. Ophthalmology Department, University of Leipzig, Leipzig, Germany

    Catharina Busch

Authors
  1. Matias Iglicki
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  2. Dinah Zur
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  4. Joaquin Esteves
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Correspondence to Matias Iglicki.

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Institutional review board (IRB) approval was obtained for a retrospective consecutive chart review. The research adhered to the tenets of the Declaration of Helsinki. All data discussed in this study were fully anonymized before they were accessed.

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This article belongs to the topical collection Eye Complications of Diabetes, managed by Giuseppe Querques.

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Iglicki, M., Zur, D., Negri, H.P. et al. Results in comparison between 30 gauge ultrathin wall and 27 gauge needle in sutureless intraocular lens flanged technique in diabetic patients: 24-month follow-up study. Acta Diabetol 57, 1151–1157 (2020). https://doi.org/10.1007/s00592-020-01530-8

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  • DOI: https://doi.org/10.1007/s00592-020-01530-8

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