Clinical Outcomes of Secondary Intraocular Lens Scleral Fixation after Acute Secondary Angle-Closure Caused by Lens...

To describe the clinical characteristics and evaluate the surgical outcomes of patients with acute secondary angle-closure associated with lens subluxation who underwent phacoemulsification with secondary intraocular lens (IOL) scleral fixation.

A retrospective study was performed on patients with unilateral lens subluxation with angle-closure who underwent phacoemulsification with secondary IOL scleral fixation using the single-loop 4-point technique, and were followed up for at least 2 years. A total of 22 affected eyes from 22 patients were enrolled in this study. Preoperative ocular biometric parameters of affected eyes were compared with those of unaffected fellow eyes. Changes in intraocular pressure (IOP) were evaluated during the 2-year follow-up period.

Among the affected eyes, 72.7% were in male patients and 63.6% involved the left eye. A history of ocular trauma was present in approximately 9.1% of patients. Preoperatively, affected eyes showed higher peak IOP (34.27 mmHg in the affected eye vs. 16.05 mmHg in the fellow eye), shallower anterior chamber depth (1.90 mm in the affected eye vs. 2.82 mm in the fellow eye), and more myopic spherical equivalent (-1.27 diopters [D] in the affected eye vs. 0.10 D in the fellow eye) compared to fellow eyes. Postoperative IOP remained stable for up to 2 years; however, 54.5% of patients required more than one antiglaucoma medication during this period. All affected eyes achieved the target IOP of <21 mmHg without requiring further glaucoma filtration surgery, although 54.5% of patients necessitated ongoing antiglaucoma medication (qualified success).

In eyes with lens subluxation-associated secondary angle-closure, phacoemulsification with secondary IOL scleral fixation resulted in stable IOP control and anatomical restoration over a 2-year follow-up period in severe cases with extensive zonular dialysis.