A small-incision technique for transcleral fixation of posterior chamber intraocular lenses

Purpose: Existing transcleral intraocular lens fixation techniques require significant intraocular manipulation which often make for a relatively timeconsuming and difficult procedure and a slow post-operative recovery. The purpose of the study was to determine if a new modification can improve both intraoperative performance and post-operative recovery. Methods: The major surgical modifications employed in this prospective, consecutive series of aphakic eyes consisted of a temporal, self-sealing, clear comeal incision, prolene suture fixation onto modified haptics of a foldable lens, and insertion of the lens in the folded position through the small incision. Results: Over a one year period, six procedures were performed, three of which were in combination with a three-port pars plana vitrectomy for necessary posterior segment work. In all six cases, intraoperative globe stability was enhanced and ocular manipulation was reduced, greatly decreasing the operative time. Postoperatively, healing and visual recovery were rapid with the eyes refractively stable by 2 weeks and without significant induced astigmatism. No intra- or postoperative complications have been encountered with a minimum follow-up of 6 months (mean, 12 months). Conclusions: This small incision approach improves upon existing methods by safely and consistently reducing intraoperative steps, decreasing operative time, and expediting visual rehabilitation.