TREATMENT OF ANTERIOR VITREOUS BEFORE SUTURING AN INTRAOCULAR-LENS TOTHE CILIARY SULCUS

Purpose: To clarify the relationship between suturing an intraocular l ens (IOL) and residual vitreous after vitrectomy and transscleral IOL suturing. Setting: Toranomon Hospital, Tokyo, Japan. Methods: Enucleat ed pigs' eyes were fixed to the observation device. Three methods for removing the crystalline lens and the vitreous were tested; an IOL was then sutured to the ciliary sulcus. Miyake's posterior approach and a n endoscope were used to observe the movement of fluorescein-stained r esidual vitreous during these procedures. Results: Considerable residu al vitreous and extensive vitreous entwinement with the IOL were seen when IOL suturing followed anterior vitrectomy through a limbal incisi on. These were absent when IOL suturing followed careful pars plana vi trectomy and capsulectomy. Conclusions: Our findings indicate that sut uring the IOL to the ciliary sulcus should be followed by the removal of as much anterior vitreous and lens capsule as possible to prevent s uch postoperative complications as tractional retinal detachment and c ystoid macular edema.