Christina Y. Weng

Purpose: To describe refractive outcomes with intrascleral haptic fixation (ISHF) of the light adjustable lens (LAL). Setting: Baylor College of Medicine and one private practice in United States. Design: Retrospective sequential cohort. Methods: All patients undergoing double-needle ISHF of the LAL were included in the study. Pre-treatment and post-lock-in uncorrected distance visual acuity (UDVA) were recorded. Mean numerical errors, refractive prediction errors, and astigmatism outcomes were measured. Results: Ten eyes were included. Initial pre-treatment UDVA after surgery ranged from 20/25 to 20/150, and post-lock in UDVA ranged from 20/12.5-20/40 [median UDVA 20/20; mean 0.01 logMAR (SE 0.04)]. Mean magnitude of refractive astigmatism was 0.70D (range 0.00-1.50 D) pre-treatment and 0.25 D (range 0.0-0.75 D) after final lock-in. Pre-treatment mean numerical error was +1.00 D (SD 0.94 D) and was reduced to -0.022 D (SD 0.28) after treatments and lock-in sessions. All eyes (10/10) achieved their full visual potential in UDVA. Conclusions: Our study illustrates that, with careful planning and patience, patients with poor or absent capsular support who previously did not have a customizable option can potentially achieve personalized visual outcomes with excellent refractive accuracy with scleral fixation of the light adjustable lens.