SCLERAL FIXATION OF AN INTRAOCULAR-LENS IN THE ABSENCE OF CAPSULAR SUPPORT

Purpose: To ascertain the best surgical technique for fixating an intr aocular lens (IOL) in the posterior chamber in the absence of capsular support. Setting: From the Institute of Ophthalmology, Pavia Universi ty, Pavia, Italy. Methods: Using the SFVT System, the phases of IOL fi xation were evaluated in cadaver eyes. In addition, IOLs were implante d in the posterior chamber in 340 eyes of patients without capsular su pport. One of several IOL fixation methods was used; IOL power was cal culated using the same parameters as when the lens is positioned in th e sulcus. Mean follow-up was 3.5 years (range 2 months to 5 years). Re sults: Intraocular lens placement was accurate only when the loops wer e positioned in the sulcus, with the best approach being internal with suspension sutures placed at 3 and 9 o'clock. In most cases, refracti ve results were good; 152 eyes were within +/-1.00 diopter of the pred icted value. Conclusion: In eyes without capsular support, IOL implant ation in the sulcus was possible only when sutures were placed exactly through the sulcus. An internal approach using suspension sutures at 3 and 9 o'clock gave the best results.