Outcomes of Scleral Fixation With Fibrin Glue for IOLs
Narrative Responses:
Purpose
Our purpose is to report the anatomic, visual, and refractive outcomes of our first 10 patients who received scleral-fixation of an IOL with fibrin glue.
Methods
A retrospective chart review 10 consecutive patients that had scleral-fixation of an IOL using fibrin glue was performed retrospectively. The procedure involved the creation of two partial thickness scleral flaps 180 degrees from each other. A 3-piece IOL was inserted, with each haptic being externalized through a sclerotomy under the flap and tucked into an intrascleral tunnel. The flaps were then closed with fibrin glue. Operative and post-operative outcomes were assessed including complications, centration of IOL, and best corrected visual acuity.
Results
Eight edematous, pseudophakic bullous keratopathy eyes with poor visibility through the cornea had an IOL exchange procedure in which the offending primary anterior chamber IOL was replaced by a glued IOL; this was later followed by endothelial keratoplasty (EK). The remaining two eyes were treated for traumatic lens subluxation. Intraoperatively, one patient had a broken haptic. Postoperatively, 2 patients had mild haptic exposure and 1 patient developed a retinal detachment. Eight of the 10 patients had a well-centered IOL with the remaining 2 patients having mild IOL decentration at one year follow-up. Visual acuity remained stable in all 10 patients.
Conclusion
Scleral-fixation of IOLs with fibrin glue resulted in few intra-operative complications and good post-operative IOL centration. Furthermore, the glued IOLs were stable enough to tolerate an EK procedure afterwards.