Transconjunctival Sutureless Intrascleral Fixation of Secondary Intraocular Lenses in Patients with Uveitis.

ABSTRACT

PURPOSE: Secondary intraocular lens (IOL) placement in uveitic eyes is challenging. We describe a series of sclerally fixated IOLs using a transconjunctival sutureless (SIS) technique in eyes with history of uveitis. METHODS: This is an interventional, retrospective, consecutive case series. RESULTS: Five patients with a history of well-controlled uveitis were included. All underwent vitrectomy, with removal of residual lens fragments if necessary. All received pre-, intra- and perioperative steroids, which were slowly tapered over the weeks after the surgery. If possible the dislocated IOL was rescued; otherwise, insertion of a new three-piece IOL was made. Postoperatively, all IOLs remained centered and haptics covered by conjunctiva without dislocation, erosion, or scleral thinning. There were no significant complications related to the surgery. Overall, the mean preoperative visual acuity was improved from logMAR 2.09 preoperatively to 0.59 postoperatively, which was statistically significant (p = 0.015). All eyes were deemed quiet at follow-up and none required escalation of therapy for long-term uveitis control. CONCLUSION: SIS IOL fixation is a safe and effective option for well-controlled uveitic eyes.