Glued Intrascleral Haptic Fixation of an Intraocular Lens (Glued IOL)
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.
KeywordsOptical Coherence Tomography Anterior Chamber Cystoid Macular Edema Penetrate Keratoplasty Scleral Flap
No financial interest in any of the product/procedure is mentioned or discussed in this chapter.
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)
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