Comparison of flanged intrascleral haptic fixation and 2-point transscleral Gore-Tex-sutured IOL fixation: 12-monthcohort study.

PURPOSE: To compare the short-term and long-term visual and refractive outcomes between flanged intrascleral haptic fixation (FIHF) and 2-point transscleral polymethyl methacrylate (PMMA) intraocular lens (IOL) fixation using Gore-Tex sutures in patients lacking capsular support.

SETTING

National Cheng Kung University Hospital, Tainan, Taiwan.

DESIGN

Retrospective cohort study using propensity score matching to minimize baseline differences between groups.

METHODS

Medical records of adult patients who underwent FIHF or Gore-Tex-sutured IOL fixation between 2014 and 2024 were reviewed. Patients with less than 12-month follow-up or conditions affecting visual prognosis were excluded. Postoperative corrected distance visual acuity (CDVA), refractive cylinder, and complications were analyzed.

RESULTS

82 eyes (46 FIHF, 36 sutured) were identified; after matching, 34 eyes in each group were analyzed. After matching, the FIHF group demonstrated significantly better CDVA than the sutured IOL group at 1 month (mean logMAR, 0.73 vs 1.08; P = .003) and 3 months (0.62 vs 0.94; P = .009) postoperatively. Cylindrical power at 3 months was significantly lower in the FIHF group (1.94 vs 3.69 diopter, P = .009), indicating less surgically induced astigmatism. No significant differences were observed in CDVA, complication rates, or refractive outcomes at 12 months.

CONCLUSIONS

FIHF may facilitate earlier reduction in astigmatism, thereby promoting faster visual recovery, particularly in cases of IOL subluxation or dislocation, compared with sutured IOL fixation. However, no significant differences were observed between the 2 groups in visual acuity, refractive status, or complication rates at 1 year postoperatively.