ESCRS - FP16.03 - A 7-Year Comparative Analysis Of Retinal Complications And Refractive Outcomes Of Two Modern Techniques For Scleral-Fixated Iol Surgery

A 7-Year Comparative Analysis Of Retinal Complications And Refractive Outcomes Of Two Modern Techniques For Scleral-Fixated Iol Surgery

Published 2026 - 44th Congress of the ESCRS

Reference: FP16.03 | Type: Free paper | DOI: 10.82333/3q0t-sj20

Authors: Mr Ishan Bhanot 1 , Dr Karanpreet Singh Multani 2 , Dr Kamran Riaz* 2

1Ophthalmology,University of Oklahoma Health Sciences Center,Oklahoma City,United States, 2Ophthalmology,Dean McGee Eye Institute,Oklahoma City,United States

Purpose

To compare retinal complications and identify risk factors between intrascleral haptic fixation (ISHF-IOL, Yamane technique) and Gore-Tex–sutured scleral IOL fixation using modified eyelet toric IOLs (GSF-MET IOL) over a seven-year period.

Setting

Single tertiary academic center.

Methods

Records of eyes undergoing secondary IOL implantation (2019–2025) were reviewed. Primary outcomes were postoperative cystoid macular edema (CME) and retinal detachment (RD). Secondary outcomes included reoperation, refractive astigmatism, IOL tilt, inflammation, and intraocular pressure (IOP) abnormalities. All eyes were included regardless of final visual acuity, with stabilization and refraction assessed 60–120 days postoperatively. Eyes with missing visual acuity or insufficient follow-up (<60 days) were excluded. Eyes with incomplete refractive data were included for complication and acuity analyses but excluded from refractive outcome calculations.

Results

A total of 344 eyes (278 ISHF-IOL, 66 GSF-MET IOL) were included. Primary outcomes were similar between groups, with comparable rates of CME (8.6% vs 6.1%) and RD (3.6% vs 3.0%). Secondary complication rates were also similar, including reoperation (9.0% vs 6.1%) and IOL tilt (20.1% vs 10.6%, p=0.070). GSF-MET IOL achieved significantly greater reduction in postoperative astigmatism (-0.95 vs 0.32 D, p<0.001). In ISHF-IOL eyes, older age increased reoperation risk (OR 2.11 per 10-year increase, p=0.017), while Sensar AR40 use was protective against postoperative IOP elevation (OR 0.17, p=0.019).

Conclusions

Rates of CME and retinal detachment were comparable between techniques, supporting the safety of both approaches for secondary IOL implantation in eyes without capsular support. The GSF-MET IOL technique provided superior control of postoperative astigmatism. Patient age and lens selection should be considered to minimize complications following ISHF-IOL.