Comparative analysis of refractive outcomes and incidence of iris-optic capture in sutured versus sutureless scleral fixation intraocular lens techniques

This study compared postoperative refractive outcomes and iris-optic capture incidence between sutured scleral intraocular lens (SF IOL) fixation and sutureless intrascleral haptic fixation (Yamane technique). A retrospective analysis involved two SF IOL groups: sutured (32 eyes) and sutureless (68 eyes). Primary outcomes were spherical equivalent (SE) difference from target at 2 months and final follow-up, and iris-optic capture occurrence. A surgeon subgroup analysis for the sutureless technique was performed. The sutured group showed a myopic shift from target (− 0.31 ± 0.80 D at 2 months), while the sutureless group had a slight hyperopic shift (0.14 ± 0.69 D). This persisted at final follow-up (sutured: −0.23 ± 0.82 D; sutureless: 0.19 ± 0.69 D). Iris-optic capture occurred in 12.5% (sutured) versus 1.5% (sutureless), a significant reduction. Surgeon subgroup outcomes for the sutureless technique were similar. The sutureless SF IOL technique provided stable refractive outcomes closer to target and significantly reduced iris-optic capture compared to the sutured method. These benefits likely stem from more anatomical IOL optic positioning achievable with the sutureless approach.