Single scleral suture for subluxated capsular bag in pseudophakiceyes

Purpose In-the-bag posterior chamber intraocular lens (PC-IOL) dislocation is an unusual late complication of cataract surgery that can be managed either by exchange with a scleral fi xated intraocular lens or by PC-IOL repositioning with scleral fi xation. In the presence of mild subluxation, in older patients, we prefer to suture the fi brotic capsular bag to the sclera without opening the anterior chamber. Methods 5 patients (mean age 80 y.o.) who had uncomplicated phacoemulsifi cation with implantation of a posterior chamber intraocular lens (IOL) into the continuous capsulorhexis several years before (4-12 years), suff ered from PC-IOL subluxation secondary to dehiscence of the zonules supporting the capsular bag. All capsular bags were fi brotic and previously received yag capsulotomy for PCO. Using two self sealing side ports the capsular bag was successfully sutured to the sclera at 12’ by introducing a double-armed polypropylene suture through a scleral fl ap. Results Th e fi nal postoperative visual acuity was 20/30 or better with no complications during the surgical procedure. Patients discomfort was minimum and no endothelial cell loss was reported. Conclusion Scleral fi xation by single suture can be a useful and low-complication rate procedure for late in-the-bag PC-IOL subluxation in older patients. Use of Th is procedure in selected cases, can avoid whole capsular bag extraction and replacement with scleral fi xated sulcus IOL, with minimal stress for the ocular structures.