Authors
Kislitsyna N.M.1, Hodjaev N.S.1, Sultanova D.M.1, Novikov S.V.2
1 The S. Fyodorov Eye Microsurgery Federal State Institution, Moscow
2 OOO «NEP MG», Moscow
Abstract
Rationale: To date, the main focus of ophthalmic surgery development is aimed at the development of high-quality domestic models of IOLs with the possibility of implantation through a small incision, providing a clearly controlled position during suture fixation in the ciliary sulcus, having a certain shape and location of holes in the haptic elements, which allow under visual control to guide the needle in case of miosis or pupil deformation.
Objective: To modernize the design of the domestic model of IOL RSP -1 within the current technical specifications.
Methods: Together with OOO NEP «Eye Microsurgery» we modernized the design of haptic elements of IOL RSP-1, which is a monolithic IOL with plate gaptic with holes of a certain shape and size.
Suturing of the proposed modernized IOL model was performed in 8 patients for intraocular correction of aphakia. The cause of aphakia was closed eye trauma type A III.
Preoperative visual acuity ranged from 0.01 to 0.7 with aphakic correction. Intraocular pressure ranged from 15 to 20 mmHg.
Suturing of this IOL model is performed using two straight needles connected by thread. In the inner segment 2 mm from the limbus in the projection of the ciliary sulcus a puncture is made with a 30G guide needle. Through the paracentesis at 3 hours the needles are alternately passed under the haptic part of the IOL and withdrawn from the eye at 9 hours in the projection of the ciliary sulcus. The loop formed captures the haptic part of the IOL. Similarly, the haptic part of the IOL is fixed in the opposite segment through other V-shaped holes. By pulling the ends of the threads taken out of the eye, repositioning and fixation of the IOL in the projection of the ciliary sulcus is performed.
Results: In the postoperative period in all cases stable IOL position was fixed, IOL was centered. Visual acuity 0.2 to 0.9 with correction. IOP from 11 to 17 mm Hg. The picture obtained by ultrasound biomicroscopy indicates the central position of the IOL.
Conclusion: The proposed modification of IOL RSP -1 with four haptic holes has a number of advantages: import substitution, injector implantation of IOL through a small incision. The shape and location of the holes allow to perform atramatic and clearly controlled IOL suturing regardless of the pupil diameter. Four-point fixation of the IOL in the projection of the ciliary sulcus provides reliable, stable and anatomofuctional position of the IOL, monoblock design in case of combined vitreoretinal surgery performs the role of a barrier-optical membrane and does not interfere with the visualization of the eye fundus. This model of IOL is also suitable for capsular and extracapsular fixation.
Keywords: intraocular lens, RSP-1, domestic IOL model, guide needle, ciliary sulcus.
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