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Uludağ Ü.Tıp Fak. Göz Hast. A.D., Bursa Purpose: To determine the incidence of and factors related to rhegmatogenous retinal detachment (RD) following scleral-fixated intraocular lens (SFIOL) implantation.
Material and Method: This study included 272 eyes of 259 patients (172 male, 87 women; age range: 2-83 years) who underwent SFIOL implantation by modified Levis method. Aphakia was secondary to a cataract surgery in 226 eyes (in 159 eyes senil, in 57 eyes traumatic and in 10 eyes congenital cataract) and dislocation of the crystalline lens in 46 eyes (posttraumatic in 30 eyes and developmental in 16 eyes). Implantation of SFIOL was performed as a primary procedure in 68 eyes at the time of lens extraction and as a secondary procedure in 204 eyes. Simultaneously, pars plana vitrectomy (PPV) was performed in 61 eyes, partial penetrating keratoplasty in 15 eyes, silicone removal in 13 eyes, anterior chamber intraocular lens removal in 9 eyes and encircling in 3 eyes. Mean follow-up time was 7.8 months (4 - 60 months). The two groups with and without postoperative RD were compared for several clinical parameters.
Findings: Postoperative rhegmatogenous RD developed in 9 eyes (3.3 %). Mean time between the implantation and diagnosis of RD was 5.2 weeks (1-13 weeks). A retinal tear or hole was found in 5 eyes, retinal dialyses in 2 eyes and giant tear in 1 eye. No retinal break was found in 1 eye. Axial length of the eye was significantly greater in eyes with RD (P=0.04, Student-t test). Retinal detachment was also more frequent in eyes which underwent primary SFIOL implantation and simultaneous PPV surgery (P<0.001 and P=0.01, Fisher's exact test). Reattachment was obtained in-7 of 9 eyes (78%) by the methods of scleral indentation and/or vitreus surgery.
Discussion: Complication of RD occurs more frequently after SFIOL surgery when it is compared with other intraocular lens implantation methods. Retinal breaks may result from both posterior vitreus detachment and traction of the peripheral vitreus base. The patients should be followed with routine peripheral fundus examination after SFIOL surgery. Keywords : Retinal detachment, scleral-fixated intraocular lens