Iris Suture Fixation Of Dislocated Intraocular Lens

To evaluate the efficacy and safety of iris suture fixation of out-of-the-bag dislocated 3-piece intraocular lenses.

St Erik Eye hospital, Stockholm, Sweden.

In a retrospective case control study, a chart review was performed in 2 groups of patients: 14 patients with a dislocated out-of-the-bag 3-piece IOL that underwent IOL fixation to the iris (Iris group) and 18 patients that underwent IOL exchange with a new scleral-sutured IOL (Exchange group).  Surgical safety and efficacy were compared between the groups. The median follow-up time was 13.5 months (interquartile range (IQR), 10 – 20) in the Iris group and 12.5 (IQR, 10 – 14) in the Exchange group.

The BCVA improved significantly in both groups (p = 0.005 and < 0.001, respectively. Postoperative intraocular pressure did not differ between the Iris and the Exchange groups: 15.4 mm Hg (±3.9) and, respectively, 15.2 mm Hg (±3.1). Significantly less surgically induced astigmatism (p = 0.03) and a lower number of postoperative visits (p < 0.001) was noted in the Iris group. Complications were few: intraocular hemorrhage (1 patient in the Iris group, 3 patients in the Exchange group) and choroidal effusion in 2 patients in the Exchange group.

Suturing dislocated 3-piece IOL to the iris is an acceptable surgical management with less surgically induced corneal astigmatism and fewer postoperative visits than IOL exchange.