In a retrospective study of 75 consecutive eyes having transscleral suturing of a posterior chamber intraocular lens (IOL) (mean follow-up five months), 57% had improved best corrected visual acuity; 67% of those obtained a visual acuity of 20/40 or better. Thirty-seven eyes had an IOL exchange without penetrating keratoplasty (PKP) at the time of implantation, 15 had simultaneous PKP, and 23 had secondary lens implantation without IOL exchange or a corneal transplant. Transscleral fixation is an effective means of implanting a posterior chamber lens in eyes without capsular support. It allows secure two-point lens fixation with minimal risk of IOL tilting or suture erosion through the conjunctiva or sclera.
We retrospectively reviewed 76 Molteno implants in 72 eyes, with a minimum of 18 months' follow up. Double-plate implants were used initially in 64 of these eyes. After a mean follow up of 33.27 months, the mean intraocular pressure (IOP) was 14.0 mm Hg, as compared with 35.31 mm Hg preoperatively. With success defined as an IOP greater than 5 mm Hg but no greater than 21 mm Hg at the last visit, the success rate was 74%. If the four cases of chronic hypotony without loss of best-corrected vision are included, the success rate was 79%. The most frequent complications included corneal graft failure, filtration tube blockage, choroidal effusion, and hyphema/vitreous hemorrhage.
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