Sutureless scleral-fixated IOLs with flanged haptics appear stable

Using a combination of retrospective surgical data and cadaveric experiments, investigators assessed the stability of a haptic flanging during 27-gauge sutureless intrascleral fixation of IOLs.

Study design

The cadaveric eye experiment comprised 5 eyes that were used to compare the force require to dislocate a scleral-fixated IOL, with and without haptic flanging. The surgical case series included 52 eyes of 52 patients who underwent 27-gauge sutureless intrascleral fixation of 3-piece IOLs with haptic flanging.

Outcomes

In the cadaveric eye experiment, significantly more force was required to dislocated scleral-fixated lenses with haptic flanging than lenses that were fixed without flanging (P=0.03).

In the surgical case series, mean visual acuity improved from 20/140 preoperatively to 20/50 at postoperative month 1 (P<0.001). The most common postoperative complication was an immediate IOP increase (23%). Only 4% of eyes required IOL repositioning.

Limitations

This study was limited by its relatively small sample size and retrospective nature. No refractive data were available, which prevented researchers from evaluating the efficacy of the IOL implantation procedure. Furthermore, there was no uniformity in IOL type or surgical technique/vitrectomy gauge.

Clinical significance

This study suggests that 27-gauge sutureless fixation of an IOL with flanging of the haptics appears to confer good IOL stability and the ability to stay fixated despite impact. In practice, the procedure seems to carry a good safety profile, with low complication and dislocation rates.