Evaluation of Flanged Haptics Intrascleral Sutureless Intraocular Lens Fixation

Abstract

Background: successful intraocular lens (IOL) placement in patients undergoing cataract surgery has become synonymous with the IOL being placed in the capsular bag. Purpose: to evaluate the flanged haptic sutureless intrascleral intraocular lens fixation with double needle technique as a method of scleral fixation of posterior chamber IOL (PCIOL) as regard to its stability and safety as well as its complications. Patients and Methods: this is a prospective study, which included 20 eyes of 20 patients with aphakia with no adequate capsular support. Results: post-operatively the best corrected visual acuity (BCVA) was improved to reach up to 0.8 decimal unit. Intra-operatively, haptic breakage was reported in 3 cases where the IOLs were explanted and new IOLs were implanted and sclerally fixated. The post-operative complications included iris capture in 2 cases (10%), haptic deformation in 2 cases (10%), exposure in 5 cases (25%) and slippage in 2 cases (10%), corneal edema in 6 cases (30%), IOL decentration in 4 cases (20%) one of them was significantly decentered and needed for reoperation where one point fixation by a stitch of the slipped haptic , spontaneous IOL dislocation in 2 cases (10%) 1 month and 3 months post-operatively, both required re operation where the slipped IOL was explanted and new one is re implanted and sclerally fixated. There were no incidents of post-operative ciliary body injury, retinal tear or detachment or endophthalmitis. Conclusions: the flanged haptics intrascleral sutureless IOL fixation with double needle technique can be done for aphakic cases with no adequate capsular support.