Suture-supported posterior chamber intraocular lens implantation

This article describes a new technique for secondary implantation of posterior chamber intraocular lenses in the absence of capsular support. In this technique, the intraocular lens is supported by a simple net, consisting of two mattress sutures that pass across the eye at the most anterior area of the pars plana ciliaris, 3 mm from the limbus. Both sutures have limbs 3 to 4 mm apart that intersect at 90 degrees angles in the pupillary area. The main advantage of this technique is that the sutures are placed prior to the opening of the globe, thereby reducing the time that the eye must be open for the insertion of the intraocular lens. Because the exposure time and the intraocular manipulations are decreased, the consequent vitreous disturbances and the risk of infection, cystoid macular edema, and retinal detachment are likewise reduced. Another advantage of this technique is the additional support for the intraocular lens, which reduces the incidence of decentration and tilt. Moreover, because the sutures are placed in the most anterior part of the pars plana ciliaris, which is avascular, the incidence of bleeding is decreased.