Intraocular Lens Position Research Articles

Anatomical and optical origins of negative dysphotopsia

Negative dysphotopsia (ND) is a complaint after, an otherwise uneventful, cataract surgery with intraocular lens (IOL) implantation. It is generally described as a shadow in the temporal peripheral visual field. Approximately 3% of the patients suffer from this condition and complaints range from mild visual field defects to a significant loss of peripheral vision that disturbs daily life. Originally, this condition was poorly understood as conventional ophthalmic techniques are not designed for a comprehensive evaluation of the peripheral vision. In the last years, however, a combination of dedicated anatomical measurements and optical ray tracing simulations have revealed the cause of ND and proposed different treatments.In this presentation the basic principles of ray tracing of the eye will be presented, followed by the main results of the ESCRS vRESPOND study. In this study, a detailed anatomical assessment of the pseudophakic population with and without ND was made. The distinct differences between both groups, such as a smaller (p = <0.01) and more decentered (p < 0.01) pupil and an increased temporal‐tilted iris (p < 0.01), will be discussed. Interestingly, high‐resolution ocular MRI revealed that the in‐the‐bag IOL position and retinal shape did not differ significantly between both groups. The impact of these differences on the patient's peripheral vision will be shown through ray tracing simulations. First the optical origin of the shadow, caused by light rays missing the IOL, will be presented, followed by a quantitative analysis of the effect the different anatomical and IOL‐design parameters on the severity of this shadow. At the end of the presentation, the optical rationale behind some of the treatments of ND will be discussed.

The human capsular bag model as a pre‐clinical evaluation tool for IOLs

Cataract affects the vision and well‐being of millions. At present the only means of treating cataract is through surgical intervention. Modern cataract surgery typically retains a ring of anterior lens capsule and the entire posterior capsule. This is known as a capsular bag, which can house an intraocular lens (IOL) implant. Initial surgical outcomes are excellent, but with time lens cells that remain following surgery undergo a wound‐healing response. In essence the trauma of surgery provokes cells to proliferate and migrate across the acellular capsular surfaces and in some case the IOL surface. Most importantly, cells ultimately grow within the visual axis, on the central posterior capsule, and undergo fibrotic events that are associated with transdifferentiation to myofibroblasts, matrix deposition and matrix contraction that can lead to a secondary loss of vision termed posterior capsule opacification (PCO). PCO affects a large proportion of patients and is one of the most common fibrotic conditions in the world. It is therefore of great importance to better understand this condition and thus strong experimental systems are required for this purpose. To this end cataract surgery can be performed on human donor eyes within a laboratory setting to provide a biological product that is configured in the same manner as in the patient. This is known as the human capsular bag model. Using this clinically relevant model it has been possible to tease our key regulatory molecules driving human lens growth and fibrosis. While the human capsular bag model has been a useful tool to identify therapeutic targets or test putative therapeutics no pharmacological treatment is currently in clinical use. As a result, the intraocular lens is currently the major tool employed to manage PCO progression. Characteristics required for an IOL include strong optical performance, stability within the lens capsular bag and anti‐PCO properties. To meet international standards for IOL manufacture a number of tests are performed to predict IOL behaviour when implanted. However, ISO guided tests take place in a non‐biological setting and are limited to assessing purely physical characteristics. Therefore, understanding how the IOL interacts with the capsular bag and how wound‐healing responses could influence IOL position and stability is an area of great importance. The human capsular bag model can address this shortfall in the IOL development pipeline to relate design features to IOL stability and anti‐PCO performance in a clinically relevant setting. The presentation will highlight the evolution of the model as a tool for IOL testing and development.

