Scleral fixation in eyes with loss of capsule or zonule support

Abstract

We describe a new scleral fixation technique for posterior chamber intraocular lens (IOL) implantation in eyes with partial or total loss of the posterior capsule or zonule support. This technique uses a scleral incision that can be completed in less time than a conventional scleral flap and prevents unnecessary trauma to the eye. A double-thread, 10-0 polypropylene suture loop is introduced once through a scleral layer pathway inside the eye. The free ends of the polypropylene suture are buried between the 2 edges of the scleral incision. This technique was used in 15 eyes, with a follow-up of 6 to 30 months. Complications included iris capture, irregular pupil, hyphema, vitreous hemorrhage, choroidal hemorrhage, localized peripheral anterior synechias, and retinal detachment. The mean postoperative visual acuity was 20/40 at the last follow-up. This modified technique is an easy and effective way to achieve scleral fixation of the IOL.

Glued posterior chamber IOL in eyes with deficient capsular support: a retrospective analysis of 1-year post-operative outcomes

“…On each follow-up visit (1,3,6, and 12 months), the following parameters were assessed: uncorrected visual acuity (UCVA) and best spectacle-corrected visual acuity (BCVA), refraction, intraocular pressure (IOP, noncontact tonometry), slit lamp biomicroscopy, dilated fundus examination, specular microscopy (SP-2000P, Topcon, Tokyo, Japan), and AC cellular reaction grading with SUN (Standardization of Uveitis Nomenclature) classification. 13 All the pre-operative parameters were compared with 1-year post-operative parameters.…”

“…1 However, in eyes with deficient anterior capsular rim, anterior chamber (AC) IOL, iris claw lenses, or sutured scleral-fixated (SF) IOL are usually performed. [2][3][4][5][6][7][8] Fibrin glue-assisted posterior chamber (PC) IOL implantation is a new technique started in December 2007 in eyes with deficient capsular support. [9][10][11][12] The purpose of this article is to evaluate the post-operative outcome, namely, visual prognosis and complication profile, of eyes operated using this technique at the end of 1 year.…”

Comparision of surgical outcomes of intraocular lens refixation and intraocular lens exchange with perfluorocarbon liquid and fibrin glue-assisted sutureless scleral fixation

“…5 In-the-bag IOL dislocation, however, usually occurs several years after cataract surgery and is thus thought to depend on slowly progressive dehiscence of the zonules. 6,7 When endocapsular IOL placement is not possible, the choices include sutured scleral-fixated IOLs, 8,9 sutureless scleral-fixated IOLs, 10,11 iris-fixated IOLs, 12 iris-claw IOLs, 13 or anterior chamber (AC) IOLs. 14 However, scleral-fixated IOLs are subject to problems such as suture degradation, pseudophacodonesis, endophthalmitis, and late IOL decentration owing to suture-related complications.…”

Transscleral fixation of single-piece foldable acrylic lens with eyelets at the optic-haptic junction

“…[1][2][3][4][5][6] Although numerous publications have introduced several surgical methods of transscleral fixation using various types of IOL, ophthalmologists are often unsure which type of IOL to use and how it should be fixed. 3,[5][6][7][8][9][10][11][12][13][14][15][16][17][18] Maintaining proper lens position is one of the important factors for a successful transscleral fixation.…”