Scleral fixation of a 4-eyelet foldable intraocular lens in patients with aphakia using a 4-flanged technique

To report a new technique for performing sutureless intrascleral fixation of a posterior chamber intraocular lens (IOL).

To report the intermediate multicenter results of a technique of sutureless intrascleral fixation of a standard 3-piece posterior chamber intraocular lens (PC IOL) in the ciliary sulcus. Four European ophthalmology centers. A technique for sutureless intrascleral fixation of the haptics of a standard 3-piece PC IOL was retrospectively evaluated. The technique uses standardized maneuvers to fixate the PC IOL without need for special haptic architecture or preparation or haptic suturing. All patients having IOL implantation by the technique were evaluated for preoperative status (visual acuity, refractive error, preexisting ocular conditions, optical biometry), postoperative status, complications, and need for further surgery. The study evaluated 63 consecutive patients from 4 institutions (4 surgeons). The median follow-up was 7 months. Two dislocated PC IOLs (3.6%) were decentered; the other 61 IOLs (96.8%) were stable and well centered. There were no cases of recurrent dislocation, endophthalmitis, retinal detachment, or glaucoma. Fixation of PC IOL haptics in a limbus-parallel scleral tunnel provided exact centration and axial stability of the IOL and prevented distortion and subluxation in most cases. Copyright 2010 ASCRS and ESCRS. All rights reserved.

The authors, after analyzing the different clinical situations where a secondary IOL implantation is indicated, describe 3 surgical techniques based on a common premise relying on the use of lens guide sutures for transportation or transportation and permanent fixation of the IOL's loops. The transportation sutures makes secondary implantation easier in anterior chamber lenses in technique I. The double purpose of transportation and permanent fixation at the angle permits a safe procedure with anterior chamber lenses in cases with no iris support in technique II and the possibility of sulcus or ciliary body fixation of a J type posterior chamber lens after ICCE in technique III.