Оценка смещений интраокулярной линзы по данным ультразвуковой биомикроскопии

Purpose. To analyze the postoperative IOL displacements toward the haptic plane using ultrasound biomicroscopy (UBM). Material and methods. Biometry data of 172 patients (211 eyes) 71.32 ± 7.75 years old were analyzed, among whom 41.25% were men. IOL position were analyzed at 1 and 3 months after standard phacoemulsification. Results. The IOL was visualized with UBM. Stabilization of lens position was observed by the 3rd month of observation. The displacement of optical part IOL in forward was determined in 24.95%, backward – in 16.57% of cases. Eyes with opposite IOL displacements differed significantly in crystalline lens diameter, ciliary sulcus diameter and the power of implanted IOL. Conclusions. An important technique in the search for possible causes of changes in postoperative refraction is visualization of IOL displacement. The number of displacements of the intraocular lens increases by 3 months, which may cause in visual acuity changes. Keywords: Intraocular lens (IOL) optical part displacement, ultrasound biomicroscopy (UBM), phacoemulsification

Relationship between anterior capsule opening and direction of intraocular lens decentration.

To compare intraocular lens (IOL) decentration between patients in whom the continuous curvilinear capsulorhexis (CCC) completely covers the IOL optic and those in whom it incompletely covers the IOL optic and determine how an incompletely covered CCC affects the IOL position. A tertiary hospital in Japan. Single-center retrospective study. This study included 57 eyes of 57 patients (mean age 70.8±6.2 years) that underwent phacoemulsification and IOL (SN60WF; Alcon Laboratories, Fort Worth, TX) implantation in the bag between April 2010 and April 2015. The patients were classified based on whether the CCC completely (CC group) or incompletely (NCC group) covered the IOL optic using an anterior eye segment analysis system (EAS-1000; NIDEK, Gamagori, Japan). The IOL decentration of the groups was analyzed using EAS-1000 at 1 week, 1 month, 3 months, and 6 months postoperatively and compared. The relationship between the NCC location and IOL direction at 3 months postoperatively was analyzed. The NCC group (25 eyes) had a significantly higher amount of IOL decentration than the CC group (32 eyes) at 1 week, 1 month, 3 months, and 6 months postoperatively (P < .05). There was a correlation between the direction of IOL decentration and NCC location, and IOL decentration in the NCC group occurred in the opposite direction to the NCC area. An anterior capsule opening that completely covers the IOL optic is important to control IOL decentration.

A mini-invasive surgical technique for Carlevale IOL implantation: case series study and description of concomitant surgery

PurposeTo examine the feasibility and outcomes of a modified technique for the implantation of scleral fixated Carlevale intraocular lens (IOL) (I71 FIL SSF. Soleko IOL Division, Pontecorvo, Italy), and to analyze the occurrence of adverse events.MethodsThis is a retrospective observational study conducted revising patients charts from 2018 to 2023. Thirty-five eyes of 33 patients were included. Patients requiring IOL explantation had either IOL dislocation or opacification. The implantation of the Carlevale IOL was performed with the subconjunctival positioning of the anchors without any scleral flap. All maneuvers were performed transconjunctivally. The anatomical outcomes considered were IOL positioning, and the absence of postoperative complications. The functional outcomes analyzed were best correctedvisual acuity (BCVA) and refraction.ResultsIn all the cases, the IOL was well positioned and centered postoperatively. No cases of conjunctival erosion were recorded. The best corrected visual acuity (BCVA) was 0.9±0.6 logMar (mean±standard deviation) preoperatively and 0.5±0.5 logMar (mean±standard deviation) postoperatively. The mean preoperative spherical equivalent was +6.8±7.7 dioptres, while postoperatively it was -1.1±1.6 dioptres. The most frequent procedure associated to secondary IOL implantation was posterior vitrectomy (25 eyes, 71.4%), which was performed with 25-gauge transconjunctival cannulas in the ciliary sulcus. The follow-up period was 24.5±16.9 months (mean±standard deviation).ConclusionThe described mini-invasive technique for Carlevale IOL implantation is safe and effective. It can be recommended either as a stand-alone operation or associated to concurrent surgical procedures.

