Outcomes of intraocular lens scleral fixation with the friction knot technique

Abstract

Purpose To examine the clinical outcomes of intraocular lens (IOL) scleral fixation with the friction knot technique. Methods Retrospective case series of 152 eyes of 152 patients with inadequate capsular bag support operated with the friction knot IOL scleral fixation technique by a single surgeon. The fixated IOLs were one‐piece or three‐piece models all with open loop haptics. Main outcome measures were change in corrected distance visual acuity (CDVA) and postoperative complications. Results The mean follow‐up time was 11.7 months (median 4.9, range 0.7–64.8). The mean logarithm of the minimum angle of resolution CDVA improved from preoperative 0.77 ± 0.73 (Snellen 20/118 ± 7.3 lines) to 0.44 ± 0.56 (Snellen 20/55 ± 5.6 lines) at the final visit (p < 0.001). The main postoperative complications were ocular hypertension (30.3%), uveitis–glaucoma–hyphaema syndrome (12.5%; UGHS), vitreous haemorrhage (11.2%) and retinal detachment (8.6%). Two (1.3%) cases of suture breakage were seen. In multivariate Cox regression analysis, age under 60 years [hazard ratio (HR) = 5.41; 95% confidence interval (CI) 1.95–15.01] and scleral fixated one‐piece IOL (HR = 4.23; 95% CI 1.44–12.44) were found as significant independent risk factors for developing new UGHS. Conclusion The friction knot technique provides a firm scleral fixation. Scleral fixation may successfully be utilized in dislocated three‐piece IOLs with loop haptics. We recommend avoiding scleral fixation of one‐piece IOLs in young patients due to a high risk of UGHS.

A modified intrascleral intraocular lens fixation technique with fewer anterior segment manipulations: 27-gauge needle-guided procedure with built-in 8–0 absorbable sutures

“…Postoperative ocular hypertension could be explained by mild viscoelastic material retention and steroid response. Transiently IOP elevations were controlled by antiglaucoma medications without affecting the final visual outcome [34]. Since vitrectomy surgery has been previously performed in all cases, no cases of VH or CME were detected during the follow-up period.…”

A modified intrascleral intraocular lens fixation technique with fewer anterior segment manipulations: 27-gauge needle-guided procedure with built-in 8-0 absorbable sutures

“…[25] The by antiglaucoma medications without affecting the final visual outcome. [34] Since vitrectomy surgery has been previously performed in all cases, no cases of VH or CME were detected during the follow-up period.…”

A modified intrascleral intraocular lens fixation technique with fewer anterior segment manipulations: 27-gauge needle-guided procedure with built-in 8-0 absorbable sutures

“…Transiently IOP elevations were controlled by antiglaucoma medications without affecting the final visual outcome. [34] Since vitrectomy surgery has been previously performed in all cases, no cases of VH or CME were detected during the follow-up period.…”