Complications and visual outcome of sutureless, scleral fixated intraocular lens in cases with traumatic aphakia

Ther Adv Ophthalmol. 2021 Apr 20;13:25158414211009095. doi: 10.1177/25158414211009095. eCollection Jan-Dec 2021.

Abstract

Purpose: The aim of this study is to describe the complications and outcome of sutureless scleral fixated intraocular lens (SFIOL) implantation in traumatic aphakia.

Setting: The study was conducted in a tertiary eye care centre in South India.

Design: The study involved a retrospective data analysis.

Methods: Medical records of cases with traumatic aphakia who had undergone sutureless SFIOL implantation in the last 2 years were included in the study. Data on intraoperative and postoperative complications and visual outcome were collected and analysed.

Results: In total, 45 cases were recruited. Mean logarithm of the minimum angle of resolution (logMAR) best-corrected visual acuity (BCVA) improved from preoperative 1.64 ± 0.45 to 0.63 ± 0.36 at last follow-up visit, and the difference was statistically significant (p < 0.0001). Final logMAR BCVA was worse than one in three patients who had associated posterior segment pathology. There was no incidence of intraoperative haptic rebound into the vitreous cavity or intraocular lens (IOL) drop. Four cases had hypotony, two cases had choroidal detachment, four cases had raised intraocular pressure (IOP), eight cases had transient corneal oedema and six patients had mild dispersed vitreous haemorrhage during immediate postoperative period. Six patients had postoperative cystoid macular oedema (CME). Two cases developed glaucoma. None of the patients had postoperative haptic exposure, retinal detachment (RD), iris capture of IOL or SFIOL dislocation till the last follow-up.

Conclusion: Final visual outcome of sutureless SFIOL implantation in traumatic aphakia may be affected by concomitant posterior segment pathology. The immediate and late postoperative complications noted in our study were comparable with other similar studies. However, longer follow-up is needed to detect RD and angle recession glaucoma at the earliest and initiate therapy.

Keywords: IOL drop; haptic rebound; sutureless SFIOL; traumatic aphakia; traumatic glaucoma.