Injection and suturing technique for scleral fixation foldable lens in the vitrectomized eye.

摘要

The transscleral suture fixation intraocular lens (IOL) technique has been widely used in the management of IOL implantation with loss of capsular support or capsule rupture since its initial report in 1986 by Malbran et al.There have been many modifications of the technique for scleral fixation. Today, the foldable lens forceps is the most commonly used method for implantation of scleral fixation foldable IOL. In this method, the haptics are tied by the sutures, and the IOL was implanted through a 3.5-mm clear corneal incision. However, implantation by forceps has a number of disadvantages. 1) Intraocular pressure (IOP) is harder to maintain because the corneal incision leads to mass aqueous outflow while inserting the IOL by forceps. Especially, the resulting drop in IOP has potentially severe complications such as eyeball collapse and subchoroidal expulsive hemorrhages because of loss of vitreous body support in the vitrectomized eye. 2) The forceps may damage the IOL optical surface, which will influence the vision outcome. Forceps folding provoked more surface irregularities, which probably makes the IOL more susceptible to bacterial adhesion. 3) Difficulty in tying the haptics can cause the IOL optic to touch the external eye.