Intrascleral Haptic Fixation of IOLs in Combination With Iris Repair or Iris Prosthesis
Purpose
To report visual outcomes, photophobia, cosmetic outcomes and complications of posterior chamber intraocular lens (IOL) intrascleral haptic fixation with adjunct iris surgery or iris prosthesis.
Methods
Retrospective consecutive case series of eyes that underwent intrascleral haptic fixation (ISHF) of a 3-piece intraocular lens with adjunctive iris surgery or iris prosthesis implant. Primary outcome measure was corrected distance visual acuity (CDVA). Secondary outcome measures were, IOL centration, improvement of photophobia, and cosmetic results.
Results
We included 12 eyes of 12 patients. Indications for ISHF were: aphakia (83%) and IOL subluxation (17%). Adjunctive procedures included 9 pupilloplasties, 1 iris cerclage and 2 customized silicone iris prosthesis implants. Mean preoperative CDVA improved from 1.33± 0.80 to 0.61± 0.55 (p=0.036). All patients reported resolution or improvement of their photophobia postoperatively. Two IOLs (16.6%) were mildly decentered at 6 months follow-up and 11 patients (91.7%) were very satisfied with their cosmetic results. The most common complication was ocular hypertension (33%), which resolved in all cases.
Conclusion
Intrascleral haptic fixation with iris repair or prosthesis resulted in an improvement in CDVA and resolution or improvement of photophobia with satisfactory cosmetic results in this group of complex eyes.