Scleral Fixation of a Toric Lens to Treat Corneal Astigmatism in Eyes without Capsular Support

Abstract

Purpose

To describe surgical technique and report short-term visual outcomes after suture-fixation of a single-piece eyelet-toric (SET) intraocular lens (IOL) for treatment of concurrent aphakia and astigmatism.

Design

Retrospective, noncomparative, and non-consecutive case series.

Methods

This was a case series of eleven eyes who underwent successful SET. Eligible eyes had loss of capsular support or aphakia with a minimum of symmetric corneal astigmatism 1.75 diopters (D). Outcome measures included uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), magnitude of residual refractive cylinder, and complications resulting from the SET procedure.

Results

Preoperative UDVA and CDVA in logMAR scale were 1.46 and 0.45, respectively. Mean preoperative keratometric and refractive cylinder were 3.67 D and 2.52D, respectively. Postoperative UDVA and CDVA were 0.51 and 0.27, respectively, three months after surgery (POM3). Residual refractive cylinder at POM3 was 0.93 D.

Conclusion

SET technique reduced refractive cylinder and improved UDVA and CDVA. SET may be adapted by surgeons using a readily available IOL and familiar scleral-fixation maneuvers.

Keywords:

• aphakia
• toric
• suture fixation
• secondary lens
• astigmatism

Value Statement

What Was Known

Transscleral fixation of secondary posterior chamber IOLs is a safe, reliable and effective way of treating spherical refractive error in patients with aphakia or dislocated IOLs. Current broadly employed fixation techniques do not permit correction of corneal astigmatism at the IOL plane.

What This Paper Adds

SET is a simple and effective modification of a current IOL fixation technique that achieved significant IOL-based correction of corneal astigmatism resulting in improved UDVA and CDVA in a small series of patients.

Disclosure

The authors have not received grant support, research funding, nor have any proprietary interests in the materials described in the article.