Abstract
Purpose :
Although placement of an intraocular lens (IOL) in the capsular bag is ideal during cataract surgery, complications require ophthalmologists to know alternative methods of IOL implantation. We performed a retrospective chart review to learn about the pre-operative parameters/indications and post-operative outcomes in patients that underwent transscleral-fixated IOL (TSFIOL) implantation at our institution. Our hope is to better understand which patients may be more suitable for TSFIOL's based on these considerations.
Methods :
We conducted a retrospective chart review of 30 patients (22 males and 8 females; mean age of 68.6) at our institution that underwent TSFIOL implantation by a posterior segment surgeon. Data was collected from EyeMD (the ophthalmology clinic electronic medical record (EMR)) and Allscripts (hospital EMR), and then separated into 2 main categories: pre-operative parameters/indications for surgery and post-operative outcomes/complications.
Results :
Review of pre-operative parameters revealed that 14 patients were aphakic, 7 had a ruptured capsule, 8 had a dislocated IOL, 9 had a traumatic event, 11 had iris damage, 6 had a shallow anterior chamber, and 9 had corneal pathology. Initial preoperative visual acuity (VA) was compared with final VA (3 months post-operatively). The majority displayed an improvement in VA (n = 23), while a minority had a decline (n=2; the remaining were lost to follow up or had no change in VA). We further divided our population into emergent (7 cases) or planned surgeries (22 cases) and compared improvement in VA between the 2 groups. No significant difference was found between the 2 groups in terms of improvement in VA (p=0.748). The overall complication rate was 48.28%, which includes choroidal detachment, hypotony, corneal edema, Irvine Gass syndrome, and elevated intraocular pressure.
Conclusions :
Long-term data on functional outcomes after TSFIOL implantation is limited. Overall, 79.31% of patients had unchanged/improved VA. Therefore, the majority had improved VA after TSFIOL implantation. Improvement in VA's among planned and emergency cases was not significantly different. The most common complication in our cohort was ocular hypertension. We hope to include additional patients in our retrospective review to better understand which patients may be more suitable candidates for a TSFIOL.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.