Small-Incision 4-Point Scleral Suture Fixation of Foldable Hydrophilic Acrylic IOL in Absence of Capsule Support
Purpose
To determine visual outcomes and complications of a novel small incision technique for four-point fixation of a hydrophilic, acrylic posterior chamber IOL in the absence of capsule support.
Methods
Retrospective chart review of 37 eyes from 35 patients who underwent secondary IOL placement from 2011 to 2014. Cases were performed by three surgeons at three independent sites. Indications for surgery, clinical results and complications were analyzed. Primary outcomes included postoperative best-corrected visual acuity and surgical complications.
Results
Mean age at surgery was 56 years and the mean follow-up was 6 months (range 3-24 months). Clinical indications included dislocated IOL (35%), ocular trauma (19%), crystalline lens subluxation (19%), UGH syndrome (8%), post complicated cataract (8%), congenital cataract (8%), and decompensated cornea (3%). Mean BCVA improved from 20/80 preoperatively to 20/40 postoperatively (P<0.01). Thirty-six eyes (97%) had an improved or unchanged BCVA and one (3%) had a reduced BCVA (due to worsening glaucoma). Postoperative complications included ocular hypertension (24%), iritis (5%), wound leakage (3%), transient corneal edema (3%), glaucoma requiring tube shunt (3%), and IOL dislocation (3%).
Conclusion
Small incision four-point scleral fixation of the Akreos AO60 hydrophilic, acrylic IOL in the absence of capsular support appears to be a safe and effective technique for secondary IOL placement.