Comparison of Clinical Outcomes Between Intracapsular Implantation and Intrascleral Fixation Using the Same Model of Intraocular Lens

PURPOSE: To compare the clinical outcomes of intrascleral intraocular lens (IOL) fixation surgery with those of intracapsular IOL implantation in conventional cataract surgery. PATIENTS AND METHODS: Twenty-one eyes of 21 consecutive patients who underwent intrascleral IOL fixation (SF group) and 21 eyes of 21 patients who underwent IOL intracapsular implantation during cataract surgery (IN group) were retrospectively enrolled. For both groups, the same model of IOL was used in all cases. For all cases in the SF group, Yamane’s double-needle technique was performed. RESULTS: The mean corrected visual acuity (logMAR) after surgery was significantly better in the IN than in the SF group (−0.063 ± 0.12 vs 0.05 ± 0.14; p = 0.0083). The mean anterior chamber depth after surgery was significantly smaller in the IN than in the SF group (4.65 ± 0.23 mm vs 4.98 ± 0.61 mm; p = 0.0231). The amounts of tilt and decentration were also significantly smaller in the IN group (5.21°± 1.47° and 0.22 ± 0.13 mm, respectively, vs 8.8° ± 3.9° and 0.52 ± 0.35 mm, respectively; p = 0.0003 and p = 0.0007). The mean absolute refractive prediction error was significantly smaller in the IN than in the SF group (0.22 ± 0.17 D vs 0.86 ± 0.59 D; p = 0.0002). CONCLUSION: The intrascleral IOL fixation surgery proved to be highly effective. However, its clinical outcomes were slightly inferior to those of IOL intracapsular implantation, and further improvement of this surgical technique may be needed.