Single scleral suture for subluxated capsular bag in pseudophakic eyes

Abstract

Abstract Purpose In‐the‐bag posterior chamber intraocular lens (PC‐IOL) dislocation is an unusual late complication of cataract surgery that can be managed either by exchange with a scleral fixated intraocular lens or by PC‐IOL repositioning with scleral fixation. In the presence of mild subluxation, in older patients, we prefer to suture the fibrotic capsular bag to the sclera without opening the anterior chamber. Methods 5 patients (mean age 80 y.o.) who had uncomplicated phacoemulsification with implantation of a posterior chamber intraocular lens (IOL) into the continuous capsulorhexis several years before (4‐12 years), suffered from PC‐IOL subluxation secondary to dehiscence of the zonules supporting the capsular bag. All capsular bags were fibrotic and previously received yag capsulotomy for PCO. Using two self sealing side ports the capsular bag was successfully sutured to the sclera at 12' by introducing a double‐armed polypropylene suture through a scleral flap. Results The final postoperative visual acuity was 20/30 or better with no complications during the surgical procedure. Patients discomfort was minimum and no endothelial cell loss was reported. Conclusion Scleral fixation by single suture can be a useful and low‐complication rate procedure for late in‐the‐bag PC‐IOL subluxation in older patients. Use of This procedure in selected cases, can avoid whole capsular bag extraction and replacement with scleral fixated sulcus IOL, with minimal stress for the ocular structures.