[Iris sutures for refixation of decentered intraocular lenses]

Most revisions after intraocular lens (IOL) implantation are due to an insufficiency of the zonular apparatus. Frequently, an inferior decentration can be seen ("sunset syndrome"). In this clinical study, suture refixation of the haptics to the iris was assessed. Functional and morphological results were considered.

21 eyes with subluxation of the IOL were treated with iris sutures for refixation. The operation was performed under topical and intracameral anaesthesia. Refixation was achieved by suturing one or both haptics to one or two fixation points in the outer periphery of the iris. Complete zonular dialysis made it necessary to suture at two fixation spots. All eyes were examined preoperatively, at one day and three months postoperatively considering functional results and postoperative IOL centration.

In 15 eyes (71%), the IOL was optimally centred postoperatively. In 5 eyes (24%), a revision had to be performed due to instable centration. In one further case the IOL was minimally decentred, but its position was stable. Best corrected visual acuity was 0.3 +/- 0.2 preoperatively and 0.5 +/- 0.2 after three months. The mean refraction was stable in the postoperative course and astigmatism did not change significantly. There were no major complications intraoperatively or postoperatively, but a localised iris atrophy at the haptic fixation points was noted.

In the presence of a partially intact zonular apparatus, iris sutures are a safe and minimally invasive method for fixing a decentred IOL. Postoperative centration and functional results were stable after 3 months.