Abstract
Purpose :
To compare the visual outcomes and postoperative complication rates of iris-sutured intraocular lens (IOL’s) and scleral-glued IOL’s in eyes with inadequate capsular support undergoing either secondary IOL placement or IOL exchange.
Methods :
A retrospective chart review was performed at The New York Eye and Ear Infirmary of Mt Sinai of two surgeons (JS, DR) from 2002 to 2015. 122 eyes with iris-sutured IOL’s and 57 eyes with scleral-glued IOL’s were analyzed. Preoperative data collected included age of patient at time of surgery, gender, pre-existing ocular conditions, pre-surgical vision and type of surgery performed. The postoperative data collected focused on best corrected visual acuity (BCVA) intraoperative and postoperative complications including subluxation of IOL, corneal edema, vitreous hemorrhage and intraocular pressure spikes. Exclusion criteria included those who had prior secondary IOL placement and those followed for less than 3 months. Both the Fisher’s Exact Test and Chi-Squared Test were used in the data analysis.
Results :
Of the patients with iris-sutured IOL’s, 52% (63/122) were female and 48% (59/122) were male. The average age was 63.0 years at the time of surgery. Of the patients with scleral-sutured IOL’s, 45.6% (26/57) were female and 54.4% (31/57) were male. The average age was 70.6 at the time of surgery. There was no significant difference in the preoperative diagnoses between the two patient groups (p=0.768). A statistically significantly greater percentage of patients achieved either the same or improved BCVA after secondary IOL placement in the scleral-glued category (89.5%, n=51) as compared with iris-sutured (76.2%, n=03), p=0.044. There was also a statistically significant decrease in the incidence of subluxation of IOL after surgery in scleral-glued compared with iris-sutured through the final follow up visit. (24/122 iris, 3/57 scleral, p=0.013).There were no other statistically significant post-operative complication differences between the two groups.
Conclusions :
Scleral-glued IOL’s led to statistically significant better BCVA with a decreased incidence of IOL subluxation as compared with iris-sutured IOL’s. However, this difference may change as we follow the scleral glued IOL's for longer periods. There was no difference in the rate of other postoperative complications.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.