Comparison of the anatomical and functional results of two different surgical techniques applied to the implantation of intraocular lens with scleral fixation

Purpose: Patients who underwent scleral fixation intraocular lens implantation with or without suture technique; preoperative visual acuities, causes of aphakia, postoperative visual acuity, postoperative refractive results, postoperative complications and intraocular lens positions were evaluated and it was aimed to compare the superiority of the two methods to each other in terms of anatomical and functional results. Methods: The postoperative 6-month follow-up data of patients who underwent scleral fixation intraocular lens implantation surgery between February 2018 and November 2022 were evaluated retrospectively. The patients were divided into two groups as sutured scleral fixation surgery group and Yamane technique group. The patients were evaluated in terms of demographic characteristics, causes of aphakia, need for revision, postoperative best-corrected visual acuity, refractive results, intraocular lens position and tilt grade, and postoperative complications, and the two groups were compared. Results: Complicated phacoemulsification surgery was the most common reason for scleral fixation surgery indication in both groups. When compared with preoperative visual acuity in both patient groups, significant visual acuity improvement was observed on postoperative 30th, 90th and 180th days (p<0,0001). Cystoid macular edema was detected in 2 patients in the sutured surgery group and in 4 patients in the Yamane technique group. While anterior segment complications developed in the sutured surgery group; it was not observed in the Yamane technique group. In the sutured surgery group, it was observed that the intraocular lens was decentralized to the superior-temporal; superior-nasal decentralization was detected in the Yamane technique group. A higher tilt rate was observed in the group in which Yamane technique was applied in the horizontal plane (p=0,025). There was no correlation between tilt angle and best corrected visual acuity and postoperative cylindrical value. The advantages of this method are that there is no need for scleral flap preparation and no suture-related complications in sutureless surgery. Key words: Complicated cataract surgery, aphakia, intraocular lens implantation with scleral fixation, intraocular lens decentralization, cystoid macular edema