Abstract
Purpose :
Different techniques of scleral fixation can be used to manage dislocated intraocular lenses (IOLs) in the absence of capsular support. This study aimed to determine the surgical efficacy and clinical outcomes of conventional sutured scleral IOL fixation versus flanged sutureless intrascleral fixation technique.
Methods :
A retrospective observational study of 144 eyes that underwent conventional sutured scleral fixation and 40 eyes that underwent flanged sutureless intrascleral fixation was performed over a six-year study period. The primary outcomes were uncorrected visual acuity (UCVA) and best corrected visual acuity (BCVA), assessed at the preoperative and postoperative month 3 (POM3) visits. Secondary outcomes were postoperative complications including reoperation due to IOL instability.
Results :
Mean UCVA change from preoperative to POM3 visits was -0.83 ± 1.05 logMAR (p = 0.112) in the conventional group vs. -0.55 ± 0.64 logMAR in the flanged sutureless group (p<0.001). Improvement in BCVA was also seen from preoperative to POM3 visits and had a mean change of -0.13 ± 0.25 logMAR (p = 0.272) in the conventional group vs. -0.18 ± 0.37 logMAR in the flanged sutureless group (p<0.001). Refixation was performed in 3 eyes (7.5%) in the conventional group compared to 2 eyes (1.4%) in the flanged sutureless group. 2 eyes developed an epiretinal membranein both groups, while hyphema developed in 2 eyes (1.4%) in the conventional group vs. 1 eye in the sutureless group (2.5%).
Conclusions :
Both conventional sutured scleral fixation and flanged sutureless intrascleral fixation techniques showed improvements in visual acuity postoperatively, with a similar postoperative complication profile. Further large-scale studies assessing the safety and efficacy of both techniques are warranted.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.