New Approach to Secondary Implantation: Sutureless Scleral Fixation with the Carlevale FIL-SSF Implant (A Prospective Study Regarding 24 Cases)

The management of aphakia in the absence of capsular support is becoming increasingly common, largely due to the rising incidence of implant dislocations [1]. This scenario presents a significant surgical challenge, with several options available: anterior chamber implantation (using an angulated support lens or an iris-claw lens on the anterior surface of the iris), posterior fixation to the iris (with either an iris-claw lens or sutures), or scleral fixation (with or without sutures). Each approach has its own set of advantages, disadvantages, and potential complications. Despite the advancements in techniques reported by various authors in recent years [2, 3], there is still no consensus on the optimal approach. The Carlevale FIL-SSF implant, a novel hydrophilic lens specifically designed for sutureless scleral fixation and placement in the ciliary sulcus, has shown promising results in recent publications [4-6]. We conducted a prospective interventional study at the Intercommunal Hospital Center of Villeneuve-Saint-Georges, Île-de-France, Paris, including 24 eyes diagnosed with aphakia, subluxation or dislocation of an intraocular implant. All our patients consulted in the ophthalmology department between March 2023 and December 2023. Our patients underwent secondary implantation surgery by Sutureless scleral fixation technique (SSF) with a Carlevale-type lens (Soleko, Italy). The post-operative follow-up was adjusted to the evolution of each case, with a minimum of 6 months' follow-up. It included at each visit the assessment of the best corrected visual acuity (BCVA), refraction, Intra-ocular pressure, clinical ophthalmic examination, implant centering, endothelial cellularity count and the occurrence of peri- and post-operative complications. Seven women and seventeen men were included in the study. The mean age was 62.55 years. The surgical indications were posterior chamber implant dislocation in 11 cases, secondary implantation due to post-traumatic ......