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No Sulcus Support Present
Continuing in
Management of Dislocated Intraocular Lens
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This video segment describes the approach to a case with partial sulcus support, type of IOL to be used and methods to stabilize the IOL.
Keywords
- Scleral Fixation
- Intraocular lens
- IOL
- Dislocated IOL
- Microincision Vitrectomy Surgery
- MIVS
- Glued IOL
- Trans-scleral fixated IOL
- active extrusion
Conflict of Interest
The author declares no conflict of interest.
About this video
- Author(s)
- Ramandeep Singh
- Simar Rajan Singh
- First online
- 27 April 2021
- DOI
- https://doi.org/10.1007/978-981-16-1105-6_3
- Online ISBN
- 978-981-16-1105-6
- Publisher
- Springer, Singapore
- Copyright information
- © Producer, under exclusive license to Springer Nature Singapore Pte Ltd. 2021
Video Transcript
Moving on to cases where only a partial sulcus support is present-- here also in a few cases, it may be possible to reposition the same IOL in the sulcus, especially when approximately 270 degrees of the sulcus support is present, including the inferior six clock hours. Here we can see a dislocated PMMA IOL with a deficient superior sulcus support.
An endoilluminator is being used to support the IOL with one hand, while the other hand dials the IOL into the sulcus with the help of a Sinskey hook. The iris hooks are then removed after the checking for stability of the IOL and the case is concluded. In cases where the inferior support is deficient, it becomes important to stabilize the IOL by fixing one haptic to the sclera.
After lifting the IOL off the retinal surface, it is dialed into the partial sulcus that is present. It must be noted that the sulcus is deficient in the inferior half here.
The inferior haptic of the PMMA IOL is externalized through a side port incision. One end of a 10-0 polypropylene suture is also externalized to the same side port after inserting it under a scleral flap created in the inferior half. The polypropylene suture is tied over a groove created on the PMMA IOL with the help of a thermal cautery The haptic is then secured with the scleral wall while the other end rests in the available sulcus support. This can be done both for three-piece, as well as PMMA IOLs.