Photoanalysis of Fixation of Posterior Chamber Intraocular Lenses

Abstract

OBJECTIVE: To analyse various posterior chamber intraocular lens (PC-IOL) fixation patterns by direct visualization through a uveo-sclera window. STUDY DESIGN: Experimental implantation of PC-IOLs and evaluation of fixation characteristics immediately postoperatively. SETTING: Side-view photography of PC-IOL fixation in an intact capsular bag, in the presence of radial tears, and after scleral suturing. PATIENTS: Human eyes obtained post mortem were prepared for side-view photography by removal of a uveo-scleral window, while preserving the entire capsular bag. MAIN OUTCOME MEASURES: Optic and haptic (loop) location, uveal contact, centration, IOL tilt. RESULTS: Excellent centration and no uveal contact were achieved when both loops were located in-the-bag. Asymmetrical bag-sulcus fixation is prone to IOL decentration and tilt. Suturing into the ciliary region is most consistent when the needle exits at 1.0 mm posterior to the limbus. CONCLUSIONS: Optimal position is obtained with in-the-bag symmetrical fixation through an intact continuous curvilinear capsulorhexis.