Early Clinical Outcomes of Intrascleral Fixation Using an Intraocular Lens with Hook-Shaped Haptics.

Purpose In this study, we aimed to report on the early results of intrascleral intraocular lens (IOL) fixation using a hook-shaped haptic IOL (hsh-IOL). Patients and methods We enrolled 27 consecutive eyes of 27 patients (mean age, 74±11.4 years) who underwent intrascleral IOL fixation with an hsh-IOL and were followed-up for 3 months postoperatively. The reasons for surgery included insufficient capsular support, including IOL dislocation, aphakia, or dislocated crystalline lens. The haptic of the hsh-IOL was externalized from the eye using forceps, and the hook was buried in the scleral tunnel. We investigated the preoperative and 3-month postoperative corrected visual acuity (VA), intraocular pressure (IOP), corneal endothelial cell density, refractive prediction error, postoperative intraocular astigmatism, surgically induced astigmatism, and intraoperative and postoperative complications. Results The mean postoperative corrected VA (logMAR, 0.083±0.18) was significantly better than the mean preoperative value (0.42±0.60, p=0.0007). The 3-month postoperative mean absolute prediction error was 1.00±0.96 D. The mean IOL-induced astigmatism was 0.95±0.70 D. Further, the mean postoperative corneal endothelial cell count (2036±644 cells/mm2) was significantly lower than the preoperative value (2316±527 cells/mm2) (p=0.009). No patient had a 1-month postoperative IOP 25 mmHg. There were no intraoperative or vision-threatening complications, such as retinal detachment, endophthalmitis, or IOL dislocation, due to postoperative haptics misalignment. Conclusion Intrascleral IOL fixation using hsh-IOL is an effective option for eyes with insufficient capsular support.