Pars Plana Vitrectomy With Endoscope-Guided Sutured Posterior Chamber Intraocular Lens Implantation in Children and Adults

Anterior chamber intraocular lens, sutured posterior chamber intraocular lens, or glued intraocular lens

“…IOL placement may occur at the same time as complicated cataract extraction, or as a secondary procedure at a later date [2,*8]. Capsular weakness is not always recognized at the time of complicated cataract surgery, which may lead to late IOL dislocation.…”

“…When visual acuity is no longer correctable with these approaches, surgical lens removal with IOL fixation is indicated [**13]. Several recent series have included patients with ectopia lentis, typically due to Marfan syndrome [*8, **13– 15]. …”

“…In this case, ciliary sulcus location is established by external landmarks, usually distance from limbus. A recent case series describes a novel technique involving intraocular endoscopy to pass sutures ab interno under direct visualization, ensuring ciliary sulcus localization [*8]. Most authors prefer double-armed polypropylene suture (Prolene), size 8–0, 9–0 or 10–0 for sutured scleral fixation.…”

Iris Fixation of Unstable Anterior Chamber Intraocular Lenses

“…Also, it is important to note that scleral fixation involves passing sutures through ciliary tissue, which may lead to complications such as retinal detachment or intraocular hemorrhage. [22][23][24][25][26][27] Scleral fixation has also been associated with late IOL dislocation or tilt. 21,25,26,28,29 Moreover, eyes undergoing these surgeries are often compromised with varying degrees of anatomical alterations because of previous trauma and complex surgeries and are therefore more vulnerable to the above-mentioned complications compared with eyes that are naive to intraocular surgery.…”

“…[22][23][24][25][26][27] Scleral fixation has also been associated with late IOL dislocation or tilt. 21,25,26,28,29 Moreover, eyes undergoing these surgeries are often compromised with varying degrees of anatomical alterations because of previous trauma and complex surgeries and are therefore more vulnerable to the above-mentioned complications compared with eyes that are naive to intraocular surgery. Sutureless intrascleral fixation of PCIOLs, first reported by Gabor and Pavlidis in 2007, 30 was later popularized by Kumar and Agarwal 31 and termed "glued IOL" because fibrin glue is used to stabilize the haptics in the early postoperative period, obviating the need for sutures.…”