A Reverse Ab Externo Scleral Fixation for Posterior Chamber Intraocular Lens Dislocation

Abstract

Purpose: To report the clinical effects of reverse ab externo scleral fixation with scleral penetration using a 10-0 prolene needle in patients with dislocation of a posterior chamber intraocular lens (PCIOL). Methods: The ab externo scleral fixation technique uses a corneal tunnel and a loop of 10-0 propylene made by 2 consecutive scleral sutures to fix the haptic to the sclera. The reverse technique penetrates the sclera with a 10-0 prolene needle instead of a 26-gauge needle and introduces the 26-gauge needle into the corneal tunnel to pull the 10-0 prolene needle through, thus creating a loop around the haptic and fixing it to the sclera. Scleral fixation was performed on one haptic in 2 eyes and on both haptics in 3 eyes. Results: The dislocated IOLs were successfully repositioned, and the corrected visual acuity was improved postoperatively in all 5 eyes. There was no specific complication except mild hyphema in 1 eye. Conclusions: Reversed ab externo scleral fixation is an easy and effective way to reposition dislocated PCIOLs and decrease the complication of hemorrhage and hypotony frequently associated with the standard ab externo technique.