Long-term Results of Scleral Fixation of Dislocated Intraocular Lenses Using Haptic Externalization through a Small Corneal Incision

Several methods have been reported for refixation of dislocated intraocular lenses (IOLs). However, these methods are associated with some disadvantages including vitreous prolaps, vitreous traction, ocular collapse, intraocular hemorrhage, high astigmatism, and the need for complex intraocular maneuvers. The aim of this study was to evaluate the results of transscleral fixation of dislocated intraocular lenses (IOLs) by externalizing the haptics through a small corneal incision. Patients and This retrospective, non-comparative, interventional study comprised 28 eyes (28 patients) in which IOLs were dislocated into the vitreous cavity. After bringing the IOL to the anterior chamber, a suture was introduced into the eye via scleral flap and retrieved via another flap. Then the thread was pulled out through a small clear corneal incision. The suture was tied to the externalized haptic, and the tied haptic was placed back in the anterior chamber and dialed to externalize the second haptic. After the second externalized haptic was tied, the IOL was reimplanted behind the iris. Data was analyzed using t-test. Through the mean follow-up of 34.5 ± 23.8 months, the PC IOL remained well centered in all eyes and no tilt or dislocation was observed. The difference between the mean of best corrected visual acuity before IOL dislocation (0.35 ± 0.21 logMAR) and the mean after IOL refixation (0.38 ± 0.19 logMAR) was not statistically significant (P=0.2). In addition, the difference between the mean astigmatism at the final examination (1.35 ± 0.64 diopters) and the mean astigmatism before IOL dislocation (1.25 ± 0.69 D) was not statistically significant (P=0.19). Scleral fixation of dislocated IOLs using temporary haptic externalization through a clear corneal incision minimized the need for complicated intraocular maneuvers, and provided an easy and effective way to reposition dislocated IOLs. Long-term results are promising.