Scleral-fixated IOLs – A comprehensive review of current practices and emerging trends

Scleral-fixated intraocular lenses (SFIOLs) have emerged as a vital option for visual rehabilitation of aphakia in cases where capsular support is inadequate or absent. Although alternative methods such as anterior chamber IOLs (ACIOLs) and iris-claw lenses may also be employed in such scenarios, SFIOLs are particularly suitable for eyes with low endothelial cell counts, shallow anterior chambers, iris abnormalities, or aniridia. First introduced by Malbran et al., SFIOL techniques have evolved significantly, with numerous modifications and innovations contributed by surgeons worldwide. This article comprehensively reviews the current evidence surrounding SFIOL implantation, including advancements in surgical methods, complications, and long-term outcomes. It highlights emerging trends such as sutureless techniques, improved lens designs, and minimally invasive approaches that enhance safety and efficacy and the application of SFIOLs in complex clinical scenarios.