Abstract
Purpose :
Multiple intraocular lens (IOL) options and surgical techniques are available to surgeons in the management of aphakia in the absence of capsular support. The goal of this study is to investigate the current preferences in surgical management and IOL type of surgeons when approaching a patient without capsular support.
Methods :
In the Fall of 2023, a 10-question survey regarding the approach of surgeons to surgical management of aphakia in the absence of capsular support was conducted. The survey was sent to the e-mail listservs of the Cornea Society, the American Glaucoma Society, and numerous vitreoretinal surgery specialists at academic institutions and private practices. Questions focused on surgeon demographic information, preferred surgical technique, and frequency of exposure.
Results :
168 surgeons responded to the survey from North America, South America, Asia, Europe, and Africa. Sub-specialties covered by responders included cornea and external disease, vitreoretinal surgery, glaucoma, comprehensive, and pediatric ophthalmology. 62.5% of respondents offered surgical management to patients before recommending usage of aphakic contact lenses. When surgery is performed, preferred surgical technique differed: 50.6% of surgeons preferred an intrascleral haptic fixation (Yamane) technique, 23.0% preferred scleral-sutured IOLs, 9.4% preferred an anterior chamber IOLs, 7.0% preferred aphakic contact lenses, 3.5% preferred scleral-glued IOLs, 3.5% preferred iris-claw IOLs, and 2.9% preferred iris-sutured IOLs.
Conclusions :
When managing patients with aphakia in the absence of capsular support, the majority of surgeons prefer surgical management to aphakic contact lenses. Scleral fixation is the preferred surgical technique, followed by anterior chamber IOL implantation, and iris fixation being least popular. Of respondents, intrascleral haptic fixation (Yamane) technique of a 3-piece IOL is the most commonly performed secondary intraocular lens surgery.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.