EC Ophthalmology

Rationale: Currently, the primary emphasis in the development of ophthalmic surgery is centred towards the development of high-quality domestic intraocular lens (IOL) models. These models are designed for implantation through a small incision, ensuring precise positioning during suture fixation in the ciliary sulcus. They are characterised by specifically designed shapes and strategically positioned holes in the haptic elements, enabling visual-guided needle manipulation even in instances of miosis or pupil deformation.

Objective: To modernise the design of the domestic model of IOL RSP -1 within the current technical specifications.

Materials and Methods: In collaboration with OOO NEP Eye Microsurgery, we have undertaken a modernisation venture aimed at enhancing the design of the haptic elements of the RSP-1 IOL. This monolithic IOL features plate haptics adorned with precisely crafted holes of specific shapes and sizes.

Suturing with the modernised IOL model was undertaken in eight patients to address intraocular correction of aphakia. The aetiology of aphakia was closed eye trauma of Type A III.

Preoperative visual acuity ranged from 0.01 to 0.7 with aphakic correction, whilst Intraocular pressure ranged from 15 to 20 mmHg.

Suturing this IOL model requires the use of two straight needles interconnected by thread. A puncture is made with a 30G guide needle at a point 2 mm from the limbus within the projection of the ciliary sulcus in the inner segment. Subsequently, through a paracentesis at the 3 o’clock position, the needles are alternately passed beneath the haptic part of the IOL and then withdrawn from the eye at the 9 o’clock position within the projection of the ciliary sulcus. This manoeuvre forms a loop that captures the haptic part of the IOL. Similarly, fixation of the haptic part of the IOL Is achieved in the opposing segment through other V-shaped holes. Repositioning and fixation of the IOL within the projection of the ciliary sulcus is accomplished by pulling the ends of the threads extracted from the eye.

Results: In the postoperative period in all cases, stable IOL position was fixed and IOL was centered. Visual acuity: ranged from 0.2 to 0.9 with correction, whilst Intraocular Pressure (IOP) ranged from 11 to 17 mmHg. 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 atraumatic and clearly controlled IOL suturing regardless of the pupil diameter. Four-point fixation of the IOL within the ciliary sulcus projection ensures a reliable, stable and anatomically functional position of the IOL. Additionally, the monoblock design serves as a barrier-optical membrane during combined vitreoretinal surgery without obstructing eye fundus visualisation. This IOL model is versatile and suitable for both capsular and extracapsular fixation.

 Keywords: Intraocular Lens; RSP-1; Domestic IOL Model; Guide Needle; Ciliary Sulcus

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