Long term outcome of in situ scleral fixation of subluxated capsular bag - intraocular lens complex.

PURPOSE: To examine the long-term outcome in terms of visual performance and positional stability of a minimally invasive in situ fixation technique for repositioning of subluxated capsular bag-intraocular lens complex.

SETTING

Tertiary eye care and postgraduate training institute.

DESIGN

Single-center retrospective study.

METHODS

The medical records of 13 pseudophakic patients who presented with Subluxated capsular bag - intraocular lens complexes operated by a single surgeon with a minimally invasive in situ fixation technique from January 2014 to February 2020 were retrospectively reviewed. This technique employs creation of a scleral pocket and an opposing paracentesis to pass the nonabsorbable suture to engage the subluxated capsular bag-intraocular lens complex followed by centration and tying of suture ends and burying the knot. The uncorrected and best-corrected visual acuity and centration and stability of the repositioned complex were analyzed at baseline, 3 weeks, and final visit. The refractive status and ocular residual astigmatism were also analyzed.

RESULTS

On comparing the best corrected visual acuity at baseline with that at final visit mean follow-up 53 months, 92.3% had successful visual outcome as defined in this study. Centration was achieved in 12 patients on follow-up visits except in one patient who had inferior iris coloboma. The measured ocular residual astigmatism ranged between J0 -0.55 and J45 -0.17. Three patients had posterior capsule opacification as the only late complication that would occur even otherwise.

CONCLUSION

The minimized surgical manoeuvring and long term satisfactory visual outcomes suggest that this technique can be performed as a primary repositioning surgery for subluxated capsular bag - intraocular lens complex.