J Korean Ophthalmol Soc.  2014 Oct;55(10):1452-1459. 10.3341/jkos.2014.55.10.1452.

Astigmatic Changes and Clinical Outcomes after Scleral Fixation of IOL

• Oh SY
• Kim SS

• KMID: 2216862
• DOI: http://doi.org/10.3341/jkos.2014.55.10.1452

Abstract

PURPOSE
To evaluate the clinical outcomes, complications and surgically induced astigmatism (SIA) after scleral fixation in patients with intraocular lens (IOL) or crystalline lens dislocation.
METHODS
The present study retrospectively investigated the postoperative best corrected visual acuity (BCVA), refractory change, corneal astigmatism, clinical outcomes, and influencing factors of SIA in 57 eyes of 55 patients with a follow-up of 6 months after the IOL scleral fixation.
RESULTS
In comparison of preoperative and postoperative 6 months, BCVA, spherical equivalent and astigmatism were significantly improved but corneal astigmatism was not and SIA (diopter, D) improved from 2.10 +/- 1.88 D to 0.86 +/- 0.73 D (p = 0.002). 4 eyes having redislocation were repositioned and 4 eyes having tilted IOL, 6 eyes having elevated intraocular pressure, 3 eyes having exposure scleral knots, 1 eye having endophthalmitis, and 1 eye showing macular edema were observed. At postoperative 3 months, the SIA of a large incision size (>3 mm) and small incision size (< or =3 mm) was significantly differented (p = 0.041). According to the location of scleral fixation, SIA at postoperative 1 month was significantly different but, was not different at postoperative 6 months.
CONCLUSIONS
Surgical management of dislocated IOLs or crystalline lens resulted in significant improvement of visual acuity and absence of influencing SIA factors. However, location of scleral fixation and small incision size influenced corneal astigmatism.

Keyword

Dislocated IOL; Dislocated lens; IOL reposition; Scleral fixation; Surgically induced astigmatism

MeSH Terms

Astigmatism
Dislocations
Endophthalmitis
Follow-Up Studies
Humans
Intraocular Pressure
Lens, Crystalline
Lenses, Intraocular
Macular Edema
Retrospective Studies
Visual Acuity

Figure

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  Figure 1. Changes of best corrected visual acuity (BCVA), astigmatism, corneal astigmatism and surgically induced astigmatism (SIA) in scleral fixation of intraocular lens (IOL).

Reference

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