Sutureless Intrascleral Haptic Fixation

  • Gabor B. SchariothEmail author


A vitreoretinal surgeon could be faced with three main scenarios. The patient could be aphakic after complicated phacoemulsification, trauma, vitreoretinal surgery or years after intracapsular cataract extraction. Second, the patient is pseudophakic with dislocated intraocular lens or even dislocated capsular bag-intraocular lens-complex, sometimes with capsular tension ring in place. Even more complicated if previous secondary implantation with intraocular (transiridal or transscleral) suturing was performed. Last the vitreoretinal surgeon could recognize the dislocation during intraocular surgery (preexisting or caused by the surgeon himself) complicating the surgery and may require intraoperative repair.


Intraocular Lens Prolene Suture Scleral Flap Scleral Tunnel Ciliary Sulcus 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Supplementary material

Video 12.1

Intrascleral haptic fixation_aphakia (MPG 353178 kb)

Video 12.2

Luxated IOL_intrascleral fixation (MPG 146209 kb)

Video 12.3

Glued IOL (MPG 240484 kb)

371294_1_En_12_MOESM4_ESM.wmv (68.1 mb)
Video 12.4 Iris-claw implantation (WMV 69754 kb)
371294_1_En_12_MOESM5_ESM.wmv (123.4 mb)
Video 12.5 Iris-claw implantation and artificial pupil (WMV 126324 kb)


