LONG-TERM OUTCOMES OF SUTURELESS INTRASCLERAL INTRAOCULAR LENS FIXATION IN CHILDREN AND ADULTS

ABSTRACT Purpose: Report and compare long-term outcomes and complications of sutureless scleral tunnel (SST) and flanged haptic (FH) scleral fixated IOLs (SFIOL), with spontaneous IOL dislocation as primary outcome measure. Methods: Retrospective single-surgeon case series of 95 SST and 458 FH eyes from 2011-2022 (553 total eyes). Demographics, surgical indications, ocular history, visual acuity and complication rates were collected. Results: Reoperation-requiring spontaneous IOL dislocation rate was significantly different ( P =0.0167) between FH (3.7%) and SST (10.5%). Mean follow-up was 3.31±0.30 vs. 1.58±0.07 years for SST and FH, respectively. There was no significant difference between preoperative (20/305 vs. 20/300) or final postoperative (20/77 vs. 20/62) visual acuity. Other complications included any cystoid macular edema (20.0% vs. 25.3%), elevated IOP (16.8 vs. 9.6%), IOL tilt requiring re-operation (5.3 vs. 0%), haptic exposure (2.1 vs. 3.3%), and reverse pupillary block (4.2 vs. 1.1%). Conclusions: Haptic flanging resulted in fewer eyes meeting the primary endpoint of IOL dislocation. We report the longest-to-date follow-up of both non-flanged SST IOL fixation and our FH modified Yamane technique. Our FH modified Yamane technique represents a safe, durable, and potentially superior option for SFIOL.