Refractive, Visual, and Safety Outcomes of Three Surgical Techniques for Aphakia Correction.

Abstract

Purpose: To compare refractive, visual, and safety outcomes of three methods for surgical correction of aphakia: anterior chamber IOL (ACIOL), intrascleral haptic fixation IOL (ISHF-IOL), and Gore-Tex suture fixation of modified eyelet toric IOL (GSF-MET IOL).

Setting: Tertiary care academic center.

Design: Multi-surgeon retrospective case series.

Methods: Review of 357 eyes undergoing one of the above three techniques between 2017 and 2024. Comparative refractive (defocus (spherical equivalent (SE)), astigmatism (refractive cylinder (RefCyl)), and blur (defocus equivalent (DEQ))), visual acuity (corrected distance visual acuity (CDVA)), and safety outcomes (cystoid macular edema (CME) and return to the operating room (ROR) events) were recorded. Due to concerns about IOL tilting with one of the models, a subgroup analysis was performed on two IOL models within the ISHF group. Statistical analyses included descriptive statistics, Chi-Square tests, one-way ANOVA, and two-sample t-testing.

Results: All three groups had similar SE (p = 0.87), RefCyl (p = 0.91), and CDVA in eyes without significant comorbidities (p = 0.23). ROR was similar among all groups (p = 0.08). Within the ISHF-IOL group, CT Lucia 602 and Sensar AR40 had similar SE and RefCyl (p = 0.18 and p = 0.15, respectively). CDVA was similar in eyes without significant comorbidities for both IOL models (p = 0.70). ROR was significantly higher with CT Lucia 602 than with Sensar AR40 (p = 0.03).

Conclusions: All three surgical techniques can provide good refractive, visual acuity, and safety outcomes. Within the ISHF-IOL group, the Sensar AR40 had lower ROR rates than the CT Lucia 602, with similar CDVA outcomes.