Scleral Fixation Intraocular lenses

Background: The 1ry indication for scleral fixation of intraocular lenses (IOL) is dislocation as a principal complication of cataract surgery. Inadequate capsular support is the most common cause of IOL dislocation. Other indications include traumatic phakic lens dislocation (cataractous or clear), surgically aphakic eyes or anterior chamber IOL with complications (persistent hyphema, uveitis). Methods: 20 eyes of 20 patients were done, surgery was done only when the IOL was dislocated peripheral to the visual axis and was causing symptoms of visual loss sufficient to interfere with the patient’s activities of daily living, or patients who were left aphakic for a 2ry implantation procedure. A modification of the technique was done which made the procedure faster and preserved the surrounding conjunctiva. Results: Best corrected visual acuity (BCVA) preoperatively ranged from 1/60 -6/60 and postoperatively between 6/60 – 6/6. Statistical analysis of the logarithm of the minimum angle of resolution (LogMAR) between the preoperative and postoperative visual acuity revealed significant improvement (p≤0.05). Intraoperative complications included one case of accidental iris injury, two cases of mild vitreous hemorrhage, two cases of moderate vitreous hemorrhage. Early postoperative complications included pupillary block. Midterm post operative complications occurred in one case with the occurrence of cystoid macular edema. Conclusion: Scleral fixation of IOL is a safe procedure with minimal complications, but needs surgical skills to be managed optimally. [Ayman Shouman, Mohamed Marzouk, Hesham Ali and Ehab Zakzook. Scleral Fixation Intraocular lenses. Journal of American Science 2010;6(11):680-687]. (ISSN: 1545-1003).