Comparison of Clinical Outcomes between Refixation of Dislocated Intraocular Lenses and Exchange with Intrascleral Fixation

Purpose: To investigate the clinical outcomes of refixation of a dislocated intraocular lens (IOL) and IOL exchange with intrascleral fixation. Methods: We performed a retrospective study of 90 patients (91 eyes) who underwent refixation or exchange of IOLs from January 2014 to April 2019. The patients were divided into an ab externo scleral refixation group (group 1), an intrascleral refixation group (group 2), and an exchange with intrascleral fixation group (group 3). We evaluated the best-corrected visual acuity (BCVA), spherical equivalent, cylindrical power, intraocular pressure, and postoperative complications. Results: The BCVA was 0.10 +/- 0.17 (group 1), 0.15 +/- 0.29 (group 2), and 0.31 +/- 0.52 (group 3) at 6 months after surgery. The BCVA change in group 3 was significantly greater than that in groups 1 and 2 (p = 0.018 and p = 0.046, respectively). The final BCVA was not significantly different among the groups (p = 0.422). The spherical equivalent was -1.26 +/- 1.72 diopters (D) (group 1), -1.32 +/- 2.09 D (group 2), and -0.17 +/- 1.58 D (group 3) at 6 months after surgery, showing that group 1 and group 2 were more myopic than group 3 (p = 0.004 and p = 0.001, respectively). Haptic slippage was the most common complication. Conclusions: Refixation of dislocated IOLs and IOL exchange with intrascleral fixation did not differ significantly in terms of the final visual outcomes. Refixation was associated with more myopia and a higher risk of IOL dislocation or haptic slippage than exchange.