PMMA HAPTIC BENDING: LENS CENTRATION AND REFRACTIVE OUTCOME FOLLOWING A NEW TRANSSCLERAL IOL FIXATION TECHNIQUE

To evaluate IOL centration and refractive outcome of a new transscleral fixation technique using an IOL with a PMMA haptic (ZA 9003, J&J).

Department of Ophthalmology and Optometry at the Kepler University Clinic Linz, Austria

In this prospective study 51 patients were included who underwent implantation of a three piece IOL with PMMA haptics using modified Yamane technique. The haptic endings were bend at approximately 1mm. A 27Gauge sclerotomy was performed at the 3' and 9' o'clock position for externalisation of the bended haptics. No further cauterization or glueing was performed. In all cases a follow-up visit was performed 6 to 8 weeks after surgery. At this follow-up CASIA 2 (Tomey, Japan) measurements, autorefraction and subjective refraction were performed.

Reason for the need of the transscleral IOL was IOL subluxation, complicated cataract surgery and Marfan syndrome in 40 (of those 28 PEX), 10 and 1 cases, respectively. Mean absolute IOL tilt was 6.0° (SD: 1.8°, median: 6.6° and maximum tilt 8.7°) and IOL decentration was 0.4mm (SD: 0.2 mm, median 0.4 mm and maximum decentration 0.6 mm). Mean absolute post-operative refractive error was 0.75 D (SD: 0.6; median 0.5 D; maximum: 2.0 D) and post-operative cylinder was 1.6 D (SD: 0.8 D, median 1.8 D, maximum 3.0 D).

This study showed a save and repreducible technique for trans-scleral PMMA haptic fixation. This technique could be helpful in cases of thin sclera or if PVDF haptics IOLs are not availiable in lower diopter ranges.