Comparative Outcomes of Double-Flanged, Conventional Sutured, and Intrascleral Haptic Fixation Techniques for Secondary Intraocular Lens Implantation

<title>Abstract</title> <p> <bold>Purpose:</bold> To compare surgical outcomes among conventional sutured, intrascleral haptic fixation technique, and the double-flanged technique for intraocular secondary intraocular lens implantation. <bold>Methods:</bold> This retrospective comparative study included 136 eyes that underwent scleral fixation of an intraocular lens and completed 6 months of follow-up. Eyes were divided into double-flanged (n=44), conventional sutured (n=74), and intrascleral haptic fixation (n=18) groups. Surgical time, best-corrected visual acuity (BCVA), intraocular pressure (IOP), refractive outcomes, and postoperative complications were compared. <bold>Results:</bold> Baseline characteristics and postoperative BCVA, IOP, and refractive outcomes were comparable among groups. The intrascleral haptic fixation technique demonstrated shorter operative time compared with the double-flanged (p=0.045) and conventional (p=0.050) techniques. Astigmatism increased significantly at 6 months in the conventional group (p=0.002), but not in the other groups. Mechanical intraocular lens–related complications were significantly lower in the double-flanged group (0% vs 12.2% vs 16.7%, p=0.03). <bold>Conclusions:</bold> The double-flanged technique demonstrated a significantly lower rate of mechanical intraocular lens complications while maintaining comparable functional outcomes. </p>