Outcomes of Four-Point Suture Fixated And Two-Point Sutureless Posterior Chamber IOLs Combined With Pars Plana Vitrectomy

Background: While each scleral fixation method has its own advantages, there is a lack of strong evidence to suggest a superior technique. Advances in cataract surgery expand patient eligibility for successful cataract extraction, benefitting a growing population of pseudophakic patients. However, implantation of secondary intraocular lens (IOL) with compromised anterior or posterior capsule is a more challenging task. Each method of scleral fixation has its own advantages and none of them has strong evidence to be superior. This paper describes postsurgical outcomes of two scleral intraocular(IOL) fixation techniques combined with pars plana vitrectomy(PPV) from a single tertiary referral eye center.Methods: Patients underwent PPV and IOL implantation with either four-point sutured scleral fixation (Akreos AO60(AK); n=24) or two-point sutureless flanged intrascleral fixation (CT Lucia(CTL); n=7). Reports include IOL and sclerotomy placement, fixation techniques, and IOL model. Results: 31 eyes of 30 patients were analyzed. Average change in vision from baseline measurement was LogMAR -0.68±0.66 and -0.90 ±0.63 for AK and CTL groups, respectively. Average postoperative refractive error was -0.3 ±1.03 D (AK) and 0.4 ±0.60 D (CTL). No opacification cases of Akreos lens were found in this study with the longest follow up of 53 months.Conclusions: Both methods of implantation (sutured and sutureless) could provide good visual and refractive outcomes. Minimal complication rates were reported despite including patients with multiple comorbidities, making both techniques an attractive choice for secondary IOL implantation.