Influence of sclerotomy size on intraocular lens tilt after intrascleral intraocular lens fixation

Abstract

Purpose: To determine whether differences in sclerotomy size during intrascleral intraocular lens (IOL) fixation influence IOL tilt and visual acuity after surgery.

Setting: University of Fukui Hospital and Japanese Red Cross Fukui Hospital, Japan.

Design: Retrospective case series.

Methods: The study reviewed the records of patients who had intrascleral IOL fixation with transconjunctival 25-gauge pars plana vitrectomy and a follow-up longer than 6 months. The preoperative and postoperative visual outcomes, degree of IOL tilt, and intraoperative and postoperative complications were statistically compared between the sclerotomy groups.

Results: The study included 65 eyes (60 patients). Postoperatively, the maximum degree of IOL tilt was significantly smaller in the 24-gauge sclerotomy group than in the 30-gauge sclerotomy group (P = .003). The degree of IOL tilt was significantly correlated with the amount of postoperative IOL astigmatism (total astigmatism - corneal astigmatism) (P = .0001, R² = 0.23). There were no statistically significant differences in the preoperative or postoperative corrected distance visual acuity (CDVA) or the complication rate between the sclerotomy groups.

Conclusion: A smaller sclerotomy for intrascleral IOL fixation was associated with greater IOL tilt and IOL astigmatism after surgery; however, this did not clinically or significantly affect the postoperative CDVA.