title: Two-step technique for posterior optic buttonholing of intraocular lens.
abstract: OBJECTIVE
  This study aims to describe a two-step surgical technique for placement of a posterior chamber intraocular lens (IOL) in cases with crystalline lens subluxation resulting from non-progressive zonular dialysis.
  
  
  METHODS
  The first stage entails a phacoemulsification with creation of a 4-mm posterior capsular opening using an automated vitrector. The second stage performed 6 weeks later includes an anterior vitrectomy and injection of a foldable three-piece IOL in the sulcus. The haptics of IOL are positioned in the sulcus while the optic is pushed behind the posterior capsular opening therefore "buttonholing" the IOL.
  
  
  RESULTS
  Seven eyes of seven patients with posttraumatic zonular dialysis were operated using this technique. Follow-up of all cases revealed a well-centered IOL with good postoperative visual acuity (20/20 to 20/80).
  
  
  CONCLUSIONS
  Our two-stage surgical technique precludes the insertion of capsular tension ring in cases with non-progressive zonular dialysis. The technique is recommended in the presence of less than or equal to 6 clock hours of zonular dialysis with preexisting posterior capsular tear or herniation of vitreous in the anterior chamber.
authors.affiliation: *MD Dr. Rajendra Prasad Centre for Ophthalmic Sciences (TA, DS, SK), All India Institute of Medical Sciences, New Delhi, India; and Department of Ophthalmology and Visual Sciences (VJ), The Chinese University of Hong Kong, Hong Kong, China.
authors.forename: Tushar
authors.initials: T
authors.lastname: Agarwal
authors.forename: Vishal
authors.initials: V
authors.lastname: Jhanji
authors.forename: Digvijay
authors.initials: D
authors.lastname: Singh
authors.forename: Sudarshan
authors.initials: S
authors.lastname: Khokhar
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D005131:Eye Injuries / Q000209:etiology / Q000601:surgery*; D005260:Female; D006801:Humans; D019654:Lens Implantation, Intraocular / Q000379:methods*; D007906:Lens Subluxation / Q000209:etiology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D018918:Phacoemulsification / Q000379:methods*; D019919:Prosthesis Implantation; D014792:Visual Acuity / Q000502:physiology; D014821:Vitrectomy; D014949:Wounds, Nonpenetrating / Q000209:etiology / Q000601:surgery*; D055815:Young Adult