Comparative analysis of outcomes of two (popular) techniques of haptic exteriorization in scleral fixation intra-ocular lens surgery - A retrospective study

Purpose:To compare the visual outcomes and complication rates between the extra-ocular needle-guided haptic insertion technique (XNIT) and the conventional handshake (HS) technique of scleral fixation intra-ocular lens (SFIOL).Methods:In this retrospective study, we retrieved data of those patients who had undergone SFIOL surgery from January 2018 to May 2022 at our institute for aphakia following either a complicated cataract surgery or an ocular trauma and had a minimum follow-up of 3 months.Results:Of the 156 eyes, the HS technique was done in 80 eyes and the remaining 76 eyes with XNIT. At 3 months follow-up visit, there was no significant difference in the median best corrected visual acuity (BCVA) (P = 0.988) and uncorrected visual acuity (UCVA) (P = 0.765) between the two techniques. There was no statistically significant difference between pre-operative median BCVA and post-operative UCVA in XNIT (P = 0.961) and the HS technique (P = 0.831) at 3 months follow-up visit. The complication rates between the two techniques were minimal and comparable. The most common post-operative complication was corneal edema. The incidence of cystoid macular edema was slightly more in the XNIT group but not statistically significant (P = 0.05). Two patients in the HS group developed retinal detachment, which settled after repeat surgery.Conclusion:The newer XNIT technique was found to be as safe and effective as compared to the conventional HS technique.