Long-Term Outcomes of Gore-Tex Sutured Scleral-Fixated Intraocular Lenses and Pars Plana Vitrectomy

Purpose: To evaluate long-term visual and anatomical outcomes and complications following combined pars plana vitrectomy (PPV) and scleral fixation of intraocular lenses (IOLs) using Gore-Tex (polytetrafluoroethylene, PTFE) suture. With an average follow up of 10 years, this study provides longitudinal data on this increasingly common technique. Methods: Single-center retrospective review of patients who underwent combined PPV and PTFE scleral sutured IOL fixation between 2012 and 2016 with a minimum follow-up of 7 years. Main outcome measures were best-corrected visual acuity (BCVA) at 3 months, 1 year, 5 years, and final follow-up, as well as the incidence and type of postoperative complications. Results: A total of 55 eyes of 55 patients with a mean follow-up of 10 years (range, 7-12) were included. The mean age was 65 years (range, 32–91), and 71% were male. Mean BCVA improved from 20/300 (1.17 ± 0.92 logMAR) preoperatively to 20/70 (0.55 ± 0.72 logMAR) at 3 months postoperatively (p<0.001). Statistically significant visual improvement was maintained at 1 year (p=0.01), 5 years (p=0.03), and final follow up (p=0.02). Postoperative complications included cystoid macular edema in 6 eyes (11%), persistent corneal edema in 2 eyes (3.6%) that required corneal transplantation, visually significant IOL tilt in 2 eyes (3.6%), and suture exposure in 2 eyes (3.6%). There were no cases of endophthalmitis or suture breakage. Conclusion: Scleral fixation of IOLs using PTFE suture demonstrates significant visual improvement and a low rate of suture-related complications and reoperations over a 10-year follow-up period.