Influence of sclerotomy size on intraocular lens tilt after intrascleral intraocular lens fixation.

PURPOSE: To determine whether differences in sclerotomy size during intrascleral intraocular lens (IOL) fixation influence IOL tilt and visual acuity after surgery.

SETTING

University of Fukui Hospital and Japanese Red Cross Fukui Hospital, Japan.

DESIGN

Retrospective case series.

METHODS

The study reviewed the records of patients who had intrascleral IOL fixation with transconjunctival 25-gauge pars plana vitrectomy and a follow-up longer than 6 months. The preoperative and postoperative visual outcomes, degree of IOL tilt, and intraoperative and postoperative complications were statistically compared between the sclerotomy groups.

RESULTS

The study included 65 eyes (60 patients). Postoperatively, the maximum degree of IOL tilt was significantly smaller in the 24-gauge sclerotomy group than in the 30-gauge sclerotomy group (P = .003). The degree of IOL tilt was significantly correlated with the amount of postoperative IOL astigmatism (total astigmatism - corneal astigmatism) (P = .0001, R2 = 0.23). There were no statistically significant differences in the preoperative or postoperative corrected distance visual acuity (CDVA) or the complication rate between the sclerotomy groups.

CONCLUSION

A smaller sclerotomy for intrascleral IOL fixation was associated with greater IOL tilt and IOL astigmatism after surgery; however, this did not clinically or significantly affect the postoperative CDVA.