Eyeworld

JAN 2016

EyeWorld is the official news magazine of the American Society of Cataract & Refractive Surgery.

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33 EW RESIDENTS January 2016 5.Gabor SG, et al. Sutureless intrascleral posterior chamber intraocular lens fixation. J Cataract Refract Surg. 2007;33:1851–4. 6. Scharioth GB, et al. Intermediate results of sutureless intrascleral posterior chamber intraocular lens fixation. J Cataract Refract Surg. 2010;36:254–9. 7. Vote BJ, et al. Long-term outcome of combined pars plana vitrectomy and scleral fixated sutured posterior chamber intraoc- ular lens implantation. Am J Ophthalmol. 2006;141(2):308–312. Contact information Pyatetsky: d-pyatetsky@northwestern.edu design, a significant concern is the small number of patients who actu- ally had a complication at all. The study is not powered to detect small changes between the 2 groups when the absolute number of complica- tions (from the small sample size) is this low, and therefore type II error to accept the null hypothesis is un- acceptably high. This may have only been recognizable in the post hoc analysis by the authors, who may have suspected a higher number of complications, but should be ac- knowledged as the major limitation of the study and need for further investigating. In summary, this is a valuable study bringing attention to a novel surgical technique for managing aphakia. Given the challenges of tra- ditional sutured SFIOL insertion, it is encouraging to see that less skill-in- tensive techniques are becoming available to surgeons. A properly constructed randomized control comparison with sufficient power and long-term follow-up is needed to determine if sutured and suture- less SFIOL insertion are equivalent in terms of efficacy and safety. How- ever, these trials cost money and time, and in the absence of them, studies such as these are invaluable as they provide guidance for surgi- cal decision-making in challenging situations. EW References 1. Wagoner MD, et al. Intraocular lens implan- tation in the absence of capsular support: a report by the American Academy of Ophthal- mology. Ophthalmology. 2003;110:840–59. 2. Evereklioglu C, et al. Comparison of secondary implantation of flexible open-loop anterior chamber and scleral-fixated posterior chamber intraocular lenses. J Cataract Refract Surg. 2003;29:301–8. 3.Chan TC, et al. Comparison of outcomes of primary anterior chamber versus secondary scleral-fixated intraocular lens implantation in complicated cataract surgeries. Am J Ophthalmol. 2015;159:221–6. 4. Luk AS, et al. Long-term outcome of scleral- fixated intraocular lens implantation. Br J Ophthalmol. 2013;97:1308–1311. A retrospective analysis" From left: Deepak Mangla, MD, Anne Langguth, MD, Caroline Minkus, MD, Dmitry Pyatetsky, MD, and Allison Soneru, MD Source: Northwestern University Feinberg School of Medicine

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