OBJECTIVE: To evaluate at six months the intraocular lens (IOL) decentration, tilt and lenticular astigmatism between foldable sutured and sutureless scleral fixation IOLs compared to conventional phacoemulsification surgery.
METHODS: We retrospectively reviewed records for 22 eyes with sutureless scleral fixation, 16 eyes with sutured scleral fixation and 23 eyes with conventional phacoemulsification. IOL decentration and angle of IOL tilt were compared on Scheimpflug images 6 months after surgery. Lenticular astigmatism is described as the difference between refractive and net corneal astigmatism.
RESULTS: The angle of tilt in both meridians was significantly lower in the sutureless group than in the sutured group (P=0.008 horizontally and P=0.002 vertically). IOL decentration did not show a significant difference between the three groups in either horizontal or vertical meridians (P˃0.05). Lenticular astigmatism was significantly lower in the sutureless and control groups than in the sutured group (P=0.003 and P<0.001).
CONCLUSIONS: In addition to being relatively quick and easy to perform, the sutureless scleral fixation technique showed superior results in terms of IOL tilt and lenticular astigmatism at the six-month follow-up compared to the sutured technique.

Lens colobomas extending more than 4 clock hours and causing visual impairment require lens extraction along with capsular support devices with scleral fixation for adequate centration of the capsular bag and for prevention of capsular fornix aspiration with inadvertent extension of zonular dialysis intraoperatively. In this case series, we describe a technique for the management of isolated lens colobomas involving 4-5 clock hours by clear lens extraction and intraocular lens implantation using a combination of a capsular tension ring with a capsular tension segment (CTS) for the centration and stability of the capsular bag. Hoffman\'s corneoscleral pocket and half-bow sliding knot technique were used for scleral fixation of the CTS.

The aim of this study is to examine and analyze the contribution of corneal and lenticular components of total astigmatism (TA) in infants and young children and to determine whether there is any compensation for astigmatism by the lenticular component or not. The study was conducted on 614 eyes of 307 infants and young children. Cycloplegic refraction and keratometric measures using the Hand-held Autokeratometer (Nidek Co. Ltd., Hiroishi, Japan) were done for the study group under general anesthesia in Paediatric Ophthalmology Center, Sohag City, Egypt. We divided the sample into high astigmats (total cylinder ≥ 1.00 D; mean, 1.99 ± 0.89 D; n = 431 eyes; 70 %) and normal astigmats (total cylinder ≤ 0.75 D; mean, 0.55 ± 0.22 D; n = 183; 30 %). The prevalence of corneal astigmatism (CA) ≥ 1.00 D was (73 %), any degree of lenticular astigmatism (LA) was (85 %), (LA > 0.25 D = 72 %) TA was predominantly with the rule (n = 499 eyes, 81 %). Eyes with against the rule astigmatism were (n = 33 eyes, 5.3 %) and eyes with oblique astigmatism were (n = 82 eyes; 13.3 %). Gender or age differences in TA, CA, LA, or type of astigmatism were not significant. The prevalence of astigmatism found in this population of newlyborn infants and young children was relatively high, primarily corneal, and WTR astigmatism with high prevalence of oblique astigmatism. LA was much less than previous reports (mean = -0.0044 D), associated with more hyperopic eyes and eyes with high TA. The data suggest that a compensatory process exists between CA and LA to decrease the amount of TA.