Glued Intrascleral Haptic Fixation of an Intraocular Lens (Glued IOL)

  • Priya NarangEmail author


Secondary intraocular lens (IOL) implantation is usually the preferred procedure for correction of aphakia. Although there are various surgical techniques that are helpful for secondary IOL implantation, the choice of the surgical procedure is often dictated by the factors such as the presence or absence of the posterior lens capsule and the integrity of the sulcus support. The status of the posterior lens capsule can vary from being totally intact to partially deficient to totally being absent. When the posterior capsule is compromised and the sulcus support is inadequate, the posterior chamber secondary IOL implantation technique may either include a sutured scleral fixation or a trans-scleral fixation of an IOL.


Optical Coherence Tomography Anterior Chamber Cystoid Macular Edema Penetrate Keratoplasty Scleral Flap 
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.


Financial Disclosure

No financial interest in any of the product/procedure is mentioned or discussed in this chapter.

Supplementary material

Video 27.1

The video demonstrates the technique of glued IOL procedure performed in cases of deficient or inadequate posterior capsule support. After 180° axis marking, two partial thickness scleral flaps (2.5 × 2.5 mm in size) are made 180° opposite to each other. Sclerotomy is done with a 20 G needle about 1.5 mm from the limbus, beneath the scleral flaps. Vitrectomy cutter is introduced from the sclerotomy site, and adequate vitrectomy is performed. A three-piece foldable IOL is loaded on to the cartridge, and the tip of the haptic is slightly extruded from the edge of the cartridge. Glued IOL forceps is introduced from the left sclerotomy site, and the tip of the haptic is grasped. Once the entire IOL has unfolded, the leading haptic is pulled and externalized. The trailing haptic is flexed into the eye, and it is then externalized from the right sclerotomy site. Scleral pockets are created with a 26 G needle, and the haptics are tucked into the pockets. Vitrectomy is again performed at the sclerotomy site to cut down all the vitreous adhesions. Air bubble is injected into the anterior chamber, and fibrin glue is applied beneath the scleral flaps. (MOV 153681 kb)


