Glued intraocular lens in eyes with deficient capsules: retrospective analysis of long-term effects.

Abstract

To assess the long-term (6-12 years) results and complications of glued transscleral-fixated intraocular lens (IOL). Dr. Agarwal's Eye Center, Chennai, India. Retrospective case series. Eyes with glued IOL of more than 5-year follow-up were evaluated. Visual acuity (logarithm of the minimum angle of resolution [logMAR]), IOL tilt, corneal topography, corneal endothelial cell density, intraocular pressure, central corneal thickness, central foveal thickness, and ocular residual astigmatism (ORA) were evaluated. Overall, 91 eyes (63 patients) with mean postoperative 8.2 ± 2.3 years were analyzed. The duration was 10 to 12 years in 31 eyes (34%), 9 years in 14 eyes (15.3%), and 6 to 9 years in 46 eyes (50.5%). No subscleral haptic was visible in 50% eyes. Mild, moderate, and severe grade of haptic visibility was noted in 33.5%, 9.4%, and 7%, respectively. The corrected distance visual acuity (CDVA) was 0.50 ± 0.50 logMAR. Clinically, no tilt was seen in 87 eyes (95.6%), whereas detectable tilt was seen in 4 eyes (4.3%). The optical coherence tomography microtilt was 0.8 ± 1.7 and 0.4 ± 1.2 degrees in 90- and 180-degree axes, respectively. The mean iris vault was 0.45 mm, and the mean ORA was 1.10 ± 1.00 diopter. Complications were glaucoma (7.6%), IOL luxation (4.4%), retinal detachment (3.2%), macular edema (4.3%), corneal decompensation (3.2%), uveitis (2.1%), and uveitis-glaucoma-hyphema syndrome (1%). Haptic reposition (3.2%), retinal detachment surgery (3.2%) keratoplasty (1%), pupilloplasty (2.1%), and IOL explantation (1%) were the second surgeries performed. Glued IOL has shown good anatomical and functional stability with minimal incidence of vision-threatening complications on long-term.