Implantation of foldable posterior chamber intraocular lens in aphakic vitrectomized eyes without capsular support Implantação lente intraocular dobrável de câmara posterior em olhos afácicos vitrectomizados sem apoio capsular

The capsule of the crystalline lens, if sufficiently present, is used as a support tissue for intraocular lens (IOL) implantation surgery performed on vitrectomized eyes. Eye trauma or iatrogenic damage during complicated cataract surgery, loss of position and zonule connections of the crystalline lens, and IOL via dislocation may cause loss of support tissue for lens capsule implantation prior to pars plana vitrectomy (PPV). During PPV, the iatrogenic removal of the lens capsule may be required depending on the etiology and severity of the vitreoretinal disease. Posterior chamber IOL implantation may be performed via posterior chamber transscleral fixation, iris fixation, intrascleral fixation, angle supported anterior chamber IOL, or iris claw IOL implantation. Advantages of PCIOL fixation include the distant position from anterior segment structures, such as the corneal endothelium, and proximity to the focal point of the eye where the lens is naturally si tuated. However, the lack of the volume creation and supporting effect of the vitreous, and the fact that the surgery is generally performed under irrigation fluid, may complicate PCIOL fixation in vitrectomized eyes. In these cases, a small corneal tunnel incision may be used to create a closed and more stable surgical space. In cases with no capsular support, the implantation of a foldable IOL can be performed through a small corneal incision into the posterior chamber with suture fixation to the sclera or iris. Alternatively, IOL implantation can be performed through a small incision to the posterior chamber with sutureless intrascleral fixation. In the present study, we evaluated three separate groups of patients with vitrectomized aphakic eyes lacking capsular support in whom foldable IOL were implanted through a small corneal incision using either transscleral fixation, iris fixation, or intrascleral fixation. Outcomes and complications were compared between the surgical methods. Implantation of foldable posterior chamber intraocular lens in aphakic vitrectomized eyes without capsular support