Early Clinical Outcomes of Intrascleral Fixation Using an Intraocular Lens with Hook-Shaped Haptics

Abstract

Norihiko Yoshida,1 Takashi Kojima,1,2 Kazuo Ichikawa3 1Department of Ophthalmology, Japanese Red Cross Gifu Hospital, Gifu, Japan; 2Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan; 3Chukyo Eye Clinic, Nagoya, JapanCorrespondence: Takashi KojimaDepartment of Ophthalmology, Keio University School of Medicine, Shinanomachi 35, Shinjuku-Ku, Tokyo, 160-8582, JapanTel [phone]Fax [phone]Email [email protected]: In this study, we aimed to report on the early results of intrascleral intraocular lens (IOL) fixation using a hook-shaped haptic IOL (hsh-IOL).Patients and Methods: We enrolled 27 consecutive eyes of 27 patients (mean age, 74± 11.4 years) who underwent intrascleral IOL fixation with an hsh-IOL and were followed-up for 3 months postoperatively. The reasons for surgery included insufficient capsular support, including IOL dislocation, aphakia, or dislocated crystalline lens. The haptic of the hsh-IOL was externalized from the eye using forceps, and the hook was buried in the scleral tunnel. We investigated the preoperative and 3-month postoperative corrected visual acuity (VA), intraocular pressure (IOP), corneal endothelial cell density, refractive prediction error, postoperative intraocular astigmatism, surgically induced astigmatism, and intraoperative and postoperative complications.Results: The mean postoperative corrected VA (logMAR, 0.083± 0.18) was significantly better than the mean preoperative value (0.42± 0.60, p=0.0007). The 3-month postoperative mean absolute prediction error was 1.00± 0.96 D. The mean IOL-induced astigmatism was 0.95± 0.70 D. Further, the mean postoperative corneal endothelial cell count (2036± 644 cells/mm2) was significantly lower than the preoperative value (2316± 527 cells/mm2) (p=0.009). No patient had a 1-month postoperative IOP < 5 mmHg or > 25 mmHg. There were no intraoperative or vision-threatening complications, such as retinal detachment, endophthalmitis, or IOL dislocation, due to postoperative haptics misalignment.Conclusion: Intrascleral IOL fixation using hsh-IOL is an effective option for eyes with insufficient capsular support.Keywords: intrascleral IOL fixation, efficacy, safety, hook-shaped haptics, visual acuity, intraocular lens

Keywords

• intrascleral iol fixation
• efficacy
• safety
• hook-shaped haptics
• visual acuity
• intraocular lens.