To evaluate the stability of intraocular lenses (IOLs) according to the haptic design in combined surgery (phacoemulsification, intraocular lens insertion, and vitrectomy) by comparing early IOP elevation and the accuracy of IOL power.

A retrospective study was conducted for 85 eyes of 85 patients who had undergone combined surgery. IOP elevation one week postoperatively and the difference between target refraction and postoperative refraction after two months were evaluated in all patients. All eyes were allocated to either a 2-haptic IOL group or a 4-haptic IOL group, and then each group was divided into three subgroups: gas-filled, silicone oil-filled, or balanced salt solution-filled.

In the balanced salt solution-filled group, the early IOP increase was significantly less in the 4-haptic IOL group than it was in the 2-haptic IOL group (3.24 mmHg vs. 6.15 mm Hg, p =0.025). The myopic shifts of the 2-haptic IOL group were significantly greater than those of the 4-haptic IOL group for all of the subgroups (gas subgroup -0.71D vs. -0.31D, p =0.045; balanced salt solution subgroup -0.66D vs. -0.16D, p =0.018).

In combined surgery, 4-haptic IOL implantation showed significantly less early IOP elevation and less myopic shift than those of 2-haptic IOL implantation.