Scleral fixated intraocular lenses - An angiographic study

Purpose: We reviewed the results, complications, and fluorescein angiograph ic (FA) findings in eyes that had undergone transscleral fixation of poster ior chamber intraocular lenses (IOLs). Methods: Posterior chamber IOL implantation with scleral fixation was perfo rmed on 18 patients. Three patients were aphakic, 14 had an intraoperative posterior capsule rupture during cataract surgery, and one was operated on for a retained lens nucleus and dislocated IOL in the vitreous. Follow-up e xaminations measured visual acuity, intraocular pressure, and IOL decentrat ion and tilting. In 14 patients, iris and retinal FA were performed. Results: No major complications were noted during the procedure. Mean best- corrected visual acuity was 20/70 preoperatively and 20/30 postoperatively after a mean follow-up of 9.8 months. Fourteen patients achieved a visual a cuity of 20/40 or better. Macular epiretinal membranes were diagnosed after surgery in five eyes but only one eye showed significant distortion of the fovea (macular pucker). Iris FA revealed no major vascular abnormalities. Fluorescein angiography showed cystoid macular edema in six cases. Light-in duced retinal lesions occurred in six eyes. Conclusions: Transscleral fixation of posterior chamber IOLs provided adequ ate visual acuity in most patients. Incomplete visual recovery after surger y may be related to the occurrence of macular edema and epiretinal membrane s. Light-induced retinal injury was the major irreversible intraoperative c omplication.