Scleral fixated intraocular lenses: an angiographic study.
OBJECTIVE
We reviewed the results, complications, and fluorescein angiographic (FA) findings in eyes that had undergone transscleral fixation of posterior chamber intraocular lenses (IOLs).


METHODS
Posterior chamber IOL implantation with scleral fixation was performed on 18 patients. Three patients were aphakic, 14 had an intraoperative posterior capsule rupture during cataract surgery, and one was operated on for a retained lens nucleus and dislocated IOL in the vitreous. Follow-up examinations measured visual acuity, intraocular pressure, and IOL decentration and tilting. In 14 patients, iris and retinal FA were performed.


RESULTS
No major complications were noted during the procedure. Mean best-corrected visual acuity was 20/70 preoperatively and 20/30 postoperatively after a mean follow-up of 9.8 months. Fourteen patients achieved a visual acuity of 20/40 or better. Macular epiretinal membranes were diagnosed after surgery in five eyes but only one eye showed significant distortion of the fovea (macular pucker). Iris FA revealed no major vascular abnormalities. Fluorescein angiography showed cystoid macular edema in six cases. Light-induced retinal lesions occurred in six eyes.


CONCLUSIONS
Transscleral fixation of posterior chamber IOLs provided adequate visual acuity in most patients. Incomplete visual recovery after surgery may be related to the occurrence of macular edema and epiretinal membranes. Light-induced retinal injury was the major irreversible intraoperative complication.
Lanzetta
P
P
Department of Ophthalmology, University of Udine, Italy.
Menchini
U
U
Virgili
G
G
Crovato
S
S
Rapizzi
E
E
D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005451:Fluorescein Angiography; D005500:Follow-Up Studies; D005654:Fundus Oculi; D006801:Humans; D007431:Intraoperative Complications; D019654:Lens Implantation, Intraocular; D007910:Lenses, Intraocular; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012590:Sclera / Q000601:surgery*; D013536:Suture Techniques; D014792:Visual Acuity