First Author: Z.Koshy UK
Co Author(s): F. Shams L. Khoo
Back to previous
We evaluate our experience with a 3-piece PCIOL inserted with scleral tunnel-fixation in the management of aphakia without capsular support
Surgical, University Hospital
All procedures were performed by a single surgeon in a teaching hospital. Retrospective case-note review was performed for 28 eyes undergoing insertion of a scleral tunnel-fixated PCIOL over a 4 year period (January 2013 - January 2017).
Indications for secondary IOL insertion included nine dislocated crystalline lenses (four secondary to trauma, three secondary to Marfan syndrome and two unspecified/other), eight dislocated IOL/capsular bag complexes and three with aphakia secondary to complicated cataract surgery. Postoperative complications include three subluxed PCIOLs requiring recentration, one retinal detachment, two pigment dispersion one suprachoroidal haemorrhage (following postoperative trauma) and one case of cystoid macular oedema which resolved with medical treatment. Postoperative visual acuity was improved in 60% of cases, while 15% remained unchanged and 25% had deteriorated.
Our experience shows that insertion of scleral tunnel-fixated PCIOLs is a viable method of secondary IOL insertion in multiple scenarios where lens capsular support is lacking. This is an intricate procedure with an associated learning curve, and vitreoretinal support is advised due to the potential for complications.