Abstract
Purpose. To compare ab interno and ab externo scleral fixation of posterior chamber intraocular lenses (PCIOL) using ultrasound biomicroscopy (UBM). Methods. Randomized patients underwent ab externo or ab interno scleral fixation of a PCIOL. Ultrasound biomicroscopy was performed 3 to 6 months postoperatively, to determine PCIOL centration, IOL distance to the iris at 12, 3, 6, and 9 hours, and haptics placement in relation to the ciliary sulcus. Results. Fifteen patients were enrolled in the study. The ab externo technique was used in 7 eyes (46.6%) and the ab interno in 8 eyes (53.3%). In the ab externo technique, 14 haptics were located: 4 (28.57%) in the ciliary sulcus; 2 (14.28%) anterior to the sulcus; and 8 (57.14%) posterior to the sulcus, 6 in the ciliary body and 2 posterior to the ciliary body. In the ab interno group, 4 haptics (25.0%) were in the ciliary sulcus, 2 (12.50%) anterior to the sulcus, and 10 (75.0%) posterior to the sulcus, 4 in the ciliary body and 6 posterior to the ciliary body. Conclusions. Ab externo and ab interno scleral fixation techniques presented similar results in haptic placement. Ab externo technique presented higher vertical tilt when compared to the ab interno.
Highlights
Capsular bag is the standard of care for posterior chamber intraocular lens (IOL) placement
The aim of fixation is to position the haptics in the ciliary sulcus; these procedures are performed without direct visualization of the path of the needle
The ab externo technique was used in 7 eyes (57.8 ± 28.4 years, 3 females) and the ab interno in 8 eyes (68.5 ± 10.7 years, 5 females)
Summary
Capsular bag is the standard of care for posterior chamber intraocular lens (IOL) placement. Ab interno and ab externo are trans scleral suture techniques described to fixate a posterior chamber intraocular lens (PCIOL) [1,2,3]. Other techniques to fixate an IOL have been described, such as the no-suture technique that places the IOL haptic inside a scleral tunnel [4,5,6]. Direct view techniques, guided by endoscopic probe, have greater rate of success in lens centration and correct haptic position [7, 8]. This technique is considered the gold standard; it requires particular equipment and specific training
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