Small benefit seen with secondary scleral fixation of IOL

Secondary scleral fixation of an IOL after complicated cataract extraction seems to have a lower early complication rate than primary scleral fixation at the time of cataract surgery, according to a retrospective study. However, final visual acuity and late complications were not significantly different between eyes with primary and secondary implantation in the study.

V.Y.W. Lee and colleagues at the Hong Kong Eye Hospital reviewed the records of 55 eyes of 55 consecutive patients who received sclerally fixated posterior chamber IOLs either during or after complicated cataract surgery. In 30 eyes the lenses were implanted at cataract surgery and in 25 eyes they were implanted in a second procedure. Follow up ranged from 6 to 36 months.

Mean logMAR postoperative best corrected visual acuity was not significantly different between the primary and secondary groups. Postop best corrected visual acuity of 6/12 or better was achieved in 58.6% of the primary patients and in 76% in the secondary patients.

The primary implantation group had 55 early complications affecting 25 eyes (83.3%). In the secondary group, 16 eyes (64%) had 26 early complications. This difference was statistically significant.

In the primary group, 21 eyes (70%) had 37 late complications (occurring 1 month or more postop). In the secondary group 13 eyes (52%) had 19 late complications. The differences in late complications was not statistically significant.

The study is published in the December issue of British Journal of Ophthalmology.