Outcomes and complications in eyes that underwent intraocular lens fixation in the absence of capsular support

Abstract

PurposeTo identify factors influencing the visual and refractive outcomes and complications in eyes that underwent intraocular lens fixation in the absence of capsular support.MethodsRetrospective case series. Patients records from 2014 to December 2019 in King Khaled Eye Specialist Hospital (KKESH) were reviewed and divided into two groups: posterior chamber iris fixated IOL (sutured) (IFIOL) and scleral fixated IOL (SFIOL). Demographic data, ocular factors (location of IOL placement), systemic comorbidities, lens status at the time of surgery were collected.Axial length, IOL calculation formula, surgeon level, IOL fixation technique, intraoperative complications, and concurrent or previous vitrectomy were correlated to the outcome. Postoperative data of corrected distance visual acuity, refraction, early and late postoperative complications were also collected and correlated to the outcome.ResultsSeventy‐five eyes of 69 patients were included in this study. The median follow‐up period was 9 months (range 0–60 months). The average age of patients in this study was 50 years. 14 eyes (18.6%) underwent IFIOL while 61 eyes (81.3%) underwent SFIOL. At the end of follow‐up, the preoperative mean of best‐corrected visual acuity (BCVA) was 0.3 log of the minimum angle of resolution (logMAR), which improved to 0.22 logMAR postoperatively. BCVA improved or remained unchanged in 71 eyes (94.6%), VA decreased two lines in 4 eyes (5.3%). Regular follow‐up examinations at 3, 6, and 12 months after IOL fixation revealed no intraoperative complications, and the postoperative complication rate was (18.6%).ConclusionsDifferent techniques of IOL fixation in the absence of capsular support are safe with favorable outcomes. However, they are technically challenging and time‐consuming. The innovation of new surgical techniques continues to provide safer and effective treatment options for the eyes that lack sufficient capsular support.