{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T20:39:57Z","timestamp":1777581597920,"version":"3.51.4"},"reference-count":31,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2024,2,2]],"date-time":"2024-02-02T00:00:00Z","timestamp":1706832000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["European Journal of Ophthalmology"],"published-print":{"date-parts":[[2024,11]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Scleral fixation of intraocular lenses constitutes a surgical option in cases where there is inadequate capsular support or zonular insufficiency. Knotless techniques, such as the z-suture technique, avoid suture-related complications, such as conjunctival erosion or exposure. The purpose of this study was to evaluate the visual outcomes and postoperative complications of patients who underwent scleral z-suture fixation of the Akreos AO\u00ae intraocular lenses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective, observational study was conducted, including 22 eyes of 20 patients who underwent Akreos AO\u00ae intraocular lenses using the z- suture scleral fixation technique.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The mean age of the patients was 55,64\u2009\u00b1\u200928,47 years old, and the mean follow-up time was 25,64 months. The most common indication for surgery was previous complicated cataract surgey. The mean postoperative spherical equivalent was +0,058D\u2009\u00b1\u20090,79D, with values ranging from - 1,50D to +1,00D. Mean best-corrected visual acuity was 0,178\u2009\u00b1\u20090,15 logMAR. Intraocular pressure was 15,07\u2009\u00b1\u20092,56 mmHg on the day after surgery, and 16\u2009\u00b1\u20092,15 mmHg 1 month after. No suture-related complications were observed in any patient postoperatively. One patient had a slight inferonasal lens dislocation and another patient had a severe case of herpetic keratitis posoperatively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>The knotless z-suture technique appears to be a reliable and safe way to fix an intraocular lens in the sclera, regardless of the patient's age. Our results show good visual results and predictable refractive outcomes. Decades of follow-up may be necessary to assess the long-term risk of lens dislocation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/11206721241230566","type":"journal-article","created":{"date-parts":[[2024,2,2]],"date-time":"2024-02-02T04:01:29Z","timestamp":1706846489000},"page":"1884-1889","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":3,"title":["Z-suture scleral fixation intraocular lenses: A refractive and safety report"],"prefix":"10.1177","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5780-0450","authenticated-orcid":false,"given":"Renato Correia","family":"Barbosa","sequence":"first","affiliation":[{"name":"Ophthalmology Department, Hospital Pedro Hispano \u2013 Unidade Local de Sa\u00fade de Matosinhos, ULSM, Matosinhos, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rui","family":"Carvalho","sequence":"additional","affiliation":[{"name":"Ophthalmology Department, Hospital Pedro Hispano \u2013 Unidade Local de Sa\u00fade de Matosinhos, ULSM, Matosinhos, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2024,2,2]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1097\/j.jcrs.0000000000001046"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1097\/j.jcrs.0000000000000954"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1111\/aos.14824"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1111\/aos.14090"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-020-80292-3"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.survophthal.2005.06.010"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12886-015-0118-8"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajo.2015.06.010"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1001\/archopht.1990.01070110021001"},{"key":"e_1_3_2_11_2","first-page":"692","article-title":"Ab externo sulcus fixation","volume":"22","author":"Lewis J","year":"1991","unstructured":"Lewis J. 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Ophthalmic Surg 1992; 23: 17\u201321.","journal-title":"Ophthalmic Surg"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0161-6420(93)31477-6"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.3928\/1542-8877-20040901-06"},{"key":"e_1_3_2_17_2","first-page":"379","article-title":"Scleral fixation without conjunctival dissection","volume":"35","author":"Hoffman R","year":"2004","unstructured":"Hoffman R, Fine I, Packer M. Scleral fixation without conjunctival dissection. J Cataract Refract Surg 2004; 35: 379\u2013382.","journal-title":"J Cataract Refract Surg"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1136\/bjo.2009.162180"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.2147\/OPTH.S340039"},{"key":"e_1_3_2_20_2","unstructured":"Bausch & Lomb. 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