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Aim: To analyse the complications as well as the long term functional and visual outcomes of anterior vitrectomy with scleral fixated posterior chamber intraocular lens implantation in patients with inadequate posterior capsular support. Settings and Design: This was a prospective study done at Coimbatore Medical College Hospital, Coimbatore during the period of May 2016 to December 2017. Materials and Methods: 30 eyes of 25 aphakic patients and 5 patients who had primary scleral fixated IOL implantation were included in the study. Anterior segment examination with slit lamp, preoperative visual acuity, intraocular pressure, fundus examination and IOL power calculation was done. Results: Scleral fixation of IOL is a safe procedure with a success rate of 93% and most of the intraoperative and postoperative complications were minor. Postoperative best corrected visual acuity of 6/12 and above was seen in 70% of patients. Conclusion: Anterior vitrectomy with scleral fixated IOL implantation is a safe and effective procedure to correct aphakia in eyes without adequate posterior capsular support. Complications seen with anterior chamber IOL are not seen with SFIOL and dreaded complications like retinal detachment, suture lysis and infection were not encountered in our study. However precise determination of small differences in visual outcome and long-term complication rates would require a large prospective, randomized clinical trial. Introduction Aphakia was once considered a complication of cataract surgery. The crystalline lens, being responsible for approximately 30 percent of the total ocular dioptric power, aphakia results in marked visual disability. The development of safe and effective IOL’s to eliminate the optical problem of aphakia is a feather in the cap for modern Ophthalmology. Modern posterior chamber IOL’s are remarkably safe and provide excellent visual outcome after insertion into the capsular bag or sulcus, compared to earlier lens designs and fixation sites. Posterior capsular rupture is one of the dreaded complications of cataract surgery, and in cases where the IOL cannot be placed primarily due to PCR, renders the patient aphakic. PCR, thus is a complication that is better prevented as we can avoid subjecting the patient to a second surgery. In the presence of a posterior capsular tear during cataract extraction, the intraocular lens (IOL) can be placed in the ciliary sulcus if the capsular rim is available or in the capsular bag itself if the tear is small with optic capture technique. In situations where the posterior capsular tear is large or the capsular rim is unstable, scleral fixated intraocular lenses (SFIOL) or anterior chamber intraocular lenses (ACIOL) can be implanted. SFIOL’s have certain advantages over ACIOL such as less corneal endothelial damage and minimising aniseikonia in contralateral eyes that are phakic or pseudophakic with a posterior chamber intraocular lens in place. SFIOL implantation also has the advantage of decreased incidence of other complications such as bullous keratopathy, uveitis and secondary glaucoma. Because of the availability of newer IOL’s and safe techniques and when optimum vision with minimal complications is the expectation of the patient in present situation, ACIOL’s are not in vogue in the present era and is rarely performed. The main aim of our study is to analyse the functional and visual outcomes and to study the long-term complications of aphakic patients without adequate capsular support undergoing anterior vitrectomy with scleral fixated IOL implantation. Materials and Methods This is a prospective clinical study that was done at Coimbatore Medical College Hospital, Coimbatore. The Article Info Received: 15th April, 2019 Accepted: 24th May, 2019 Published Online: 9th September, 2019

indian journal of clinical and experimental opthalmology

The visual outcome and surgical complications in posterior capsular rupture following cataract surgery with scleral fixated intraocular lens in tertiary care centre – A prospective study