Double-flanged 6/0 polypropylene suture versus flanged haptic technique for intraocular lens fixation

Abstract

Background Aphakia due to inadequate capsular support is a well-known complication of cataract surgery. Secondary intrascleral IOL fixation is favoured by many surgeons to overcome this problem. However, the technique of intrascleral fixation of the IOL still remains controversial and no single technique is considered ideal. Aim The aim of this study was to compare the clinical outcome of double-flanged 6/0 polypropylene (prolene) suture and flanged haptic technique for intraocular lens fixation in patients with aphakia and inadequate capsular support. Patients and methods This is a retrospective, nonrandomized, comparative study. The study included 50 eyes of 50 patients with aphakia and inadequate capsular support. They were divided into 2 groups: 25 eyes underwent the double-flanged 6/0 polypropylene suture technique (group I) and 25 eyes underwent the flanged haptic-fixation technique (group II). All patients were subjected to complete preoperative ophthalmic evaluation. The mean operative time was calculated for each method. Postoperatively, the best-corrected visual acuity (BVCA), endothelial cell count, and intraocular pressure were measured at 1-week, 1-month, 3-month, and 6-month intervals. Any intraoperative or postoperative complications were recorded. Results Both groups showed statistically significant improvement in BVCA at 1 week, 1 month, 3 months, and 6 months postoperatively compared with the preoperative BVCA (P<0.001). The mean operative time was significantly shorter in group II than in group I (12.3±1.93 min vs. 21.8±2.5 min, respectively, P<0.001). Differences in the mean endothelial cell counts and mean intraocular pressure values at 1 week, 1 month, 3 months, and 6 months postoperatively were not statistically significant within or between groups (P>0.05). Furthermore, there were no statistically significant differences in the frequency of intraoperative or postoperative complications between the 2 groups (P>0.05). Conclusions Both surgical techniques showed similar outcomes in the treatment of aphakic patients without capsular support, each with unique benefits. The double-flanged 6/0 polypropylene suture technique has a shorter learning curve and variable intraocular-lens options, while the flanged haptic technique is a faster procedure in the hands of experienced surgeons.