  1. 1.
    Anand R, Bowman RW. Simplified technique for suturing dislocated posterior chamber intraocular lens to the ciliary sulcus [letter]. Arch Ophthalmol. 1990;108:1205–6.CrossRefPubMedGoogle Scholar
  2. 2.
    Azar DT, Wiley WF. Double-knot transscleral suture fixation technique for displaced intraocular lenses. Am J Ophthalmol. 1999;128:644–6.CrossRefPubMedGoogle Scholar
  3. 3.
    Bloom SM, Wyszynski RE, Brucker AJ. Scleral fixation suture for dislocated posterior chamber intraocular lens. Ophthalmic Surg. 1990;21:851–4.PubMedGoogle Scholar
  4. 4.
    Chan CK. An improved technique for management of dislocated posterior chamber implants. Ophthalmology. 1992;99:51–7.CrossRefPubMedGoogle Scholar
  5. 5.
    Chang S. Perfluorocarbon liquids in vitreoretinal surgery. Int Ophthalmol Clin. 1992;32(2):153–63.CrossRefPubMedGoogle Scholar
  6. 6.
    Chang S, Coll GE. Surgical techniques for repositioning a dislocated intraocular lens, repair of iridodialysis, and secondary intraocular lens implantation using innovative 25-gauge forceps. Am J Ophthalmol. 1995;119:165–74.CrossRefPubMedGoogle Scholar
  7. 7.
    Fanous MM, Friedman SM. Ciliary sulcus fixation of a dislocated posterior chamber intraocular lens using liquid perfluorophenanthrene. Ophthalmic Surg. 1992;23:551–2.PubMedGoogle Scholar
  8. 8.
    Friedberg MA, Pilkerton AR. A new technique for repositioning and fixating a dislocated intraocular lens. Arch Ophthalmol. 1992;110:413–5.CrossRefPubMedGoogle Scholar
  9. 9.
    Kokame GT, Yamamoto I, Mandel H. Scleral fixation of dislocated posterior chamber intraocular lenses; temporary haptic externalization through a clear corneal incision. J Cataract Refract Surg. 2004;30:1049–56.CrossRefPubMedGoogle Scholar
  10. 10.
    Little BC, Rosen PH, Orr G, Aylward GW. Trans-scleral fixation of dislocated posterior chamber intraocular lenses using a 9/0 microsurgical polypropylene snare. Eye. 1993;7:740–3.CrossRefPubMedGoogle Scholar
  11. 11.
    Maguire AM, Blumenkranz MS, Ward TG, Winkelman JZ. Scleral loop fixation for posteriorly dislocated intraocular lenses; operative technique and long-term results. Arch Ophthalmol. 1991;109:1754–8.CrossRefPubMedGoogle Scholar
  12. 12.
    Nabors G, Varley MP, Charles S. Ciliary sulcus suturing of a posterior chamber intraocular lens. Ophthalmic Surg. 1990;21:263–5.PubMedGoogle Scholar
  13. 13.
    Schneiderman TE, Johnson MW, Smiddy WE, et al. Surgical management of posteriorly dislocated silicone plate haptic intraocular lenses. Am J Ophthalmol. 1997;123:629–35.CrossRefPubMedGoogle Scholar
  14. 14.
    Shin DH, Hu BV, Hong YJ, Gibbs KA. Posterior chamber lens implantation in the absence of posterior capsular support [letter and reply by WJ Stark, GL Goodman, JD Gottsch]. Ophthalmic Surg. 1988;19:606–7.PubMedGoogle Scholar
  15. 15.
    Smiddy WE. Dislocated posterior chamber intraocular lens; a new technique of management. Arch Ophthalmol. 1989;107:1678–80.CrossRefPubMedGoogle Scholar
  16. 16.
    Smiddy WE, Flynn Jr HW. Needle-assisted scleral fixation suture technique for relocating posteriorly dislocated IOLs [letter]. Arch Ophthalmol. 1993;111:161–2.Google Scholar
  17. 17.
    Smiddy WE, Ibanez GV, Alfonso E, Flynn Jr HW. Surgical management of dislocated intraocular lenses. J Cataract Refract Surg. 1995;21:64–9.Google Scholar
  18. 18.
    Thach AB, Dugel PU, Sipperley JO, et al. Outcome of sulcus fixation of dislocated posterior chamber intraocular lenses using temporary externalization of the haptics. Ophthalmology. 2000;107:480–4 discussion by WF Mieler, 485.CrossRefPubMedGoogle Scholar
  19. 19.
    Koh HJ, Kim CY, Lim SJ, Kwon OW. Scleral fixation technique using 2 corneal tunnels for a dislocated intraocular lens. J Cataract Refract Surg. 2000;26:1439–41.CrossRefPubMedGoogle Scholar
  20. 20.
    Lewis JS. Ab externo sulcus fixation. Ophthalmic Surg. 1991;22:692–5.PubMedGoogle Scholar
  21. 21.
    Mohr A, Hengerer F, Eckardt C. Retropupillare Fixation der Irisklauenlinse bei Aphakie; Einjahresergebnisse einer neuen Implantationstechnik. [Retropupillary fixation of the iris claw lens in aphakia; 1 year outcome of a new implantation technique.] Ophthalmologe 2002; 99:580–583Google Scholar
  22. 22.
    Hoffman RS, Fine I, Packar M. Scleral fixation without conjunctival dissection. J Cataract Refract Surg. 2006;32:1907–12.CrossRefPubMedGoogle Scholar
  23. 23.
    Teichmann KD, Teichmann IAM. The torque and tilt gamble. J Cataract Refract Surg. 1997;23:413–8.CrossRefPubMedGoogle Scholar
  24. 24.
    Por YM, Lavin MJ. Techniques of intraocular lens suspension in the absence of capsular/zonular support. Surv Ophthalmol. 2005;50:429–62.CrossRefPubMedGoogle Scholar
  25. 25.
    Wagoner MD, Cox TA, Ariyasu RG, et al. Intraocular lens implantation in the absence of capsular support; a report by the American Academy of Ophthalmology. (Ophthalmic Technology Assessment). Ophthalmology. 2003;110:840–59.CrossRefPubMedGoogle Scholar
  26. 26.
    Gross JG, Kokame GT, Weinberg DV. In-the-bag intraocular lens dislocation; the Dislocated In-the-Bag Intraocular Lens Study. Am J Ophthalmol. 2004;137:630–5.PubMedGoogle Scholar
  27. 27.
    Jehan FS, Mamalis N, Crandall AS. Spontaneous late dislocation of intraocular lens within the capsular bag in pseudoexfoliation patients. Ophthalmology. 2001;108:1727–31.CrossRefPubMedGoogle Scholar
  28. 28.
    Gabor SG, Pavlidis MM. Sutureless intrascleral posterior chamber intraocular lens fixation. J Cataract Refract Surg. 2007;33:1851–4.CrossRefPubMedGoogle Scholar
  29. 29.
    Pavlidis M, de Ortueta D, Scharioth GB. Bioptics in sutureless intrascleral multifocal posterior chamber intraocular lens fixation. J Cataract Refract Surg. 2011;27:386–8.CrossRefGoogle Scholar
  30. 30.
    Scharioth GB, Prasad S, Georgalas I, Tatru C, Pavlidis M. Intermediate results of sutureless intrascleral posterior chamber intraocular lens fixation. J Cataract Refract Surg. 2010;36:254–9.CrossRefPubMedGoogle Scholar
  31. 31.
    Agarwal A, Kumar DA, Jacob S, Baid C, Agarwal A, Srinivasan S. Fibrin glue-assisted sutureless posterior chamber intraocular lens implantation in eyes with deficient posterior capsules. J Cataract Refract Surg 34(9):1433-1438Google Scholar
  32. 32.
    Totan Y, Karadag R. Trocar-assisted sutureless intrascleral posterior chamber foldable intra-ocular lens fixation. Eye (Lond). 2012;26(6):788–91.CrossRefGoogle Scholar
  33. 33.
    Totan Y, Karadag R. Two techniques for sutureless intrascleral posterior chamber IOL fixation. J Refract Surg. 2013;29(2):90–4.CrossRefPubMedGoogle Scholar
  34. 34.
    Pavlidis M, de Ortueta D, Scharioth GB. Bioptics in sutureless intrascleral multifocal posterior chamber intraocular lens fixation. J Refract Surg. 2011;27:386–8.CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing AG 2017

Authors and Affiliations

  1. 1.Augenzentrum RecklinghausenRecklinghausenGermany

Personalised recommendations