[Sclerally fixated intraocular lens implant associated with vitrectomy: a study of 50 cases]

We present a retrospective study of 50 cases of scleral fixation of intraocular lenses (IOLs) associated with vitrectomy.

From January 1996 to June 2001, 50 consecutive patients who underwent surgery with insertion of a sclerally fixated intraocular lens implant associated with vitrectomy were studied. Indications included luxated lenses due to ocular contusion, cataract surgery complicated by capsular rupture and luxated nucleus or implant into the vitreous, and replacement of anterior chamber lenses. The implant was sutured 2 mm behind the limbus into the scleral sulcus with 10.0 Prolene. Vitrectomy was performed to treat pre-existing maculopathy, remove the lens or lens fragments luxated into the vitreous or to remove a luxated implant, and to provide for complete retinal examination during the operation.

With a mean follow-up of 30 months, the mean postoperative visual acuity was 20/30. For 95% of cases, final visual acuity was improved compared to preoperative visual acuity. No postoperative complications due to the implant were encountered. There were four cases of cystoid macular edema and two cases of retinal detachment.

Despite the macula edema and retinal detachments, there was no loss of visual acuity compared to the preoperative state. There were eight cases of raised intraocular pressure; seven were controlled medically and one after hemi-cyclocryo-therapy.

Scleral fixation of an IOL is a reliable means of correcting aphakia in the absence of capsular support and may be associated with a vitrectomy with very little risk.