Abstract
Intraocular approaches to correct aphakia in cases of inadequate capsular support include an anterior chamber intraocular lens, fixation of a posterior chamber lens to the sclera or iris by suturing or iris claw, respectively. This article reviews the indications and contraindications for iris fixation with sutures and gives an overview of surgical techniques, potential complications and outcomes. Based on a selective search of pertinent literature in PubMed the information from original articles and reviews are analyzed, summarized and discussed. New surgical techniques have imparted an impetus to iris suture fixation with encouraging functional and morphological results offering a new promising alternative to the established options. Improved aspects arise for repositioning of a decentered intraocular lens and for a minimally invasive method for repair of late in-the-bag lens dislocation as seen more frequently by cataract surgeons. A final evaluation of the proposed techniques is not possible because none has clearly emerged as the optimal method. Precise determination of small differences in visual outcome or complication rates requires a large prospective, randomized clinical trial.
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