Suturing a posterior chamber intraocular lens to the iris through limbal incisions: results in 30 eyes.

Background: I have previously reported a new technique of suture fixation of a posterior chamber intraocular lens (IOL) to the iris through a limbal incision in the absence of a posterior lens capsule. This study evaluated the results of that technique as an alternative to anterior chamber lens implantation or suturing of a posterior chamber lens through the ciliary sulcus and sclera.

Methods: The clinical records of 30 consecutive eyes that underwent this procedure between September 1987 and February 1991 were studied retrospectively. Four sutures were attached to four holes in the optic of a posterior chamber IOL. Two sutures on straight needles were passed through a superior limbal wound, to the pupil, reaching the inferior iris to be tied onto this iris. The two upper sutures on curved needles were passed through the pupil and going to the superior iris and then tied.

Results: An anterior vitrectomy was done in the pupil in 18 (60%) eyes. The mean postoperative follow-up time was 40 months (range, 24 to 66 months). Nineteen eyes (63%) had visual acuities of 20/40 or better; and 10 eyes (33%) had visual acuities between 20/50 and 20/80. The remaining eye had persistent cystoid macular edema, proven by fluorescein angiography, with 20/100 visual acuity. No serious anterior segment complications occurred. There was mild pigment dispersion on the IOL in four eyes. Four eyes needed timolol drops to lower the intraocular pressure.

Conclusions: This technique offers a viable alternative to transscleral fixation of a posterior chamber IOL via a limbal approach.