Long-term outcome of Transscleral Four-Point Fixation of Akreos Intraocular Lens with Closed Continuous-Loop Suture

PURPOSE To report the long-term clinical outcomes of transscleral four-point fixation of Akreos intraocular lens (IOL) using the closed continuous-loop suture. METHODS: Retrospective, multicenter interventional case series. Primary outcome measures were best corrected visual acuity (BCVA), intraocular pressure (IOP), corneal endothelial cell density, and complications with a minimum of 1-year follow-up. RESULTS: 192 eyes of 177 patients from two surgical hospital sites were identified. The mean BCVA improved from 0.88 ± 0.74 logMAR (Snellen 20/152) preoperatively to 0.42 ± 0.52 logMAR (Snellen 20/53) postoperatively (P<0.001). Mean preoperative IOP was 17.51 ± 8.67 mmHg and the mean postoperative IOP at final follow-up was15.08 ± 4.18 mmHg (P= 0.001). The mean corneal endothelial cell density significantly reduced from 2259 ± 729 cells/mm2 to 2077 ± 659 cells/mm2, representing a cell loss of 5.73% (P < 0.001). The IOL was fixed well during follow-up. There were no intraoperative complications noted. Postoperative complications included transient ocular hypertension in 15 eyes (7.81%), hypotony in 2 eyes (1.04%), retinal detachment in 1 eye (0.52%), and macular edema in 1 eye (0.52%). CONCLUSION: The transscleral four-point fixation Akreos IOL using the closed continuous-loop suture was effective and safe with satisfactory visual acuity with minimum 1-year follow-up.