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Four-Point Fixation Technique for Sutured Posterior Chamber Intraocular Lenses

Four-Point Fixation Technique for Sutured Posterior Chamber Intraocular Lenses Abstract Transscleral suture fixation of posterior chamber lenses is a popular recent alternative for avoiding the potential complications of anterior chamber lenses and in the absence of sufficient iris support for an anterior chamber lens. If a posterior chamber lens is fixated by only two points in the ciliary sulcus, the lens may tilt relative to the visual axis, causing clinically significant and possibly uncorrectable astigmatism. Described methods of three- or four-point fixation are technically more difficult and can result in an improperly centered lens. A method is described herein that allows stable four-point fixation with precise lens placement using only two sutures. This method also allows the suture knot to be buried in the eye without the use of scleral flaps. References 1. Stark WJ, Goodman G, Goodman DF, Gottsch J. Posterior chamber intraocular lens implantation in the absence of posterior capsular support . Ophthalmic Surg . 1988;19:240-243. 2. Spigelman AV, Lindstrom RL, Nichols BD, Lindquist TD, Lane SS. Implantation of a posterior chamber lens without capsular support during penetrating keratoplasty or as a secondary lens implant . Ophthalmic Surg . 1988;19:396-398. 3. Grehn F, Sundmacher R. Fixation of posterior chamber lenses by transscleral sutures . Arch Ophthalmol . 1989;107:954-955.Crossref 4. Malbran ES, Malbran E Jr, Negri I. Lens guide suture for transport and fixation in secondary IOL implantation after intracapsular extraction . Int Ophthalmol . 1986;9:151-160.Crossref 5. Pannu JS. A new suturing technique for ciliary sulcus fixation in the absence of posterior capsule . Ophthalmic Surg . 1988;19:751-754. 6. Shapiro A, Leen MM. External transscleral posterior chamber lens fixation . Arch Ophthalmol . 1991;109:1759-1760.Crossref 7. Lewis JS. Ab externo sulcus fixation . Ophthalmic Surg . 1991;22:692-695. 8. Mannarino AP, Hannush SB. A new technique for transscleral fixation of a posterior chamber lens in the absence of capsular support during penetrating keratoplasty . Refract Corneal Surg . 1990;6:353-356. 9. Friedberg MA, Berler DK. Scleral fixation of posterior chamber intraocular lens implants combined with vitrectomy . Ophthalmic Surg . 1992;23:17-21. 10. Lewis JS. Sulcus fixation without flaps . Ophthalmology . 1993;100:1346-1350.Crossref 11. Duffey RJ, Holland EJ, Agapitos PJ, Lindstrom RL. Anatomic study of transsclerally sutured intraocular lens implantation . Am J Ophthalmol . 1989;108:300-309. 12. Morrison JC, Van Buskirk EM. Anterior collateral circulation in the primate eye . Ophthalmology . 1983;90:707-715.Crossref 13. Funk R, Rohen JW. Scanning electron microscopic study on the vasculature of the human anterior eye segment, especially with respect to the ciliary processes . Exp Eye Res . 1990;50:651-661.Crossref 14. Schein OD, Kenyon KR, Steinert RF, et al. A randomized trial of intraocular lens fixation techniques with penetrating keratoplasty . Ophthalmology . 1993;100:1437-1443.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Ophthalmology American Medical Association

Four-Point Fixation Technique for Sutured Posterior Chamber Intraocular Lenses

Archives of Ophthalmology , Volume 112 (11) – Nov 1, 1994

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Publisher
American Medical Association
Copyright
Copyright © 1994 American Medical Association. All Rights Reserved.
ISSN
0003-9950
eISSN
1538-3687
DOI
10.1001/archopht.1994.01090230099029
Publisher site
See Article on Publisher Site

Abstract

Abstract Transscleral suture fixation of posterior chamber lenses is a popular recent alternative for avoiding the potential complications of anterior chamber lenses and in the absence of sufficient iris support for an anterior chamber lens. If a posterior chamber lens is fixated by only two points in the ciliary sulcus, the lens may tilt relative to the visual axis, causing clinically significant and possibly uncorrectable astigmatism. Described methods of three- or four-point fixation are technically more difficult and can result in an improperly centered lens. A method is described herein that allows stable four-point fixation with precise lens placement using only two sutures. This method also allows the suture knot to be buried in the eye without the use of scleral flaps. References 1. Stark WJ, Goodman G, Goodman DF, Gottsch J. Posterior chamber intraocular lens implantation in the absence of posterior capsular support . Ophthalmic Surg . 1988;19:240-243. 2. Spigelman AV, Lindstrom RL, Nichols BD, Lindquist TD, Lane SS. Implantation of a posterior chamber lens without capsular support during penetrating keratoplasty or as a secondary lens implant . Ophthalmic Surg . 1988;19:396-398. 3. Grehn F, Sundmacher R. Fixation of posterior chamber lenses by transscleral sutures . Arch Ophthalmol . 1989;107:954-955.Crossref 4. Malbran ES, Malbran E Jr, Negri I. Lens guide suture for transport and fixation in secondary IOL implantation after intracapsular extraction . Int Ophthalmol . 1986;9:151-160.Crossref 5. Pannu JS. A new suturing technique for ciliary sulcus fixation in the absence of posterior capsule . Ophthalmic Surg . 1988;19:751-754. 6. Shapiro A, Leen MM. External transscleral posterior chamber lens fixation . Arch Ophthalmol . 1991;109:1759-1760.Crossref 7. Lewis JS. Ab externo sulcus fixation . Ophthalmic Surg . 1991;22:692-695. 8. Mannarino AP, Hannush SB. A new technique for transscleral fixation of a posterior chamber lens in the absence of capsular support during penetrating keratoplasty . Refract Corneal Surg . 1990;6:353-356. 9. Friedberg MA, Berler DK. Scleral fixation of posterior chamber intraocular lens implants combined with vitrectomy . Ophthalmic Surg . 1992;23:17-21. 10. Lewis JS. Sulcus fixation without flaps . Ophthalmology . 1993;100:1346-1350.Crossref 11. Duffey RJ, Holland EJ, Agapitos PJ, Lindstrom RL. Anatomic study of transsclerally sutured intraocular lens implantation . Am J Ophthalmol . 1989;108:300-309. 12. Morrison JC, Van Buskirk EM. Anterior collateral circulation in the primate eye . Ophthalmology . 1983;90:707-715.Crossref 13. Funk R, Rohen JW. Scanning electron microscopic study on the vasculature of the human anterior eye segment, especially with respect to the ciliary processes . Exp Eye Res . 1990;50:651-661.Crossref 14. Schein OD, Kenyon KR, Steinert RF, et al. A randomized trial of intraocular lens fixation techniques with penetrating keratoplasty . Ophthalmology . 1993;100:1437-1443.Crossref

Journal

Archives of OphthalmologyAmerican Medical Association

Published: Nov 1, 1994

References