Clinical outcomes of combined pars plana vitrectomy and trans-scleral 4-point suture fixation of a foldable intraocular lens.

OBJECTIVE: To describe outcomes of combined pars plana vitrectomy (PPV) and trans-scleral 4-point suture fixation of a foldable Akreos AO60 intraocular lens (IOL) in eyes with subluxated or dislocated lens or IOL.
METHODS: Retrospective case series of 20 eyes of 18 patients who underwent this procedure with a minimum follow-up of 3 months. Outcome measures included final best-corrected Snellen visual acuity (BCVA), spherical equivalent (SE) and intraoperative and postoperative complications.
RESULTS: Mean age at surgery was 43.65 years. The commonest indication for surgery was post-traumatic subluxated or dislocated cataract. Mean BCVA improved from 6/24 preoperatively to 6/9 at final follow-up (p < 0.0001). Mean SE was 5.69 dioptres preoperatively and -1.32 dioptres postoperatively. There were no intraoperative complications. Postoperative complications included transient vitreous haemorrhage in one eye and cystoid macular oedema in one eye. Postoperative Pentacam analysis confirmed the absence of IOL tilt or decentration in six eyes. Mean follow-up was 8.9 months (range 3-30 months).
CONCLUSION: Trans-scleral 4-point suture fixation of a foldable Akreos AO60 IOL can be performed safely along with concurrent PPV across varying surgical indications resulting in a substantial improvement in visual acuity with minimal complications.