  1. 1.
    Gabor SG, Pavlidis MM. Sutureless intrascleral posterior chamber intraocular lens fixation. J Cataract Refract Surg. 2007;33:1851–4.CrossRefPubMedGoogle Scholar
  2. 2.
    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. 2008;34:1433–8.CrossRefPubMedGoogle Scholar
  3. 3.
    Narang P. Modified method of haptic externalization of posterior chamber intraocular lens in fibrin glue-assisted intrascleral fixation: no-assistant technique. J Cataract Refract Surg. 2013;39:4–7.CrossRefPubMedGoogle Scholar
  4. 4.
    Narang P. Postoperative analysis of glued intrascleral fixation of intraocular lens and comparison of intraoperative parameters and visual outcome with 2 methods of haptic externalization. J Cataract Refract Surg. 2013;39:1118–9.CrossRefPubMedGoogle Scholar
  5. 5.
    Beiko G, Steinert R. Modification of externalized haptic support of glued intraocular lens technique. J Cataract Refract Surg. 2013;39:323–5.CrossRefPubMedGoogle Scholar
  6. 6.
    Ohta T, Toshida H, Murakami A. Simplified and safe method of sutureless intrascleral posterior chamber intraocular lens fixation: Y-fixation technique. J Cataract Refract Surg. 2014;40:2–7.CrossRefPubMedGoogle Scholar
  7. 7.
    Agarwal A, Jacob S, Kumar DA, Agarwal A, Narsimhan S, Agarwal A. Handshake technique for gkued intrascleral fixation of a posterior chamber intraocular lens. J Cataract Refract Surg. 2013;39:317–22.CrossRefPubMedGoogle Scholar
  8. 8.
    Jacob S, Agarwal A, Agarwal A, Narasimhan S. Closed chamber haptic re-externalization through fresh sclerotomy for posteriorly displaced sclerotomy and inadequate haptic tuck in glued PCIOL. J Cataract Refract Surg. 2015;41(2):268–71.CrossRefPubMedGoogle Scholar
  9. 9.
    Ladi JS, Shah NA. Vertical fixation with fibrin glue-assisted secondary posterior chamber intraocular lens implantation in a case of surgical aphakia. Indian J Ophthalmol. 2013;61:126–9.CrossRefPubMedPubMedCentralGoogle Scholar
  10. 10.
    Kumar DA, Agarwal A, Prakash G, Jacob S. Managing total aniridia with aphakia using a glued iris prosthesis. J Cataract Refract Surg. 2010;36:864–5.CrossRefPubMedGoogle Scholar
  11. 11.
    Gooi P, Teichman JC, Ahmed II. Sutureless intrascleral fixation of a custom-tailored iris prosthesis with an intraocular lens. J Cataract Refract Surg. 2014;40:1759–63.CrossRefPubMedGoogle Scholar
  12. 12.
    Prakash G, Agarwal A, Jacob S, Kumar DA, Chaudhary P, Agarwal A. Femtosecond-assisted Descemets stripping automated endothelial keratoplasty with fibrin glue-assisted sutureless posterior chamber lens implantation. Cornea. 2010;29:1315–9.CrossRefPubMedGoogle Scholar
  13. 13.
    Prakash G, Jacob S, Kumar DA, Narsimhan S, Agarwal A, Agarwal A. Femtosecond-assisted keratoplasty with fibrin glue assisted sutureless posterior chamber lens implantation: new triple procedure. J Cataract Refract Surg. 2009;35:973–9.CrossRefPubMedGoogle Scholar
  14. 14.
    Jacob S, Agarwal A, Kumar DA, Agarwal A, Agarwal A, Satish K. Modified technique for combining DMEK with glued intrascleral haptic fixation of a posterior chamber IOL as a single-stage procedure. J Refract Surg. 2014;30:492–6.CrossRefPubMedGoogle Scholar
  15. 15.
    McKee Y, Price Jr FW, Feng MT, Price MO. Implementation of the posterior chamber intraocular lens intrascleral haptic fixation technique (glued intraocular lens) in a United States practice: outcomes and insights. J Cataract Refract Surg. 2014;40:2099–105.CrossRefPubMedGoogle Scholar
  16. 16.
    Agarwal A, Jacob S, Agarwal A, Narasimhan S, Kumar DA, Agarwal A. Glued intraocular lens scaffolding to create an artificial posterior capsule for nucleus removal in eyes with posterior capsule tear and insufficient iris and sulcus support. J Cataract Refract Surg. 2013;39:32.Google Scholar
  17. 17.
    Narang P, Agarwal A, Kumar DA. Glued intraocular lens scaffolding for Soemmering ring removal in aphakia with posterior capsular defect. J Cataract Refract Surg. 2015;41(4):708–13.CrossRefPubMedGoogle Scholar
  18. 18.
    Narang P, Agarwal A, Kumar DA, Jacob S, Agarwal A, Agarwal A. Clinical outcomes of intraocular lens scaffold surgery. A one-year study. Ophthalmology. 2013;120:2442–8.CrossRefPubMedGoogle Scholar
  19. 19.
    Narang P, Narang S. Glue-assisted intrascleral fixation of posterior chamber intraocular lens. Indian J Ophthalmol. 2013;61:163–7.CrossRefPubMedPubMedCentralGoogle Scholar
  20. 20.
    Kumar DA, Agarwal A, Prakash G, Jacob S, Saravanan Y, Agarwal A. Glued posterior chamber IOL in eyes with deficient capsular support: a retrospective analysis of 1-year post-operative outcomes. Eye. 2010;24:1143–448.CrossRefPubMedGoogle Scholar
  21. 21.
    Kumar DA, Agarwal A, Prakash D, Prakash G, Jacob S, Agarwal A. Glued intrascleral fixation of posterior chamber intraocular lens in children. Am J Ophthalmol. 2012;153:594–601.CrossRefPubMedGoogle Scholar

Copyright information

© Springer India 2017

Authors and Affiliations

  1. 1.Narang Eye Care & Laser CentreAhmedabadIndia

Personalised recommendations