Rotational stability of plate haptic toric intraocular lenses after combined 25-gauge vitrectomy and cataract surgery.

To evaluate the postoperative intraocular lens (IOL) rotational stability and residual refractive astigmatism following combined 25-gauge vitrectomy and cataract surgery with implantation of a plate haptic toric IOL. In this retrospective case series, 32 eyes of 32 patients underwent a combined 25-gauge vitrectomy and phacoemulsification for vitreoretinal diseases and cataract with regular corneal astigmatism of at least 1 diopter (D). A plate haptic toric IOL (AT Torbi 709M, Carl Zeiss Meditec AG) was implanted in all eyes. The outcome measures were rotational stability and refractive astigmatism up to 6mo postoperatively as well as the best corrected visual acuity (BCVA). Preoperative refractive astigmatism was 2.14±1.17 D, which was significantly reduced to 0.77±0.37 D six to eight weeks postoperatively and remained stable throughout the observation period (0.67±0.44 D at three months and 0.75±0.25 D at six months; for all groups: P<0.0001 compared to baseline). BCVA improved significantly from 0.36±0.33 logMAR preoperatively to 0.10±0.15 logMAR following surgery (P=0.02). Mean IOL axis deviation from the target axis was 3.4°±2.9° after six to eight weeks and significantly decreased over time (2.4°±2.6° six months after surgery; P=0.04). In one patient IOL, re-alignment was performed. Corneal astigmatism is significantly reduced following combined 25-gauge vitrectomy and cataract surgery. The plate haptic toric IOL position and axis remain stable during the observation period of six months.

Predicting the postoperative intraocular lens position based on IOL Master 700 biometry, compared with results from the anterior segment analysis system.

Predict intraocular lens position after cataract surgery using the IOL Master 700 and explore the associated ocular parameters compared with the results obtained from the anterior segment analysis system (Sirius, CSO Inc, Florence, Italy). A total of 98 patients (106 eyes) were included in the retrospective study. The postoperative intraocular lens position was obtained using the IOL Master 700 and measured using Adobe Illustrator software. Correlation analysis and linear regression analysis were applied to study the correlation between the actual position of the postoperative intraocular lens (ALP) and the ocular parameters. In addition, Bland-Altman consistency analysis was used to compare the consistency between any two among the predicted intraocular lens position (ALPi) obtained using IOL Master 700 biometry, the predicted artificial lens position (ALPs) calculated using the anterior segment analysis system, or the ALP. Ocular parameters, including preoperative anterior chamber depth, lens thickness, axial length, white-to-white, and postoperative refractive error were all correlated with ALP after cataract surgery (P < 0.05) using univariate analysis. However, in multivariate linear regression, only the first three variables were correlated with ALP. Compared with the equation obtained by the anterior segment analysis, the equation from IOL Master 700 biometry provided a better fit. The results of the consistency analysis showed that ALP, ALPi, and ALPs were in good agreement. IOL Master 700 biometry can help predict intraocular lens position after surgery, and its accuracy is better than that provided by the anterior segment analysis system.

Technique of using Cionni-modified capsular tension ring in the management of severely traumatic lens subluxation.

To investigate the effect of Cionni-modified capsular tension ring (CTR) implantation in patients with severely traumatic subluxated cataracts. All patients who totally had traumatic cataracts and lost zonule support and underwent cataract surgery were retrospectively analyzed. Corrected distance visual acuity (CDVA), extent of zonulysis, intraocular lens (IOL) position, intraoperative presentation, and complications were assessed. The primary outcomes included IOL centration stability and other postoperative complications. Twenty patients (20 eyes) were included in this study. The mean age in this study was 58.0±11.3y, and the average follow-up time was 17.3±12.8mo. Capsule bags were saved by Cionni-modified CTR. Nine eyes (45%) underwent simultaneously anterior vitrectomy due to the presence of vitreous in the anterior chamber. The preoperative mean CDVA was 0.83±0.24 logMAR, and the postoperative average CDVA was 0.23±0.30 logMAR (P<0.05). The horizontal and vertical IOL decentration after surgery was 0.27±0.12 mm and 0.41±0.19 mm, respectively; the vertical and horizontal IOL tilt after surgery was 5.5°±2.5° and 6.1°±2.2°, respectively. None of the eyes had obvious IOL decentration during the follow-up time. Eight eyes (40%) had posterior capsule opacification (PCO) that was severe enough to cause poor vision. Neodymium: YAG laser capsulotomy were performed on these eyes when the CTR was stabilized. With the help of Cionni-modified CTR, capsular bag preservation and better IOL concentration can be achieved without major complications in patients with severely traumatic subluxated cataracts.

