Ab externo iris fixation of posterior chamber intraocular lens through small incision

Abstract

During secondary posterior chamber intraocular lens (PC IOL) implantation with iris fixation in the absence of capsule support, we implanted an acrylic 3-piece PC IOL through a small clear corneal incision with haptics secured in knots; there was no need for IOL capture. Sutures were placed appropriately in the iris tissue before the IOL was inserted, ensuring safety of the procedure and centration of the IOL.

Anterior chamber intraocular lens, sutured posterior chamber intraocular lens, or glued intraocular lens

“…However, techniques outlining direct suturing of an IOL optic to the iris have been reported [39–40]. Suture and needle selection are similar to scleral sutured approaches, and most authors prefer 9–0 or 10–0 polypropylene with long curved needle, CIF-4 or CTC-6 needle [**13, 41–42]. …”

“…Often, hooks are used to guide needle passes and/or loop suture out through the appropriate exit site [**13, 42]. Suturing strategies include modified McCannel [*11, **13, 43] or Siepser knot [41, 44] techniques.…”

“…Suturing strategies include modified McCannel [*11, **13, 43] or Siepser knot [41, 44] techniques. Recently, a novel approach has been described using a girth-hitch knot [42]. …”

Intraocular lens implantation in the absence of capsular support

“…The iris bites should be as small and peripheral as possible to minimize both pupil distortion and reactivity. [ 13 14 15 ] The IF-IOL provides a good alternative to scleral-fixation if there is dislocation of an IOL previously placed in the capsular bag or sulcus, it is necessary to spare the conjunctiva, or in the presence of filtering blebs. [ 16 ] Relative contraindications to placement of an IF-IOL include complete lack of remnant capsule, iris trauma, multiple iridectomies, or aniridia as these result in inadequate iris support to the IOL and pseudo-phacodonesis.…”

Modern methods of fixation of rear-camera intraocular lenses after facoemulsification of the cataract complicated by the violation of capsule support of the lumber

“…Большинство работ, посвященных технике подшивания ИОЛ к радужке, описывают процесс шовного фиксирования гаптических элементов линзы к средне-периферической зоне радужной оболочки с использованием специальных узлов [16][17][18]. В то же время в литературе отмечается, что недостатками такого способа фиксации ИОЛ является высокий риск развития атрофии радужки, пигментной дисперсии, увеита и кистозного макулярного отека.…”