Relationship Between Needle Thickness and Intraocular Hemorrhage in Scleral Fixation of Intraocular Lenses

Sung Yong Park; Sung Jin Lee

doi:10.3341/jkos.2008.49.10.1578

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Yong Park and Jin Lee: Relationship Between Needle Thickness and Intraocular Hemorrhage in Scleral Fixation of Intraocular Lenses

Original Article

J Korean Ophthalmol Soc 2008;49(10):1578-1582.

Published online: 7 September 2008

DOI: https://doi.org/10.3341/jkos.2008.49.10.1578

Relationship Between Needle Thickness and Intraocular Hemorrhage in Scleral Fixation of Intraocular Lenses

Sung Yong Park, M.D, Sung Jin Lee, M.D

Department of Ophthalmology, Soonchunhyang University School of Medicine, Seoul, Korea

Address reprint requests to Sung Jin Lee, M.D. Department of Ophthalmology, Soonchunhyang University College of Medicine #657 Hannam-dong, Yongsan-gu, Seoul 140-743, Korea Tel: 82-2-709-9357, Fax: 82-2-798-7797, E-mail: wismile@unitel.co.kr

Received 11 June 2008 Accepted 7 March 2008

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To evaluate the relationship between needle thickness and intraocular hemorrhage in patients who underwent scleral fixation of intraocular lenses.

Methods

The records and surgical videos of 44 patients who underwent scleral fixation from January 2002 to December 2005 were reviewed. Only eyes with two-point scleral fixation using a 26-gauge needle and 10-0 polypropylene were included. We checked for intraoperative intraocular hemorrhage that occurred at the time of introducing the needle through the sclera. The cases were divided into those with anterior chamber bleeding, those with mild vitreous hemorrhage less than or equal to grade II, and those with severe vitreous hemorrhage greater than or equal to grade III.

Results

Of the 44 eyes, 12 eyes (27.3%) showed intraocular hemorrhage, 10 eyes (22.7%) by 26-gauge needles and 2 eyes (4.5%) by 10-0 Prolene needles ( p=0.026). Six eyes (13.6%), 5 by 26-gauge and 1 by 10-0 Prolene needles, suffered anterior chamber bleeding. Four eyes (9.1%), 3 by 26 gauge and 1 by 10-0 Prolene needles, showed mild vitreous hemorrhage, and 2 eyes (4.5%) by 26-gauge needle suffered severe hemorrhage.

Conclusions

The incidence of intraocular hemorrhage appears to be lower when thinner needles are used in scleral fixation.

Keywords: Hemorrhage, Needle, Polypropylene, Sclera fixation

References

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Figure 1.

Intraperative photograph of 56 years old patient who underwent scleral fixation. Grade I vitreous hemorrhage by 10-0 Prolene needle was identified at 7 o’clock direction.

Table 1.

Clinical characteristics of 44 patients who underwent sclera fixation

Characteristics
Age (years)
Range	12-84
Mean±SD*	55.7±17.3
Gender
Males	27 (61%)
Females	17 (39%)
Lens status
Pseudophakic	30 (68.2%)
Aphakic	8 (18.2%)
Phakic	4 (9.1%)
Indication of scleral fixation
Complicated cataract surgery	18 (40.9%)
Intraocular lens dislocation	10 (22.7%)
Aphakia	8 (18.2%)
Lens dislocation	4 (9.1%)
Opaque intraocular lens	(9.1%)
Duration of follow-up (months)
Range	1-14
Mean±SD	4.2±2.9

^* SD=standard deviation.

Table 2.

Intraoperative hemorrhage during scleral fixation

Types of needle	Hemorrhage
	H1*	H2^†	H3^‡
26 gauge needle	532	10 (22.7%)	p=0.026^§
10-0 Prolene needle	110	2 (4.5%)

^* H1=hyphema; exact test.

^† H2=mild vitreous hemorrhage (Grade I, II)

^‡ H3=severe vitreous hemorrhage (Grade III, IV)

^§ p=Fisher’s

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