Single-Haptic Z-Suture Scleral Fixation Of A Posterior Chamber Iol In Eyes With Partial Capsular Support: Optical Quality Comparison With Double-Haptic Fixation
Published 2026 - 44th Congress of the ESCRS
Reference: FP16.04 | Type: Free paper | DOI: 10.82333/fj6c-a873
Authors: Dr Seda Liman Uzun* 1 , Dr Nilay Kandemir Besek 1 , Dr Rumeysa Koçak 1 , Dr Gulay Yalcinkaya Cakir 1 , Dr Dilan Çolak Arıcı 1 , Dr Ahmet Kırgız 1 , Dr Metehan Şimşek 2
1Ophthalmology,Beyoglu Eye Training and Research Hospital,Istanbul,Türkiye, 2Ophthalmology,Doğubeyazıt Dr Yaşar Eryılmaz State Hospital,Ağrı,Türkiye
Purpose
To compare postoperative optical quality between single-haptic and double-haptic Z-suture scleral fixation of three-piece IOLs using ray-tracing aberrometry, and to describe Pentacam-derived IOL position in the single-haptic cohort.
Setting
The study was conducted at Anterior Segment Clinic of Beyoğlu Eye Training and Research Hospital, a tertiary referral center in Istanbul, Türkiye.
Methods
Retrospective comparative study including single-haptic Z-suture fixation (n=21) and double-haptic Z-suture fixation (n=26). Demographic data, preoperative and postoperative visual acuity, keratometry, axial length, and refractive outcomes were recorded for all patients.
iTrace ray-tracing aberrometry was analyzed coma RMS, internal/total HOA (µm), Spheric aberration, and MTF10 (cpd). Between-group comparisons used Mann–Whitney U tests; results are reported as median (IQR). IOL tilt (°) and decentration (mm) were summarised for the single-haptic group by Scheimpflug imaging (Pentacam). All aberrometry outcomes were analysed at a 4-mm pupil diameter.
Results
A total of 47 patients were included (single-haptic group, n=21; double-haptic group, n=26), with a mean age of 63.8 ± 13.1 years and a mean follow-up of 31.2 ± 24.7 months. Median coma RMS was 0.0755 (IQR 0.054–0.0895) µm in the single-haptic group versus 0.067 (IQR 0.036–0.137) µm in the double-haptic group (p=0.665). Median internal MTF10 was 0.359 (IQR 0.2405–0.4385) versus 0.205 (IQR 0.170–0.427), respectively (p=0.105). IOL position measurements in the single-haptic group showed a mean IOL tilt of 3.12±1.01° and a mean decentration of 0.34±0.08 mm.
Conclusions
Single-haptic Z-suture fixation achieved coma RMS values comparable to those of double-haptic fixation. Internal MTF10 was numerically higher in the single-haptic group but did not reach statistical significance. Scheimpflug imaging analysis suggested an acceptable IOL position in the single-haptic cohort. Prospective studies with standardised imaging and complete aberrometry data in both groups are warranted.
Single-haptic Z-suture scleral fixation of a posterior chamber IOL appears to be a safe and efficient option in selected eyes with partial capsular support, providing stable fixation with optical quality comparable to double-haptic fixation while minimising suture-related morbidity.