Background The clinical efficacy and long-term prognosis of intraocular lens suspension in patients with ocular trauma at different time points have not been determined.

Objective To analyze and compare the clinical characteristics of patients with ocular trauma and the clinical efficacy and long-term complications of intraocular lens suspension at different time points.

Methods Clinical data about patients with traumatic cataracts or lens dislocation due to ocular trauma admitted to the First Medical Center of Chinese PLA General Hospital from May 2009 to June 2023 were retrospectively analyzed. According to different operation time and methods, patients were divided into stage I intraocular lens suspension (stage I group) and stage II intraocular lens suspension (stage II group). The basic information, ocular trauma, operation, and prognosis of the two groups were collected and analyzed.

Results This study included 142 patients, 126 males and 16 females, with a median age of 48 (IQR: 37-61) years. The incidence of closed-eye trauma was slightly higher than that of open-eye trauma (56.34% vs 43.66%, P < 0.001), and the most common injury site in open-eye trauma was corneal penetration (62.90%). As of December 2023, the average follow-up time of the stage I group was (72.1 ± 45.6) months, and it was (81.8 ± 44.2) months in the stage II group. The best-corrected visual acuity in the stage I group improved postoperatively compared to preoperatively (0.4 0.2 - 0.7 vs 0.8 0.5 - 1.8, P<0.001). In the stage II group, the BCVA improved slightly or remained unchanged postoperatively compared to preoperatively (0.5 0.3 - 1.05 vs 0.4 0.2 - 1.7, P=0.877). There was no statistically significant difference in postoperative BCVA between the two groups (0.4 0.2 - 0.7 vs 0.5 0.3 - 1.05, P=0.093). The intraocular pressure in the stage I group was higher than that in the stage II group both preoperatively (16.9 ± 7.6 vs 13.5 ± 4.6, P=0.026) and postoperatively (14.7 ± 4.6 vs 12.9 ± 3.7, P=0.026). There were no statistically significant differences in vision prognosis, suspension intraocular lens dislocation (6 cases 10.53% vs 14 cases 16.47%), secondary glaucoma (5 cases 8.77% vs 3 cases 3.53%) between the two groups (P>0.05).

Conclusion After ocular trauma, both stage I intraocular lens suspension and stage II intraocular lens suspension can effectively improve the refractive status of patients, with no significant difference in the best-corrected visual acuity between the two groups postoperatively. Stage I intraocular lens suspension may have a higher risk of elevated intraocular pressure both preoperatively and postoperatively compared to stage II intraocular lens suspension. There is no significant difference in the long-term visual prognosis and common postoperative complications between the two timing options for IOL suspension implantation.