Premium
Single scleral suture for subluxated capsular bag in pseudophakic eyes
Author(s) -
FRUSCHELLI M,
MENICACCI F,
BAGAGLIA SA,
MENICACCI C,
SPARANO MC,
MOTOLESE I,
FREZZOTTI P,
MOTOLESE E
Publication year - 2010
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/j.1755-3768.2010.3349.x
Subject(s) - medicine , sclera , capsulorhexis , phacoemulsification , subluxation , intraocular lens , surgery , ophthalmology , fibrous joint , visual acuity , aphakia , fixation (population genetics) , population , alternative medicine , environmental health , pathology
Purpose In‐the‐bag posterior chamber intraocular lens (PC‐IOL) dislocation is an unusual late complication of cataract surgery that can be managed either by exchange with a scleral fixated intraocular lens or by PC‐IOL repositioning with scleral fixation. In the presence of mild subluxation, in older patients, we prefer to suture the fibrotic capsular bag to the sclera without opening the anterior chamber. Methods 5 patients (mean age 80 y.o.) who had uncomplicated phacoemulsification with implantation of a posterior chamber intraocular lens (IOL) into the continuous capsulorhexis several years before (4‐12 years), suffered from PC‐IOL subluxation secondary to dehiscence of the zonules supporting the capsular bag. All capsular bags were fibrotic and previously received yag capsulotomy for PCO. Using two self sealing side ports the capsular bag was successfully sutured to the sclera at 12' by introducing a double‐armed polypropylene suture through a scleral flap. Results The final postoperative visual acuity was 20/30 or better with no complications during the surgical procedure. Patients discomfort was minimum and no endothelial cell loss was reported. Conclusion Scleral fixation by single suture can be a useful and low‐complication rate procedure for late in‐the‐bag PC‐IOL subluxation in older patients. Use of This procedure in selected cases, can avoid whole capsular bag extraction and replacement with scleral fixated sulcus IOL, with minimal stress for the ocular structures.