Revised Technique of Four - Point Scleral Fixated Intraocular Lens: Visual Outcomes and Complications

Aims: To analyse the visual results and complications in sclera-fixated intraocular lenses with a four-point fixation technique.

Study Design: Case series

Place and Duration of Study: The study was conducted at Sarojini Devi Eye Hospital, which is a government medical college and tertiary eye care hospital in South India. The study was conducted between October 2013 and June 2016.

Methodology: A consecutive series of patients who had undergone secondary scleral-fixated intraocular lens (SF IOL) implantation in cases of aphakia with inadequate posterior capsular support was analysed. This is a modified four-point scleral fixation technique that is comprised of scleral tunnels to bury the suture knots and fix the IOL at four points on the sclera.

Results: The study was comprised of 30 eyes of 30 patients (17 men, 13 women). The mean age at surgery was 46.6 years (range of 8–83 years), and the mean follow-up was 19 months (range of 15–31 months). The corrected distance visual acuity was 6/24 (0.68 log mar units) preoperatively, which improved to 6/18(0.45 log mar units) postoperatively. The most common postoperative complication was raised intraocular pressure, which was seen in 13 eyes (43.6% P value <0.0001).

Conclusions: The results of the study indicate that SF IOL is a promising option in cases of aphakia with no capsular support, as the technique has minimal complications when conducted properly.