1.Comparison of Long-term Outcomes of Scleral-fixated IOL: Sutured vs. Suture-less Fixation
Ju Seouk LEE ; Chang Zoo KIM ; Seung Uk LEE ; Sang Joon LEE
Journal of the Korean Ophthalmological Society 2025;66(1):17-26
Purpose:
This study compared the long-term outcomes and complications associated with sutured and suture-less scleral fixed intraocular lenses (SFIOLs), the two primary surgical techniques for scleral fixation of IOLs.
Methods:
A total of 90 patients were included in the study with 46 in the sutured group and 44 in the suture-less group. These patients underwent SFIOL between January 2019 and June 2023 due to IOL dislocation, aphakia, or crystalline lens dislocation. Collected data included age, gender, axial length, operative time, best corrected visual acuity (BCVA), intraocular pressure (IOP), refractive value, refractive error, ocular residual astigmatism, IOL dislocation, recurrent IOL dislocation, IOL tilt, and IOL iris capture. Changes from preoperative status to 1 year postoperatively were assessed.
Results:
No significant differences were found between the sutured and suture-less groups regarding preoperative BCVA, IOP, and refractive values. However, the suture-less group demonstrated significantly better BCVA at both 1 week and 1 month postoperatively compared to the sutured group (p = 0.010, 0.015, respectively). The refractive error in the suture-less group was also significantly lower at 1 week postoperatively (p = 0.020). Ocular residual astigmatism was consistently lower in the suture-less group across all postoperative intervals (p < 0.001). While the suture-less group showed a shorter average surgical time, there was greater variability in operative duration (p < 0.001, 0.024, respectively). Additionally, a longer axial length was associated with an increased incidence of IOL iris capture (p = 0.004).
Conclusions
Suture-less SFIOL is associated with shorter operative times, although with greater variability. Patients in the suture-less group experienced faster BCVA improvement, reduced refractive error, and lower ocular residual astigmatism compared to those in the sutured group.
2.Comparison of Long-term Outcomes of Scleral-fixated IOL: Sutured vs. Suture-less Fixation
Ju Seouk LEE ; Chang Zoo KIM ; Seung Uk LEE ; Sang Joon LEE
Journal of the Korean Ophthalmological Society 2025;66(1):17-26
Purpose:
This study compared the long-term outcomes and complications associated with sutured and suture-less scleral fixed intraocular lenses (SFIOLs), the two primary surgical techniques for scleral fixation of IOLs.
Methods:
A total of 90 patients were included in the study with 46 in the sutured group and 44 in the suture-less group. These patients underwent SFIOL between January 2019 and June 2023 due to IOL dislocation, aphakia, or crystalline lens dislocation. Collected data included age, gender, axial length, operative time, best corrected visual acuity (BCVA), intraocular pressure (IOP), refractive value, refractive error, ocular residual astigmatism, IOL dislocation, recurrent IOL dislocation, IOL tilt, and IOL iris capture. Changes from preoperative status to 1 year postoperatively were assessed.
Results:
No significant differences were found between the sutured and suture-less groups regarding preoperative BCVA, IOP, and refractive values. However, the suture-less group demonstrated significantly better BCVA at both 1 week and 1 month postoperatively compared to the sutured group (p = 0.010, 0.015, respectively). The refractive error in the suture-less group was also significantly lower at 1 week postoperatively (p = 0.020). Ocular residual astigmatism was consistently lower in the suture-less group across all postoperative intervals (p < 0.001). While the suture-less group showed a shorter average surgical time, there was greater variability in operative duration (p < 0.001, 0.024, respectively). Additionally, a longer axial length was associated with an increased incidence of IOL iris capture (p = 0.004).
Conclusions
Suture-less SFIOL is associated with shorter operative times, although with greater variability. Patients in the suture-less group experienced faster BCVA improvement, reduced refractive error, and lower ocular residual astigmatism compared to those in the sutured group.
