Transscleral fixation of single-piece foldable acrylic lens with eyelets at the optic-haptic junction

Objective: To report the clinical outcomes of transscleral fixation using a single-piece foldable acrylic intraocular lens (I0L) with eyelets at the optic-haptic junction (enVista; Bausch & Lomb). Design: Retrospective, noncomparative case series. Participants: Sixty eyes of 60 patients who underwent transscleral fixation with an en Vista IOL were reviewed. Methods: Preoperative patient status, postoperative visual and refractive outcomes, and postoperative complications were analyzed. Results: The study included 60 eyes of 60 patients (52 males, 8 females) with a mean age of 56.65 +/- 15.57 years. At final follow-up visit, the mean follow-up was 11.40 +/- 4.24 months. The mean uncorrected visual acuity (logMAR) improved from 1.95 +/- 0.90 to 0.85 +/- 0.77 (p < 0.001), and best corrected visual acuity (logMAR) improved from 1.11 +/- 1.13 to 0.64 +/- 0.70 (p = 0.006). The mean spherical equivalent improved significantly from 6.90 +/- 6.10 to 0.21 +/- 2.10 D postoperatively (p < 0.001). Complications included transient ocular hypertension (15%), transient hypotony (7%), and hyphema (5%), but no serious complications were observed. In all cases, the IOL remained stable and well centred. Conclusions: Transscleral fixation using a foldable acrylic IOL with eyelets at the optic-haptic junction can be a safe and effective alternative technique to manage cases with broken capsular bag or weak zonular support.