26.2 Pars Plana Lensectomy
26.3 Intraocular Lens Explantation
26.4 Secondary Intraocular Lens Insertion Clinical Scenarios & Clinical Decision Making
26.5 Sulcus Intraocular Lens
26.6 Anterior Chamber Intraocular Lens
26.7 Iris Fixated Intraocular Lenses
26.8.1 Scleral Sutured Intraocular Lens – Traditional 2 Point Fixation
26.8.2 Scleral Sutured Posterior Chamber Intraocular Lens 4 Point Fixation
26.8.3 Scleral Sutured Posterior Chamber Intraocular Lens – “Hoffman” Corneoscleral Pockets
26.8.4 Alternate Technique to Rescue a Dislocated IOL – Triangular Scleral Flap, Sutured IOL Technique
26.8.5 Suturing Without Exchanging the Intraocular Lens
26.9 Sutureless Scleral Fixation of an Intraocular Lens
Iris-fixated intraocular lenses (IOL) use the patient’s iris to support secondary lenses in the absence of adequate capsular support. They may be positioned anteriorly (in front of the iris) or posteriorly (retropupillary location).
Prior to the implantation of an iris-fixated IOL, consider the iris anatomy, noting any prior iridectomies, significant atrophy, or the presence of other anatomical disruption that would preclude adequate support of an iris-fixated IOL.
Risk factors for such iris disruption include:
A. Iris Claw
The iris claw pinches iris tissue between two “claws” situated 180 degrees apart on the optic. The iris claw IOL was initially implanted in the anterior chamber but was subsequently developed into a posterior chamber IOL with retropupillary fixation as well.
The technique involves:
All rights reserved. No part of this publication which includes all images and diagrams may be reproduced, distributed, or transmitted in any form or by any means, including photocopying, recording, or other electronic or mechanical methods, without the prior written permission of the authors, except in the case of brief quotations embodied in critical reviews and certain other noncommercial uses permitted by copyright law.