Comparison of iris sutured versus trocar-assisted sutureless scleral fixation techniques for dislocated one-piece and three-piece intraocular lenses

Purpose: To explore the visual outcome and complications of iris sutured intraocular lenses (ISIOLs) and sutureless scleral-fixated intraocular lenses (SSIOLs) in the surgical management of patients without exchanging dislocated posterior chamber intraocular lenses (PCIOLs) into the vitreous. Methods: : Fourteen ISIOLs and 15 SSIOLs implantations for dislocated PCIOLs were analyzed retrospectively. Mean follow-up of ISIOL Group and SSIOL Group: 11,3 ± 2, 0 (range: 9-15) months and 11, 8± 2, 2 (range: 9-16) months, respectively Preoperative and postoperative outcomes, operative indications, and complications were evaluated. Results: : Primary surgical indications were pseudoexfoliation (PXE) (21,4 %), post-cataract surgery (PCS) (35,7 %) trauma (42,8 %), in ISIOL group and PXE (26,6 %), PCS (40 %) trauma (33,3 %) in SSIOL group, respectively. At latest follow-up, there was improvement in best-corrected visual acuity (BCVA) (0.053 ± 0.051 to 0.53 ± 0.13 p <0.0001) in ISIOL group and (0.05± 0, 02 to 0.64± 0, 16, p <0.0001) in SSIOL group. Postoperative complications of ISIOL group and SSIOL group included corneal oedema (14,2%; nil), IOP elevation (21,4%;7,1 %), bullous keratopathy (14,2%;nil), anterior uveitis (35,7%;13,3%), cystoid macular oedema (CME) (21,4%);7,1%), pupil ovalization (21,4%;nil), broken haptic (none; 13,3%), IOL exchange (nil; 13,3%), and vitreous haemorrhage (nil; 14,2%). Conclusions: : Self - IOL implantation may enable much earlier visual rehabilitation in the SISIOL group than the IFIOL group. Moreover, the 27G trocar-assisted SSIOL technique takes a shorter operation time and relatively lower complication rates. Further studies with larger series and longer follow-up assessments are required.