The following is a summary of “Comparison of three different intraocular lens implantation techniques in the absence of capsular support: sutured scleral, haptic flanged intrascleral, and four flanged intrascleral fixations,” published in the October 2023 issue of Opthalmology by Boz et al.
Intraocular Lens (IOL) implantation techniques vary depending on the condition of the capsular bag, with posterior chamber implantation being safer in sure eyes.
Researchers started a retrospective study to compare outcomes of sutured scleral fixation (SSF), haptic flanged intrascleral fixation (HFISF), and four flanged intrascleral fixation (FFISF) IOL implantation techniques in eyes with absent capsular support.
They included 137 aphakic eyes without capsular support. The patients were categorized into three groups: group 1 SSF, group 2 HFISF – Yamane technique, and group 3 FFISF. Surgical duration in minutes, preoperative and postoperative parameters, including best corrected visual acuity (BCVA), corneal astigmatism, lenticular astigmatism, intraocular pressure (IOP), specular microscopy, and central macular thickness (CMT) were recorded. Pseudophacodonesis was checked at 6 months post-surgery, and all complications were noted.
The results showed 137 eyes: 69 were in the SSF group, 41 were in the HFISF group, and 27 were in the FFISF group. No differences were noticed among the three groups regarding age, gender, preoperative mean BCVA, corneal astigmatism, IOP, endothelial cell density, and CMT. All three groups had improved vision after surgery, but the FFISF group had more astigmatism, pseudophacodonesis, and endothelial cell loss. The HFISF group had a shorter surgery time, with IOL decentration in 1.44% of the SSF group and 7.40% of the FFISF group. Cystoid macular edema occurred in 5.79% of the SSF group, 4.87% of the HFISF group, and 7.40% of the FFISF group. Retinal detachment was noted in 1.44% of the SSF group and 7.31% of the HFISF group.
They concluded that all three IOL implantation techniques yielded similar outcomes, but each had advantages and disadvantages.