Clinical Outcomes Following Suture Fixation of Intraocular Lenses at the University Eye Clinic Freiburg: A Retrospective Analysis

<b>Background</b>: Suture fixation of intraocular lenses (IOLs) is a rare but essential procedure for patients with inadequate capsular support, offering crucial therapeutic benefits. This study analyzes a large cohort of patients undergoing IOL suture fixation, focusing on demographics, risk factors, and clinical outcomes. <b>Methods</b>: In this retrospective analysis of 332 eyes treated at the Eye Center of the University Hospital Freiburg (2008-2022), we evaluated immediate and long-term postoperative outcomes, including visual acuity and refraction. The follow-up averaged 2.5 years. A detailed analysis of the IOL positioning was performed in 111 patients. <b>Results</b>: The most common indications were pseudoexfoliation syndrome (33%), trauma (17%), and prior complicated cataract surgery (11%). The Zeiss CT27SF lens was used most frequently (91%). The mean spherical equivalent deviation from target refraction was -0.375 diopters overall. According to the detailed analysis, IOL tilt occurred in 6.3% of patients, and decentration occurred in 7.2%. Only three patients (3.6%) required additional ocular procedures specifically for IOL repositioning. Risk factors for further surgery included underlying systemic conditions or multiple previous surgeries. <b>Conclusions</b>: Suture fixation of IOLs proves to be an adequate and effective intervention for visual rehabilitation in patients with compromised capsular support, demonstrating good refractive outcomes and low complication rates. Even in cases where the postoperative visual acuity was comparable to the best-corrected preoperative acuity, the procedure improved refractive correction by reducing the need for extensive refractive aids, such as contact lenses required for aphakia.