Ab externo scleral suture loop fixation for posterior chamber intraocular lens decentration: clinical results.
OBJECTIVE
To evaluate the efficacy and safety of an ab externo suture retrieval and scleral fixation technique in the treatment of subluxated posterior chamber intraocular lenses (PC IOLs).


METHODS
Academic tertiary care centers.


METHODS
Surgical databases from 2 surgeons were reviewed for consecutive cases from March 2000 to April 2004 in which the ab externo scleral suture fixation technique was used and a minimum follow-up of 3 months was completed. Patient charts were reviewed for 15 eyes that had decentered in-the-bag PC IOLs, 12 eyes with subluxated sulcus or bag-sulcus positioned PC IOLs, and 3 eyes with PC IOLs dislocated into the vitreous.


RESULTS
The mean time from cataract extraction to PC IOL stabilization was 3.4 years (range 2 days to 10.9 years). Surgical repositioning was successfully performed in all patients. After a mean follow-up of 14.7 months, the mean best corrected visual acuity (BCVA) improved from 20/140 to 20/40 (P = .0001). All patients had stable or improved BCVA. All patients with a successfully completed procedure achieved an adequately centered PC IOL postoperatively. One patient (3.3%) developed a significant intraoperative vitreous hemorrhage requiring the procedure to be aborted, but reoperation 3 months later was successful. Postoperative complications included persistent elevated intraocular pressure in 2 eyes (6.7%) and chronic cystoid macular edema in 1 eye (3.3%) that resolved with medication.


CONCLUSIONS
The ab externo suture loop retrieval and scleral fixation technique was effective in repositioning decentered, subluxated, or dislocated PC IOLs with excellent visual outcomes.
Chan
Clara C
CC
Department of Ophthalmology and Vision Sciences, University of Toronto, Ontario, Canada.
Crandall
Alan S
AS
Ahmed
Iqbal Ike K
II
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D005548:Foreign-Body Migration / Q000601:surgery*; D006801:Humans; D007431:Intraoperative Complications; D019654:Lens Implantation, Intraocular / Q000379:methods*; D007910:Lenses, Intraocular; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012086:Reoperation; D012189:Retrospective Studies; D012590:Sclera / Q000601:surgery*; D013536:Suture Techniques; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology