Visual and refractive outcomes with intrascleral haptic fixation of the light adjustable lens

To describe refractive outcomes with intrascleral haptic fixation (ISHF) of the light adjustable lens (LAL).

Baylor College of Medicine and 1 private practice in the United States.

Retrospective sequential cohort.

All patients undergoing double-needle ISHF of the LAL were included in the study. Pretreatment and post-lock-in uncorrected distance visual acuity (UDVA) were recorded. Mean numerical errors, refractive prediction errors, and astigmatism outcomes were measured.

10 eyes were included. Initial pretreatment UDVA after surgery ranged from 20/25 to 20/150, and post-lock-in UDVA ranged from 20/12.5 to 20/40 (median UDVA 20/20; mean 0.01 logMAR [spherical equivalent 0.04]). Mean magnitude of refractive astigmatism was 0.70 diopters (D) (range 0.00 to 1.50 D) pretreatment and 0.25 D (range 0.0 to 0.75 D) after final lock-in. Pretreatment mean numerical error was +1.00 D (SD 0.94 D) and was reduced to -0.022 D (SD 0.28) after treatments and lock-in sessions. All eyes (10/10) achieved their full visual potential in UDVA.

This study illustrates that with careful planning and patience, patients with poor or absent capsular support who previously did not have a customizable option can potentially achieve personalized visual outcomes with excellent refractive accuracy with scleral fixation of the LAL.