Clinical outcomes of a purpose-designed scleral tuck intraocular lens for sutureless glueless fixation: A 183-eye comparative series
Mehul A. Shah, Shreya M. Shah, Ritu Mamvani, Nikita Balani, Pranami Dewan, Shubham JainPurpose:
To evaluate the safety, visual outcomes, long-term stability, and cost-effectiveness of a novel scleral tuck intraocular lens (ST-IOL) for secondary IOL implantation in aphakic eyes without capsular support.
Methods:
This retrospective interventional case series included 183 eyes of 178 patients who underwent ST-IOL implantation at a tertiary eye care center between January 2017 and December 2024. The ST-IOL is a custom-designed foldable hydrophilic acrylic lens with preformed haptics that are externalized and tucked into scleral tunnels beneath partial-thickness scleral flaps without the use of sutures or fibrin glue. Best-corrected visual acuity (BCVA), postoperative complications, and IOL stability were analyzed. Redislocation-free survival was assessed using Kaplan–Meier survival analysis and compared with published outcomes of other scleral fixation techniques.
Results:
The mean patient age was 58.9 ± 13.2 years. Aphakia resulted from iatrogenic causes in 67.8%, trauma in 27.9%, and congenital etiologies in 4.4% of cases. At 6 months, 83% of eyes achieved BCVA ≥20/60, with more than 80% maintaining stable vision at 2 years. The overall complication rate was 10.4%, most commonly transient hypotony (3.2%) and cystoid macular edema (2.7%). No cases of late IOL redislocation, suture-related complications, or endophthalmitis were observed. Kaplan–Meier analysis demonstrated >95% redislocation-free survival at 3 years and >92% at 5 years. Procedural costs were approximately 40% lower compared with glued or Yamane techniques.
Conclusion:
ST-IOL implantation is a safe, effective, and cost-efficient technique for secondary IOL fixation, providing excellent long-term stability without suture- or glue-related complications, particularly suitable for high-volume and low- and middle-income country settings.