July 2019
Volume 60, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2019
Comparison of Predicted Versus Actual Refractive Outcomes for Four Point Scleral Fixation of an Acrylic Closed-Loop Haptic Lens Placed at the 3 mm Position
Author Affiliations & Notes
  • Matthew Ohr
    Ophthalmology, The Ohio State University, Powell, Ohio, United States
  • Footnotes
    Commercial Relationships   Matthew Ohr, None
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Investigative Ophthalmology & Visual Science July 2019, Vol.60, 5749. doi:
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      Matthew Ohr; Comparison of Predicted Versus Actual Refractive Outcomes for Four Point Scleral Fixation of an Acrylic Closed-Loop Haptic Lens Placed at the 3 mm Position. Invest. Ophthalmol. Vis. Sci. 2019;60(9):5749.

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      © ARVO (1962-2015); The Authors (2016-present)

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Purpose : Although various techniques for scleral fixation of intraocular lenses have been described, there is a paucity of data to guide physicians in selecting lens power to optimize refractive outcomes for patients. This study evaluates the predicted versus actual refractive outcomes for patients from a single surgeon using a single technique.

Methods : This is a retrospective study that included data from patients who had scleral fixation of an acrylic four-point closed-loop haptic lens (Akreos AO60, Bausch & Lomb) using microporous, non-absorbable monofilament suture (Gore-Tex CV-8; TTc-13, Gore). The procedure has been described previously. All patients underwent 25 g pars plana vitrectomy and suture fixation using a single technique. All data was collected from one surgeon over the course of one year. Patients were included if they had conventional optical biometry (IOL Master, Zeiss) and SRK/T formula prediction for spherical equivalent. Patients without post-operative refraction data or comorbidities that precluded an accurate refraction were excluded from the study. Pre and post-operative data were collected and analyzed.

Results : 15 eyes of 15 patients were included in the study. All eyes underwent scleral fixation 2 mm posterior to the limbus. Of the eyes undergoing surgery 100% (15/15) achieved BCVA equal to or greater than the pre-operative BCVA. There were no intraoperative complications. Overall, refractive powers predicted by conventional biometry were relatively reliable. The average predicted spherical equivalent (SE) was -0.91 diopters (D) with an average actual SE of -0.93 D post operatively. The average deviation between the predicted SE and the actual postoperative SE was 0.13 D.

Conclusions : Scleral fixation of an acrylic closed-loop haptic lens using non-absorbable monofilament suture is a safe and effective surgical technique for the treatment of aphakia in the absence of capsular support. Conventional biometry using the SRK/T formula to predict refractive outcomes appears to give reliable results.

This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.



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