Rotating the Intraocular Lens to Prevent Posterior Capsular Opacification in Cataract Surgeries.

Posterior capsule opacification (PCO) is a common postoperative complication of extracapsular cataract surgery, which is caused by the proliferation and migration of lens epithelial cells and can affect long-term visual outcomes significantly. The most effective treatment for PCO is neodymium-doped yttrium aluminum garnet (Nd:YAG) laser capsulotomy; however, this treatment is associated with posterior segment complication and can break the stability of capsular bag, affecting the position and function of trifocal or toric intraocular lenses (IOLs). Advances in surgical procedures, IOL design, and pharmacy have reduced the rate of PCO in recent years, concentrating on the inhibition of proliferative lens epithelial cells (LECs). This protocol aimed to clear LECs more thoroughly during phacoemulsification and IOL implantation. The first several steps, including clear corneal incision, continuous circular capsulorhexis, hydrodissection, hydrodelineation, and phacoemulsification, were completed as conventional procedures. After placing the IOL into the capsular bag, rotation of the IOL by at least 360° was performed using an irrigation/aspiration tip or a hook, with slight stress on the posterior capsule. Some residuals occurred in the originally transparent capsular bag after rotation of the IOLs. Then, these materials and the viscoelastic were cleared completely using an irrigation/aspiration system. A clear posterior capsule was observed after the surgery in patients undergoing this method. This method of rotating IOLs is a simple, effective, and safe way to prevent PCO by clearing residual LECs and can be carried out without extra tools or skills.

DETERMINATION OF POSITION OF INTRAOCULAR LENS IMPLANT BY DEEP LEARNING ALGORITHMS IN PATIENTS OF CATARACT SURGERY

The current study was designed to predict the position of the intraocular lens in patients who have undergone cataract surgery using machine learning. A retrospective study was conducted in the Department of Ophthalmology at Lahore General Hospital from May 2022- May 2023. 150 patients undergoing cataract surgery by implanting intraocular lenses were selected for the study. The axial length, central corneal thickness, corneal curvature radius, and horizontal corneal diameter were noted during the surgery. The data set of 300 eyes was analyzed using the following techniques; regression model, regression trees, Support Vector Machine, and Gaussian Process Regression Models. The GPR technique with the exponential kernel gives perfect prediction compared to other algorithms. A mean root square of 0.185 mm was noted for postoperative AQD and 0.179 mm for the prediction of postoperative LEQ. The horizontal corneal diameter did not vary significantly in both models, and central corneal thickness was not associated with estimating postoperative AQD. Gaussian process regression is the best machine learning algorithm to predict the intraocular lens position in cataract surgery patients.

