Refractive Outcome, Lens Power Calculation, and Surgically Induced Astigmatism After Four-Flanged Intrascleral Intraocular Lens Fixation

This study demonstrates that the four-flanged technique for scleral IOL fixation yields reliable outcomes. PE was closest to zero using the Hoffer-Q formula, although there was no statistically significant difference compared to the other formulas. Axial length emerged as the most pertinent factor for PE. Short eyes resulted in a more hyperopic outcome, whereas longer eyes resulted in a more myopic outcome than intended. This myopic and hyperopic shift was due to the standardized surgical technique with an externalization of the haptics 2.5 mm behind the limbus resulting in a consistent aqueous anterior chamber depth across all eye lengths, coupled with a reduction or increase in the distance from the IOL to the macula, which is dependent on the length of the eye. <b>[<i>J Refract Surg</i>. 2024;40(12):e985-e993.]</b>.