Flange Depth for Scleral Pocket vs No Pocket Techniques for Intrascleral IOL Fixation.

Abstract

Purpose: To compare flange depth for a modified Scleral Pocket versus No Scleral Pocket technique (“Yamane technique”) for intrascleral intraocular lens fixation. Setting: Instituto de Oftalmología Santa Fe, Santa Fe, Argentina. Design: Prospective Randomized Single Surgeon Observational Study. Methods: Eyes with aphakia and no capsular support were included. They were divided into two groups; one was programmed for a double needle flanged intrascleral IOL fixation as originally described by Shin Yamane with No Scleral Pocket (NSP) and the second group had a modified Scleral Pocket (SP) technique. Flange depth was measured with anterior segment optical coherence tomography (AS-OCT) at 1, 3, 6 and 12 months postoperatively and results compared. Results: Each group comprised 18 eyes of 18 patients, giving a total of 36 flanges per group. The groups were comparable preoperatively. At 12 months uncorrected distance visual acuity (UDVA) and corrected distance visual acuity (CDVA) were not statistically different for both groups (P = .333; P = .448). Spherical equivalent (SEQ) was not significantly different between groups at 12 months postop (P=.078). AS-OCT revealed a significantly deeper flange position for the SP group at 1, 3, 6 and 12 months postop (P < .05). Conclusion: When performing a double needle intrascleral IOL fixation in aphakic eyes with no capsular support, a modified scleral pocket technique provides a significantly deeper flange position with no difference in CDVA or SEQ 12 months after surgery.