Sutureless capsular bag-intraocular lens complex scleral fixation using iris retractors in eyes with crystalline lens...

The aim of the study was to evaluate the visual outcomes, safety and efficacy of the surgical technique used for repositioning and scleral fixation of the capsular bag - intraocular lens (IOL) complex in the surgical treatment of subluxated lenses. The study was prospective and performed between 2021 and 2025. Study included patients with different degrees of lens subluxation in cases of zonular dialysis. All patients underwent surgery using a capsular tension ring (CTR) and iris retractors, which were externalized through the sclera and cauterized to provide permanent scleral fixation of the capsular bag. Clinical and refractive outcomes were analyzed to evaluate intraocular lens stability, including tilt and decentration measurements at one year postoperatively. Safety analysis consisted of complication assessment. This study included 36 eyes from 32 patients. Mean follow-up was 396.72 ± 98.26 SD days. Mean surgical time was 40.08 ± 12.9 min. Postoperative BCVA was 0.09 ± 0.18 logMAR at one year follow-up. Postoperative total refractive error (RE) was + 0.68 ± 1.21D. Endothelial cell loss was 4.96% (123.94 cells/mm²) at one year follow-up. Mean vertical and horizontal tilt were 3.84° ± 1.78° and 4.23° ± 2.98° (p = 0.61). Mean vertical and horizontal decentration were 0.29 ± 0.14 and 0.30 ± 0.18 mm, respectively (p = 0.83). No cases of displacement capsular bag - IOL complex were reported. Long-term follow-up data suggest that simultaneously using CTR and iris retractors for permanent scleral fixation of the capsular bag - IOL complex demonstrates good visual and refractive outcomes in lens subluxation. This technique provides safe and effective long-term stabilization.Trial registration: ClinicalTrials.gov identifier, NCT07257172. Retrospectively registered, registration date 20.11.2025.