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Updated: Mar 9, 2026

Iris Fixation via External Pentagram Suturing

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Sterile Anterior Segment Inflammation Associated With Sulcus-Supported Phakic IOL Surgery.

Yishan Qian¹, Lingling Niu¹, Xianglong Yi²

¹Department of Ophthalmology, Eye and ENT Hospital, Fudan University; Key Laboratory of Myopia and Related Eye Diseases, NHC, Shanghai, China.

Journal of Refractive Surgery (Thorofare, N.J. : 1995)

|March 7, 2026

Summary

Sterile anterior segment inflammation after sulcus-supported phakic IOL implantation (SASI-pIOL) is uncommon. While it responds well to steroids and has good visual outcomes, monitoring is needed due to recurrence.

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Area of Science:

Ophthalmology
Intraocular Lens Implantation
Anterior Segment Surgery

Background:

Sulcus-supported phakic intraocular lens (pIOL) implantation is a refractive surgery procedure.
Sterile anterior segment inflammation (SASI) is a potential complication following intraocular surgery.

Purpose of the Study:

To investigate the incidence, presentation, and outcomes of sterile anterior segment inflammation following sulcus-supported phakic IOL implantation (SASI-pIOL).

Main Methods:

Retrospective case series of patients diagnosed with SASI-pIOL (early-onset ≤ 7 days; late-onset > 7 days) from July 2023 to July 2024.
Two tertiary centers in China included consecutive patients with a minimum 6-month follow-up post-diagnosis.
Data analysis included incidence rates, clinical presentation, treatment response, visual acuity, intraocular pressure, endothelial cell density, and recurrence rates.

Main Results:

SASI-pIOL occurred in 39 eyes (0.26%) of 15,209 pIOL surgeries, with 66.7% early-onset and 33.3% late-onset.
Inflammation and pIOL white deposits resolved with topical steroids; no vision loss or significant changes in IOP/endothelial cell density were observed.
Recurrence of pIOL white deposits was noted in 42.3% of early-onset and 54.5% of late-onset cases. Ophthalmic viscosurgical device use differed significantly between onset groups (P < .001).

Conclusions:

SASI-pIOL is an uncommon complication of sulcus-supported pIOL implantation.
The condition typically responds well to topical corticosteroids, leading to favorable visual outcomes.
Long-term monitoring is recommended due to a significant rate of recurrence of pIOL white deposits.