Purpose: To evaluate the efficacy of a specialized guide (double-needle guide) created to fix the angle of the scleral tunnel in preventing the tilt and decentration of flanged intraocular lenses (IOL) in intra-scleral fixation surgery using double-needle technique.
Subjects and methods: Seven surgeons (three experts and four residents) performed flanged IOL fixation on 70 artificial eyes (with each surgeon fixing 10 eyes: five with the specialized guide and five without the guide). The IOL tilt and decentration with or without the guide were measured using anterior segment optical coherence tomography (CASIAII, TOMEY). The measured values of the IOL tilt and decentration were statistically compared between the groups of the experts and residents.
Results: The mean IOL tilt was significantly lower in the guided eyes (p<0.05). Although the experts did not observe significant differences in the mean tilt (p=0.06) with or without the guide, the residents were able to significantly reduce the mean tilt using the guide (p<0.05). The mean IOL decentration tended to decrease with the guide in both groups, albeit not significantly.
Conclusion: The use of the double-needle guide improved the postoperative IOL fixation. It may be particularly effective for supporting less experienced surgeons.
Nippon Ganka Gakkai Zasshi (J Jpn Ophthalmol Soc) 123: 383-388, 2019.