Bilateral Facoemulsification and Intraocular Lens Positioning in a Child with Merosin-Positive Congenital Muscular Dystrophy

Bilateral Facoemulsification and Intraocular Lens Positioning in a Child with Merosin-Positive Congenital Muscular Dystrophy

Анализ положения интраокулярных линз у пациентов с транссклеральной фиксацией и силиконовой тампонадой витреальной полости при регматогенной отслойке сетчатки

Purpose. To conduct a comparative analysis of the position of intraocular lenses (IOL) in patients with transscleral fixation and in patients with artifacia in the conditions of silicone tamponade of the vitreal cavity. Material and methods. The studies were carried out on 64 eyes of patients aged 56 to 75 years with transscleral fixation and artifaction with silicone tamponade of the vitreal cavity. Results. In patients with transscleral fixation, the distance from the limb to the optical edge of the lens was equal to 4.31 ± 0.82 mm, in the group with articulation – 4.11 ± 1.03 mm. The absence of a statistically significant difference indicates the position of IOL when performing transscleral fixation identical to the location of the lens in the capsule bag. The indicator of the distance from the cornea to the edge of IOL in patients with transscleral fixation corresponded to 3.72 ± 1.54 mm, in patients with articulation corresponded to 3.21 ± 1.48 mm, while this indicator in the group with transscleral fixation was more variable. Conclusion. In the conditions of silicone tamponade of the vitreal cavity, the technique of transscleral fixation of IOL provides a single-format position of the lens with artificial patients. Keywords: intraocular lens, transscleral fixation, silicone tamponade

Surgeons need to know more about IOL design for accurate power calculation.

Improvement in biometry and formulas have raised the bar for accurate IOL power calculation. However, when we look closely at the performance of a specific IOL model, we often find that the prediction error varies with the implant power. This phenomenon has no explanation other than the optic design of the IOL has shifted over the power range, thereby disrupting the assumptions of the calculations. By this report we call the industry to be more transparent and disclose the basic information about the IOL design that is important for accurate IOL power calculation. The relevant information concerns: the refractive index, the central optic thickness, the anterior and posterior curvature radii, the toricity location, the spherical aberration and haptic angulation. The goal is to predict possible shifts in principal planes or IOL position over the power range causing a refractive surprise if not corrected for.

Changes of Surgically Induced Corneal Astigmatism and Position of Artificial Intraocular Lens over Time

To analyze changes in surgically induced corneal astigmatism and articial intraocular lens (IOL) stability over time following cataract surgery. To compare the interchangeability of measurements between an automatic keratorefractometer (AKRM) and a biometer. In this prospective observational study, the above-mentioned parameters were collected from 25 eyes (25 subjects) on the first day, first week, first and third month after uncomplicated cataract surgery. We used IOL-induced astigmatism (difference between refractometry and keratometry) as an indirect indicator of IOL stability change. We used the Blant-Altman method to analyze consistency between devices. At the above time points, surgically induced astigmatism (SIA) decreased as follows: 0.65 D; 0.62 D; 0.60 D and 0.41 D (in the first day, week, month and third month respectively). Astigmatism induced by changes of the position of the IOL varied as follows: 0.88 D; 0.59 D; 0.44 D and 0.49 D. Changes in both parameters were statistically significant (p0.05). Both surgically induced astigmatism and astigmatism induced by IOL decreased over time, in which both changes were statistically significant. The decrease in SIA was most pronounced between the first and third month after surgery. For IOL-induced astigmatism, the greatest decrease was within the first month after surgery. The differences in measurement between the biometer and AKRM were statistically insignificant, but the clinical interchangeability between the given methods is questionable, especially with regard to measurement of the astigmatism angle.

Improving Effective Lens Position Prediction for Transscleral Fixation of Intraocular Lens Among Congenital Ectopia Lentis Patients

