Transscleral fixation of foldable intraocular lenses

PURPOSE: To report the results of transscleral implantation of foldable intraocular lenses (IOLs). SETTING: Department of Ophthalmology Dokuz Eylül University School of Medicine, Izmir, Turkey. METHODS: Twenty eyes of 20 patients had transscleral fixation of a foldable IOL combined with conventional 3-port pars plana vitrectomy or anterior vitrectomy. Twelve eyes had lens luxation, 8 traumatic and 4 idiopathic. Six eyes were aphakic, 3 after extracapsular cataract extraction and 3 as a result of complicated phacoemulsification. One patient with a mature cataract and pseudoexfoliation had a wide zonular dialysis during phacoemulsification. One patient had an opacified hydrophilic acrylic IOL. RESULTS: The mean age of the patients was 52.9 years (range 17 to 80 years). The mean preoperative best corrected visual acuity (BCVA) was 20/63 (range counting fingers to 20/25). The mean preoperative refraction was +10.8 diopters (D) (range +10 to +13 D) and the mean preoperative astigmatism, 1.8 D (range 1.0 to 5.5 D). Sixteen IOLs were hydrophobic acrylic, 14 of which were 3-piece AcrySof MA60BM (Alcon) and 2 of which were Sensar AR40 (Allergan). Four IOLs, all VisaAcryl(Staar), were hydrophilic acrylic. The mean power of the IOLs was +22.0 D (range 19.0 to 26.0 D). The mean follow-up was 12 months (range 1 to 18 months). The postoperative BCVA ranged between 20/100 and 20/20, and the mean postoperative astigmatism was 1.1 D (range 0.5 to 4.0 D) at the last follow-up visit. The difference was statistically significant (P<.05). Suture exposure and cystoid macular edema were the only complications, each occurring in 2 eyes. CONCLUSION: Transscleral fixation of foldable IOLs takes less time and results in fewer complications and better visual outcomes.