RETROSPECTIVE ANALYSIS OF A NOVEL METHOD OF TRANSSCLERAL SUTURE FIXATION FOR POSTERIOR-CHAMBER INTRAOCULAR-LENS IMPLANTATION IN THE ABSENCEOF CAPSULAR SUPPORT

Purpose. To determine the safety and efficacy of an alternative method for transscleral fixation of a secondary posterior-chamber intraocula r lens (pcIOL) during penetrating keratoplasty. Methods. Eighty-nine e yes that underwent secondary pcIOL implantation by using a modified tr ansscleral suture-fixation technique during penetrating keratoplasty w ere retrospectively evaluated. The surgical technique used suture fixa tion to the surface of the sclera 5 mm posterior to the limbus, with t he knot buried beneath Tenon's capsule and conjunctiva. Patient record s were reviewed for postoperative complications, including suture eros ion, pcIOL subluxation, vitreous hemorrhage, and retinal detachment. M ean follow-up was 24.4 months, with a range of 4-68 months. Results. A ll eyes had successful fixation of their pcIOL immediately after surge ry. Three (3.3%) eyes had graft failure. Six (6.7%) of 89 eyes showed evidence of suture erosion or partial exposure. Postoperative suture b reakage occurred in two (2.2%) eyes. Posterior-segment complications i ncluded retinal detachment in one (1.1%) eye, vitreous hemorrhage in o ne (1.1%) eye, and limited choroidal hemorrhage in two (2.2%) eyes. Me dian visual acuity at 1-year follow-up was 20/70 (range, 20/25 to ligh t perception). Conclusion. This transscleral fixation technique provid es a straightforward alternative to previously described techniques. S uture erosion, IOL dislocation, and posterior-segment complications oc curred at relatively low rates compared with other pcIOL implantation techniques.