Clinical outcomes of iris fixation and sutureless scleral fixation of dislocated foldable posterior chamber intraocular lenses.

PURPOSE: Explore the visual outcome and complications of iris fixation intraocular lenses (IFIOL) and sutureless scleral-fixated intraocular lenses (SSFIOL) in the surgical management of patients without exchanging dislocated posterior chamber intraocular lenses (PCIOLs) in the vitreous.

METHODS

Retrospectively, 14 IFIOL and 15 SSFIOL reimplantations for dislocated PCIOLs were analyzed. Mean follow-up of reIFIOL group and reSSFIOL group: 11.3±2.0 (range: 9-15) months and 11.8±2.2 (range: 9-16) months, respectively. Preoperative and postoperative outcomes, operative indications, and complications were evaluated.

RESULTS

Primary surgical indications were pseudoexfoliation (PXE) (21.4%), post-cataract surgery (PCS) (35.7%), trauma (42.8%) in the reIFIOL group, and PXE (26.6%), PCS (40%) trauma (33.3%) in reSSFIOL group, respectively. At the latest follow-up, there was an improvement in best-corrected visual acuity (BCVA) (0.053±0.051 to 0.53±0.13, P<0.0001) in reIFIOL group and (0.05±0.02 to 0.64±0.16, P<0.0001) in reSSFIOL group. Postoperative complications of reIFIOL group and reSSFIOL group included corneal edema (14.2%; nil), IOP elevation (21.4%; 7.1%), bullous keratopathy (14.2%; nil), anterior uveitis (35.7%; 13.3%), cystoid macular edema (CME) (21.4%; 7.1%), pupil ovalization (21.4%; nil), broken haptic (none; 13.3%), IOL exchange (nil; 13.3%), and vitreous hemorrhage (nil; 14.2%).

CONCLUSIONS

Self-dislocated IOL reimplantation may enable much earlier visual rehabilitation in the reSSFIOL group than in the reIFIOL group. Moreover, the 27G trocar-assisted reSSFIOL technique takes a shorter operation time and relatively lower complication rates. However, further prospective studies with larger series and longer follow-up periods are required.