To introduce a method of predicting effective lens position (ELP) among congenital ectopia lentis (CEL) patients undergoing transscleral fixation of intraocular lens (IOL), and evaluate its effect on improving refractive outcome by utilizing the Sanders-Retzlaff-Kraff / theoretical (SRK/T) formula. Retrospective cross-sectional study. A training set (93 eyes) and validation set (25 eyes) was included. Z value as the distance between the iris plane and a hypothetic postoperative IOL position was introduced in this study. The Z-modified ELP consisted of corneal height (Ch) and Z (ELP=Ch+Z), and Ch was calculated by keratometry (Km) and white-to-white (WTW). The value of Z was identified by linear regression formula with the involvement of axial length (AL), Km, WTW, age, and gender. The comparison of mean (MAE) and mediate absolute error (MedAE) among Z-modified SRK/T formula, SRK/T, Holladay I, and Hoffer Q formula was performed to evaluate the performance of Z-modified SRK/T formula. Z value was associated with AL, K, WTW, and age (Z = offset + 15.1093 × lg (AL) + 0.0953899 × Km - 0.3910268 × WTW + 0.0164197 × Age - 19.34804). The Z-modified ELP has goodaccuracy with no difference to back-calculated ELP. The accuracy of Z-modified SRK/T formula was better than other formulas (P < .001) as the MAE was 0.24 ± 0.19 diopter (D) and MedAE was 0.22 D (95% CI: 0.01-0.57 D). Sixty-four percent of eyes had a refractive error smaller than ±0.25 D, and none of the subjects had a prediction error greater than ±0.75 D. ELP of CEL can be accurately predicted by AL, Km, WTW, and age. Z-modified SRK/T formula improved on the current formula by improving predicting accuracy of ELP and may serve as a promising formula for CEL patients with transscleral fixation of IOL.

Sulcus intraocular lens implantation in 17 dogs using a modified ab externo technique.

To describe a modified ab externo method of sulcus intraocular lens (IOL) fixation and report outcomes of eyes treated with this approach. Records of patients with lens instability or luxation that underwent a lensectomy and sulcus IOL implantation from January 2004 to December 2020 were reviewed. Nineteen eyes of 17 dogs had a sulcus IOL placed via a modified ab externo approach. The median follow-up time was 546 days (range 29-3387 days). Eight eyes (42.1%) developed POH. A total of six eyes (31.6%) developed glaucoma and required medical management long term to control IOP. The IOL position was satisfactory in most cases. Nine eyes developed superficial corneal ulcers within 4 weeks following surgery, all of which healed without complication. At the time of the last follow-up, 17 eyes were visual (89.5%). The technique described represents a potentially less technically challenging option for sulcus IOL implantation. The success rate and complications are similar to previously described approaches.

A comparative study of transscleral sutured intraocular lens fixation and sutureless flanged intraocular lens fixation

BackgroundTo compare the intraocular lens (IOL) tilt and decentration and visual outcomes of transscleral sutured IOL fixation and sutureless flanged IOL fixation. To investigate the influence of IOL tilt and decentration on internal higher-order aberrations (HOAs) in these two techniques.MethodsPatients who received transscleral sutured or sutureless flanged IOL fixation procedures were included in this prospective, non-randomized, comparative study. Corrected distance visual acuity (CDVA) was measured at baseline and at every postoperative visit for 12 months. IOL tilt and decentration were measured using a second-generation anterior segment optical coherence tomography (Casia2) and internal HOAs were measured using iTrace Visual Function Analyzer at 3 months postoperatively.ResultsThe study included 27 eyes from the transscleral sutured IOL fixation group and 26 eyes from the sutureless flanged IOL fixation group. There was no significant difference in CDVA between the two groups at all time points. The two groups did not differ in refractive difference from the predicted value, corneal endothelial cell loss, IOL tilt, IOL decentration, internal astigmatism or internal HOAs. Vertical IOL decentration significantly correlated with total internal optical aberration (r = 0.288, P = 0.036), total internal HOA (r = 0.440, P = 0.001), internal coma (r = 0.348, P = 0.001), vertical internal coma (r = 0.388, P = 0.004), average height of modulation transfer function (r = − 0.364, P = 0.007) and Strehl ratio (r = − 0.297, P = 0.031). Horizontal IOL decentration significantly correlated with horizontal internal coma (r = 0.312, P = 0.023).ConclusionsTransscleral sutured IOL fixation and sutureless flanged IOL fixation had similar IOL positions and visual outcomes. IOL decentrations correlated with internal HOAs and thus should be avoided.

