Surgical Outcomes of IOL Iris Suture Fixation in Eyes with Residual Capsule Support.

To evaluate the safety and refractive outcomes of eyes following IOL iris suture fixation (ISF). Private Practice, Los Angeles, CA. Non-randomized and unmasked retrospective chart review. We included eyes that underwent IOL exchange or repositioning with ISF with at least 270 degrees of capsular support. We excluded eyes with less than 270 degrees of capsular support, and eyes with iris damage. The primary outcome measures included incidence of cystoid macular edema (CME), IOL dislocation requiring refixation, and chronic inflammation. Secondary outcome measures included worsening IOP control, retinal tear or detachment, worsening of CDVA, and corneal decompensation. Refractive outcomes for 26 subgrouped eyes included mean and median spherical equivalent refraction accuracy (SERA), and % eyes within 0.5D and 1D of the refractive target. The study included 53 eyes of 50 patients. CME: 2/53 (3.8%), IOL dislocation requiring refixation: 2/53 (3.8%), chronic inflammation: 1/53 (1.9%), worsening IOP control: 5/53 (9.4%), retinal tear or detachment: 2/53 (3.8%). No patient experienced worsening of CDVA from baseline or corneal decompensation. Mean SERA ± standard deviation: -0.35 ± 0.29D, median SERA: -0.37D. Of the 26 eyes subgrouped for refractive analysis, 73% were within 0.5D and 100% were within 1D of the desired refractive outcome. ISF can offer stability for sulcus fixated IOLs provided there is some residual capsule support. Although there are measurable complications, there is a relatively low side effect profile. The refractive error tended to be myopic, indicating the need for further refinement of IOL power predictive formulae.

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