Visual Outcomes and Complications: Staged vs Simultaneous Pars Plana Vitrectomy and Scleral-Sutured Intraocular Lens Placement.

Abstract

Purpose: To compare the visual outcomes and postoperative complications after simultaneous scleral-sutured intraocular lens (IOL) placement and pars plana vitrectomy (PPV) (simultaneous group) with those of IOL implantation staged after PPV (staged group). Methods: In this retrospective cohort study, cases of scleral-sutured IOL placement were reviewed between July 1, 2016, and December 31, 2022. All patients had scleral-sutured Akreos AO60 IOL placement using 4-point fixation. Results: Of the 98 eyes, 83.7% had simultaneous surgery and 16.3% had staged surgery. The mean preoperative visual acuity (VA) was similar between the staged group and simultaneous group (1.8 logMAR [Snellen equivalent, 20/1262] vs 1.3 logMAR [Snellen equivalent, 20/400]; P = .104]. The mean logMAR VA improved to 0.98 (Snellen equivalent, 20/191) and to 0.50 (Snellen equivalent, 20/63), respectively. The median logMAR improvement was 0.93 (Snellen equivalent, 20/170) in the staged group and 0.80 (Snellen equivalent, 20/126) in the simultaneous group (P = .49). The overall transient postoperative hypotony rate was 8.2%, with all cases occurring in the simultaneous group (P = .194). Conclusions: Both staged surgery and simultaneous PPV with scleral-sutured Akreos AO60 IOL placement are safe and efficacious procedures for visual rehabilitation in patients with dislocated IOLs, retained lens material, and aphakia resulting from other causes. Staged scleral-sutured Akreos AO60 IOL placement after PPV may offer a safe approach for eyes with significant ocular comorbidities and decrease the risk for transient postoperative hypotony.