Flanged Polypropylene Scleral Fixation: A Comprehensive Analysis Of Outcomes And Considerations
Published 2026 - 44th Congress of the ESCRS
Reference: FP03.10 | Type: Free paper | DOI: 10.82333/89xy-sq41
Authors: Dr Michael Ostrovsky* 1 , Dr Mor Levi 1 , Dr Shalhevet Goldfeather Ben-Zaken 1 , Dr Mor Schlesinger 1 , Prof. Arie Marcovich 1 , Dr Efraim Berco 1 , Dr Mor Bareket 1
1Ophthalmology,Kaplan Medical Center,Rehovot,Israel
Purpose
To evaluate visual, refractive, and safety outcomes of secondary flanged polypropylene scleral intraocular lens (IOL) fixation in a large cohort. Additionally, to compare outcomes between pre-existing IOL repositioning versus exchange, and between horizontal versus vertical flange orientation.
Setting
Single-center retrospective study at a tertiary referral ophthalmic center.
Methods
Retrospective cohort of consecutive eyes undergoing flanged polypropylene scleral IOL fixation between January 2021 and August 2024, with a minimum follow-up of 6 months. Pre- and postoperative visual acuity (VA), refraction, and complications were analyzed. Subgroup analyses compared outcomes between IOL repositioning versus exchange and horizontal versus vertical flange fixation.
Results
A total of 138 eyes were included. Mean VA improved from 1.11±0.63 to 0.40±0.43 logMAR at 12 months (p<0.001). Final refraction showed a mean spherical equivalent of −0.60±2.35 D. Complications occurred in 10.1% of cases, predominantly flange-related (5.8%) and manageable. Residual spherical equivalent was closer to emmetropia following IOL exchange compared with repositioning (−0.15±1.50 D vs −0.80±2.26 D; p=0.047), while VA and complication rates were similar. Fixation orientation (horizontal vs vertical) had no significant effect on VA, refraction, or complication rates (all p>0.05).
Conclusions
Flanged polypropylene scleral IOL fixation provides substantial visual improvement with low complication rates. Compared with repositioning, pre-existing IOL exchange was associated with residual refraction closer to emmetropia, without increased risk. Flange orientation did not significantly impact clinical outcomes. Surgical decisions should therefore be guided by surgeon expertise and the clinical context.