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Outcomes of intraocular lens scleral fixation with the friction knot technique
Author(s) -
Aaltonen Petri,
Oskala Pertti,
Immonen Ilkka
Publication year - 2019
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/aos.13931
Subject(s) - medicine , ophthalmology , visual acuity , confidence interval , glaucoma , surgery , hazard ratio , intraocular lens , fixation (population genetics) , intraocular lenses , population , environmental health
Purpose To examine the clinical outcomes of intraocular lens ( IOL ) scleral fixation with the friction knot technique. Methods Retrospective case series of 152 eyes of 152 patients with inadequate capsular bag support operated with the friction knot IOL scleral fixation technique by a single surgeon. The fixated IOL s were one‐piece or three‐piece models all with open loop haptics. Main outcome measures were change in corrected distance visual acuity ( CDVA ) and postoperative complications. Results The mean follow‐up time was 11.7 months (median 4.9, range 0.7–64.8). The mean logarithm of the minimum angle of resolution CDVA improved from preoperative 0.77 ± 0.73 (Snellen 20/118 ± 7.3 lines) to 0.44 ± 0.56 (Snellen 20/55 ± 5.6 lines) at the final visit (p < 0.001). The main postoperative complications were ocular hypertension (30.3%), uveitis–glaucoma–hyphaema syndrome (12.5%; UGHS ), vitreous haemorrhage (11.2%) and retinal detachment (8.6%). Two (1.3%) cases of suture breakage were seen. In multivariate Cox regression analysis, age under 60 years [hazard ratio ( HR ) = 5.41; 95% confidence interval ( CI ) 1.95–15.01] and scleral fixated one‐piece IOL ( HR = 4.23; 95% CI 1.44–12.44) were found as significant independent risk factors for developing new UGHS . Conclusion The friction knot technique provides a firm scleral fixation. Scleral fixation may successfully be utilized in dislocated three‐piece IOL s with loop haptics. We recommend avoiding scleral fixation of one‐piece IOL s in young patients due to a high risk of UGHS .