{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T13:24:36Z","timestamp":1788269076258,"version":"build-2803163510"},"reference-count":33,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2025,6,19]],"date-time":"2025-06-19T00:00:00Z","timestamp":1750291200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Open Access Publication Fund of the University of Duisburg-Essen"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: Different surgical techniques are available in cases of missing or insufficient capsular bag support. Next to the anterior chamber or iris-fixated intraocular lenses (IOL), the implantation of the Carlevale IOL provides a sutureless and scleral fixated treatment method. Methods: In a retrospective single-center study, the perioperative data of 100 patients who consecutively received a scleral fixated Carlevale IOL combined with a 25 gauge (G) pars plana vitrectomy between September 2021 and June 2024 were investigated. The intraoperative and postoperative results were analyzed in terms of complication rates and refractive outcomes. Results: IOL dislocation was the most common surgical indication (50%) for sutureless Carlevale IOL implantation, followed by postoperative aphakia in 35 patients (35%). Nearly every fourth patient (24%) had a preoperative traumatic event, and 21% had pseudoexfoliation (PEX) syndrome. The average surgery time was 60.2 (\u00b120.1) min. Intraoperative intraocular hemorrhage occurred in seven cases, and IOL haptic breakage in two patients. Temporary intraocular pressure fluctuations represented the most common postoperative complications (28%). Severe complications such as endophthalmitis or retinal detachment were not observed in our cohort. The mean refractive prediction error was determined in 67 patients and amounted to an average of \u22120.7 \u00b1 2.0 diopters. The best corrected visual acuity (BCVA) at the last postoperative follow-up showed an improvement of 0.2 \u00b1 0.5 logMAR (n = 76) compared to the preoperative BCVA (p = 0.0002). The postoperative examination was performed in 72% of the patients, and the mean follow-up period amounted to 7.2 \u00b1 6.4 months. Conclusions: Overall, sutureless and scleral fixated implantation of the Carlevale IOL represents a valuable therapeutic option in the treatment of aphakia and lens as well as IOL dislocation in the absence of capsular bag support with minor postoperative complications and positive refractive outcomes.<\/jats:p>","DOI":"10.3390\/jcm14124378","type":"journal-article","created":{"date-parts":[[2025,6,19]],"date-time":"2025-06-19T08:43:58Z","timestamp":1750322638000},"page":"4378","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Implantation of Sutureless Scleral-Fixated Carlevale Intraocular Lens (IOL) in Patients with Insufficient Capsular Bag Support: A Retrospective Analysis of 100 Cases at a Single Center"],"prefix":"10.3390","volume":"14","author":[{"given":"Jan","family":"Strathmann","sequence":"first","affiliation":[{"name":"Department of Ophthalmology, Eye Cancer Center Essen, University Hospital Essen, Hufelandstr. 55, 45147 Essen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sami","family":"Dalbah","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Eye Cancer Center Essen, University Hospital Essen, Hufelandstr. 55, 45147 Essen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tobias","family":"Kiefer","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Eye Cancer Center Essen, University Hospital Essen, Hufelandstr. 55, 45147 Essen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0180-1112","authenticated-orcid":false,"given":"Nikolaos E.","family":"Bechrakis","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Eye Cancer Center Essen, University Hospital Essen, Hufelandstr. 55, 45147 Essen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Theodora","family":"Tsimpaki","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Eye Cancer Center Essen, University Hospital Essen, Hufelandstr. 55, 45147 Essen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7868-5167","authenticated-orcid":false,"given":"Miltiadis","family":"Fiorentzis","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Eye Cancer Center Essen, University Hospital Essen, Hufelandstr. 55, 45147 Essen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,6,19]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1007\/s10792-012-9635-0","article-title":"Secondary intraocular lens interventions: Predisposing factors, indications and coincident procedures","volume":"33","author":"Lichtinger","year":"2013","journal-title":"Int. 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