Sutureless, scleral fixated-IOLs
Reviewed by Su Young

This was a retrospective cohort study of 112 sutureless, scleral-fixated posterior chamber intraocular lens implantations (SSFCIOL) over a four-year time period. Mean follow-up duration was 13.0 ±10.4 months. The primary indication for SSFCIOL was dislocation of IOL due to zonular weakness (77 eyes, 68.8%). A MA60AC IOL (Alcon) was implanted in 92 (82.1%) eyes, with fixation of the pre-existing three-piece IOL in remaining eyes (20 eyes, 17.9%). At latest follow-up, the study recorded improvement in uncorrected visual acuity (1.3 ±0.8 to 0.64 ±0.60 logMAR, p<0.01), and best-corrected visual acuity (BCVA) (0.6 ±0.5 logMAR to 0.36 ±0.40 logMAR, p<0.01). Postoperative complications include transient IOP elevation (30 eyes, 26.8%), cystoid macular oedema (16 eyes, 14.3%), transient hypotony (13.4%), iris capture (12.5%), uveitis-glaucoma-hyphema (UGH) syndrome (11.6%), and vitreous haemorrhage (VH) (6.3%). Operative reinterventions included SSFIOL exchange (3.6%), SSFIOL repositioning (5.4%), and SSFIOL removal (2.7%). Ten (8.9%) patients required multiple re-interventions. The study’s findings suggest SSFIOL as a reasonable option in cases with inadequate capsular support, with visual improvement noted in the majority of patients. The authors report that many of the operative complications were related to a floppy iris-lens diaphragm, and surgical modifications can be made to minimise iris-related complications.

Outcomes of using sutureless, scleral-fixated posterior chamber intraocular lenses.
Kansal L, Onasanya O, Colleaux K, Rawlings L.
SEMINARS IN OPHTHALMOLOGY
2019;34(7-8):488-96.