Visual outcome of secondary lens implantation after trauma or complicated retinal detachment surgery

Visual outcome of intraocular lens (IOL) implantation as a separate surgical procedure after severe trauma of the anterior or posterior segment or after vitreoretinal surgery for complicated retinal detachment resulting in aphakia was evaluated.

The charts of all patients undergoing secondary IOL implantation for the above reasons between 1988 and 1992 were retrospectively reviewed. A special transcleral suturing technique was developed for the posterior chamber lenses, where needles are primarily passed from the outside through the sclera to enhance correct positioning of the sutures.

In all but one of the cases in group 1, visual acuity after surgery was equal to or better than before surgery. In the second group, visual acuity after surgery was equal to or better than before surgery in 9 of 12 cases.

Secondary IOL implantation after severe trauma or vitreoretinal surgery for complicated retinal detachment is a fairly safe technique, with only few transient complications. Visual acuity did not deteriorate after surgery by more than two lines in any the cases discussed. Peripheral binocularity was restored in all cases. The suturing technique described here, in which the needles are primarily passed from the outside through the sclera, offers the advantage of exact positioning of the haptics in the ciliary sulcus.