A Comparison of Visual Quality and Contrast Sensitivity between Patients with Scleral-Fixated and In-Bag Intraocular Lenses

Abstract

Purpose: To analyze visual quality and contrast sensitivity in patients after intraocular lens (IOL) implantation with sutured scleral fixation. Setting: Chang Gung Memorial Hospital, Taoyuan, Taiwan. Design: Retrospective observational study. Methods: Data on the refractive outcome, visual acuity, and subjective visual symptoms in patients with scleral-fixated or in-bag IOL implantation were collected from September 2019 to March 2020. We also investigated patients’ postoperative higher-order aberrations (HOAs) and dysphotopsia using a wavefront aberrometer and glaretester, respectively. The following values were compared: corrected distance visual acuity, spherical equivalent, root mean square values for aberrations, and contrast sensitivity. Results: A total of 23 eyes implanted with scleral-fixated IOL and 74 eyes with in-bag IOL were studied. The mean postoperative spherical equivalent and logarithm of the minimum angle of resolution after scleral fixation were −1.09 ± 3.32 D and 0.20 ± 0.17, respectively. The ocular HOAs were higher in the scleral-fixation group than in the in-bag group (p = 0.001). Contrast sensitivity was negatively associated with age, and it was similar between the two groups after controlling for the age effect. Conclusions: Ocular HOAs and refractive errors were higher in the scleral-fixation group than in the in-bag group. However, no significant difference was noted in contrast sensitivity between advanced scleral fixation and in-bag IOL implantation.

4-Point scleral fixation technique using Gore-tex® sutures for cut-out plated haptic intraocular lenses

“… 6 In these cases, hydrophobic IOLs were preferred over hydrophilic lenses that have a tendency for postoperative opacification 9 which may require additional surgery for replacement. Aspheric aberration neutral IOLs are the preferred choice for fixation in this case due to their lower incidence of spherical aberrations induced postoperatively 10 and their tolerance to some degree of tilt and decentration. 11 , 12 …”