Iris Fixation of Unstable Anterior Chamber Intraocular Lenses

To present a surgical approach for the treatment of unstable anterior chamber intraocular lenses (ACIOLs).

We present a series of 8 patients who underwent iris fixation of an unstable open-looped ACIOL associated with progressive corneal damage. The loops of the intraocular lens were firmly fixated to the iris using 9-0 or 10-0 polypropylene sutures. In 2 cases, iris fixation was associated with penetrating keratoplasty. The other cases were performed using a relatively closed-system technique.

All procedures were uneventful, with no intraoperative or postoperative complications. Suture fixation effectively prevented anterior-posterior or propelling movement. The ACIOLs in all cases were stable and well centered at the end of follow-up.

Fixation of an existing unstable angle-supported ACIOL to the iris is an effective and simple alternative to intraocular lens exchange and posterior chamber fixation.