Iris and Scleral Fixation of Posterior Chamber IOLs: Indications and Outcomes
Purpose
To assess the indications for iris fixation and scleral fixation of posterior chamber intraocular lenses (PCIOLs), evaluate efficacy, and identify postoperative complications.
Methods
This is a retrospective case review of iris-fixated PCIOLs and scleral-fixated PCIOLs from April 2003 to June 2014. The variables studied include indications for IOL fixation, history of trauma, visual acuity, and postoperative complications.
Results
266 eyes of 256 patients were studied. The average patient age at the time of the surgery was 69 years. The average length of postoperative follow-up was 15 months (range 1-72 months). The indications for a sutured PCIOL were non-traumatic dislocation/subluxation of the original IOL implant (92%), poor capsular support due to trauma (6%) and ectopia lentis (2%). Visual acuity improved in 67 eyes (64%), was maintained in 18 eyes (17%), and decreased in 19 eyes (18%). Final visual acuity of 20/40 or better was achieved in 43 eyes (41%). Postoperative complications included subsequent dislocation of the sutured PCIOL in 8 eyes. Vitreous hemorrhage occurred postoperatively in 5 eyes and retinal detachment occurred in 3 eyes. Choroidal detachment occurred in one case as did endophthalmitis.
Conclusion
Iris and scleral fixation of PCIOLs appears to be an effective technique to treat dislocation of primary PCIOLs and aphakia in cases with insufficient capsular support. Visual acuity improved in most cases and rates of complication were low.