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Clinical Outcomes of Glued Transscleral Fixated Intraocular Lens in Functionally One-Eyed Patients

Ashok Kumar, Dhivya M.D.; Agarwal, Amar M.S., F.R.C.S., F.R.C.Ophth.; Agarwal, Athiya M.D.; Chandrasekar, Radhika B.Sc.

Eye & Contact Lens: Science & Clinical Practice: July 2014 - Volume 40 - Issue 4 - p e23–e28
doi: 10.1097/ICL.0000000000000039
Case Report

Purpose: To analyze the indications, visual outcome, mental status, and quality of life after glued transscleral fixated intraocular lens (IOL) in functionally one-eyed individuals.

Setting: Dr Agarwal's Eye Hospital and Eye Research Centre, Chennai, India.

Design: Prospective observational comparative case series.

Methods: Patients with one functioning eye with surgical indications (aphakia, luxated IOL, or dislocated lens) and the fellow eye with no perception of light were included. Indications, uncorrected distant visual acuity (UDVA), corrected distant visual acuity (CDVA), mental status (Amsterdam Preoperative Anxiety and Information Scale) and quality of life (visual function scoring VF-14) were assessed. Outcomes of nonsurgical and surgical management were evaluated and compared.

Results: Of 22 patients, 10 (45.4%) patients underwent glued IOL (group A) and 12 (54.5%) wore spectacles (group B). There was a strong association between the initial clinical presentation and management (χ2, P=0.000). Subluxated cataract and dislocated lens (or IOL) required surgical treatment. Postoperative aphakia with adequate spectacle correction were conservatively treated. There was change (P=0.005) in UDVA and CDVA after glued IOL surgery. There was no loss of CDVA. There was difference between the 2 groups in reading small prints (P=0.021), sporting activities (P=0.000), and night driving (P=0.000). Surgical anxiety was higher in group B (P=0.014). Females were more anxious than the males (P=0.014). There was an association of increasing age and the decision for nonsurgical management (χ2, P=0.005).

Conclusion: Glued transscleral fixated IOL can be safely performed in one-eyed patients for specific indications to provide good functional results.

Department of Cataract, Anterior Segment and Uvea, Dr. Agarwal's Eye Hospital and Eye Research Centre, Chennai, India.

Address correspondence to Amar Agarwal, M.S., F.R.C.S., F.R.C.Ophth., Dr. Agarwal's Eye Hospital and Eye Research Centre, 19, Cathedral Road, Chennai 600086, Tamil Nadu, India; e-mail: dragarwal@vsnl.com

A. Agarwal is the paid consultant for Staar Surgicals. The other authors have no funding or conflicts of interest to disclose.

Accepted April 25, 2014

© 2014 Contact Lens Association of Ophthalmologists, Inc.