Combining flanged intrascleral IOL fixation with Glaucoma Surgery: Initial experience.

Area of Science:

• Ophthalmology
• Glaucoma Surgery
• Intraocular Lens Implantation

Background:

• Glaucoma and the need for intraocular lens (IOL) implantation often coexist.
• Traditional approaches may involve multiple surgical stages, increasing risks and costs.

Purpose of the Study:

• To evaluate the initial clinical outcomes of a single-stage combined procedure involving glaucoma surgery and flanged intrascleral intraocular lens (F-SFIOL) fixation.
• To assess the safety and efficacy of this novel combined surgical technique.

Main Methods:

• Retrospective, non-comparative case series.
• Inclusion of eyes undergoing combined glaucoma surgery and F-SFIOL with at least 6-month follow-up.
• Procedures performed by a fellowship-trained senior glaucoma surgeon.

Main Results:

• Twelve eyes of 10 patients underwent F-SFIOL, with 8 combined with glaucoma procedures (trabeculectomy, Ahmed Glaucoma Valve, or bleb needling).
• Significant reduction in intraocular pressure (IOP) from 29.1 mmHg to 14.5 mmHg (p=0.006) and anti-glaucoma medication (AGM) use from 3.7 to 0.7 (p<0.001).
• Best corrected visual acuity (BCVA) remained stable or improved in all eyes; one eye required IOL explantation.

Conclusions:

• Single-stage F-SFIOL combined with glaucoma surgery is a promising initial approach.
• This technique avoids the costs, specialized skills, and potential complications associated with posterior approaches.
• This represents a novel, suture-less, flap-less, glue-less method for combined IOL fixation and glaucoma management.