September 2, 2015
IOL implantation is an essential step for visual rehabilitation in cataract surgery or in cases of secondary IOL placement. When the IOL is placed within a capsular bag that is supported by the zonules 360° during cataract surgery, the IOL is usually in an acceptable and relatively stable position. However, in the absence of a posterior capsular bag, alternative approaches to IOL placement will be necessary.
These alternatives include anterior chamber placement of an anterior chamber IOL, iris-sutured IOL, ciliary sulcus placement of a posterior chamber IOL, scleral-supported posterior chamber IOL that includes the use of sutures, or scleral pocket-supported glued IOL. When placing an IOL in the anterior chamber or ciliary sulcus, the overall IOL length and the relative dimensions of the anterior chamber and ciliary sulcus are important considerations for a stable IOL implantation. This is less critical with an iris-sutured IOL placement, but mechanical rubbing of the IOL haptic against the iris should be prevented in such cases. In a scleral-fixated posterior chamber IOL using sutures, the suture length can be adjusted to compensate for the required optimal placement.