Comparison of Clinical Outcomes of Iris Fixation and Scleral Fixation as Treatment for Intraocular Lens Dislocation




We read with interest the article by Kim and Kim titled “Comparison of Clinical Outcomes of Iris Fixation and Scleral Fixation as Treatment for Intraocular Lens Dislocation.” We would like to congratulate the authors on a well-conducted study comparing both surgical techniques for dislocated intraocular lenses. However, we have a few comments to make.


Firstly, vitreous disturbance following intraocular lens dislocation is a common finding following a complicated cataract surgery. The presence of either vitreous in the anterior chamber or a disturbed vitreous face can lead to multiple ocular complications like decompensated corneal endothelium, secondary glaucoma, cystoid macular edema, and retinal detachment, which can have an effect on the final postoperative visual outcome.


Secondly, passing of the needles in the scleral fixation technique through the anterior vitreous face in a completely nonvitrectomized eye can cause peripheral retinal traction leading to retinal complications like cystoid macular edema and retinal detachment.


Finally, we would also like to add that recurrence rates of refixating the same intraocular lens in the present study was 13.6% in the iris fixation group vs 17.1% in the scleral fixation group, while Kubaloglu and associates in their study of intraocular lens exchange reported a recurrence rate of 3% with astigmatism of 1.09 ± 0.45 diopters at the end of 1 month.


In conclusion, we suggest that vitreous loss and the role of vitrectomy in dislocated intraocular lenses need to be considered and further comparative studies between various surgical procedures are necessary to decide a technique having lower recurrence rates and excellent visual outcomes.

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Jan 6, 2017 | Posted by in OPHTHALMOLOGY | Comments Off on Comparison of Clinical Outcomes of Iris Fixation and Scleral Fixation as Treatment for Intraocular Lens Dislocation
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