Modified Surgical Technique for Transscleral Fixation and Clinical Outcomes

Abstract

Purpose: To introduce a modified four-point transscleral intraocular lens fixation method and evaluate its safety and clinical outcomes. Methods: We retrospectively reviewed the medical records of patients who underwent transscleral fixation from March 2015 to February 2020. Vitrectomy was performed, and a foldable intraocular lens was inserted through the corneal wound and fixed at four scleral points 2.0 mm posterior from the limbus. We analyzed the visual acuity, best corrected visual acuity, spherical equivalent, intraocular pressure, and complications at preop and 1 day, 1 month, 2 months, and 6 months postoperatively. Results: In this study, 61 eyes of 59 patients were enrolled, and the mean follow up period was 12.68 ± 8.10 months. Best corrected visual acuity (logarithm of the minimal angle resolution) was improved and statistically significant at 1 month, 2 months, and 6 months postoperatively compared to preoperative values (all p < 0.001, paired t-test). Spherical equivalent changed to myopic and was significantly different at all periods compared to preoperative values (all p < 0.001, paired t-test). Prediction error was -0.77 ± 0.82 diopters at 6 months after the operation and tended to shift toward myopia. Macular edema occurred at one eye, but no retinal detachment, endophthalmitis, suture erosion, optic capture, intraocular lens tilt, or decentration was detected. Conclusions: This modified four-point transscleral intraocular lens fixation surgical method is an easy procedure with excellent clinical outcomes and minimal complications.