Purpose: To describe effective lens position and postoperative Refractive outcomes for:
in-the-bag, iris-fixated anterior chamber IOLs (ACIOL), sulcus, optic capture, reverse optic capture, scleral sutured, iris-fixated posterior chamber IOLs (PCIOL), and IOLs with capsule tension ring (CTR) or capsular tension segment (CTS) use

Study Design: Single-centre, retrospective, cohort study.

Methods: 212 eyes, 192 patients that underwent cataract from Feb. 2007 to Aug. 2019. 35 eyes had iris-fixated ACIOLs, 6 with iris-fixated, 41 eyes with in-the-bag, 20 with either CTR or CTS, 39 eyes with sulcus, 36 eyes with OC, 22 eyes with ROC, and 13 eyes with SS PCIOLs. The primary outcome was ELP (measured by anterior-segment OCT from the anterior corneal vertex to the anterior surface of the IOL) and the secondary outcome was mean arithmetic error (MArE); measured as the difference between post-operative refraction and pre-operative targeted refraction for in-the-bag placement (with the exception of the ACIOL group).  ELP and MArE were reported as mean, in millimeters (mm) and diopters (D) ± standard deviation, respectively. 

Results: In the following groups, ELP was determined to be: 2.96±0.53 mm in the iris-fixated ACIOL group, 3.94±0.35 mm for iris-fixated PCIOL, 3.88±0.29 mm for in-the-bag, 3.71±0.61 FOR in-the-bag with either CTR/CTS, 3.66±0.34 mm in sulcus, 4.02±0.42 mm in OC, 3.66±0.51 mm in ROC, and 3.59±0.63 mm in SS.  The MArE of each group was determined to be: -0.51±0.85 D for iris-fixated ACIOL, -1.24±1.08 D for iris-fixated PCIOL, -0.39±0.83 D for in-the-bag, -0.03±0.99 D for in-the-bag with either CTR/CTS, -0.92±1.10 D in sulcus, -0.24±1.08 D in OC, -0.43±0.84 D in ROC, and -0.97±1.39 D in SS. 

Conclusion:  IOL fixation techniques have an effect on ELP and ultimate refractive outcome, which should be taken into consideration when planning complex IOL fixation to optimize visual outcome.

Effective lens position and refractive outcomes of complex IOL fixation techniques

[Poster Abstract Booklet](https://drive.google.com/file/d/1AGitRGyG9W0FiZ2Xjz6RNO2h7C0XglOL/view)

[Surgical Video Abstract Booklet](https://drive.google.com/file/d/1B-IkojrZhXk4AgXzsEQyuE_FwPG1Lvpe/view?usp=sharing)

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