Posterior chamber intraocular lens supported by an intact vitreous face

We describe a technique of posterior chamber intraocular lens (IOL) implantation in eyes with inadequate capsule support caused by inadvertent or planned intracapsular cataract extraction (ICCE) or in eyes having secondary IOL implantation after previous ICCE. The procedure is only performed in eyes with an intact anterior vitreous face, no vitreous prolapse into the anterior chamber, and no vitreous loss. The anterior vitreous is pushed back by viscoelastic material or air. The viscoelastic material is injected under the iris to create a free space between the iris and anterior vitreous. A single-piece, C-loop, poly(methyl methacrylate) IOL is slid onto the iris to rest on the anterior vitreous face; care is taken not to disturb the anterior vitreous. The technique was used in 15 eyes with a follow-up from 19 months to 5 years. All eyes had a stable IOL at each follow-up, and the visual acuity was 6/12 or better at the last follow-up.