Comparative evaluation of re-use or replacement of dislocated 3-piece intraocular lenses with a scleral fixation technique

Abstract

To compare the surgical outcomes of refixation and exchange in cases with 3-piece intraocular lens (IOL) dislocation which underwent scleral fixation. Between 2014 and 2017, 65 eyes of 65 patients diagnosed with 3-piece IOL dislocation were treated with scleral fixation, and their records were retrospectively evaluated. Our patients were divided into two groups based on the treatment - exchange (Group 1) and refixation (Group 2). Dislocated IOL removal and new IOL insertion was performed with scleral fixation in group 1, and in group 2, scleral fixation of the dislocated intraocular lens performed without removal. Visual results, intraoperative and postoperative complications and lens induced astigmatism secondary to scleral fixation were compared between two groups. Patients in both groups were followed for an average of 13.62±3.4 months. Twenty-six patients were in group 1 and 39 patients were in group 2. All of the scleral fixation lenses were 3-pieced. Increased visual acuity was observed in both groups, and no difference was detected between the two groups (P˂0.01). Intraocular lens-induced astigmatism was similar in both groups (P=0.68). Intraocular hemorrhage as an intraoperative complication was seen in two patients in group 1 and one patient in group 2. Redislocation in three patients in group 2 and cystoid macular edema in one patient in each groups were observed. Refixation and exchange are both effective in IOL dislocation, and no significant difference between the methods was detected in terms of the results obtained.