{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T20:03:30Z","timestamp":1783973010899,"version":"3.55.0"},"reference-count":24,"publisher":"MDPI AG","issue":"15","license":[{"start":{"date-parts":[[2024,7,29]],"date-time":"2024-07-29T00:00:00Z","timestamp":1722211200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Objectives: This study compared long-term surgical outcomes of the scleral flap versus scleral pocket technique for sutureless intrascleral one-piece intraocular lens (IOL) fixation. Methods: A retrospective comparative study was conducted at a single center, involving consecutive patients undergoing sutureless intrascleral one-piece IOL implantation, between January 2020 and May 2022. Eyes were divided into two groups based on the surgical technique: group 1 underwent scleral flap (n = 64), and group 2 received scleral pocket technique (n = 59). Visual acuity, refractive outcomes, and complications were assessed over a minimum 24-month follow-up period. Results: Both groups showed improvements in best-corrected visual acuity (BCVA), increasing from 0.84 \u00b1 0.56 logMAR at baseline to 0.39 \u00b1 0.23 logMAR (p = 0.042) at 24 months in group 1 and from 0.91 \u00b1 0.63 logMAR at baseline to 0.45 \u00b1 0.38 logMAR (p = 0.039) at 24 months in group 2. No significant differences in BCVA were observed between the groups at baseline (p = 0.991), 12 (p = 0.496) and 24 months (p = 0.557). Mean spherical equivalent (\u22120.73 \u00b1 1.32 D in group 1 and \u22120.92 \u00b1 0.99 D in group 2, p = 0.447), refractive prediction error (\u22120.21 \u00b1 1.1 D in group 1 and \u22120.35 \u00b1 1.8 D in group 2, p = 0.377), and surgically induced astigmatism (0.74 \u00b1 0.89 D in group 1 and 0.85 \u00b1 0.76 in group 2, p = 0.651) were comparable between the two groups. An IOL tilt of 5.5 \u00b1 1.8 and 5.8 \u00b1 2.0 degrees (p = 0.867) and an IOL decentration of 0.41 \u00b1 0.21 mm and 0.29 \u00b1 0.11 mm (p = 0.955) were obtained, respectively, in group 1 and group 2 at 24 months. Mean endothelial cell density remained stable at 24 months in both groups (p = 0.832 in group 1 and p = 0.443 in group 2), and it was 1747.20 \u00b1 588.03 cells\/mm2 in group 1 and 1883.71 \u00b1 621.29 cells\/mm2 in group 2 (p = 0.327) at baseline, 1545.36 \u00b1 442.3 cells\/mm2 in group 1 and 1417.44 \u00b1 623.40 cells\/mm2 in group 2 (p = 0.483) at 24 months. No cases of endophthalmitis were observed. Conclusions: The scleral pocket technique for sutureless intrascleral one-piece IOL fixation is comparable to the traditional scleral flap technique in terms of long-term visual outcomes and safety. The scleral pocket technique offers a simplified approach and a viable option even for less experienced surgeons.<\/jats:p>","DOI":"10.3390\/jcm13154452","type":"journal-article","created":{"date-parts":[[2024,7,30]],"date-time":"2024-07-30T11:02:27Z","timestamp":1722337347000},"page":"4452","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Long-Term Surgical Outcomes of Scleral Flap versus Scleral Pocket Technique for Sutureless Intrascleral One-Piece Lens Fixation"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8881-0926","authenticated-orcid":false,"given":"Paola","family":"Marolo","sequence":"first","affiliation":[{"name":"Department of Ophthalmology, University of Turin, 10126 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paolo","family":"Caselgrandi","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, University of Turin, 10126 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michele","family":"Gaidano","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, University of Turin, 10126 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabio","family":"Conte","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, University of Turin, 10126 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0795-618X","authenticated-orcid":false,"given":"Guglielmo","family":"Parisi","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, University of Turin, 10126 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enrico","family":"Borrelli","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, University of Turin, 10126 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matteo","family":"Fallico","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, University of Catania, 95123 Catania, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7152-2613","authenticated-orcid":false,"given":"Mario Damiano","family":"Toro","sequence":"additional","affiliation":[{"name":"Department of General Ophthalmology, Medical University of Lublin, 20079 Lublin, Poland"},{"name":"Eye Clinic, Public Health Department, Federico II University, 80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3182-557X","authenticated-orcid":false,"given":"Luca","family":"Ventre","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Beauregard Hospital, 11100 Aosta, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9061-0050","authenticated-orcid":false,"given":"Agostino S.","family":"Vaiano","sequence":"additional","affiliation":[{"name":"Institute of Ophthalmology, Santa Croce e Carle Hospital, 12100 Cuneo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1368-6729","authenticated-orcid":false,"given":"Michele","family":"Reibaldi","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, University of Turin, 10126 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,7,29]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"429","DOI":"10.1016\/j.survophthal.2005.06.010","article-title":"Techniques of Intraocular Lens Suspension in the Absence of Capsular\/Zonular Support","volume":"50","author":"Por","year":"2005","journal-title":"Surv. 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