Long-Term Outcomes Of Scleral Fixation Of Hydrophobic Acrylic Intraocular Lenses Using Baykara Suture-Burial Technique

To assess the causes of aphakia, surgical outcomes, and long-term complications following scleral fixation of single-piece hydrophobic acrylic intraocular lenses (IOLs) using the Baykara Suture-Burial technique.

Tertiary referral center, Department of Ophthalmology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.

A retrospective review of patients who underwent scleral fixation of single-piece hydrophobic acrylic IOLs using the Baykara technique from 2013 to 2019. Data from 25 eyes of 22 patients were analyzed. Pre- and post-operative refraction, best-corrected visual acuity (BCVA), intraocular pressure (IOP), endothelial cell density, and complications were recorded. Lenticular astigmatism was calculated using the vector analysis method described by Holladay et al.

The mean age of patients was 50.6 ± 22.4 years, with an average follow-up of 76.9 ± 7.7 months. Mean BCVA improved from 1.54 ± 0.52 to 0.90 ± 0.76 LogMAR (p = 0.001). A significant decrease in endothelial cell density was observed, averaging 22% (range, 8–36%) (p = 0.003). Mean lenticular astigmatism was  1,56± 0,94 diopter (range 0,5-3,5%). Glaucoma remained stable in eyes with preexisting disease, while 2 eyes (8%) developed postoperative glaucoma, which was controlled with medication. Complications included cystoid macular edema (8%), uveitis–hyphema–glaucoma syndrome (8%), retinal detachment requiring vitrectomy (8%), and suture exposure (8%).

The Baykara suture-burial technique for scleral fixation of single-piece hydrophobic acrylic IOLs is an effective and safe long-term option for aphakia. Lens tilt may affect refractive outcomes, and patients should be monitored for endothelial loss and late complications.