Clinical Outcomes of Sutureless Scleral-Fixated Intra-ocular Lenses with and without Fibrin Glue

To compare the clinical outcomes of sutureless scleral-fixated posterior chamber intraocular lens (SFIOL) implantation performed with fibrin glue versus without fibrin glue in eyes with inadequate posterior capsular support.

This prospective, randomized, comparative clinical study included 40 eyes of 40 patients requiring secondary intraocular lens implantation. Patients were randomly allocated into two groups: Group A (n = 20) underwent glued sutureless SFIOL implantation using fibrin glue, and Group B (n = 20) underwent non-glued sutureless SFIOL implantation. Preoperative evaluation included visual acuity, intraocular pressure (IOP), anterior segment assessment, corneal pachymetry, specular microscopy, and posterior segment examination. Outcome measures included surgical time, intra-operative complications, postoperative visual acuity, anterior segment parameters, IOP changes, scleral flap healing, pupillary abnormalities, and IOL centration. Patients were followed for a minimum of six months.

Both groups demonstrated significant improvement in best-corrected visual acuity postoperatively (p < 0.001), with no significant intergroup difference at final follow-up (p = 0.853). Mean surgical time was longer in the glued IOL group but was not statistically significant (p = 0.361). A statistically significant postoperative rise in IOP was observed only in the glued IOL group (p = 0.049). Endothelial cell loss, corneal clarity, anterior chamber depth changes, and IOL centration were comparable between the two groups. Intra-operative and postoperative complications were generally mild and manageable.

Both glued and non-glued sutureless scleral-fixated IOL techniques provide comparable visual and anatomical outcomes in eyes lacking capsular support. The non-glued technique offers a cost-effective alternative without compromising safety or efficacy and may be particularly advantageous in resource-limited settings.