Scleral-fixated intraocular lens implants-evolution of surgical techniques and future developments

Area of Science:

• Ophthalmology
• Surgical Innovation

Background:

• Loss of capsular support necessitates secondary intraocular lens (IOL) implantation.
• Causes include complicated cataract surgery, trauma, and inherited conditions like Marfan syndrome or pseudoexfoliation.
• Management options include optical correction and surgical IOL fixation (anterior chamber, iris-fixated, scleral-fixated).

Purpose of the Study:

• To provide a comprehensive review of intrascleral lens fixation techniques.
• To analyze the evolution of surgical methods for secondary IOL implantation.
• To identify areas for future research and development in the field.

Main Methods:

• Literature review of surgical techniques for intrascleral lens fixation.
• Analysis of historical and recent modifications in scleral-fixated lens implantation.
• Synthesis of data on optical and surgical approaches for IOLs without capsular support.

Main Results:

• Scleral-fixated lens techniques have evolved significantly since the 1980s.
• Existing studies often suffer from retrospective design, small sample sizes, and short follow-up durations.
• A need exists for more robust evidence on long-term outcomes of various intrascleral fixation methods.

Conclusions:

• Intrascleral lens fixation is a viable option for secondary IOL implantation when capsular support is absent.
• Further high-quality research is required to optimize surgical techniques and assess long-term efficacy.
• Future developments should focus on addressing limitations of current studies and improving patient outcomes.