This resource is only available for ASCRS Members. Please log in using the teal "Login" button in the top right-hand corner to log in.
There is no consensus on the best IOL implantation method in the lack of capsular support. In cases that preclude anterior chamber or iris fixation, scleral support techniques must be undertaken. We compare the visual outcomes and postoperative complications of Gore-Tex suture (GS), fibrin glue (FG), and flanged-haptic (FH) fixation techniques.
Retrospective, comparative case series of patients with lack of capsular bag support who underwent scleral-fixated IOL implantation at our institution between April 2015 and September 2018. There were approximately 40 patients in this study: approximately 20 Gore-Tex-sutured Bausch + Lomb Akreos AO60 IOLs, 7 fibrin-glued Alcon MA60ACs or Zeiss CT Lucia 602 IOLs, and approximately 15 double-needle flanged-haptic Aaren Scientific EC-3 PAL IOLs or Zeiss CT Lucia 602 IOLs. Patient demographics, surgical indications, changes in BCVA, IOP, and postop complications were recorded. Continuation of a study on this topic which we presented as a poster and paper at ASCRS 2018.
Mean logarithm of the minimum angle of resolution (logMAR) of BCVA improved from 0.95±0.19 (20/179 Snellen) to 0.45 ± 0.07 (20/57) with sutured Akreos at 3 months, from 0.97 ± 0.38 (20/186) to 0.87±0.36 (20/148; p=0.1) with glued MA60ACs, and from 1.17 ± 0.31 (20/295) to 0.43 ± 0.11 (20/53; p=0.05) with flanged-haptic EC-3 PAL / CT Lucia 602. The most common complications were: OHTN (50%), recurrent/chronic inflammation (35.7%), and late CME (21.4%) in the GS group, Worsening of preexistent OHTN (28.4%) in the FH group, and Hypotony (28.6%) in the FG group.
Vision improved in all, but worsened with time in sutured IOLs and improved with FH IOLs There were relatively more complications with Gore-Tex-sutured IOLs. The most common complications were ocular HTN (50%), recurrent/chronic inflammation (35.7%), and late-onset CME (21.4%) in the Gore-Tex group, worsening of preexistent OHTN (28.4%) in the FH group, and hypotony (28.6%) in the FG group.