- Doctor Dr. Deepak Vaidya
- Surgery Lasik
- Date December 2, 2022
Scleral fixated IOLs
Ideally a cataract surgery should result in the placement of an intraocular lens (IOL) within the capsular bag. However, this desirable outcome might be averted due to either preexisting zonular deficit or intraoperative posterior capsular tear, resulting in aphakia. This necessitates the need for an alternate means of IOL implantation. The surgeon can exercise the options of an anterior chamber IOL or iris fixated IOL or a scleral fixated IOL. Developments in IOL designs and modifications in implantation techniques have rendered them safe and efficacious. Recent studies have reported no significant differences in the postoperative visual recovery or complications rate between the 3 approaches.1 However, each option should be analyzed not only in accordance with surgeon’s experience but also with patient’s age, local, and systemic comorbidities.2
Scleral fixated IOL (SFIOL) involves sutured/sutureless fixation of the IOL to the sclera. SFIOL’s position closely approximates the normal anatomic position of a within-the-bag IOL. It does not hinder pupillary dilation unlike an iris-claw IOL. Moreover, the occurrence of untoward events such as corneal endothelial decompensation, pupillary block, angle-closure, and ocular inflammation is lesser in comparison to anterior chamber and iris fixated IOL’s.1-4 These factors make SFIOL a favored IOL over the other two. However, it is surgically more challenging and needs a certain amount of dexterity and skill.
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