Clinical Outcomes Of Scleral Fixation Using Light Adjustable Lens For The Management Of Intraocular Lens Dislocation Or Subluxation

To evaluate the clinical outcomes of intrascleral haptic fixation (ISHF) using a Light Adjustable Lens (LAL) for patients with IOL dislocation or subluxation, and to compare refractive results before and after Light Delivery Device (LDD) adjustments and final lock-in.

First Samsung Eye Clinic, Seoul, Republic of Korea.

This single-arm, retrospective study included 15 eyes that underwent secondary IOL implantation using the Yamane technique with LAL and pars plana vitrectomy. Uncorrected distance visual acuity (UDVA), best-corrected visual acuity (BCVA), and manifest refraction (spherical equivalent, SE; and cylinder) were measured at baseline (before LDD adjustment, typically 3-4 weeks post-op) and at 1 month after final UV lock-in. Complication rates and their management were also recorded.

At the baseline visit (before LDD), the mean SE was 0.39 ± 0.83 D and mean cylinder was -0.97 ± 0.43 D. After a mean of 1.2 LDD adjustment sessions, the final mean SE improved to 0.05 ± 0.13 D and cylinder to -0.13 ± 0.20 D (P <.001). Achieved UDVA at last visit was -0.01 ± 0.11(-0.18~0.3) after final lock-in. Post-operative complications occurred in 26.7% of cases. The most frequent complications were [e.g., pupillary capture (20%), or macular edema (6.7%)]. Pupillary capture was managed by pupilloplasty in one case and peripheral iridectomy with Nd-YAG in two cases. No vision-threatening complications like endophthalmitis or retinal detachment were observed.

Scleral fixation of LAL via the Yamane technique is an effective method for treating IOL dislocation. The LAL platform successfully compensates for the refractive unpredictability and astigmatism induced by haptic misalignment in sutureless scleral fixation, providing superior visual outcomes compared to standard 3-piece monofocal IOLs.