JUL 31, 2019
Refractive Mgmt/Intervention, Retina/Vitreous
Investigators retrospectively evaluated refractive outcomes after combined pars plana vitrectomy (PPV) and scleral fixation of an IOL using Gore-Tex suture.
This study assessed refractive outcomes of 55 eyes from 53 patients who underwent PPV and received either an Akreos A060 or enVista MX60 IOL, fixated 2 mm or 3 mm posterior to the limbus with Gore-Tex suture. Postoperative manifest refractions were performed at least 3 months after surgery, and were compared with preoperative predicted target refraction based on in-the-bag IOL calculations.
The mean postoperative spherical equivalent was -1.53 D for the 2-mm group, and -0.82 D for the 3-mm group (P=0.09). The mean amount of surgically induced astigmatism over the entire cohort was 0.77 D. The mean difference in spherical equivalent and induced astigmatism was similar between the IOL models.
This study was limited by its retrospective nature and small sample size in the MX60 group (8 eyes). The distance between sclerotomies varied between 3 and 5 mm, and was not included as a study variable.
Fixating an IOL 3 mm behind limbus is likely the better option for patients, not only in terms of better refractive outcomes but also for prevention of complications such as iris chaffing and vitreous hemorrhage.