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First Author: N.Oliveira PORTUGAL
Co Author(s): J. Nolasco C. Fonseca S. Freire M. Neves
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To report the surgical approach of an incorrectly implanted anterior chamber intraocular lens (AC IOL) explantation and exchange for a scleral fixated posterior chamber intraocular lens (SF IOL), in a 70-years old male patient.
Centro Hospitalar e Universitário de Coimbra, Hospital Geral, Ophthalmology Department
The surgery was performed under general anesthesia. Two 3mm scleral grooves were created horizontally at 3 and 9 oclock, 0.50.75mm from the limbus. One polypropylene 10-0 on a straight needle was introduced into one scleral groove through the wall of the sclera. The needle was passed across the eye, behind the iris and delivered to the opposite side through guidance by a 27 Gauge needle introduced through the scleral groove, resulting in one 10-0 suture passing across the eye with separated ends on either side. Then the AC IOL was explanted through a 6 mm scleral tunnel incision. The polypropylene 10-0 suture was then retrieved through the 6mm incision by a sinskey hook and cutted in half. Each end was tied to the hole on each SF IOL haptic. The SF IOL was inserted into the anterior chamber and each suture end was pulled to centralize it and sutured to the sclera, burying the knot into each scleral groove. Conjunctival closure was done with a 7-0 polyglactin suture.
At one-year follow-up, best-corrected visual acuity (BCVA) was 20/40, without complications.
Scleral fixated posterior chamber intraocular lens implantation is clinically safe, effective and a viable alternative to correct aphakia in patients without capsular support