3.Comparison of Long-term Outcomes of Scleral-fixated IOL: Sutured vs. Suture-less Fixation
Ju Seouk LEE ; Chang Zoo KIM ; Seung Uk LEE ; Sang Joon LEE
Journal of the Korean Ophthalmological Society 2025;66(1):17-26
Purpose:
This study compared the long-term outcomes and complications associated with sutured and suture-less scleral fixed intraocular lenses (SFIOLs), the two primary surgical techniques for scleral fixation of IOLs.
Methods:
A total of 90 patients were included in the study with 46 in the sutured group and 44 in the suture-less group. These patients underwent SFIOL between January 2019 and June 2023 due to IOL dislocation, aphakia, or crystalline lens dislocation. Collected data included age, gender, axial length, operative time, best corrected visual acuity (BCVA), intraocular pressure (IOP), refractive value, refractive error, ocular residual astigmatism, IOL dislocation, recurrent IOL dislocation, IOL tilt, and IOL iris capture. Changes from preoperative status to 1 year postoperatively were assessed.
Results:
No significant differences were found between the sutured and suture-less groups regarding preoperative BCVA, IOP, and refractive values. However, the suture-less group demonstrated significantly better BCVA at both 1 week and 1 month postoperatively compared to the sutured group (p = 0.010, 0.015, respectively). The refractive error in the suture-less group was also significantly lower at 1 week postoperatively (p = 0.020). Ocular residual astigmatism was consistently lower in the suture-less group across all postoperative intervals (p < 0.001). While the suture-less group showed a shorter average surgical time, there was greater variability in operative duration (p < 0.001, 0.024, respectively). Additionally, a longer axial length was associated with an increased incidence of IOL iris capture (p = 0.004).
Conclusions
Suture-less SFIOL is associated with shorter operative times, although with greater variability. Patients in the suture-less group experienced faster BCVA improvement, reduced refractive error, and lower ocular residual astigmatism compared to those in the sutured group.
4.Long-Term Outcomes by Tube Position After Combined Ahmed Valve Implantation and Vitrectomy in Neovascular Glaucoma
Chang Min CHA ; Ju Seouk LEE ; Chang Zoo KIM ; Seung Uk LEE ; Sang Joon LEE
Journal of the Korean Ophthalmological Society 2025;66(12):468-477
Purpose:
We evaluated the 3-year clinical outcomes of simultaneous Ahmed valve implantation and vitrectomy in patients with neovascular glaucoma.
Methods:
We retrospectively reviewed 38 eyes that underwent combined Ahmed valve implantation and vitrectomy. Best-corrected visual acuity, intraocular pressure (IOP), and the number of IOP-lowering medications were assessed preoperatively and up to 36 months postoperatively. Patients were categorized into two groups (anterior chamber and vitreous cavity) based on the site of Ahmed valve tube insertion. Clinical outcomes were compared between the two groups. Surgical success was defined as maintaining IOP between 6 and 21 mmHg, with or without topical IOP-lowering medications. Surgical failure was defined as IOP outside this range despite IOP-lowering therapy, loss of vision to no light perception, or the need for valve replacement or additional Ahmed valve implantation.
Results:
The overall surgical success rate was 68.4%; rates were 58.8% in the anterior chamber group and 76.2% in the vitreous cavity group. The mean durations of target IOP maintenance were 24.91 ± 3.45 months in the anterior chamber group and 29.00 ± 2.89 months in the vitreous cavity group, with no significant difference between groups (p > 0.05). Changes in visual acuity before and after surgery did not significantly differ between groups. However, at 36 months postoperatively, the vitreous cavity group required significantly more IOP-lowering medications (p = 0.044). The most common complication was encapsulation removal (39.5%), followed by tube obstruction (10.5%).
Conclusions
Surgical success rates and the duration of target IOP maintenance did not significantly differ between the anterior chamber and vitreous cavity groups. However, patients in the vitreous cavity group required more IOP-lowering medications postoperatively. These findings suggest that the tube insertion site should be considered when planning surgery for neovascular glaucoma.

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