The implantation of the scleral-fixated posterior chamber intraocular lens with 9/0 polypropylene sutures – Long-term visual outcomes and complications

To analyze long-term visual outcomes and complications of the implantation of a scleralfixated posterior chamber intraocular lens (PC-IOL) in patients with the lack of adequate capsular support, and to verify if the procedure can be performed with 9-0 polypropylene sutures.The study was designed as a long-term retrospective analysis. Patients after the implantation of a scleralfixated PC-IOL were evaluated for the best corrected visual acuity (BCVA), intraocular pressure and occurrence of postoperative complications.The analysis included 29 eyes from 28 patients. Indications for the IOL implantation included ocular trauma (89.7%) and previous complicated cataract surgery (10.3%). A postoperative improvement of BCVA was observed in 25 eyes (86.2%). Mean follow-up time was 63.9 months (range 50-83 months). During this time, six patients (21.4%) were diagnosed with glaucoma (21.4%), and retinal detachment was found in one eye (3.4%). A total of six suture breakages were recorded in four eyes from four patients (13.8%); one breakage was precipitated by a trauma, and another five, involving three eyes from three patients, were spontaneous. Mean time to the spontaneous suture breakage was 40.8 months.Scleral fixation of the PC-IOL provides satisfactory visual outcomes. However, this procedure is associated with a considerable risk of postoperative complications. The incidence of postoperative suture breakage in our series was similar as in previous studies in which the PC-IOL was fixated with 10-0 polypropylene suture. A superiority of 9-0 polypropylene suture needs to be verified in larger series of consecutive patients.