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Ramon Lee, Nathan Farley, Ashkan M Abbey, Maxwell S Stem, George A. Williams, Lisa F Faia, Tarek S Hassan, Alan J Ruby, Sandeep Randhawa, Jeremy D Wolfe; Refractive Outcomes after Sutureless Intrascleral Fixation of Secondary Intraocular Lens with Pars Plana Vitrectomy. Invest. Ophthalmol. Vis. Sci. 2020;61(7):1657.
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© ARVO (1962-2015); The Authors (2016-present)
Sutureless intrascleral fixation of secondary intraocular lens (SIS IOL) with pars plana vitrectomy (PPV) can provide excellent visual potential for eyes with subluxed or dislocated intraocular lenses, aphakia, or retained lens fragments. This study aims to evaluate refractive outcomes of this technique.
This study was a retrospective, consecutive cohort from multiple surgeons of a single center. Inclusion criteria included eyes that underwent SIS IOL with PPV and obtained refraction at 3 months and 1 year follow up. Eyes were excluded if refraction was unable to be obtained for any reason. Primary outcome measures included spherical equivalent (SEQ) and change in SEQ (ΔSEQ) at 3 month, 1 year, and last follow up compared to predicted preoperative SEQ aim of the implanted IOL. Secondary outcomes measures included visual acuity (VA) and refractive outcomes between IOL fixation at 1.5mm, 2mm, and 2.5mm posterior to the limbus.
In total, 74 eyes of 70 patients were included. Preoperative logMAR VA was 1.21±0.67. Mean follow up times was 2.52±1.35 years. All eyes were implanted with an Alcon MA60AC IOL with predicted SEQ of -1.07±0.81D. Five eyes, 61 eyes, and 8 eyes had the IOL fixated 1.5mm, 2mm, and 2.5mm posterior to the limbus, respectively. At 3 month follow up, logMAR VA was 0.24±0.21, SEQ was -0.56±1.65D, and ΔSEQ was 0.51±1.54D. At 1 year follow up, logMAR VA was 0.22±0.21, SEQ was -0.68±1.56D, and ΔSEQ was 0.39±1.42D. At last follow up, logMAR VA was 0.23±0.21, SEQ was -0.54±1.47D, and ΔSEQ was 0.53±1.28D. At 3 months, 1 year, or last follow up, there was no difference between SEQ or ΔSEQ (p=0.83 and p=0.80, respectively). Comparing IOL fixation 1.5mm, 2mm, and 2.5mm posterior to the limbus, there was no difference in ΔSEQ at 3 months (p=0.11) or 1 year (p=0.051), but there was a difference at last follow up (p=0.03).
The refractive outcomes for SIS IOL with PPV were favorable. This study showed postoperative SEQ to be stable and to be more hyperopic compared to preoperative IOL calculations, particularly for more posterior fixation. These results may aid surgeons with IOL power calculations to better predict refractive outcomes.
This is a 2020 ARVO Annual Meeting abstract.
Box-and-whisker plot showing postoperative SEQ at 3 months, 1 year, and last follow up.
Box-and-whisker plot showing postoperative ΔSEQ at last follow up at varying fixation distances posterior to the limbus.
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