To describe a novel technique for toric intraocular lens (IOL) repositioning and fixation in the absence of adequate capsular support.
Case report and literature review.
Two cases are presented with scleral fixation of a one-piece toric IOL (SN6AT series; Alcon Laboratories, Inc., Fort Worth, TX). In both cases, toric IOLs initially placed within the capsular bag became decentered due to poor capsular support. To avoid the potential complications of lens explantation and maintain the astigmatic benefits of the toric IOL, scleral fixation of the lenses was performed. The Hoffman technique was used to create reverse scleral pockets without conjunctival dissection. A 10-0 non-dissolvable suture was used to capture and then secure the lens haptics in a lasso-type fashion. Sutures were then buried within the previously created scleral pockets. Both patients had well-centered lenses postoperatively that remained stable at last follow-up, 30 months postoperatively.
In the absence of adequate capsular support, scleral fixation is a viable option for one-piece toric IOL fixation to avoid IOL explantation.
From Emory Vision at the Emory Eye Center, Atlanta, Georgia (MEE, JBR); and Jules Stein Eye Institute at the David Geffen School of Medicine, UCLA, Los Angeles, California (SM).
Supported in part by Research to Prevent Blindness, Inc., New York, New York, and the National Institutes of Health Core Grant P30 EYO6360, Bethesda, Maryland.
Dr. Masket is a consultant to Alcon Laboratories, Inc., Fort Worth, Texas. The remaining authors have no financial or proprietary interest in the materials presented herein.
Dr. Randleman did not participate in the editorial review of this manuscript.
Study concept and design (SM, JBR); data collection (MEE, JBR); analysis and interpretation of data (MEE, JBR); drafting of the manuscript (MEE, JBR); critical revision of the manuscript (MEE, JBR, SM); supervision (JBR)
Correspondence: J. Bradley Randleman, MD, Emory Vision, 875 Johnson Ferry Road, Suite 100, Atlanta, GA 30322. E-mail: firstname.lastname@example.org
Received: October 20, 2012
Accepted: December 14, 2012