BACKGROUND: Transscleral fixation of a posterior chamber intraocular lens has been proposed in eyes lacking adequate posterior capsular support. METHODS: We performed a retrospective review of 38 eyes of 38 patients who had a 12 months follow-up. Visual acuity, intraocular pressure and complications have been studied. We performed a transscleral fixation of posterior chamber lens with the following indications: 1. planned intraocular cataract extraction; 2. following intraoperative complications of phacoemulsification; 3. in combination with perforating keratoplasty; 4. in combination with parsplana vitrectomy. RESULTS: There were no serious intra- or shortly postoperative complications. 34% of the implanted lenses were not perfectly positioned. Up to 12 months, there were only minor problems in the anterior segment (suture erosions, anterior synechiae, iris capture). As longterm postoperative complications one patient developed retinal detachment, 3 others proliferative vitreoretinopathy after previous retinal detachment surgery. Two patients developed new onset glaucoma, and 3 glaucoma patients showed a medically uncontrollable intraocular pressure postoperatively. CONCLUSIONS: The transscleral fixation of a posterior chamber intraocular lens has been performed in combination with a vitrectomy in order to minimize postoperative complications. Especially in combination with a pars-plana vitrectomy and silicone oil filing the transsclerally fixated posterior chamber intraocular lens is superior to the anterior chamber IOLs.
BACKGROUND: Transscleral fixation of a posterior chamber intraocular lens has been proposed in eyes lacking adequate posterior capsular support. METHODS: We performed a retrospective review of 38 eyes of 38 patients who had a 12 months follow-up. Visual acuity, intraocular pressure and complications have been studied. We performed a transscleral fixation of posterior chamber lens with the following indications: 1. planned intraocular cataract extraction; 2. following intraoperative complications of phacoemulsification; 3. in combination with perforating keratoplasty; 4. in combination with parsplana vitrectomy. RESULTS: There were no serious intra- or shortly postoperative complications. 34% of the implanted lenses were not perfectly positioned. Up to 12 months, there were only minor problems in the anterior segment (suture erosions, anterior synechiae, iris capture). As longterm postoperative complications one patient developed retinal detachment, 3 others proliferative vitreoretinopathy after previous retinal detachment surgery. Two patients developed new onset glaucoma, and 3 glaucomapatients showed a medically uncontrollable intraocular pressure postoperatively. CONCLUSIONS: The transscleral fixation of a posterior chamber intraocular lens has been performed in combination with a vitrectomy in order to minimize postoperative complications. Especially in combination with a pars-plana vitrectomy and silicone oil filing the transsclerally fixated posterior chamber intraocular lens is superior to the anterior chamber IOLs.