Long-term outcome of scleral-fixated intraocular lens implantation without conjunctival peritomies and sclerotomy in ocular trauma patients

Background: To investigate the long-term outcomes and complications of scleral-fixated intraocular lens (SFIOL) implantation without conjunctival peritomies and sclerotomy in patients with a history of ocular trauma with inadequate capsular support during primary pars plana vitrectomy or silicone oil removal. Methods: Records of ocular trauma patients who underwent implantation of SFIOL without conjunctival peritomies and sclerotomy during primary pars plana vitrectomy or silicone oil removal. Results: Sixty-nine eyes of 69 patients were included in this study. The median follow-up period was 34months (range, 6-99months). The average patient age at the time of surgery was 44years old (range, 4-80years). At the end of follow-up, the preoperative mean of best corrected visual acuity (BCVA) was 0.790.86 log of the minimum angle of resolution (logMAR), which improved 0.20 +/- 0.26 logMAR postoperatively (P=0.01). BCVA improved or remained unchanged in 64 eyes (92.8%), VA decreased two lines in five eyes (7.2%). Early postoperative complications included transient corneal edema in seven eyes (10.1%), minor vitreous hemorrhage in four eyes (5.8%), transient elevated intraocular pressure (IOP) in one eye (1.4%), and hypotony in three eyes (4.3%). Late postoperative complications included persistent elevated IOP in five eyes (7.2%), epiretinal membrane formation in three eyes (4.3%), and cystoid macular edema noted in one eye (1.4%). Conclusions: Use of a scleral-fixated intraocular lens implantation without conjunctival peritomies and sclerotomy in ocular trauma patients during either primary pars plana vitrectomy or second silicone oil removal is a valuable approach for the management of traumatic aphakia in the absence of capsular support.