Suturing technique for scleral fixation of toric intraocular lens in the traumatic aphakic eye with corneal astigmatism

Purpose: To describe the clinical outcomes of traumatic aphakic eyes with corneal astigmatism after using a novel technique for toric intraocular lens suture fixation. Methods: In total, 12 eyes of 12 patients who underwent a new scleral suture fixation technique of one-piece toric intraocular lens (SN6AT series, Alcon Inc., TX, USA) were included in our retrospective study. Preoperative patient status, postoperative visual acuity and refractive outcomes, postoperative intraocular lens rotation, tilt, decentration, and complications were analyzed. Results: The mean follow-up was 11.6 +/- 1.0 months. The mean preoperative best-corrected visual acuity was 0.55 +/- 0.32 in the logarithm of minimum angle of resolution equivalent; the postoperative best-corrected visual acuity was 0.45 +/- 0.34. The mean preoperative total corneal astigmatism was 2.51 +/- 1.67 D. The mean postoperative residual astigmatism was 0.77 +/- 0.54 D. The mean intraocular lens rotation was 3.33 degrees +/- 1.37 degrees (range, 1 degrees-6 degrees). The mean intraocular lens tilt in horizontal direction was 3.64 degrees +/- 1.02 degrees (range, 2.6 degrees-6.3 degrees) and in vertical direction it was 3.19 degrees +/- 1.07 degrees (range, 1.6 degrees-5.2 degrees). The mean intraocular lens decentration in horizontal direction was 0.14 +/- 0.03 mm (range, 0.089-0.192 mm) and in vertical direction it was 0.15 +/- 0.02 mm (range, 0.113-0.181 mm). One patient had mild vitreous hemorrhage and two other patients had high postoperative residual sphere and astigmatism, respectively. But no other serious complications were observed. Conclusion: Scleral suture fixation of foldable toric intraocular lens to correct corneal astigmatism can be a safe and effective alternative technique to manage traumatic aphakic eyes that lack adequate capsular support.