To describe a safe , simple, tissue and time friendly approach of scleral fixation of a post traumatic partially posteriorly dislocated SF-IOL with one broken suture
Ishwar eye centre , a tertiary eye care centre in Northern India
The patient underwent 3port pars plans vitrectomy, the posteriorly dislocated IOL was lifted with a forceps and its haptic brought into the anterior chamber, made to rest on the peripheral iris. A 3mm x 3mm paralimbal partial thickness scleral flap was made diagonally opposite the point where the other haptic of the lens was already scleral fixated. A straight 10-0 proline needle was passed through the scleral flap base and subsequentlythrough the haptic fenestration of the IOL and brought out through a clear corneal incision diagonally opposite the scleral flap on a bent 26 g needle and then passed in the exact opposite fashion encircling the haptic and brought out under the scleral flap. The lens was now pushed behind the iris. On sequential tightening and tying the suture the Intra ocular lens was stable and well centered in the ciliary sulcus. Post operatively the patient was satisfied with the quick and stable recovery of vision.
The patients vision improved from uncorrected visual acuity of counting fingers vision to 6/9 snellen visual acuity in the operated eye. The eye was quiet , with clear cornea and healthy retina in the post operative period.
This procedure describes a simple , safe and elegant method for re-scleral fixating a foldable posteriorly dislocated intra ocular lens. It avoids a longer surgery and concurrently more tissue / corneal trauma of making large incisions to remove these lenses and replacing them with a new scleral fixated lens with resulting prolonged post operative recovery and higher astigmatism induction. It results in a stable lens and a happy patient
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