Fibrin Glue Assisted Trans-Scleral Fixation of an Endocapsular Device for Sutureless Trans-Scleral Capsular Bag Fixation in Traumatic Subluxations: The Glued Endocapsular Ring/Segment

摘要

Subluxated cataracts secondary to blunt injury are a challenge to treat from the construction of rhexis to IOL insertion. For that reason, we designed a new glued endocapsular ring (ECR)/ segment (ECS) for subluxated cataracts and IOLs for sutureless fibrin glue assisted trans-scleral fixation of the capsular bag. The glued ECR/segment stabilizes the capsular bag intra and post-operatively, allowing for sutureless fibrin glue assisted trans-scleral fixation. The segment gives vertical, horizontal and rotational stability as well as forniceal expansion. The advantages to this approach include easier implementation; faster surgery; easy adjustability; sturdier scleral fixation; fewer chances of segment drop into vitreous and lack of suture-related complications. Our hypothesis is that a glued versus sutured ECR/ECS will be more viable and stable on the sclera in the long term. Less pseudophakodonesis will also lead to a more stable capsule-bag complex and reduce the risk of posterior segment complications such as retinal detachment and cystoid macular edema. The nature of the device also makes its removal, if required, much more straightforward than the sutured rings/segments. This device can be used in patients with subluxated cataracts, colobomatous lens or subluxated IOLs.