Transscleral fixation of a single-piece hydrophilic foldable acrylic intraocular lens

To evaluate the results of transscleral fixation of foldable hydrophilic acrylic intraocular lenses (IOLs).

Twenty eyes of 16 patients, aphakic after phacoemulsification (PE) surgery and with at least 6 months follow-up, were included in the study. All eyes were implanted with single-piece hydrophilic foldable acrylic lenses by transscleral fixation, either with PE surgery (2 eyes) or secondarily.

Follow-up was 11.6 months (SD 4.85, range 6-20 mo). Age was 62.3 years (SD 12.95, range 18-78 y); 10 patients were women. Preoperative best corrected visual acuity (BCVA) was 0.20 (SD 0.14, range 0.1-0.3) in eyes with primary IOL implantation and 0.53 (SD 0.12, range 0.3-0.7) in secondary implantation. Astigmatism was 1.4 D (SD 1.19, range 0.25 to 5.0 D). Postoperatively, transient corneal edema developed in 6 eyes (30%) and transient IOP elevation in 2 eyes (10%). BCVA was 0.69 (SD 0.15, range 0.4-0.9), astigmatism was 0.84 D (SD 0.80, range 0.25 to 3.0 D), both p < 0.01. Spherical refractive error was -0.38 D (SD 0.47, range +0.75 to -1.25 D). Cystoid macular edema was observed in 2 eyes (10%). No IOL decentration was observed on biomicroscopy in any eye with undilated pupil; IOL decentration with no effect on vision was observed in 3 eyes (15%) after pupil dilation. No IOL tilt, retinal detachment, suture exposure, or endophthalmitis was observed.

Scleral fixation of foldable IOLs may be preferred in eyes with insufficient zonular and capsular support. This technique reduces surgery time and complications, and it provides early visual rehabilitation.