Simple method of transscleral fixation of a posterior chamber intraocular lens in the absence of the lens capsule.

BACKGROUND There are several advantages to implanting a posterior chamber intraocular lens (IOL) in the ciliary sulcus when the lens capsule is absent. I have developed a simple method of fixating an IOL into the ciliary sulcus which does not require different needles, multiple needle passes, scleral dissection, or awkward surgical maneuvers. METHODS Thirty eyes were enrolled in this study. All eyes were either aphakic, requiring a secondary lens implantation, or required IOL exchange. The patients were followed for 30 months. Using a single 10-0 double-armed, polypropylene suture, a through-and-through infraciliary scleral pass secured each haptic without tying. The lens was then positioned into the ciliary sulcus and the knots tied outside the eye under direct visualization. RESULTS This procedure has been used in 30 eyes without erosion of sutures, dislocation or tilting of the IOL, or induced astigmatism. Twenty-one eyes (70%) had spectacle-corrected visual acuity of 20/40 or better. CONCLUSION The results of this study demonstrate that posterior chamber transscleral fixated IOLs give improved postoperative visual results.