Evaluation of the postoperative axial lens position and refractive correction of a hydrophobic one-piece intraocular lens

Evaluation of the postoperative axial lens position and refractive correction of a hydrophobic one-piece intraocular lens

Repositioning of in-the-bag Dislocated Intraocular Lenses: A Randomized Clinical Trial Comparing Two Surgical Methods

Introduction: The aim of this study was to evaluate intraocular lens (IOL) tilt, IOL-induced astigmatism (IIA), refractive change, and impact of capsular fibrosis on IOL position after scleral fixation of dislocated IOL using two methods: ab externo scleral suture loop fixation (group A) and a modification, embracing the continuous curvilinear capsulorhexis (group B). Methods: In this prospective randomized clinical trial conducted at St. Erik Eye Hospital, 117 patients with dislocated IOL were randomized to group A (n = 61) or B (n = 56). Patients with ordinary pseudophakia (n = 60) served as controls. IOL tilt was measured three-dimensionally with anterior segment optical coherence tomography (AS-OCT). Results: The median IOL tilt was similar with both methods (A: 7.8°; B: 8.3°; p = 0.51) but higher than in ordinary pseudophakia (5.4°; p < 0.001). Both groups showed a myopic shift, p < 0.001. In cases without capsular fibrosis, the median IOL tilt was 15.5° in group A (n = 7) and 7.0° in group B (n = 5), p = 0.19. For each degree of IOL tilt, IIA increased by 0.075 D (p < 0.001). IOL position could be measured with AS-OCT in all patients given that the IOL was visible in the pupil. Conclusion: After IOL fixation surgery, IOL tilt is higher than in normal pseudophakia. A study involving more patients without capsular fibrosis could clarify whether IOL position is better with method B in this subgroup. IAA is low, but myopic shift is common. AS-OCT is useful for IOL tilt assessment after IOL fixation surgery.

Flapless and Conjunctiva-Sparing Technique for Transscleral Fixation of Intraocular Lens to Correct Refractive Errors in Eyes without Adequate Capsular Support.

To evaluate refractive outcomes, intraocular lens (IOL) power calculation, and IOL position following a novel conjunctiva-sparing transscleral fixation technique. Forty-one eyes of 40 patients managed with a flapless transscleral-sutured technique were included. Preoperative and postoperative refractive errors (spherical equivalents, SE) were compared. IOL position was assessed on the Scheimpflug images. IOL power was calculated by SRK/T, Holladay 1, and Hoffer Q formulas. The mean age was 57.39 ± 14.83 years (range: 26 to 79 years), and the mean follow-up was 7.46 ± 6.42 months (range: 1 to 24 months). Surgical indications were aphakia (n = 14), subluxated lenses (n = 3), and IOL dislocation (n = 24). The SE was 4.50 ± 6.38 diopter (D) (range: -3.75 to 13.75 D) preoperatively and -1.68 ± 1.57 D (range: -5.50 to 1.13 D) postoperatively (P < 0.001). The mean tilt angle and decentration were 2.90° ± 1.93° (range: 0.39° to 9.10°) and 0.23 ± 0.19 mm (range: 0.02 to 0.94 mm) vertically, and 1.75° ± 1.41° (range: 0.24° to 7.65°) and 0.18 ± 0.19 mm (range: 0.02 to 1.06 mm) horizontally, which were clinically insignificant. All three IOL formulas produced myopic errors (range: -0.29 to -0.50 D). The SRK/T had the lowest median absolute error (0.55 D), followed by the Holladay 1 (0.70 D) and the Hoffer Q (0.74 D). The three formulas had the same percentage of prediction errors (PEs) within ±0.5 D (43.48%), while the Hoffer Q had the highest percentage of PEs within ±1.0 D (82.61%). The present technique can serve as an alternative approach for transscleral IOL fixation and refractive correction in eyes with compromised capsular support, ensuring the stability of IOLs and reasonable IOL power calculation accuracy.