Complications following two methods of posterior chamber intraocular lens suturing

The aim of this study is to compare complication rates in two different operative techniques applied for the secondary, posterior chamber intraocular lens (PCIOL) implantation with sulcus fixation. 179 eyes with partial or no posterior capsule support underwent surgery. Applied techniques were: transscleral fixation of the IOL by passing with the fixation needle through the sulcus from the inside (70 eyes) or from the outside (109 eyes) of the bulbus. The most frequent intraoperative complications were haemorrhages and vitreous prolaps with no significant difference between used techniques. In the 'from the inside' group, following late postoperative complications developed: astigmatism of > 4D (24%), cystoid macular oedema (20%), pupil distortion (14%), partial posterior capsule opacification (10%), suture exposure (10%), IOL decentration (8%) and hemophthalmus (3%). In the 'from the outside' group same complications showed a decreased rate: 17%, 16%, 8%, 8%, 9%, 5% and 1%, respectively. Other late complications like high intraocular pressure, synechiae and uveitis were adequately represented in both techniques. After 24 months follow-up, best corrected visual acuity > or = 0.8 was achieved in 48.5% of eyes when 'from the inside' and in 57.7% of eyes when 'from the outside' technique was used.