Clinical evaluation of a novel technique of flange formation using green laser in 4-flange scleral fixated intra-ocular lens implantation.

Purpose: Scleral-fixated intraocular lens (SFIOL) is the mainstay of restoration of vision where natural lens or its support is absent for placing an IOL in the bag. The aim of the study was to clinically evaluate the novel four-flange SFIOL technique using 532 nm laser for flange making in a tertiary eye care center in central India.

Methods: We reviewed total 33 patients who have undergone four-flanged SFIOL between January 2023 to October 2023. The clinical parameters like best corrected visual acuity (BCVA), intraocular pressure (IOP), spherical equivalent (SE), and postoperative complication like cystoid macular edema (CME) were evaluated. All the surgeries were performed by a senior vitreo-retinal (VR) surgeon in a tertiary eye care center.

Results: The mean preoperative BCVA was improved from 0.7 log MAR unit to 0.21 log MAR unit postoperatively. The mean preoperative IOP and SE improved from 19.48 mmHg to 17.12 mm Hg and 8.98D to 0.63D on postoperative follow-up, respectively. Early complications, within 1 month of surgery, noted in 15 patients (45%) and includes corneal edema - six cases (18.18%), CME - three cases (9.09%), intraocular lens tilting - two cases (6.06%), flange exposure - two cases (6.06%), and one case (3.03%) each of vitreous hemorrhage and glaucoma.

Conclusion: Four-flange SFIOL using green laser for flange formation is a safe and effective modification of sutured SFIOL with good outcome in long term.