Functional results of posterior chamber lens implantation with scleral fixation

Recently, scleral fixation has been used in posterior chamber intraocular lens implantation in the absence of the posterior capsule. Fixation is achieved with a suture through the ciliary sulcus and sclera at a horizontal or vertical position. To achieve good functional results, the optical portion of the lens must lie on the optical axis. Unilateral lens implantation in the absence of the posterior capsule was performed with scleral fixation in 48 patients. Follow-up ranged from 14 months to 2.6 years. The position of the posterior chamber lens was defined in relation to the limbus and the pupillary margin. There was no evidence of lens decentration in miosis. Under conditions of extreme mydriasis, decentration of less than 1.0 mm was found in four patients; four others had approximately 1.5 mm of decentration. Magnetic resonance imaging was used to determine lens position in some cases. Scleral fixation is a viable alternative for implantation of posterior chamber lenses in the absence of the posterior capsule.