Comparison of Rescue Approach with Gore-Tex Suture Scleral Fixation and Lens Explantation Combined with Standardized Flanged Intrascleral Fixation

Introduction: The aim of this study was to evaluate the safety and effectiveness of fixing dislocated intraocular lenses (IOLs) with Gore-Tex suture scleral fixation, compared to IOL explantation combined with a secondary implant using a standardized flanged intrascleral fixation (Yamane technique). Methods: The study included patients that underwent rescue of a dislocated single-piece, four-eyelet acrylic IOL, fixated to the sclera with Gore-Tex sutures (group A), or IOL explantation followed by three-piece IOL implant using the Yamane technique (group B). Primary outcomes: uncorrected and best corrected distance visual acuity (UCDVA and BCDVA), refractive target, corneal cylinder (CC), endothelial cell loss (ECL), and postoperative complications. Results: Thirty-four eyes (group A, 16; group B, 18) of 34 consecutive patients were included. Overall mean follow-up was 11.4 ± 2.2 months. In both groups, UCDVA and BCDVA significantly improved (p < 0.001) at last visit. Final refractive target and CC were not significantly different between the groups (p = 0.62). ECL was significantly greater (p = 0.001) in group B (14.7%; -306 ± 11 cells/mm2) than in A (5.1%; -105.6 ± 12 cells/mm2). Conclusions: The rescue approach with Gore-Tex suture scleral fixation was similar to IOL explantation combined with Yamane technique regarding functional and refractive outcomes. A lesser degree of ECL occurred after the rescue approach.