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Factors Influencing Visual and Refractive Outcomes for Scleral-Sutured Intraocular Lenses
Sonia B Kim1,2, Kevin C Allan2,3, Amy S Nowacki1,4
1Case Western Reserve University School of Medicine, Cleveland, OH, USA.
Journal of Vitreoretinal Diseases
|July 1, 2026
Summary
Successful outcomes after scleral-sutured intraocular lens (IOL) implantation depend on preoperative vision and ocular health. Lens choice also impacts vision success, guiding surgical planning and patient expectations.
Area of Science:
- Ophthalmology
- Surgical Outcomes
- Intraocular Lens Implantation
Background:
- Scleral-sutured intraocular lens (IOL) implantation is a common procedure.
- Identifying factors associated with successful outcomes is crucial for optimizing patient care.
Purpose of the Study:
- To identify variables linked to successful surgical outcomes in patients undergoing scleral-sutured IOL implantation.
- To analyze factors influencing both visual and refractive success post-surgery.
Main Methods:
- Retrospective analysis of 182 eyes undergoing scleral-sutured IOL implantation.
- Inclusion criteria: age ≥18 years, ≥1 follow-up visit; exclusion: concurrent ophthalmic procedures (except pars plana vitrectomy) or outside follow-up.
- Variables analyzed: demographic, biometric, preoperative, intraoperative, and 3-month postoperative data. Success defined by visual acuity and refractive targets. Statistical analysis included t-tests, Wilcoxon signed-rank tests, chi-squared tests, Fisher exact tests, random forest modeling, and multivariable logistic regression.
Main Results:
- 72% of eyes achieved vision success (≥20/40 or ≥3 lines improvement) at 3 months.
- Worse preoperative vision increased odds of vision success (OR, 3.92).
- More preexisting ocular conditions (OR, 0.55) and use of CZ70BD lenses (OR, 0.23) decreased odds of vision success.
- 24% of eyes achieved refractive success (within 0.5 diopters of target).
- Lower power IOLs were associated with refractive success (mean 16.4D vs 18.0D; P=.05), with a positive correlation (R=0.3, P=.002).
Conclusions:
- Preoperative ocular status significantly influences visual outcomes after scleral-sutured IOL implantation.
- Intraoperative factors, including the choice of IOL brand, play a role in surgical success.
- Findings can inform surgical planning and help set realistic postoperative expectations for patients.
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