Scleral fixated secondary intraocular lenses: a review of recent literature

A variety of techniques exist for secondary intraocular lens (IOL) implantation. Of note, scleral fixated intraocular lenses have become more popular with a variety of techniques, both with and without use of sutures. Herein, we focus on reviewing recently published studies describing the long-term outcomes of scleral fixation techniques.

Although initial papers describing novel techniques often report short-term outcomes, several studies have recently described intermediate and long-term outcomes for scleral fixated IOLs, albeit all being retrospective case series. Suture fixation methods with long-term follow-up, up to a minimum of 50 months, report dislocation rates between 0 and 15%. Sutureless scleral fixation techniques have increased in popularity the past several years. Although they appear to have a lower rate of IOL dislocation: several studies have reported 0% and one study 8%. The follow-up period for sutureless scleral fixation technique studies, however, is shorter with most studies reporting follow-up of less than a year. Rates of retinal detachment vary between individual studies, but are similar for both suture fixation and sutureless with the majority of studies reporting a rate between 0 and 5%. These studies show that long-term outcomes are important considerations in surgical decision-making.

Scleral fixation techniques have shown long-term durability and safety in recent retrospective studies. Comparison of techniques has been limited, and more robust studies may be required to provide stronger anatomic, functional, and comparative data.