CHARACTERIZING INTRAOCULAR LENS POSITION, STABILITY, AND IRIS MOBILITY IN EYES THAT HAVE UNDERGONE SUTURELESS INTRASCLERAL HAPTIC FIXATION.

Abstract

To characterize intraocular lenses (IOL) position, IOL stability and iris dynamics in eyes with sutureless intrascleral haptic fixated intraocular lenses (SIS-IOLs). This nonconsecutive observational study used ultrasound biomicroscopy to better characterize SIS-IOLs. We included individuals who had SIS-IOL surgery between October 2014 and October 2018. We excluded individuals younger than18 years and those with active uveitis, advanced glaucoma, known ocular syndrome(s), and those with repeated SIS-IOL dislocations before the time of the ultrasound evaluation. Serial ultrasound biomicroscopy were performed in both the seated/supine positions and IOL position and stability were described as our primary outcome. As a secondary outcome, iris mobility was evaluated through dynamic ultrasound biomicroscopy in both the SIS-IOL and posterior chamber IOL (surgery between 2001 and 2019) groups. Analysis of ultrasound biomicroscopy of 22 SIS-IOLs and 10 posterior chamber IOLs, showed that on average, SIS-IOLs were positioned significantly more posteriorly than standard posterior chamber IOLs (aqueous depth = 0.59 vs. 0.48 mm; P < 0.00006)). Over time, SIS-IOLs demonstrated a slight posterior displacement of the IOL (0.18 mm shift posteriorly). Finally, in eyes with SIS-IOLs there was a high degree of iris mobility when compared with the posterior chamber IOL group (Fleiss Kappa 0.887). This study provides ultrasound-based evidence demonstrating a more posterior IOL position with increased iris mobility in eyes with an SIS-IOL. These data provide valuable information which may inform surgeons as they consider IOL selection and surgical technique.