title: Comparison of clinical outcomes of iris fixation and scleral fixation as treatment for intraocular lens dislocation.
abstract: OBJECTIVE
  To compare the efficacy and safety of iris fixation with scleral fixation in surgical repositioning of dislocated intraocular lenses (IOLs).
  
  
  METHODS
  Retrospective, consecutive, comparative interventional case series.
  
  
  METHODS
  setting: Referral hospital.
  
  
  METHODS
  Seventy-eight consecutive patients who underwent surgical repositioning of dislocated intraocular lenses using suturing to the sclera or iris.
  
  
  METHODS
  Forty-four eyes of 44 patients underwent scleral fixation and 35 eyes of 34 patients underwent iris fixation of dislocated intraocular lenses.
  
  
  METHODS
  Visual acuity, refractive stability, operation time, and perioperative complications, including recurrence of IOL dislocation.
  
  
  RESULTS
  Corrected distance visual acuity (CDVA) improved significantly 1 month postoperatively in both groups (P < .01 each), and remained stable for 12 months. One week postoperatively, however, CDVA improved significantly in the scleral fixation (P = .040) but not in the iris fixation (P = .058) group. The amount of refractive error significantly diminished 1 day after surgery (P = .028 in the scleral fixation and P = .046 in the iris fixation group). For the astigmatic components, Jackson crossed cylinders equivalent to conventional cylinders of positive power at axes of 0 degrees (J0) and 45 degrees (J45), J45 differed significantly in the scleral fixation and iris fixation groups (P = .009), whereas J0 was similar (P > .05). Operation time was significantly shorter (P = .0007), while immediate postoperative inflammation was significantly more severe (P = .001), in the iris fixation than in the scleral fixation group. Recurrence rates were similar (P > .05), but the mean time to recurrence was significantly shorter in the iris fixation than in the scleral fixation group (P = .031).
  
  
  CONCLUSIONS
  Iris fixation and scleral fixation techniques had similar efficacy in the repositioning of dislocated intraocular lenses. Although operation time was shorter for iris fixation, it had several disadvantages, including induced astigmatism, immediate postoperative inflammation, earlier recurrence, and less stable refraction.
authors.affiliation: Department of Ophthalmology, Haeundae Paik Hospital, Busan, South Korea; Department of Ophthalmology, Inje University College of Medicine, Busan, South Korea.
authors.forename: Kyeong Hwan
authors.initials: KH
authors.lastname: Kim
authors.affiliation: Department of Ophthalmology, Haeundae Paik Hospital, Busan, South Korea; Department of Ophthalmology, Inje University College of Medicine, Busan, South Korea. Electronic address: khkim@inje.ac.kr.
authors.forename: Wan Soo
authors.initials: WS
authors.lastname: Kim
mesh_terms: D000368:Aged; D060437:Artificial Lens Implant Migration / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D006801:Humans; D007498:Iris / Q000601:surgery*; D019654:Lens Implantation, Intraocular / Q000379:methods*; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D011183:Postoperative Complications; D012008:Recurrence; D012029:Refraction, Ocular / Q000502:physiology; D012189:Retrospective Studies; D012590:Sclera / Q000601:surgery*; D013536:Suture Techniques; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology