One-Haptic Fixation of Posterior Chamber Intraocular Lenses without Scleral Flaps

Ashraf I Moawad,Asaad A Ghanem

doi:10.1155/2012/891839

Abstract

Purpose. To assess visual results and complications of a modified technique of posterior chamber intraocular lenses (PC IOLs) in aphakic eyes without scleral flaps. Methods. Modified one-haptic scleral fixation was performed in one eye each of 25 patients with aphakia and insufficient capsule support. Follow-up period was six months. Outcome measures included best-corrected visual acuity, intraocular pressure (IOP), and postoperative complications. Results. The study included 15 males and 10 females. The preoperative best-corrected visual acuity (BCVA) ranged from 5/60 to 6/9. The operation time ranged from 25 to 45 minutes (mean 35.25 ± 5.34 min). Anterior vitrectomy was performed in 12 cases (48%). There was no major IOL decentration. The final BCVA ranged from 6/36 to 6/9. Seven cases (28%) showed postoperative glaucoma, five cases (20%) had temporary hypotony, and hyphema in 2 eyes (8%). No cases of suture erosion, postoperative endophthalmitis, retinal detachment, or IOL dislocation were detected. Conclusion. This technique of one-haptic scleral fixation of posterior chamber IOLs is a good choice in presence of insufficient capsule support. It reduces the operation time, achieves the IOL stability, and minimizes postoperative suture-related complications.

Highlights

There are three methods to implant an intraocular lens (IOL) in presence of inadequate capsule support: anterior chamber IOL implantation, iris-sutured posterior chamber IOL implantation, and transscleral sutured posterior chamber IOL implantation [1]
Transcleral sutured posterior chamber IOLs, when placed properly, do not contact the iris and reduce the risk for complications associated with iris-sutured IOLs [4]
The aim of the present study is to evaluate the visual results and complications of one-haptic scleral fixation of posterior chamber intraocular lenses in aphakic eyes with inadequate capsule support without scleral flaps

Summary

Introduction

There are three methods to implant an intraocular lens (IOL) in presence of inadequate capsule support: anterior chamber IOL implantation, iris-sutured posterior chamber IOL implantation, and transscleral sutured posterior chamber IOL implantation [1]. Transscleral sutured posterior chamber IOLs have been shown to be safe and effective for optical rehabilitation of aphakic eyes in which capsule support is inadequate [2]. Transscleral sutured posterior chamber IOL is technically difficult, it avoids complications with anterior chamber IOL implantation, such as corneal endothelial decompensation, uveitis-glaucoma-hyphema syndrome, and cystoid macular edema [3]. Transcleral sutured posterior chamber IOLs, when placed properly, do not contact the iris and reduce the risk for complications associated with iris-sutured IOLs [4]. Tilting and decentration of transscleral sutured posterior chamber IOL can occur [5]. Traumatic surgery and stable IOL placement are imperative for good functional and anatomic results [7]

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Conclusion