title: Iris suture fixation of subluxated intraocular lenses.
abstract: OBJECTIVE
  To assess the results of iris suture fixation of subluxated intraocular lenses.
  
  
  METHODS
  Retrospective study.
  
  
  METHODS
  This was a nonrandomized chart review of eyes with subluxated intraocular lenses that underwent iris suture fixation at an academic institutional care center. Seventy-two eyes of 67 consecutive patients were included. The following cases were excluded: posterior dislocations necessitating pars plana vitrectomy; secondary implantations for aphakia; and iris suture fixation at primary cataract extraction. Main outcome measures included visual acuity improvement, surgically induced astigmatism, and postsurgical complications.
  
  
  RESULTS
  The mean follow-up duration was 16.64 ± 24.37 months (median = 4.03 months). All patients had preoperative monocular diplopia or unstable vision attributable to the subluxated intraocular lenses, and 40.3% of them required aphakic correction. There was an overall improvement in best-corrected visual acuity from a mean preoperative logMAR 0.35 ± 0.32 (Snellen equivalent∼20/45) to logMAR 0.21 ± 0.25 (20/32, P = .001). There was no significant change in astigmatism secondary to the surgery. The mean difference in preoperative keratometry readings was 1.6 ± 1.07 diopter (D), whereas the mean postoperative manifest refraction astigmatic error (vertexed to the corneal surface) was 1.29 ± 0.92 D (P < .02). Re-subluxations occurred in 7 eyes during follow-up; the majority of these eyes underwent repeat fixation. Most (93.55%) intraocular lenses were stable and centered at the final follow-up. Glaucoma developed in 2 eyes postoperatively.
  
  
  CONCLUSIONS
  Iris suture fixation of subluxated intraocular lenses was efficacious for the eyes included in this study, and it led to long-term stability of the intraocular lenses in 93.55% of cases.
authors.affiliation: Cornea Division, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland.
authors.forename: Uri
authors.initials: U
authors.lastname: Soiberman
authors.affiliation: Cornea Division, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland.
authors.forename: Qing
authors.initials: Q
authors.lastname: Pan
authors.affiliation: Cornea Division, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland.
authors.forename: Yassine
authors.initials: Y
authors.lastname: Daoud
authors.affiliation: School of Public Health, Department of Biostatistics, Johns Hopkins University, Baltimore, Maryland.
authors.forename: Peter
authors.initials: P
authors.lastname: Murakami
authors.affiliation: Cornea Division, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland. Electronic address: wstark@jhmi.edu.
authors.forename: Walter J
authors.initials: WJ
authors.lastname: Stark
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D060437:Artificial Lens Implant Migration / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007498:Iris / Q000601:surgery*; D019654:Lens Implantation, Intraocular / Q000379:methods*; D008297:Male; D008875:Middle Aged; D019591:Pseudophakia / Q000503:physiopathology; D012189:Retrospective Studies; D013536:Suture Techniques; D014792:Visual Acuity / Q000502:physiology