ESCRS - FPM12.01 - Comparison Of Clinical Outcomes Of Anterior Chamber Intraocular Lens Implantation Versus Four-Flanged Scleral Fixation Technique In The Absence Of Capsular Support

Comparison Of Clinical Outcomes Of Anterior Chamber Intraocular Lens Implantation Versus Four-Flanged Scleral Fixation Technique In The Absence Of Capsular Support

Published 2022 - 40th Congress of the ESCRS

Reference: FPM12.01 | Type: Free paper | DOI: 10.82333/9sej-w092

Authors: Adi Einan-Lifshitz* 1 , Biana Dubinsky-Pertzov 1 , Francis Simaan 1 , Idan Hecht 1 , Eran Pras 1 , Ori Mahler 1

1Tel Aviv University. Shamir medical center Israel,Tel Aviv,Israel

Purpose

To compare the outcomes of anterior chamber intraocular lens (ACIOL) implantation vs scleral fixated IOL with the four-flanged fixation technique in eyes with no capsular support.

Setting

Shamir medical cente

Methods

A retrospective cohort study of all patients in whom IOL was implanted during a cataract surgery in the absence of capsular support with at least 6-months follow-up, between 2014 to 2021 in Shamir medical center. Two different IOL fixation techniques were compared: angle support fixation using an ACIOL (ACIOL group) and scleral fixation using the four-flanged fixation technique (flange group). Main outcome measures included the postoperative best-corrected visual acuity (BCVA) and postoperative complications including corneal edema, elevated Intraocular pressure (IOP) and glaucoma, retinal detachment, central macular edema, and suture erosion.

Results

: Fifty-seven eyes were included in the study. Thirty-three eyes in the ACIOL group and 24 eyes in the flange group. Mean uncorrected visual acuity six months after surgery was 1.14±1.08 and 0.57±0.46 logMAR (Snellen equivalent 20/276 and 20/74) in the ACIOL and the flange groups, respectively. Overall complications rate was 50% in the ACIOL group and 21% in the flange group (P=0.026). Postoperative corneal edema developed in 10 (30%) eyes in the ACIOL group and in none of the eyes in the flange group (P=0.03). Glaucoma or deterioration of preoperatively diagnosed glaucoma was reported in 10 (30%) eyes in the ACIOL group and in 3 (12.5%) eyes in the flange group.

Conclusions

In the setting of inadequate capsular support, the four-flanged scleral fixation technique showed better visual results and a lower rate of complications compared to ACIOL implantation.