Marcin Woźniak

Background/Objectives: The purpose of this study was evaluation of the efficacy and the rate of complication of a foldable sutureless scleral-fixated intraocular lens (SSF-IOL), named Carlevale IOL, for the treatment of aphakia without sufficient capsular support due to trauma or complicated cataract surgery. Methods: Retrospective, consecutive interventional case series. All consecutive eyes with secondary implantation of aphakic SSF-IOL were considered. The primary outcomes were as follows: best corrected visual acuity (BCVA), refractive error (RE), and intraocular pressure (IOP). Secondary outcome was the occurrence of intraoperative and postoperative complications. Results: SSF-IOL was performed in 21 eyes of 21 patients (7 men and 14 women) with mean age of 74 years (range from 36 to 90 years). The mean follow-up time was 11.4 months. VA improved significantly (p = 0.0007) from 0.38 logMAR at baseline to 0.11 logMAR at the final follow-up. BCVA improved in 18 patients, remained equal in 2 cases, and worsened in 1 case. Mean postoperative RE was −0.83 Diopters (D) (Median = −0.50 D, SD = 1.05 D) and it was less than 1D in 61.9% of patients. Mean IOP at the end of the follow-up was 15.78 mmHg (ranged from 10 to 22 mmHg, SD = 3.65). In one patient a vitreous hemorrhage was observed intraoperatively, but it resolved spontaneously. Postoperative complications included one case of cystoid macular edema and one case of epiretinal membrane. Conclusions: Carlevale SSF-IOL implantation seems to be an effective and safe procedure, ensuring good visual outcomes with a low rate of complication in eyes indicated for secondary IOL implantation.

Corneal transplantation is the most effective treatment for corneal blindness. Standard planned keratoplasties have a high success rate. Conditions such as active inflammation at the time of surgery, the presence of ocular surface disease, previous graft disease, or neovascularization make them more susceptible to rejection. These are so-called high-risk corneal transplantations. In our study, we selected 52 patients with a higher risk of graft rejection. A total of 78 procedures were performed. The main indications for the first keratoplasty were infections (59.6%) and traumas (21.2%). Visual acuity (VA) significantly improved from 2.05 logMAR on the day of keratoplasty to 1.66 logMAR in the latest examination (p = 0.003). An analysis of the graft survival showed a 1-year survival of 54% and a 5-year survival of 19.8% of grafts. The mean observation time without complications after the first, second, and third surgery was 23, 13, and 14 months, respectively. The best results were noted among patients with infectious indications for keratoplasty (p = 0.001). Among them, those with bacterial infection had the best visual outcomes (p = 0.047).